The gynecological problems in adolescence are different from that of adults and these conditions may be caused by other disease conditions or hormonal imbalance.
Delayed Puberty
Puberty changes usually occur between 7 and 13 years in girls and 9 and 15 years in boys. Delayed puberty is the condition where the child exhibits the puberty changes very late in life. Puberty changes observed in girls are the development of breasts, sudden growth, the onset of menstruation, growth of pubic hair. Delayed puberty occurs because of familial history, medical conditions such as cystic fibrosis, kidney diseases, asthma, malnutrition, and disorders of glands that produce hormones responsible for these changes.
Treatment depends on the cause of delayed puberty. Treatment options include treating underlying disease conditions or administration of hormonal preparations. In children with strong familial background and having no other causes, no treatment may be required.
Menstrual Irregularities
Abnormalities in the menstrual cycle of a woman are called menstrual irregularities. Various menstrual irregularities include:
- Amenorrhea: No menstrual periods until the age of 16 years or absence of menstrual periods for 3 consecutive months and is not pregnant
- Dysmenorrhea: Painful menstruation periods
- Menorrhagia: Excessive bleeding which lasts for 8 to 10 days
- Oligomenorrhea: Irregular menstrual periods or getting periods frequently
- Premature ovarian failure: Normal function of the ovary is stopped
- Uterine fibroids: Non-cancerous tumors observed in women of child-bearing potential
- Endometriosis: Tissues lining the uterus from inside, grow outside the uterus (normally the tissue grows inside the uterus)
Symptoms
Symptoms observed in patients with menstrual irregularities include burning while urinating, fever, painful bowel movements, vaginal discharge, painful cramps, and lower back pain. Menstrual irregularities should be diagnosed early to prevent complications such as infertility (inability to get pregnant), anemia, hemorrhage, and uterine cancer.
Treatment
Treatment includes:
- For amenorrhea, medroxyprogesterone will be given.
- For dysmenorrhea, ibuprofen and naproxen are given to relieve pain.
- For menorrhagia, iron supplements and anti-prostaglandin medications are given. In severe cases of menorrhagia, surgeries such as thermal balloon endometrial ablation, transcervical resection of the endometrium (TCRE), and hysterectomy will be done.
- For endometriosis, hormonal preparations, pain relievers will be given to shrink the tissues. Laparoscopic surgery is done to remove the tissues lining the uterus.
- Fibroids can be treated by medications that can slow or stop the growth of cancer and will relieve you from pain. Surgery can also be done to remove the fibroids.
Ovarian Cyst
Cysts are non-cancerous sacs filled with fluid that develop in women’s ovaries. Cysts are formed when the follicle that contains an egg fails to break and release the egg out of the ovary, resulting in accumulation of fluid in the follicle.
Some of the risk factors for cyst formation include heredity, early menstruation, irregular menstrual cycles, excessive upper body fat distribution, and hormonal imbalance. If there is more than one cyst present inside the ovary, the condition is called polycystic ovary syndrome (PCOS).
Ovarian cysts usually do not cause any symptoms, but you must visit your doctor if you observe swelling or bloating of the abdomen, experience pain during bowel movements, pelvic pain, severe pain leading to nausea and vomiting, and pain in the pelvic region before or after the menstrual period begins.
Some cysts will disappear by themselves and some cysts that are large will require treatment.
Treatment of Ovarian Cyst
Treatment options include non-surgical and surgical treatment. The non-surgical treatment includes:
- Birth control pills help to decrease the formation of new cysts and prevent the formation of eggs that will become cysts.
- Non-steroidal anti-inflammatory drugs such as ibuprofen and acetaminophen help to relieve pain. Surgery will be recommended to remove the cyst or ovary if the medications do not help or cysts that are 5 to 10 cm in diameter. Different types of surgeries to remove the cysts include laparotomy and pelvic laparoscopy surgery.
Sexually transmitted infections (STIs)
They are infectious diseases caused by bacteria or virus that spread from one person to another by sexual contact. Adolescents who are sexually active may develop STIs because of lack of sex education and intense sexual experimentation.
The most common STI’s are chlamydia, genital herpes, AIDS, and gonorrhea. Some of the commonly occurring symptoms include vaginal discharge, pain in the lower abdomen, skin rash, ulcers, blisters around the genital area, and fever. If STIs are not treated, it may lead to problems such as infertility, cancer of the cervix, paralysis, mental problems, heart damage, and also death.
Non-surgical treatment includes antibiotics such as penicillins, cefixime, tetracyclines, azithromycin, or erythromycin and antiviral medications such as acyclovir, famciclovir, and valacyclovir.
Adolescence Pregnancy
It is very common among teenagers who are 19 years or younger. Some of the causes include lack of sex education, unprotected sexual intercourse, sexual assault, or sexual experimentation. The common pregnancy symptoms include breast enlargement, fatigue, nausea and vomiting, fainting, missed periods, and abdominal distension.
Adolescence pregnancy can cause health problems such as chronic pelvic inflammatory disease, pregnancy-induced hypertension, sexually transmitted diseases, depression, premature delivery, anemia, and toxemia (toxins in the blood). The infants born to teen mothers may develop low birth weight because of inadequate growth of the fetus during pregnancy. Adolescence pregnancy may result in the death of the mother or the infant, and other infant developmental problems.
Your doctor will discuss with the pregnant teen about abortion, adoption, and raising the child with family support. Your doctor may also suggest various programs about self-care and care of the baby.
There are several preventive measures which can help teenagers to understand the risk of early pregnancy. Some of the education programs include:
- Birth control education programs: They will help the teens to resist sexual activity until marriage and prevent unintended pregnancies.
- Knowledge-based programs: They will provide information about the use of contraceptives and the prevention of sexually transmitted diseases.
- Other counseling programs: They will provide skills and information on the use of contraceptives.
