Teen Gynecology

Learn more about teen gynecology from Mary Fournier, MD, in Adolescent Medicine.

What do you typically receive referrals for?

One of the big categories that we get referrals for is adolescent gynecology. I am not a gynecologist, but I do have training in developmentally appropriate adolescent gynecologic care. If problems arise when girls start going through puberty and their periods start, we can help assess and manage that. We also talk about managing birth control and screening for sexually transmitted infections or HIV. We provide preventive care for HIV to very high-risk teens. There’s a wide range of services.

What issues do you see in teen gynecology?

The interesting thing with teenagers as opposed to adults is that the causes of period problems in early adolescence can vary and are often different from things that arise later on in life as adults. As an adolescent specialist, I’m sensitive to what those issues could be. I also feel very comfortable talking to them about their periods, which can be a very embarrassing topic for some patients. Patients are often more willing to be open or seek care in an adolescent office because it’s not necessarily as intimidating as, for instance, an adult gynecologist’s office. Commonly, we’ll see things like painful periods, heavy periods, irregular periods, and ovarian cysts. I think the other big topic that we provide care for is birth control counseling. There’s a variety of options available to teens now including procedures such as IUDs and implants, which we offer. Those can sound scary initially, so we just talk them through what the options are and the benefits and risks involved. Things like that can be very important because often teens will not seek care or will not talk to a provider about birth control until maybe a year after they become sexually active, and that’s concerning. We do a lot of preventive counseling. We talk about risks for sexually transmitted infections, how to get tested, how to have the conversations with your partner, and then treatment and prevention for those as well. In a broader circumstance, we talk about preventive measures and nutrition, mental health, school, and functioning within the teen’s everyday life.

Do patients often have concerns about common issues?

We see that with heavy or prolonged periods. People might think, “Oh my gosh. This is not the way I was told it was going to be. This is not what I’m seeing my friends’ experience. I must be weird or different, or something’s wrong with me.” I can provide the experience and the perspective that this is actually pretty common in the developing teenager. This can be treated and managed. You’re going to be able to go on with your life. Teenagers are still growing up. They’re still learning what the world is about, and so they have experience, but they have their own limited amount of experience. Talking them through their concerns and their worries and helping them realize that this is going to get better. This will get better but also validating those concerns. One of the things that we often see in teenagers is they feel overlooked, under listened to, or under appreciated. We just recognize that these are your concerns, and we can work together to find a way past them.