Journal of pediatric and adolescent gynecology最新文献

{"title":"Mother-Daughter Dyads’ Perceptions of Contraception","authors":"Caroline L Katzman MD ,&nbsp;Jessica C Sims MD ,&nbsp;Julen N Harris MD, MPH ,&nbsp;Susan L Rosenthal PhD ,&nbsp;Jenny KR Francis MD, MPH","doi":"10.1016/j.jpag.2024.09.005","DOIUrl":"10.1016/j.jpag.2024.09.005","url":null,"abstract":"<div><h3>Study Objective</h3><div>In an increasing number of states, parents must provide permission for their daughters under 18-years-old to start contraception. We sought to understand perceptions among mother-daughter dyads about sources of information, and to describe dyadic interactions when discussing contraception.</div></div><div><h3>Methods</h3><div>Dyads were recruited from an adolescent medicine clinic in Dallas, TX. A semistructured joint interview was conducted with each dyad. Interviews were recorded, transcribed, and coded through an iterative approach.</div></div><div><h3>Results</h3><div>There were 11 dyadic interviews (22 participants). Sources of information about contraception included mothers, healthcare providers (HCPs), friends/family, school, and individualized learning. Dyads identified distinct purposes and limitations of each source. Mothers noted the importance of supporting their daughter's development and specific needs. Often these conversations began with a discussion of menstrual management. Information from friends/family was overwhelmingly anecdotal. Schools and HCPs were viewed as trusted sources, and the internet/social media as possibly inaccurate or misleading. Dyads described several risks and benefits of different methods. Minimal conflict was noted.</div></div><div><h3>Conclusion</h3><div>These results provide rich information about how mother-daughter dyads view contraception in joint discussion. It is important to ensure that accurate stories about contraception are accessible and teaching health literacy would be helpful. Menstrual management appears to be an acceptable starting point to discuss contraception. Schools and HCPs are trusted sources and measures should be taken to ensure teaching is accurate, developmentally appropriate and teaches evaluation of online information. Regardless of parental consent laws for adolescent contraception, engaging caregivers in the process can help support adolescent contraceptive decision-making.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 1","pages":"Pages 79-84"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual and Reproductive Health Goals and the 2030 Global Agenda for Sustainable Development: Progress, Prospects, and Challenges","authors":"Areej Hassan MD, MPH ,&nbsp;Sarah Golub MD, MPH","doi":"10.1016/j.jpag.2024.09.002","DOIUrl":"10.1016/j.jpag.2024.09.002","url":null,"abstract":"<div><div>Today, it is globally recognized that sexual and reproductive health is a human rights issue critical to economic growth and stability, ending poverty, and fostering sustainable development. Calls for improving sexual and reproductive health, including a spotlight on adolescents and young women, are highlighted in the Sustainable Development Goals (SDG) adopted by the United Nations in 2015. In this commentary, we aim to (1) briefly review the history and objectives of global development goals, (2) review the adolescent health-related Sustainable Development Goal targets and indicators with a focus on sexual and reproductive health, (3) discuss global progress and challenges in achieving target measures, and (4) examine action steps that clinicians can take to accelerate progress.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 1","pages":"Pages 13-17"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Outcomes of Ovary Preserving Procedure for Neonatal Ovarian Cysts","authors":"XiaoLi Chen,&nbsp;DuoTe Cai,&nbsp;Yi Chen,&nbsp;BinBin Yang,&nbsp;YueBin Zhang,&nbsp;QingJiang Chen,&nbsp;ZhiGang Gao","doi":"10.1016/j.jpag.2024.09.007","DOIUrl":"10.1016/j.jpag.2024.09.007","url":null,"abstract":"<div><h3>Objective</h3><div>We aim to evaluate the long-term outcomes of ovarian preserving surgery for neonatal ovarian cysts.</div></div><div><h3>Method</h3><div>The clinical data of neonatal ovarian cysts treated in our hospital from January 2015 to December 2022 were retrospectively analyzed.</div></div><div><h3>Results</h3><div>Our study included 22 patients, of which 21 were unilateral and 1 was bilateral. There were 13 cases of simple cysts and 9 cases of complex cysts, and one cyst changed from simple to complex. The mean largest diameter of simple cysts was 5.7 ± 2.1 cm, and that of complex cysts was 4.6 ± 2.0 cm. There was no significant difference between the two groups (<em>P</em> = .2264). Among the 22 patients, 21 underwent laparoscopic cystectomy. The only patient with bilateral cysts underwent percutaneous drainage of the right simple cyst. Twenty-one histological specimens were reviewed, of which 18 (85.7%) contained viable ovarian tissues. Five cases lost follow-up after surgery, and the remaining 17 cases had a follow-up period of 6 months to 5 years. The last ultrasound follow-up showed that 9 cases had bilateral normal ovaries, and 8 cases lost the ipsilateral ovary. The ovarian preservation rate of simple cyst was 90% (9/10), which was significantly higher than that of complex cyst (12.5%, 1/8) (<em>P</em> = .003).</div></div><div><h3>Conclusions</h3><div>Simple cysts (≥4 cm) had an excellent prognosis, with a long-term ovarian preservation rate of 90%. The long-term ovarian preservation rate of complex cysts after surgery was relatively low. Our study suggested that surgical treatment did not increase the chances of preserving the ovaries of patients with complex cysts.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 1","pages":"Pages 35-38"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuation of the Levonorgestrel-Releasing Intrauterine Device Among Adolescents With Endometriosis","authors":"Jessica Y. Shim MD ,&nbsp;Carly E. Milliren MPH ,&nbsp;Amy D. DiVasta MD, MMSc","doi":"10.1016/j.jpag.2024.10.005","DOIUrl":"10.1016/j.jpag.2024.10.005","url":null,"abstract":"<div><h3>Study Objective</h3><div>To estimate the 1-year continuation rate of the levonorgestrel-releasing intrauterine device (LNG-IUD) in adolescents with endometriosis, and the frequency at which additional systemic hormonal treatment (HT) is utilized.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was performed of patients aged 12-21 years who underwent laparoscopy for endometriosis and LNG-IUD insertion at a single tertiary care institution between 2018 and 2021.</div></div><div><h3>Results</h3><div>We evaluated 224 adolescents (mean age = 17.0, SD = 1.8 years) who underwent LNG-IUD placement during laparoscopic evaluation for endometriosis. Stage I endometriosis was most common (84.4%), followed by stage II (13.0%). Of 221 with follow-up, 208 (94.1%) had HT added or continued postsurgery. The most common additional HT was norethindrone acetate (42.5%), followed by combined hormonal contraceptives (34.8%). The 1-year LNG-IUD continuation rate was 92.0%. There were 18 IUD removals (8%) by 1 year, and the median time to removal was 118 days (interquartile range = 159; range 8-293). Use of additional HT was associated with a lower hazard of IUD removal within the first year of use (hazard ratio = 0.19, 95% confidence interval: 0.06-0.56, <em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>The majority of adolescents used the LNG-IUD with additional systemic HT for endometriosis management. While overall continuation was high, adolescents who were using LNG-IUD and HT were more likely to continue LNG-IUD than those who were not utilizing additional HT.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 1","pages":"Pages 85-88"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FIGIJ and NASPAG Advocacy Statement-Eliminating the Persistent Misconception of the “Virgin Hymen”","authors":"Judith Celine Simms-Cendan ,&nbsp;Angela G. Sison-Aguilar ,&nbsp;Mariela Orti ,&nbsp;Clara DiNunzio ,&nbsp;Anastasia Vatopoulou ,&nbsp;Ellen Rome ,&nbsp;Michalina Drejza ,&nbsp;Jasmin Jayasinghe ,&nbsp;Daniela Ivanova Panova ,&nbsp;Marisa Labovsky","doi":"10.1016/j.jpag.2024.08.014","DOIUrl":"10.1016/j.jpag.2024.08.014","url":null,"abstract":"<div><div>This advocacy statement endeavors to clarify the concept of the hymen as a symbol of “virginity.” The anatomic variants of this structure precludes any correlation to prior sexual activity and the value of physical assessment of this structure is thus questioned. Moreover, physical examination of the hymen is painful, traumatic, and humiliating and is a form of gender-based violence. This statement exhorts various sectors—governments, educators, the medical community, and the general public—to discard the concept of the “virgin hymen,” avoid its use when documenting sexual abuse, and provide progressive education to affirm female sexuality.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 1","pages":"Pages 11-12"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NASPAG Clinical Consensus on Nonsexually Acquired Genital Ulcers (Vulvar Aphthous Ulcers)","authors":"Jacquelyn R. Evans DO ,&nbsp;Amanda V. French MD","doi":"10.1016/j.jpag.2024.08.010","DOIUrl":"10.1016/j.jpag.2024.08.010","url":null,"abstract":"<div><div>The objective of this document is to provide guidance on the recognition, diagnosis and management of non-sexually acquired genital ulcers in the pediatric and adolescent patient. Commonly known as genital or vulvar aphthous ulcers, lesions are typically seen in the peri‑menarchal population, are exquisitely painful, generally self-limited and managed with supportive care. Details of ulcer physical appearance, proposed etiology and options for management are provided to familiarize clinicians with this entity, which can be alarming for patients and families.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 1","pages":"Pages 4-10"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142093547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The hymen: An Overrated Thin Membrane","authors":"María Clara Di Nunzio MD ,&nbsp;Mariela Orti MD","doi":"10.1016/j.jpag.2024.09.006","DOIUrl":"10.1016/j.jpag.2024.09.006","url":null,"abstract":"","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 1","pages":"Page 1"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143039552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bladder Health Knowledge, Attitudes, and Beliefs among US Adolescent Women","authors":"Deepa R. Camenga MD, MHS ,&nbsp;Sonya S. Brady PhD, LP ,&nbsp;Andrea Bilger MPH ,&nbsp;Heather Klusaritz PhD, MSW ,&nbsp;Terri H. Lipman PhD, CRNP ,&nbsp;Elise C. Levin PhD, MSc ,&nbsp;Oluwateniola Brown MD ,&nbsp;Shayna D. Cunningham PhD ,&nbsp;D. Yvette LaCoursiere MD, MPH ,&nbsp;Aimee S. James PhD, MPH ,&nbsp;Sheila Gahagan MD, MPH ,&nbsp;Jeni Hebert-Beirne PhD, MPH ,&nbsp;Lisa Kane Low PhD CNM FACNM, FAAN","doi":"10.1016/j.jpag.2024.09.008","DOIUrl":"10.1016/j.jpag.2024.09.008","url":null,"abstract":"<div><h3>Study Objective</h3><div>Lower urinary tract symptoms (LUTS) can have a pronounced impact on adolescent women's overall health and quality of life, both during adolescence and across the life course. Little research has examined adolescent women's knowledge, attitudes, and beliefs (KAB) about bladder health and preventing LUTS.</div></div><div><h3>Methods</h3><div>This study combines data from two large multi-site focus group studies of individuals born female, who identified as women, conducted by the Prevention of Lower Urinary Tract Symptoms Research Consortium. The first study included data from 8 focus groups conducted in 2018 with 44 adolescents aged 11 through 17 years. The second consisted of data from 20 focus groups conducted in 2020 with 123 adolescents aged 13 through 17 years. We used directed content analysis, including deductive and inductive approaches, to explore textual data and identify emergent insights. We present themes that emerged from analyzing coded data related to KAB.</div></div><div><h3>Results</h3><div>Themes included: (1) lack of information about bladder function, leading to limited knowledge, (2) hydration as a healthy behavior, (3) distinguishing healthy versus unhealthy voiding, (4) social and environmental barriers to voiding, and (5) shame and stigma of bladder related behaviors.</div></div><div><h3>Conclusion</h3><div>Our data suggests that adolescent women are aware of healthy and unhealthy behaviors related to bladder health, despite little exposure to formal education about the bladder. Social and environmental factors, including stigma, appear to be primary drivers of adolescents’ behaviors around bladder health, suggesting that multi-level socio-ecological prevention interventions are needed to prevent LUTS in this population.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 1","pages":"Pages 60-67"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraceptive Choice and Sexual Behaviors in Both-Sex Attracted Adolescents: A Retrospective Cohort Study","authors":"Lauren E. Matera DO ,&nbsp;Andrea E. Bonny MD ,&nbsp;Elise D. Berlan MD, MPH ,&nbsp;Ian S. Watson MS ,&nbsp;Gayathri Chelvakumar MD, MPH","doi":"10.1016/j.jpag.2024.10.008","DOIUrl":"10.1016/j.jpag.2024.10.008","url":null,"abstract":"<div><h3>Study Objective</h3><div>Bisexual adolescents have higher rates of unintended pregnancy than their heterosexual peers and increased rates of high-risk sexual behaviors. They may be less likely to use effective contraception, though limited data is available. This study sought to compare contraceptive choice and sexual risk behaviors of both-sex attracted and opposite-sex attracted adolescents and young adults (AYA) presenting to a contraception clinic.</div></div><div><h3>Methods</h3><div>A retrospective chart review of AYA aged 14-24 years who presented for an initial visit to a contraception clinic from 2014 to 2020. The primary outcome was contraceptive choice (long-acting reversible contraception (LARC), non-LARC, or nothing). Secondary outcomes included sexual behaviors. Results were analyzed using Pearson's chi-square and Wilcoxon tests.</div></div><div><h3>Results</h3><div>A total of 2369 AYA were included in this study. Both-sex attracted and opposite-sex attracted patients were similar in age, race, and ethnicity. There was no difference between groups in percentage selecting LARC (71% vs 66.1%, <em>P</em> = .11). Both-sex attracted patients reported a younger age at first sex (14.6 years vs 15.5 years, <em>P</em> &lt; .001), more lifetime sexual partners (4.1 vs 2.8, <em>P</em> &lt; .001), and a higher prevalence of forced intercourse (21.9% vs 8.8%, <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Both-sex attracted and opposite-sex attracted AYA patients chose LARCs at similar rates in a setting with standardized contraceptive counseling. Both-sex attracted patients had more sexual risk behaviors. Healthcare providers should be inclusive in their approach to obtaining sexual health histories and providing contraceptive counseling and be cognizant that adolescents with both-sex attraction may be at higher risk of forced intercourse.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 1","pages":"Pages 89-92"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Natural History of Menstrual Pain and Associated Risk Factors in Early Adolescence","authors":"Rachel E. Modarelli MD ,&nbsp;Samantha A. Molsberry PhD ,&nbsp;Sofia Malave-Ortiz BS ,&nbsp;Madison Calvert BS ,&nbsp;Janet Lucien MD ,&nbsp;Sheri Denslow PhD ,&nbsp;Daniel Zaccaro PhD ,&nbsp;Camilia Kamoun MD, MSME ,&nbsp;Natalie D. Shaw MD, MMSc","doi":"10.1016/j.jpag.2024.10.006","DOIUrl":"10.1016/j.jpag.2024.10.006","url":null,"abstract":"<div><h3>Study Objective</h3><div>To determine the natural history of menstrual pain without pelvic pathology, the role of progesterone in its pathophysiology, and associated risk factors in a longitudinal study of early postmenarchal girls in North Carolina.</div></div><div><h3>Methods</h3><div>Participants contributed daily urine samples for up to 3.5 years to measure pregnanediol-3-glucuronide (PdG) (mean 589 urines/participant), completed menstrual diaries, and reported menstrual pain using the Menstrual Symptom Questionnaire (MSQ) biannually. MSQ scores were log-transformed and generalized estimating equations assessed associations with gynecologic age, cycle peak PdG, presumed ovulation, physical activity, anxiety, and depression. Models were adjusted for age at menarche, baseline body mass index, race/ethnicity, parental education and employment, and gynecologic age.</div></div><div><h3>Results</h3><div>Forty-three girls, aged 12.6 ± 1.1 years (mean ± SD) at enrollment with a gynecologic age 0.3 ± 0.2 years, participated. Total MSQ scores were higher for every 1-year increase in gynecologic age (MSQ score ratio: 1.12; 95% CI: 1.08, 1.17; <em>P</em> &lt; .0001). Overall MSQ (ratio: 1.04; 95% CI: 1.02, 1.06; <em>P</em> = .0002) and abdominal pain-specific (ratio: 1.04; 95% CI: 1.01, 10.7; <em>P</em> = .004) scores were higher for every 1000 ng/mg creatinine increase in peak PdG in the preceding cycle. Overall MSQ scores were higher (ratio 1.26; 95% CI: 1.11, 1.44; <em>P</em> = .0005) if the preceding cycle was presumed ovulatory. Menstrual pain was not associated with physical activity, anxiety, or depression.</div></div><div><h3>Conclusions</h3><div>In early postmenarchal girls, gynecologic age and PdG were associated with menstrual pain, suggesting a pathophysiologic role for progesterone and other unknown factors in the development of menstrual pain.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 1","pages":"Pages 52-59"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}