Whether your adolescent sees a general gynecologist or a pediatric and adolescent gynecologist, the provider can address a variety of issues. “If a young woman or even a young girl has eczema and ‘sensitive skin,’ that has implications for the vulva, including itching and rashes,” says Dr. Cron. Even before puberty, girls can develop annoyances like vaginitis that need treating. “They may have had an issue with hygiene that results in discharge, discomfort, and itching,” she says.
A gynecologist can also evaluate anatomical problems of the reproductive system, such as an imperforate hymen, when the hymen covers the entire opening of the vagina (rather than part of it), requiring surgery. “Those patients can present with pain and a lack of menstrual periods,” says Dr. Cron.
Difficult periods are a common complaint. But gynecologists have a repertoire of remedies for heavy or painful periods or irregular bleeding, such as hormone-based birth control methods or long-acting reversible contraceptives (LARC) — intrauterine devices and implants, says Dr. Cron.
“In the past the thought was that they had to just live with it,” says Dr. Cron. “But, in fact, there are things that we can do that can really transform people’s lives. If your period is impacting your life, meaning you’re missing school, sports, and time with your friends, there are solutions.”
Dr. Cron says a patient’s specific period pattern can also uncover more significant problems. “Periods are a vital sign,” she says. “They can be an indicator of other things going on.”
Missed periods can alert the doctor to a young patient’s eating disorder, for instance. “The girls who are underweight and have disordered eating might present with irregular or no periods,” says Dr. Cron. “And that’s the time to intervene and talk about a healthy diet and the minimum weight that’s normal.”
Teens who have missed, irregular, or very light periods may be experiencing a hormonal problem like polycystic ovary syndrome (PCOS), which causes the ovaries to produce an abnormal amount of testosterone and is associated with a higher weight and, later, fertility problems.
“If we intervene early in terms of diet and exercise, we can improve the hormonal imbalance for lots of these young people and prevent them from developing some of the complications of PCOS,” says Dr. Cron.
As young patients get older and have more complex needs, they will have established a relationship in which they are comfortable talking about them, says Dr. Cron.
“You want your teen to have a trusted adult that they can talk to about their concerns,” Dr. Cron says. “You know they’re talking about them with their friends and going online. But you also want them to have somebody who will give them evidence-based answers.”