Journal of pediatric and adolescent gynecology最新文献

{"title":"Social Support Related to Menses in Gender-Diverse Adolescents: A Qualitative Study.","authors":"Christopher Garrick, Benjamin Bear, Meghan Gannon, Anne E Kazak, Julia Eisenberg, Yasaman Alibabaee, Beth I Schwartz","doi":"10.1016/j.jpag.2025.04.006","DOIUrl":"10.1016/j.jpag.2025.04.006","url":null,"abstract":"<p><strong>Study objective: </strong>Menses in transgender or gender-diverse people can cause dysphoria, which has been linked to various comorbid conditions including depression, anxiety, and suicidal ideation. Although social support is thought to be beneficial for adolescents in general, little is known about its effects on gender-diverse adolescents (GDAs) receiving care. Thus, this study sought to document the effects of social support on the menses management experiences for GDAs and highlight how such support influences their access to and satisfaction with gender-affirming care.</p><p><strong>Methods: </strong>Participants were recruited from a tertiary care children's hospital to participate in semi-structured phone interviews. Eligibility included adolescents who were 12-20 years of age and had undergone menarche. Interviewers asked respondents about the impact of menses on their mental health, relationships, daily activities, and experiences with menses management and suppression.</p><p><strong>Results: </strong>A total of 36 individuals participated, with a mean age of 16.82 (SD 2.02) years. Six major themes were identified related to social support: Types of Support, Support Persons within the Social Network, School Environment, Medical Providers as a Social Support, Resources, and Advice for Others.</p><p><strong>Conclusion: </strong>This study highlights the vital role of social support as GDAs navigate gender-affirming care and menses management. The exploration of various sources of support-such as family, peers, and health care providers-emphasizes the importance of safe, affirming environments for GDAs. Clinicians as perceived support have a unique opportunity to foster shared decision-making and health advocacy by using preferred pronouns, recognizing dysphoria triggers, and considering GDAs' perspectives when developing care plans.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968359","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":"Young People's Perceptions of Why Sexually Active Peers May Not Use Prescribed Contraception.","authors":"Brooke Whitfield, Zoe H Pleasure, Renee M Odom-Konja, Cambray Smith, Subasri Narasimhan, Tracey A Wilkinson, Laura D Lindberg","doi":"10.1016/j.jpag.2025.04.004","DOIUrl":"10.1016/j.jpag.2025.04.004","url":null,"abstract":"<p><strong>Study objective: </strong>Access to contraception is a necessary component of reproductive autonomy for adolescents and young adults (AYAs). AYAs persistently face barriers to accessing confidential, affordable contraception. In this study, we characterize and describe the most common reasons AYAs perceive that their sexually active peers might not use prescribed contraception.</p><p><strong>Methods: </strong>Using a cross-sectional national text-based survey of AYAs aged 14-24, we conducted a content analysis of open-ended text responses to a question about why AYAs' sexually active peers might not use prescribed contraception (n = 554). We identified the most common reasons for non-use and examined differences in reported reasons for non-use by demographic factors.</p><p><strong>Results: </strong>AYAs reported that their sexually active peers may not use prescribed contraception because they have concerns about it being harmful, they may be stigmatized for using contraception, and it can be logistically difficult for AYAs to obtain. Older and pregnancy-capable respondents were more likely to perceive contraceptive harm as a reason for prescribed contraception non-use (P < .05) but were less likely to perceive stigma and logistical barriers as a reason for non-use (P < .05) compared to younger and pregnancy-incapable respondents.</p><p><strong>Conclusion: </strong>We found that perceptions of contraceptive non-use by peers vary by respondents' age and pregnancy capability, likely due to differences in exposure to contraception information in peer groups and their own contraceptive use experiences. Understanding AYAs' perceived reservations towards prescribed contraception is vital to inform clinicians' counseling conversations and for public health messaging.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970718","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":"Availability of Inpatient Sexual and Reproductive Health Services at U.S. Children's Hospitals.","authors":"Sarah A Golub, Alissa Roberts, Colleen McCarty, Erin Sullivan, Sahar N Rooholamini, Taraneh Shafii","doi":"10.1016/j.jpag.2025.04.005","DOIUrl":"10.1016/j.jpag.2025.04.005","url":null,"abstract":"<p><strong>Objective: </strong>To understand the scope of sexual and reproductive health (SRH) services provided to adolescents assigned female at birth in pediatric hospitals in the United States.</p><p><strong>Methods: </strong>Data were collected via an electronic survey of inpatient clinical leaders at freestanding and nested children's hospitals in the United States. Survey domains included availability of trained clinicians, equipment to perform pelvic exams, contraceptive methods offered, and facilitators and barriers in providing SRH services. Descriptive statistics were used for analysis.</p><p><strong>Results: </strong>Of 160 invited hospitals, 52 (33%) responded with 25 (48%) surveys completed by Pediatric Hospital Medicine and 23 (44%) Adolescent Medicine specialists. Twenty-two (42%) worked in free-standing and 30 (58%) in nested children's hospitals with 42 (81%) reporting academic- or university-affiliations. Only 3 (6%) reported having the equipment needed to perform pelvic exams on the inpatient unit. Eleven (21%) reported providing some form of long-acting reversible contraception, of which all provided implants; only 5 (10%) institutions offered intrauterine device insertion. A common facilitator was having clinicians with required skills (65%) and a common barrier was SRH not being considered an inpatient problem (83%).</p><p><strong>Conclusion: </strong>While clinicians identify SRH services at children's hospitals as important, many lack the basic equipment needed and institutional support to provide comprehensive SRH care. This study suggests that the integration of clinicians appropriately trained in SRH care may be one of the greatest facilitators to providing inpatient SRH care in children's hospitals.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012621","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":"Polish Mothers and Cervical Cancer Prophylaxis: What Do They Know and What Attitude Do They Have Toward Human Papillomavirus Vaccination?","authors":"Karina Matusiak, Zana Bumbuliene","doi":"10.1016/j.jpag.2025.04.002","DOIUrl":"10.1016/j.jpag.2025.04.002","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study was to assess the knowledge and awareness of cervical cancer primary and secondary prophylaxis among our patients' mothers, and their attitude toward human papillomavirus (HPV) vaccination.</p><p><strong>Methods: </strong>During patients' appointments at Children's Memorial Health Institute Pediatric and Adolescent Gynecology Clinic in Warsaw we asked 234 mothers (aged <20-60) to complete a self-prepared survey. The data were analyzed using t-student test and chi-square test.</p><p><strong>Results: </strong>Only 61.5% of respondents correctly indicated the purpose of cervical cytology. Similarly, 67.9% claimed that it should be performed annually, and 79.4% that till the end of life. Although 87.6% of answerers have heard about HPV vaccination, still 69.3% of them were willing to get more information. Physicians were considered the most reliable source of knowledge about HPV vaccination and had a relevant impact on mothers' decision to vaccinate (P < .05). Nearly all respondents (92.7%) weren't vaccinated against HPV. Still, 57.3% declared willingness to vaccinate their children. The vaccine skeptics indicated that they had too little information (59%), feared side effects (45%), and doubted HPV vaccine effectiveness (23%). Mothers aged 40 and older and with higher education had greater knowledge about cervical cancer screening (P < .05) and were more willing to vaccinate their children (P < .05).</p><p><strong>Conclusion: </strong>Since cervical cytology was invented 100 years ago, knowledge about this screening test is low. The HPV vaccine is well-recognized and well-accepted, but most respondents lack information. Consequently, it is crucial to initiate multidirectional educational actions to raise awareness about cervical cancer and its prophylaxis.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023191","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 Advocacy Committee Statement: Addressing the Barriers to Adolescent and Young Adult Abortion Access in the Post-Dobbs Era in the United States.","authors":"Kristl Tomlin, Amitha Ganti, Swetha Naroji","doi":"10.1016/j.jpag.2025.03.008","DOIUrl":"10.1016/j.jpag.2025.03.008","url":null,"abstract":"","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022813","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":"\"Really Hard to Navigate\": A Qualitative Study of Motivators, Barriers, and Supports of Adolescent-Clinician Communication on Patient Portals.","authors":"Andrea J Hoopes, Alina Metje, Creagh Miller, Charissa M Tomlinson, Thang D Dao, Marlaine Figueroa Gray","doi":"10.1016/j.jpag.2025.03.007","DOIUrl":"10.1016/j.jpag.2025.03.007","url":null,"abstract":"<p><strong>Purpose: </strong>To understand how patient portals can support adolescent sexual and reproductive health (SRH) care needs and to identify factors impacting use of patient portals for adolescent-clinician communication.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with adolescents, parents/guardians, and primary care providers (PCPs) by video or phone. Interview guides explored experiences with adolescent healthcare-seeking generally and SRH care specifically, as well as perspectives regarding adolescent portal use. Interviews were recorded, transcribed, and deidentified. Interviewer summaries written after each interview noted key themes that informed analysis. The analysis team collaboratively coded transcripts. Codes were synthesized into analytic memos, which were refined to develop results.</p><p><strong>Results: </strong>We interviewed 31 people from 1 health system: 10 adolescents 14-17 years old and 10 parents/guardians of adolescents aged 14-17, and 11 primary care providers (PCPs). A motivator of portal use shared by all participants included convenience of use. Clinicians and parents/guardians also viewed portals as a tool to support adolescent independence and improve quality of care. Barriers shared by all participants included lack of adolescent portal uptake and dissatisfaction with functionality. Clinicians and adolescents raised concerns about confidentiality while parents and clinicians raised concerns about safety of care. Supports shared by all participants included encouragement and guidance from trusted adults, while adolescents and clinicians described the reinforcing nature of positive care experiences using the portal.</p><p><strong>Discussion: </strong>Through the perspectives of adolescents, parents/guardians, and clinicians, we elucidated key factors that may influence adolescent portal use for SRH care needs. We identified critical intervention targets for future research.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795696","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 Financial Return from Investing on Girls and Women Health.","authors":"Saverio Bellizzi, Dina Said, Catello Mario Panu Napodano, Miriam Orcutt, Alessandra Nivoli","doi":"10.1016/j.jpag.2025.03.009","DOIUrl":"10.1016/j.jpag.2025.03.009","url":null,"abstract":"","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780375","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":"Inaction Despite Motivation: Assessing Systemic and Personal Barriers to Pediatricians' Post-Dobbs Emergency Contraception Utilization.","authors":"Elizabeth Hovel, Michelle Pickett, Alexis Visotcky, Kelsey Porada, Wendi Ehrman, Margaret Thew, Vanessa McFadden","doi":"10.1016/j.jpag.2025.03.006","DOIUrl":"10.1016/j.jpag.2025.03.006","url":null,"abstract":"<p><strong>Purpose: </strong>Following the US Supreme Court's Dobbs vs Jackson Women's Health (Dobbs) decision and subsequent changes to abortion access, increasing emergency contraception (EC) access for adolescents is vital. The first step is understanding providers' knowledge, attitude and practices regarding EC post-Dobbs.</p><p><strong>Methods: </strong>This cross-sectional internet-based survey was sent to providers within 3 general pediatric primary care systems from November 2023 to January 2024. Questions addressed EC knowledge, attitudes (perceived barriers and desired support to increase EC prescription) and practices post-Dobbs.</p><p><strong>Results: </strong>There were 51 participants. Most (81%) providers felt adolescent EC prescription was more important post-Dobbs, but very few (7%) had increased their own prescribing practices. Overall, providers had a mean knowledge score of 71%. Providers closer to training had a higher EC knowledge score (77% vs 68%, P = .02), as did providers who were generally willing to provide EC (72% vs 58%, P = .004). Providers in urban and rural areas were more likely to have prescribed EC than suburban counterparts (54% urban, 40% rural, 16% suburban, P = .04). Various barriers were elicited, most commonly relating to lack of awareness and knowledge about EC. Over half of respondents noted they would be more likely to prescribe EC with clinical decision support built into the EMR (69%), an order set in the electronic medical record (57%), and education sessions (55%).</p><p><strong>Discussion: </strong>This study highlights a strong need to bolster provider EC education in pediatrics and address systems factors that will facilitate easier, more confident EC prescription.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663707","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":"Effects of Combined Hormonal Contraceptives (CHCs) on Bone Health in Adolescent Girls-A Systematic Review.","authors":"Leek Mei Lim, Wogud Ben Said, Pallavi Latthe","doi":"10.1016/j.jpag.2025.03.004","DOIUrl":"10.1016/j.jpag.2025.03.004","url":null,"abstract":"<p><strong>Objective: </strong>To summarize the effects of combined hormonal contraceptives (CHCs) on bone health in adolescent girls DESIGN: A systematic search was performed using the following databases: Medline, EMBASE, CINAHL, and Cochrane Library clinical trials register, from inception to July 2024.</p><p><strong>Eligibility: </strong>Intervention and cohort studies that assessed the use of CHCs on bone health in adolescent girls aged 10-19 years old were included.</p><p><strong>Data synthesis: </strong>Four randomized control trials and 8 observational studies (n = 2689) were included.</p><p><strong>Conclusion: </strong>Current evidence indicates that the use of CHCs in postmenarchal adolescent girls reduces bone accrual compared with non-users. The negative impact on bone accrual is likely related to the estrogen dose in the CHC preparation, the regimen used, and the duration of use.</p><p><strong>Prospero registration number: </strong>PROSPERO CRD 42024574905 on 31 July 2024.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649461","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":"Effect of Transdermal Estrogen Therapy on Bone and Neurobehavioral Health in Youth with Premature Ovarian Insufficiency: A Case-Control Study.","authors":"Halley Wasserman, Heidi J Kalkwarf, Mekibib Altaye, Kimberly Yolton, Catherine M Gordon","doi":"10.1016/j.jpag.2025.03.005","DOIUrl":"10.1016/j.jpag.2025.03.005","url":null,"abstract":"<p><strong>Study objective: </strong>Estrogen replacement therapy (ERT) improves bone and neurocognitive health in adult women with premature ovarian insufficiency (POI). However, the response in adolescents is largely unknown. We aimed to assess the impact of transdermal estrogen replacement therapy on these outcomes in adolescents with POI.</p><p><strong>Methods: </strong>Nine adolescents with idiopathic POI, naïve to ERT, and 9 controls with regular menses matched for age, race, and body mass index were recruited between 2018 and 2023 for a 24-month study. The primary bone health outcomes were changes in lumbar spine bone mineral density (BMD) Z-score and 3% distal radius trabecular volumetric BMD. The primary neurocognitive outcomes were quality of life (CHQ-87 survey) and memory (ChAMP).</p><p><strong>Results: </strong>Adolescents with POI experienced significant increases in BMD Z-scores at all dual-energy x-ray absorptiometry skeletal sites (lumbar spine ∆ +0.68, total hip ∆ +0.37, femoral neck ∆ +0.56, total body less head ∆ +0.82, all P < .05). Control participants exhibited an increase in BMD Z-score at the total body less head (∆ 0.43, P = .034) with no significant change at other skeletal sites. There were no significant changes from baseline to 24 months in peripheral quantitative computed tomography measures. Total memory index significantly increased in both groups from baseline to 24 months (controls ∆ +17.2, cases ∆ +24.6, P = .041 and .001, respectively), but there was no difference between groups. There were no other significant differences in neurocognitive outcomes among or between groups.</p><p><strong>Conclusion: </strong>Central BMD increased in adolescents with idiopathic POI in response to transdermal estrogen replacement therapy, but peripheral BMD measures were unchanged. The impact on neurocognitive outcomes in these adolescents remains uncertain.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649460","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}