Journal of pediatric and adolescent gynecology最新文献

{"title":"\"Hey guys, how are your vaginas doing?\" Exploring Adolescents' and Young Adult Women Attitudes and Practices Toward Vulvovaginal Health: A Qualitative Study.","authors":"Roxanne Rengifo, David N Williams, Gabrielle D'Ambrosi, Grace Leahy, Jessica Addison, Areej Hassan","doi":"10.1016/j.jpag.2026.03.007","DOIUrl":"https://doi.org/10.1016/j.jpag.2026.03.007","url":null,"abstract":"<p><strong>Study objective: </strong>Vaginal self-care and vulvovaginal health trends are frequently viewed by adolescent and young adults (AYA) on social media. This study explored AYA understanding, attitudes, knowledge, and practices regarding vulvovaginal health with a focus on the positive and negative influences of social media.</p><p><strong>Methods: </strong>We recruited AYA using a criteria-based purposeful sample from an urban practice. Semi-structured qualitative interviews explored attitudes, practices, and social media use related to vulvovaginal health. Interviews were recorded, transcribed, coded and thematically analyzed using inductive and deductive methods.</p><p><strong>Results: </strong>28 participants assigned female at birth (range 15-25 years) were interviewed. Four major themes were identified: (1) Vulvovaginal health is viewed as important and often overlooked; (2) AYA engage in vulvovaginal health practices, such as daily vulvar washing with water or gentle soap, shaving, and explored products like wipes, washes, and vajaycials; (3) AYA view vulvovaginal health content on social media and express diverse attitudes toward products and practices; (4) AYA trust healthcare providers as reliable sources of guidance. A subtheme suggested that older participants feel particularly cautious about social media content. Several recommendations emerged for effective communication.</p><p><strong>Conclusions: </strong>Social media is a popular source of vulvovaginal health information. Some participants questioned the credibility of content, while also appreciating raised awareness of vaginal health on these platforms. Health care providers should be aware of misinformation and provide evidence-based guidance.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521223","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":"A Digital Referral Tool to Link Adolescent Females from the Emergency Department to Sexual and Reproductive Healthcare: A Cohort Study.","authors":"Talia Adler, Lisa-Pierre Tchoungui, Janet Garth, Ana Cepin, Lauren S Chernick","doi":"10.1016/j.jpag.2026.03.005","DOIUrl":"https://doi.org/10.1016/j.jpag.2026.03.005","url":null,"abstract":"<p><strong>Purpose: </strong>Emergency departments (EDs) provide a critical access point for adolescents with unmet sexual and reproductive health (SRH) needs; yet, effective connection to follow-up care remains limited. This study aimed to develop and pilot test the Dr. Erica Digital Referral Tool (Dr.E-DRT), a patient-facing tool designed to educate adolescent females and facilitate linkage to person-centered sexual healthcare after ED discharge.</p><p><strong>Methods: </strong>We conducted a prospective cohort study from July 2023 to February 2024 in an urban pediatric ED. Biologically female, English-speaking adolescents aged 14-19 years were screened for eligibility. Enrolled participants completed a baseline survey, interacted with the Dr.E-DRT and were offered the option to schedule a follow-up appointment for SRH care. Two-month follow-up was completed via survey and electronic medical record (EMR) review. Outcomes included feasibility, acceptability, and potential efficacy to increase outpatient follow-up.</p><p><strong>Results: </strong>Of 223 adolescents screened, 31 met eligibility criteria and 25 enrolled. All participants completed the tool and 16 participants (64%) scheduled a follow-up visit at our local family planning practice. Acceptability of Dr.E-DRT was high across multiple dimensions, with mean Likert scores ranging from 4.2 to 4.4 out of 5 for satisfaction, appeal, and likelihood of recommending the tool. At 2-month follow-up, survey completion was 40% (10/25). Only three participants attended the follow-up visit.</p><p><strong>Discussion: </strong>Dr.E-DRT was feasible to implement and well accepted by adolescents in the ED. While appointment scheduling was high, visit completion remained low, highlighting the need for additional strategies to support linkage to SRH care after ED visit.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513065","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":"Clinical and Biochemical Characteristics of Girls with Polycystic Ovary Syndrome presenting with Amenorrhea.","authors":"Manahil Mustafa, Erica A Eugster","doi":"10.1016/j.jpag.2026.03.003","DOIUrl":"https://doi.org/10.1016/j.jpag.2026.03.003","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the prevalence of polycystic ovary syndrome (PCOS) in girls presenting with amenorrhea and to compare the clinical and biochemical features of those with primary (PA) versus secondary amenorrhea (SA).</p><p><strong>Methods: </strong>We performed a retrospective chart review of girls aged 12-18 years seen in the pediatric endocrine clinic for amenorrhea between 2014 and 2024. PA was defined as absent menses by age 15 or ≥3 years after puberty onset, and SA as cessation of menses for ≥ 6 months one-year post-menarche. Data collected included demographics, family history, clinical features, laboratory studies, response to a progesterone challenge test and treatment. Non-parametric tests (Mann-Whitney U) and chi-square tests were used for comparisons.</p><p><strong>Results: </strong>Among 377 patients, 126 (33%) were diagnosed with PCOS, of whom 32 (25.4%) had PA and 94 (74.6%) had of SA. Mean age was similar in PA and SA groups (15.2 ± 1.3 vs 15.3 ± 1.5 years). BMI was elevated in both groups (37.1 ± 7.5 vs 36.3 ± 8.4 kg/m²). Family history of PCOS was more frequent in those with PA (31.3% vs 14.9%, p = 0.042). Failure to bleed after a progesterone challenge failure was more common in girls with PA (36.8% vs 14.0%, p = 0.041). Androgen levels were higher in girls with PA (p < 0.05).</p><p><strong>Conclusions: </strong>PCOS is a frequent cause of both PA and SA in adolescents. Girls with PA exhibit greater hyperandrogenism and are more likely to fail a progesterone challenge, suggesting a more severe phenotype than in those with SA.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504192","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 Advocacy Statement on Climate Change.","authors":"Marnie Slonim, Judith Simms-Cendan, Angela Aguilar, Anastasia Vatapoulou, Ellen Rome, Marisa Labovsky, Daniela Ivanova Panova, Maria Clara Di Nunzio, Mariela Orti, Michalina Drejza, Yasmin Jayasinghe","doi":"10.1016/j.jpag.2026.03.002","DOIUrl":"https://doi.org/10.1016/j.jpag.2026.03.002","url":null,"abstract":"<p><p>Climate change is an escalating global crisis that disproportionately threatens the health and rights of children and adolescents, with girls facing particularly heightened vulnerability. Increasing temperatures, extreme weather events, food and water insecurity, and exposure to environmental toxins directly and indirectly affect sexual and reproductive health. These impacts include altered timing of menarche, worsened dysmenorrhea, increased risks of subfertility and pregnancy complications, and reduced access to essential reproductive health services. Broader climate related instability further contributes to malnutrition, disruption of education, child marriage, displacement, and gender-based violence, compounding longstanding gender, socioeconomic, and geographic inequities. FIGIJ affirms climate change as a health emergency and aligns with international efforts calling for urgent, coordinated action. FIGIJ supports the development of strong coalitions between governments, health care systems and communities, to amplify the healthcare sector's voice in global and regional climate advocacy. Protecting the next generation requires coordinated efforts, effective collaboration and ongoing commitment to supporting a healthier, more resilient and equitable future.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504203","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":"Laparoscopic Resection of Vaginal Embryonal Rhabdomyosarcoma in a 16-Month-Old Girl: An Organ-Preserving Surgical Approach.","authors":"Jianji Xu","doi":"10.1016/j.jpag.2026.03.006","DOIUrl":"https://doi.org/10.1016/j.jpag.2026.03.006","url":null,"abstract":"<p><p>Vaginal rhabdomyosarcoma is a rare malignant soft tissue tumor in pediatric patients, and optimal management aims to achieve tumor control while preserving pelvic organs. We report the case of a 16-month-old girl who presented with a protruding vaginal mass. Imaging studies revealed a vaginal tumor near the cervix without evidence of metastatic disease. Histopathological examination confirmed embryonal rhabdomyosarcoma. The patient received 12 weeks of neoadjuvant VAC/VA chemotherapy followed by laparoscopic tumor resection, which was chosen to address the limited pelvic space in infancy and to preserve surrounding organs. The postoperative course was uneventful, and adjuvant chemotherapy was completed. At 32 months of follow-up, no local recurrence or distant metastasis was observed. This case suggests that laparoscopic resection combined with chemotherapy may represent a feasible and organ-preserving treatment option for selected infants with vaginal rhabdomyosarcoma, although long-term follow-up remains necessary.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147498775","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":"Diagnostic Evaluation and Therapeutic Approach to Management of Acute Heavy Menstrual Bleeding in Adolescents Utilizing a Clinical Practice Pathway and Comparison of Response by BMI: A 5-Year Retrospective Cohort Study in a Children' Hospital.","authors":"Julia E Shuford, Maeve M McNamara, Katie Liu, Anna Schwartz, Morgan Buchanan, Robert Sidonio, Megan C Brown, Nancy A Sokkary","doi":"10.1016/j.jpag.2026.03.004","DOIUrl":"https://doi.org/10.1016/j.jpag.2026.03.004","url":null,"abstract":"<p><strong>Objective: </strong>To compare differences by body mass index (BMI) in (1) menstrual characteristics, (2) laboratory evaluation, and (3) hospitalization outcomes among adolescents with heavy menstrual bleeding (HMB) presenting to the emergency department (ED) using a standardized clinical pathway.</p><p><strong>Methods: </strong>A retrospective chart review was conducted for menstruating patients aged 8-25 years with acute HMB ED encounters at a large tertiary children's hospital network from 2017-2022. Patients were grouped by BMI (<85^th vs ≥85^th percentile). Demographics, menstrual characteristics, and laboratory studies were compared between BMI groups using two-sample hypothesis tests. Among hospitalized patients, the effect of BMI on treatment outcomes of length of stay (LOS), red blood cell (RBC) transfusion, and ongoing HMB requiring secondary medication (tranexamic acid (TXA) utilization) was assessed using logistic regression. Multivariable models were adjusted for medication and laboratory values.</p><p><strong>Results: </strong>Among the 515 patients with documented BMI, 367 were hospitalized, and received medication (35% norethindrone acetate, 65% IV conjugated estrogen). Patients with elevated BMI more often experienced menarche before age 12 (58% vs 47%, p=0.011). Most demographics and labs did not differ by BMI. Endocrine labs were more frequently drawn for elevated BMI, per clinical pathway recommendations. No significant differences in treatment outcomes were observed by BMI. Multivariable analysis showed no association between BMI ≥ 85^th percentile and prolonged LOS, RBC transfusion, or TXA use.</p><p><strong>Conclusion: </strong>While menstrual characteristics and laboratory evaluation varied slightly by BMI, management and treatment outcomes did not.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147498489","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":"Parental Menstrual Health Literacy as a Missing Link in the Timely Recognition of Dysmenorrhea and Heavy Menstrual Bleeding.","authors":"Herul Wahyudin, Megawati, Maria Oktasari, Ida Dwi Lestari, Dita Kurnia Sari","doi":"10.1016/j.jpag.2026.02.015","DOIUrl":"https://doi.org/10.1016/j.jpag.2026.02.015","url":null,"abstract":"","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147493613","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":"Trends in pediatric benign ovarian surgery and risk of subsequent ovarian surgery: an Ontario population-based study.","authors":"Justin Wj Lim, Nancy N Baxter, Rinku Sutradhar, Ning Liu, Sho Podolsky, Lisa Allen, Sumit Gupta, Sari Kives, Andrea N Simpson","doi":"10.1016/j.jpag.2026.03.001","DOIUrl":"https://doi.org/10.1016/j.jpag.2026.03.001","url":null,"abstract":"<p><strong>Study objective: </strong>To identify factors associated with ovarian-conserving surgery in children, to examine population trends in benign ovarian surgeries over 20 years, and to evaluate long-term risk of subsequent ovarian surgeries.</p><p><strong>Methods: </strong>We conducted a population-based retrospective cohort study of females <18 years undergoing benign ovarian surgery in Ontario, Canada (2003-2022). Factors associated with ovarian-conserving surgery were identified with multivariable log-binomial regression. Surgical trends (ovarian-conserving surgery, laparoscopy, pediatric hospital utilization) were evaluated using the Cochrane-Armitage test. Cumulative incidences of subsequent surgeries were estimated with Kaplan-Meier analysis and compared using log-rank tests.</p><p><strong>Results: </strong>Among 3,452 children (median age 15 years), 2,827 (81.9%) underwent ovarian-conserving surgeries and 625 (18.1%) oophorectomies. Ovarian-conserving surgery was more likely with laparoscopy (RR 1.40, 95%CI 1.33-1.47), female surgeons (RR 1.04; 95%CI 1.01-1.07), and non-gynecologist (RR 1.04; 95%CI 1.01-1.08), and less likely in rural patients (RR 0.93, 95%CI 0.88-0.98) and younger children (RR 0.84, 95%CI 0.75-0.94). Although rates of surgery remained stable, there was an increase in laparoscopy (63% to 83%, p<0.0001), pediatric hospital use (32% to 56%, p<0.0001), and ovarian-conserving surgeries (80% to 87%, p<0.0001). Cumulative incidence of subsequent ovarian surgery rose with time after index operation, remaining higher after ovarian-conserving surgery than oophorectomy (p<0.0001).</p><p><strong>Conclusions: </strong>Adoption of minimally invasive techniques and specialized pediatric care is increasing. Persistent risk of reoperation among all patients in this cohort highlights the need for strategies to ensure appropriate follow up for this at-risk group, promoting ovarian preservation, and equitable access to pediatric gynecologic expertise.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147486317","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":"Eating Disorders and Long-Acting Reversible Contraception Side Effects: A Matched Retrospective Cohort Analysis.","authors":"Chloe Gao, Carly E Milliren, Sofya Maslyanskaya, Nicole R Ferrigno-Layton, Sarah A Golub, Gabriela Vargas, Sarah A B Pitts, Amy D DiVasta, Areej Hassan","doi":"10.1016/j.jpag.2026.02.014","DOIUrl":"https://doi.org/10.1016/j.jpag.2026.02.014","url":null,"abstract":"<p><strong>Study objective: </strong>Fear of weight gain is a feature of many eating disorders (EDs). We examined patient-reported side effects and the need for menstrual management after long-acting reversible contraception (LARC) insertion among a matched cohort of adolescent and young adults (AYAs) with and without EDs.</p><p><strong>Methods: </strong>Patients with EDs were matched with patients without EDs based on factors including age, device type, LARC indication, and weight status. We examined associations between EDs and reported side effects, and the need for medication-based menstrual management (any medication or hormonal-only) using mixed-effects logistic regression models, accounting for clustering within matched groups.</p><p><strong>Results: </strong>We included 313 patients (mean age=18.5, age range=13.4, 24.7), of which 58 (18.5%) had EDs and 255 (81.5%) did not. There was no difference between patients with and without EDs in the likelihood of reporting LARC concerns, either any side effect (OR=1.39; 95% CI: 0.72, 2.69), or pelvic pain specifically (OR=0.83; 95% CI: 0.35, 1.97). However, in adjusted models, patients with EDs had 1.96 times the odds of reporting unsatisfactory bleeding compared to those without (95% CI: 1.04, 3.69). There was no difference in the receipt of medication-based menstrual management between patients with and without EDs.</p><p><strong>Conclusion: </strong>Patients with EDs reported a higher prevalence of unsatisfactory bleeding with LARC use, though we saw no between-group differences in the receipt of medication-based menstrual management. These findings highlight the importance of proactively counseling AYAs with EDs about potential bleeding changes after LARC insertion.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377939","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":"Bilateral Ovarian Mucinous Cystadenocarcinoma in an Adolescent Girl: A Case Report.","authors":"Alekhya Suri, Yuvaraj Srinivasan, Anupama Hari","doi":"10.1016/j.jpag.2026.02.013","DOIUrl":"https://doi.org/10.1016/j.jpag.2026.02.013","url":null,"abstract":"<p><strong>Background: </strong>Primary epithelial ovarian malignancies in adolescents are extremely rare (<1%). Mucinous cystadenocarcinoma (MCAC), especially bilateral disease, is exceptional and often mimics benign ovarian cysts, delaying the diagnosis.</p><p><strong>Case: </strong>We report a 16-year-old girl with hypothyroidism who presented with abdominal distension, pain, and 20-kg weight gain. Imaging showed bilateral ovarian masses with omental nodularity despite normal tumor markers. Surgery confirmed FIGO IIIC bilateral MCAC, and she completed six cycles of paclitaxel-carboplatin.</p><p><strong>Conclusion: </strong>At three‑ year follow‑ up, the patient continues to be disease‑ free. This case highlights the limitations of tumor markers in adolescent ovarian malignancy, emphasizes the importance of cross‑ sectional imaging and clinical correlation, and demonstrates the challenges of management including considerations of future fertility.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326258","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}