Practical Pediatric and Adolescent Gynecology

Clinicians are often uncomfortable with the gynecologic concerns of young girls and developing women. How can I put the patient at ease? What are the rights of the patient and her parents? How do I ask the questions in a way that allows her to trust me so that I can better understand her medical and social situation?   In Pediatric and Adolescent Gynecology, Dr Hillard has designed a new textbook that puts the patient at the center. It follows the patient’s life and her changing needs as she matures. An emphasis on effective, patient-friendly encounters is the prelude to a sensitive clinical approach to intimate, potentially awkward, clinical challenges. Short, practical chapters provide guidance on the issues rather than an academic treatise.   This ‘in the office’ guide to effective patient care is informed by evidence-based practice and backed by a wealth of practical features:   Algorithms and guidelines to most effective approaches ‘Tips and Tricks’ boxes so you can improve you clinical outcomes ‘Caution’ warning boxes so you can avoid complications ‘Science Revisited’ boxes give a quick reminder of the basic science principles   Dr Hillard has assembled an expert group of authors to provide straightforward guidance to caring for and reassuring your younger patients and their parents. If you provide clinical care to girls and young women then Pediatric and Adolescent Gynecology is designed for you. SECTION 1 PREPUBERTAL GIRLS, 1 Part 1 Introduction 1 Initial assessment, 3 Maureen Lynch Part 2 Prepubertal Girls: Symptoms and Signs 2 Ambiguous genitalia in the neonate and infant, 6 Sejal Shah and Avni C. Shah 3 Vaginal discharge and odor, 14 Corinne Bazella and Majorie Greenfield 4 Vaginal bleeding, 18 Valerie S. Ratts 5 Ovarian masses, 22 Julie L. Strickland and Anne-Marie Priebe Part 3 Prepubertal Girls: Gynecologic Conditions 6 Labial adhesions, 29 Jane E. D. Broecker 7 Pediatric vulvovaginitis, 33 Sari Kives 8 Sexual abuse, 38 Nancy D. Kellogg and James L. Lukefahr SECTION 2 CONCERNS IN PREPUBERTAL GIRLS AND IN ADOLESCENTS, 43 Part 1 External Genitalia 9 Normal hymen and hymenal variations, 45 Amy D. DiVasta and Estherann Grace 10 Vulvar signs and symptoms, 49 10.1 Overview of vulvar signs and symptoms, 49 Paula J. Adams Hillard 10.2 Vulvar ulcers and aphthosis, 57 Helen R. Deitch 10.3 Vulvar tumors, cysts, and masses, 60 Meredith Loveless 10.4 Vulvar abscesses, 64 Jennie Yoost and S. Paige Hertweck 11 Vulvar lichen sclerosus, 69 Paula J. Adams Hillard 12 Accidental trauma, 72 Mariel A. Focseneanu and Diane F. Merritt 13 Female genital mutilation, 76 Katherine A. Zakhour and Comfort Momoh Part 2 Puberty 14 Normal puberty, 80 Jennifer C. Kelley and Frank M. Biro 15 Precocious puberty, 87 Paul B. Kaplowitz 16 Delayed puberty, 91 Sara E. Watson, Peter A. Lee and Christopher P. Houk SECTION 3 ADOLESCENT GIRLS, 97 Part 1 Adolescent Health 17 Initial assessment: consultation with an adolescent girl, 99 Paula J. Adams Hillard 18 Confidentiality, 103 Janice Bacon and Jennifer A. Greene 19 Legal issues, 108 Rebecca Gudeman and Abigail English 20 Adolescent sexuality, 114 Linda M. Kollar 21 Adolescent preventive care for healthy teens, 119 Kristin L. Kaltenstadler and Corinne Lehmann 22 Weight, 125 22.1 Overweight and obesity and gynecologic conditions, 125 Stephanie Crewe and Maria Trent 22.2 Eating disorders, 131 Anne Hsii and Neville H. Golden 23 The female athlete, 138 James R. Ebert 24 Immunizations, 142 Amy B. Middleman 25 Substance abuse: screening and brief intervention, 146 Patricia Schram and Sharon Levy 26 Suicidal ideation and self-harm: screening, 151 Matthew B. Wintersteen and Christopher V. Chambers 27 Healthcare for lesbian, bisexual, and transgender adolescents, 154 Elizabeth B. Erbaugh and Margaret J. Blythe 28 Developmental delay, 158 Lisa Allen and Melanie Ornstein 29 Menstrual health, 163 29.1 Tampons and menstrual hygiene products, 163 Stephanie Stockburger and Hatim A. Omar 29.2 Normal menses, 166 Paula J. Adams Hillard 29.3 Menstrual suppression, 169 Kelly Kantartzis and Gina Sucato 30 The gynecologic exam, 174 30.1 When and how to perform a gynecologic exam, 174 Paula J. Adams Hillard 30.2 Cervical cytology screening, 180 Paula J. Adams Hillard 31 Sexually-transmitted disease screening, 183 Michael G. Spigarelli Part 2 Pregnancy Prevention and Options 32 Unintended pregnancy: options and counseling, 187 Kaiyti Duffy and Rachael Phelps 33 Contraceptive counseling, 192 33.1 Contraceptive counseling for healthy teens, 192 Stephanie B. Teal 33.2 Contraceptive counseling for teens with medical illness, 197 Melissa Gilliam and Amy Whitaker 34 Contraception, 205 34.1 Barrier methods, 205 Uri Belkind and Susan M. Coupey 34.2 Oral contraception, 210 Emily M. Godfrey and Melissa Kottke 34.3 Transdermal and vaginal combination methods, 217 Sherine Patterson-Rose and Paula Braverman 34.4 Intrauterine devices, 222 Sophia Yen 34.5 Progestin-only contraception, 226 Michelle M. Isley and Andrew M. Kaunitz 34.6 Emergency contraception, 230 Kaiyti Duffy and Melanie A. Gold Part 3 Adolescent Girls: Symptoms and Signs 35 Hirsutism, 234 Dianne Deplewski and Robert L. Rosenfield 36 The breast, 241 36.1 Breast concerns, 241 Kaylene J. Logan and Eduardo Lara-Torre 36.2 Breast discharge, 246 Donald E. Greydanus and Colleen Bryzik Dodich 37 Vaginal discharge, 249 Seema Menon, Mandakini Sadhir, and Susan Jay 38 Pelvic masses, 254 Noam Smorgick-Rosenbaum and Elisabeth H. Quint 39 Gynecologic pain, 260 39.1 Pelvic and abdominal pain, 260 Geri D. Hewitt 39.2 Myofascial (musculoskeletal) pain, 266 John Jarrell 40 Amenorrhea, 269 Melanie Nathan and Andrea L. Zuckerman 41 Abnormal uterine bleeding, 275 Jennifer E. Dietrich and Jennifer L. Bercaw-Pratt 42 Premenstrual syndrome/premenstrual dysphoric disorder and mood disorders, 281 Michael Dobbs and Paula Braverman Part 4 Adolescent Girls: Gynecologic Conditions 43 Vulvovaginal conditions, 285 43.1 Yeast/candida, 285 Sofya Maslyanskaya and Elizabeth Alderman 43.2 Bacterial vaginosis, 289 Jennifer Louis-Jacques and Rebecca Flynn O’Brien 44 Sexually-transmitted diseases, 293 44.1 Genital herpes, 293 Terri Warren 44.2 Human papillomavirus and condyloma, 297 Lea E. Widdice and Jessica A. Kahn 44.3 Chlamydia, 302 Taraneh Shafii and Gale R. Burstein 44.4 Gonorrhea, 307 Bree Weaver and J. Dennis Fortenberry 44.5 Trichomonas, 312 Samantha E. Montgomery and Jill S. Huppert 44.6 HIV, 315 Anita Radix and Donna Futterman 44.7 Other sexually-transmitted diseases, 318 Ellen S. Rome 45 Dysmenorrhea, 325 Michelle Forcier and Zeev Harel 46 Congenital anomalies, 330 Amy M. Vallerie and Lesley L. Breech 47 Ectopic pregnancy, 339 Michelle Vichnin 48 The ovaries, 342 48.1 Ovarian cysts, 342 Paula J. Adams Hillard 48.2 Ovarian germ cell tumors, 348 Claire Templeman 49 Endometriosis, 351 Mary Anne Jamieson 50 Polycystic ovary syndrome, 355 Samantha M. Pfeifer 51 Pelvic infl ammatory disease, 361 Colleen McNicholas and Jeffrey F. Peipert 52 Gonadal dysgenesis, 366 Courtney A. Marsh and Yolanda R. Smith 53 Sexual assault and date rape, 371 Beth L. Emerson and Kirsten Bechtel Appendix 1 Essential information, 375 Appendix 2 Useful web resources for adolescents, their parents/caregivers, and clinicians, 389 Index, 391