Journal of pediatric and adolescent gynecology最新文献

英文中文

Multi-Site Pain During Menstruation in Adolescents is Associated With Impaired Functioning Across Various Domains: A Cross-Sectional Observational Study 青少年月经期间的多部位疼痛与各领域功能受损有关：一项横断面观察研究。

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2026-02-01 DOI: 10.1016/j.jpag.2025.10.009

Laura C. Seidman BS , Laura A. Payne PhD

Study Objective

To evaluate multi-site pain (i.e., number of painful body regions) during menstruation in a sample of adolescents, and to assess relationships between multi-site pain during menstruation and other menstrual cycle, pain, and psychosocial factors.

Methods

Participants in this cross-sectional observational study included 141 girls ages 13-19 years with varying levels of menstrual pain. Participants indicated on a body map the areas where they usually experience pain when menstruating. Participants also completed a set of validated self-report questionnaires. Menstruation-associated multi-site pain was calculated as the total number of body regions reported (out of 21). Partial correlations controlling for baseline menstrual pain intensity were conducted between menstruation-associated multi-site pain and other variables of interest.

Results

The average number of body regions reported was 2.8 (SD = 1.5; min = 0; max = 8). Menstruation-associated multi-site pain was significantly positively correlated with number of pre-menstrual syndrome symptoms, non-menstrual multi-site body pain, pain interference over the prior week, fatigue, sleep disturbance, somatization, and multisensory sensitivity. Menstruation-associated multi-site pain was not significantly correlated with age, age at menarche, gynecologic age, menstrual pain interference, and non-menstrual body pain intensity.

Conclusion

Pain during menstruation in adolescents is not limited to the abdominal and pelvic regions, and many girls experience pain in numerous body locations during their periods. The associations between menstruation-associated multi-site pain and other pain and psychosocial measures provide preliminary evidence for the existence of a sub-group of adolescents who may be at increased risk for future pain problems.

研究目的：评估青少年月经期间的多部位疼痛（即身体疼痛区域的数量），并评估月经期间多部位疼痛与其他月经周期、疼痛和社会心理因素之间的关系。方法：这项横断面观察性研究的参与者包括141名年龄在13-19岁之间的女孩，她们有不同程度的月经疼痛。参与者在一张身体地图上标出她们经期通常感到疼痛的部位。参与者还完成了一套有效的自我报告问卷。月经相关的多部位疼痛计算为报告的身体区域总数（共21个）。在月经相关的多部位疼痛和其他感兴趣的变量之间进行了控制基线月经疼痛强度的部分相关。结果：报告的身体区域数平均为2.8个（SD=1.5; min=0; max=8）。经期相关多部位疼痛与经前综合征症状、非经期多部位身体疼痛、前一周疼痛干扰、疲劳、睡眠障碍、躯体化和多感觉敏感性显著正相关。经期相关多部位疼痛与年龄、初潮年龄、妇科年龄、经期疼痛干扰、非经期身体疼痛强度无显著相关。结论：青少年经期疼痛并不局限于腹部和骨盆区域，许多女孩在经期的许多身体部位都会感到疼痛。经期相关的多部位疼痛与其他疼痛和社会心理测量之间的关联为存在一个青少年亚群提供了初步证据，该亚群可能会增加未来疼痛问题的风险。

{"title":"Multi-Site Pain During Menstruation in Adolescents is Associated With Impaired Functioning Across Various Domains: A Cross-Sectional Observational Study","authors":"Laura C. Seidman BS , Laura A. Payne PhD","doi":"10.1016/j.jpag.2025.10.009","DOIUrl":"10.1016/j.jpag.2025.10.009","url":null,"abstract":"<div><h3>Study Objective</h3><div>To evaluate multi-site pain (i.e., number of painful body regions) during menstruation in a sample of adolescents, and to assess relationships between multi-site pain during menstruation and other menstrual cycle, pain, and psychosocial factors.</div></div><div><h3>Methods</h3><div>Participants in this cross-sectional observational study included 141 girls ages 13-19 years with varying levels of menstrual pain. Participants indicated on a body map the areas where they usually experience pain when menstruating. Participants also completed a set of validated self-report questionnaires. Menstruation-associated multi-site pain was calculated as the total number of body regions reported (out of 21). Partial correlations controlling for baseline menstrual pain intensity were conducted between menstruation-associated multi-site pain and other variables of interest.</div></div><div><h3>Results</h3><div>The average number of body regions reported was 2.8 (SD = 1.5; min = 0; max = 8). Menstruation-associated multi-site pain was significantly positively correlated with number of pre-menstrual syndrome symptoms, non-menstrual multi-site body pain, pain interference over the prior week, fatigue, sleep disturbance, somatization, and multisensory sensitivity. Menstruation-associated multi-site pain was not significantly correlated with age, age at menarche, gynecologic age, menstrual pain interference, and non-menstrual body pain intensity.</div></div><div><h3>Conclusion</h3><div>Pain during menstruation in adolescents is not limited to the abdominal and pelvic regions, and many girls experience pain in numerous body locations during their periods. The associations between menstruation-associated multi-site pain and other pain and psychosocial measures provide preliminary evidence for the existence of a sub-group of adolescents who may be at increased risk for future pain problems.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"39 1","pages":"Pages 50-56"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318361","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}

引用次数: 0

Postpartum Contraception Use among Adolescent Mothers 青少年母亲产后避孕措施的使用。

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2026-02-01 DOI: 10.1016/j.jpag.2025.10.011

Julie Maslowsky PhD , Eleanor Esbrook MD , Renee Odom-Konja MPH , Haley Stritzel PhD , Catherine Gimbrone MPH , Dorothy Mandell PhD

Study Objective

To describe patterns of postpartum contraception use among primiparous and multiparous adolescent mothers.

Methods

Cross-sectional data came from the Pregnancy Risk Assessment Monitoring System Phase 7 (2012-2015). The analytic sample included postpartum respondents ages 15-19 in 40 US states (N = 5535). Exposures included age, race, parity, intimate partner violence, psychosocial stressors, prenatal care utilization, postpartum home health visits, and insurance type. The primary outcome was postpartum use of effective contraception. The secondary outcome was reasons for not using postpartum contraception.

Results

Adolescents who attended postpartum check-ups (AOR = 2.12; 95% CI 1.58-2.84) or received home health visits (AOR = 1.37; 95% CI 1.06-1.77) were more likely to use effective contraception postpartum, whereas those experiencing more stressors were less likely (AOR = 0.93; 95% CI: 0.86-1.00). Non-Hispanic Black adolescents were less likely to use effective contraception (AOR = 0.69; 95% CI 0.50-0.94) compared to non-Hispanic White adolescents. Among those who did not use contraception postpartum, having a postpartum home health visit was associated with lower odds of endorsing contraceptive side effects (AOR = 0.33; 95% CI 0.18-0.60) or not wishing to use contraception (AOR = 0.43; 95% CI 0.22-0.86) as reasons for nonuse.

Conclusion

Access to postpartum care via home health and postpartum clinic visits was associated with significantly higher likelihood of using effective contraception. However, disparities persisted among non-Hispanic Black adolescents and those experiencing high levels of psychosocial stress. For postpartum adolescents who do not desire a subsequent birth, increasing their ability to obtain effective contraceptives can be achieved through increased access to postpartum care, particularly for underserved populations.

研究目的：描述初产和多产青少年母亲产后避孕的使用模式。方法：横断面数据来自妊娠风险评估监测系统第7期（2012-2015）。分析样本包括美国40个州15-19岁的产后受访者（N= 5535）。暴露因素包括年龄、种族、胎次、亲密伴侣暴力、心理社会压力源、产前护理利用、产后家庭健康访问和保险类型。主要结局是产后有效避孕的使用情况。次要结果是未使用产后避孕措施的原因。结果：参加产后检查（AOR=2.12; 95% CI: 1.58-2.84）或接受家庭健康访问（AOR=1.37; 95% CI: 1.06-1.77）的青少年更有可能在产后使用有效的避孕措施，而经历更多压力源的青少年更不可能（AOR=0.93; 95% CI: 0.86-1.00）。与非西班牙裔白人青少年相比，非西班牙裔黑人青少年较少使用有效避孕措施（AOR=0.69; 95% CI 0.50-0.94）。在那些产后没有使用避孕措施的妇女中，产后家庭健康访问与赞同避孕副作用（AOR=0.33; 95% CI 0.18-0.60）或不希望使用避孕措施（AOR=0.43; 95% CI 0.22-0.86）作为不使用原因的几率较低相关。结论：通过家庭保健和产后门诊就诊获得产后护理与使用有效避孕措施的可能性显著增加相关。然而，在非西班牙裔黑人青少年和那些经历高水平社会心理压力的青少年中，差异仍然存在。对于不希望再生育的产后青少年，可以通过增加获得产后护理的机会来提高他们获得有效避孕药具的能力，特别是对服务不足的人群。

{"title":"Postpartum Contraception Use among Adolescent Mothers","authors":"Julie Maslowsky PhD , Eleanor Esbrook MD , Renee Odom-Konja MPH , Haley Stritzel PhD , Catherine Gimbrone MPH , Dorothy Mandell PhD","doi":"10.1016/j.jpag.2025.10.011","DOIUrl":"10.1016/j.jpag.2025.10.011","url":null,"abstract":"<div><h3>Study Objective</h3><div>To describe patterns of postpartum contraception use among primiparous and multiparous adolescent mothers.</div></div><div><h3>Methods</h3><div>Cross-sectional data came from the Pregnancy Risk Assessment Monitoring System Phase 7 (2012-2015). The analytic sample included postpartum respondents ages 15-19 in 40 US states (<em>N</em> = 5535). Exposures included age, race, parity, intimate partner violence, psychosocial stressors, prenatal care utilization, postpartum home health visits, and insurance type. The primary outcome was postpartum use of effective contraception. The secondary outcome was reasons for not using postpartum contraception.</div></div><div><h3>Results</h3><div>Adolescents who attended postpartum check-ups (AOR = 2.12; 95% CI 1.58-2.84) or received home health visits (AOR = 1.37; 95% CI 1.06-1.77) were more likely to use effective contraception postpartum, whereas those experiencing more stressors were less likely (AOR = 0.93; 95% CI: 0.86-1.00). Non-Hispanic Black adolescents were less likely to use effective contraception (AOR = 0.69; 95% CI 0.50-0.94) compared to non-Hispanic White adolescents. Among those who did not use contraception postpartum, having a postpartum home health visit was associated with lower odds of endorsing contraceptive side effects (AOR = 0.33; 95% CI 0.18-0.60) or not wishing to use contraception (AOR = 0.43; 95% CI 0.22-0.86) as reasons for nonuse.</div></div><div><h3>Conclusion</h3><div>Access to postpartum care via home health and postpartum clinic visits was associated with significantly higher likelihood of using effective contraception. However, disparities persisted among non-Hispanic Black adolescents and those experiencing high levels of psychosocial stress. For postpartum adolescents who do not desire a subsequent birth, increasing their ability to obtain effective contraceptives can be achieved through increased access to postpartum care, particularly for underserved populations.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"39 1","pages":"Pages 76-83"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145401321","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}

引用次数: 0

Focal Adenomyosis in a 17-Year-Old Patient: A Case Report 17岁患者局灶性脑卒中1例报告

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2026-02-01 DOI: 10.1016/j.jpag.2025.10.007

Maja Banović MD, PhD , Dina Gržan MD , Vladimir Banović MD, PhD

引用次数: 0

Authors’ Response to “Responding to Adolescents’ Emotional Needs in Abortion: The Importance of Empathy-Based Counseling and Flexible Choice” 作者对“应对青少年堕胎中的情感需求：移情咨询和灵活选择的重要性”的回应

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2026-02-01 DOI: 10.1016/j.jpag.2025.08.004

Laura Kirkpatrick MD

引用次数: 0

Implementation of No-Test Medication Abortions in Primary Care: A Roadmap from an Adolescent and Young Adult Medicine Clinic 实施无测试药物流产在初级保健：路线图从青少年和青年医学诊所。

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2026-02-01 DOI: 10.1016/j.jpag.2025.09.014

Julia H. Raney MD , Amanda E. Bryson MD, MPH , Chelsea A. Garnett MD , Lisa Mihaly FNP, MS , Sara M. Buckelew MD, MPH , Marissa Raymond-Flesch MD, MPH

Study Objective

Over 2 years post-Roe, 22 states have banned or significantly limited abortion access, exacerbating existing structural barriers to abortions for adolescents and young adults (AYAs), including cost, transportation, parental notification requirements, and confidentiality concerns. We provide a roadmap for and demonstrate the feasibility of implementing no-test medication abortions (MABs) to expand abortion access in an adolescent-focused pediatric primary care setting.

Methods

An interdisciplinary team in an AYA-focused primary care clinic developed and implemented a no-test MAB protocol. Iterative rounds of protocol development engaged stakeholders including hospital leadership, OBGYN consultants, nurses, and program directors for residency, fellowship, and nursing trainees. Frequent interdisciplinary debriefs identified facilitators, barriers, and solutions to optimize care.

Results

Over 6 months, we identified clinic champions, built relationships with key stakeholders, developed clinic protocols, and disseminated MAB clinical training. In our first 6 months of implementation, we provided 4 MABs. Facilitators identified by staff include provider expertise in AYA development and patient and parent preferences for MABs in their medical home. System-level barriers (eg, timely scheduling challenges), staff factors (eg, fear of complications), and patient factors (eg, ambivalence about pregnancy) were identified. Solutions developed include establishing scheduling procedures, formalizing consultative pathways with gynecology, and integrating social work support.

Conclusion

It is feasible for adolescent primary care practices to provide no-test MABs. Through interdisciplinary planning and iterative design, barriers from the health system, clinic staff, and patient levels can be identified and addressed, expanding equitable access to safe, AYA-focused abortion care.

研究目标：在roe案件发生后的两年多时间里，22个州禁止或严重限制了堕胎机会，加剧了青少年和年轻人（AYA）堕胎的现有结构性障碍，包括成本、交通、父母通知要求和保密问题。我们提供了一个路线图，并证明了实施无测试药物流产（mab）的可行性，以扩大流产获得在青少年为重点的儿科初级保健设置。方法：一个跨学科的团队在一个以aya为重点的初级保健诊所开发并实施了一个无测试的MAB协议。反复的协议制定涉及到包括医院领导、妇产科顾问、护理、住院医师项目主管、奖学金和护理实习生在内的利益相关者。频繁的跨学科汇报确定了优化护理的促进因素、障碍和解决方案。结果：在6个月的时间里，我们确定了临床冠军，与主要利益相关者建立了关系，制定了临床方案，并传播了MAB临床培训。在我们实施的前6个月，我们提供了4个单克隆抗体。工作人员确定的促进因素包括提供人员在AYA开发方面的专业知识以及患者和家长在其医疗家中对单克隆抗体的偏好。确定了系统层面的障碍（如及时安排的挑战）、工作人员因素（如对并发症的恐惧）和患者因素（如对怀孕的矛盾心理）。制定的解决方案包括建立日程安排程序，与妇科正式协商途径，以及整合社会工作支持。结论：在青少年初级保健机构中提供免检测单克隆抗体是可行的。通过跨学科规划和迭代设计，可以确定和解决来自卫生系统、诊所工作人员和患者层面的障碍，扩大公平获得安全、以人工流产为重点的人工流产护理的机会。

{"title":"Implementation of No-Test Medication Abortions in Primary Care: A Roadmap from an Adolescent and Young Adult Medicine Clinic","authors":"Julia H. Raney MD , Amanda E. Bryson MD, MPH , Chelsea A. Garnett MD , Lisa Mihaly FNP, MS , Sara M. Buckelew MD, MPH , Marissa Raymond-Flesch MD, MPH","doi":"10.1016/j.jpag.2025.09.014","DOIUrl":"10.1016/j.jpag.2025.09.014","url":null,"abstract":"<div><h3>Study Objective</h3><div>Over 2 years post-Roe, 22 states have banned or significantly limited abortion access, exacerbating existing structural barriers to abortions for adolescents and young adults (AYAs), including cost, transportation, parental notification requirements, and confidentiality concerns. We provide a roadmap for and demonstrate the feasibility of implementing no-test medication abortions (MABs) to expand abortion access in an adolescent-focused pediatric primary care setting.</div></div><div><h3>Methods</h3><div>An interdisciplinary team in an AYA-focused primary care clinic developed and implemented a no-test MAB protocol. Iterative rounds of protocol development engaged stakeholders including hospital leadership, OBGYN consultants, nurses, and program directors for residency, fellowship, and nursing trainees. Frequent interdisciplinary debriefs identified facilitators, barriers, and solutions to optimize care.</div></div><div><h3>Results</h3><div>Over 6 months, we identified clinic champions, built relationships with key stakeholders, developed clinic protocols, and disseminated MAB clinical training. In our first 6 months of implementation, we provided 4 MABs. Facilitators identified by staff include provider expertise in AYA development and patient and parent preferences for MABs in their medical home. System-level barriers (eg, timely scheduling challenges), staff factors (eg, fear of complications), and patient factors (eg, ambivalence about pregnancy) were identified. Solutions developed include establishing scheduling procedures, formalizing consultative pathways with gynecology, and integrating social work support.</div></div><div><h3>Conclusion</h3><div>It is feasible for adolescent primary care practices to provide no-test MABs. Through interdisciplinary planning and iterative design, barriers from the health system, clinic staff, and patient levels can be identified and addressed, expanding equitable access to safe, AYA-focused abortion care.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"39 1","pages":"Pages 109-113"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213124","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}

引用次数: 0

Perforated Rotated Mesenteric Cyst Presenting as Acute Abdominal Pain in a Female Pediatric Patient: A Case Report 穿孔旋转肠系膜囊肿表现为急性腹痛的女儿科患者：一个病例报告。

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2026-02-01 DOI: 10.1016/j.jpag.2025.09.011

Valerie Josephine Dirjayanto MRes , Astrid Indrafebrina Sugianto MD, BMedSci , Riana Pauline Tamba MD, PhD

Introduction

Although more than half of cases are asymptomatic or mild in symptoms, mesenteric cysts can present clinically and radiologically similar to gynecologic diseases.

Case

A female child presented with worsening episodes of abdominal pain 1 day before admission. Abdominal x-ray suggested mechanical obstruction of the small bowel, and CT scan suggested ileal abnormality.

Discussion

During open surgery, we found 2 rotated chylous mesenteric cysts, accompanied by adhesions and jejunal perforation 57 cm from the ligament of Treitz. Cyst excision, adhesiolysis, ileo-ileal resection, and anastomosis were performed.

Conclusion

Although rare and challenging to identify, mesenteric cysts should be kept in the differential diagnosis of female children presenting with abdominal pain.

简介：虽然超过一半的病例无症状或症状轻微，但肠系膜囊肿的临床和放射学表现与妇科疾病相似。病例说明：一女患儿入院前1天腹痛加重。腹部x线提示机械性小肠梗阻，CT提示回肠异常。讨论：在开放手术中，我们发现两个旋转的乳糜肠系膜囊肿，伴粘连和空肠穿孔，距Treitz韧带57厘米。行囊肿切除、粘连松解、回肠-回肠切除术、吻合术。结论：虽然肠系膜囊肿罕见且难以识别，但在以腹痛为表现的女性儿童中应保留其鉴别诊断。

引用次数: 0

Improving Minimally Invasive Surgical Approaches to Large Adnexal Masses in Pediatric Gynecology: Combining Mini-Laparotomy With Single Port Laparoscopy 改进小儿妇科大附件肿物的微创手术入路：小剖腹与单口腹腔镜相结合。

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2026-02-01 DOI: 10.1016/j.jpag.2025.09.012

Megan F. Sumida MD , Olivia K. Winfrey MD, MPH , Julie Hakim MD , Jennifer E. Dietrich MD, MSc

In pediatric populations large ovarian cysts are often benign, and minimally invasive approaches are preferred to minimize perioperative pain and recovery, allow for same day discharge, and improve incision cosmesis. Ovarian preservation is also prioritized and cystectomy is preferred over oophorectomy. While tactile sensation and dexterity are improved in mini laparotomy cases, there are limitations with visualization that are improved with laparoscopy. We describe a technique that employs both diagnostic laparoscopy and mini laparotomy using the GelPOINT Mini™ Advanced Access Platform for single site laparoscopy in pediatric patients. This case series includes cysts ranging 7-24 cm with benign preoperative risk stratification, in patients aged 3-16 years, who underwent successful same-day, ovarian-sparing surgery with the benefits of both open and laparoscopic procedures.

在儿科人群中，较大的卵巢囊肿通常是良性的，微创方法可以最大限度地减少围手术期疼痛和恢复，允许当天出院，并改善切口美容。卵巢保存也是优先考虑的，膀胱切除术优于卵巢切除术。虽然在小型剖腹手术病例中触觉和灵活性得到了改善，但腹腔镜手术改善了视觉上的局限性。我们描述了一种使用GelPOINT mini™高级访问平台进行儿科患者单部位腹腔镜检查的诊断腹腔镜和迷你剖腹手术技术。本病例系列包括7-24厘米的囊肿，术前良性风险分层，患者年龄3至16岁，接受了成功的当天卵巢保留手术，开放和腹腔镜手术均有好处。

引用次数: 0

Nonsedated Intrauterine Device Experiences Among Transgender and Cisgender Adolescents and Young Adults in the Outpatient Setting 门诊跨性别、顺性别青少年和年轻人使用非镇静宫内节育器的经验。

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2026-02-01 DOI: 10.1016/j.jpag.2025.08.007

Liz Abernathey MD, MS , Morgan E. Ryan MS , Carly E. Milliren MPH , Kym Ahrens MD, MPH , Amy D. DiVasta MD, MMSc , Sarah Pitts MD , Michelle Escovedo MD , Sofya Maslyanskaya MD , Sarah A. Golub MD, MPH

Study Objective

This study compares the demographic characteristics and experiences of three different groups of adolescent and young adults (AYAs) seeking nonsedated intrauterine device (IUD) insertion in the outpatient setting: (1) cisgender individuals, (2) transgender and gender diverse (TGD) individuals receiving gender-affirming testosterone therapy, and (3) TGD individuals not receiving gender-affirming testosterone therapy.

Methods

This retrospective cohort study included AYAs age 13-21 years seeking IUD insertion. Data were obtained from the electronic health record via a pre-existing, multi-institutional shared quality improvement collaborative. The patient population was characterized by descriptive statistics; inferential statistics compared procedural complications, outcomes, and patient-reported side effects. Unadjusted Kaplan–Meier and Cox proportional-hazard modeling assessed continuation rates.

Results

Of the 683 participants attempting IUD insertion, 623 were cisgender individuals, 18 were TGD individuals on gender-affirming testosterone, and 42 were TGD individuals not on testosterone. There was no difference in insertion indication (P = .25). TGD patients on testosterone were more likely to have experienced a procedural adverse event (17%; P = .04), and to have reported pain beyond expectation (P = .003), although insertional success did not differ significantly between groups (P = .22).

Conclusion

TGD AYAs had similar reasons as cisgender patients for seeking the IUD. While TGD individuals on testosterone were more likely to have pain or an adverse procedural event, insertional success did not differ. One-year IUD continuation rates were similarly high in all groups.

研究目的：本研究比较了三种不同的青少年和年轻人（AYAs）在门诊寻求非镇静宫内节育器（IUD）插入的人口统计学特征和经历：(1)顺性别个体，(2)变性和性别多样化（TGD）个体接受性别肯定睾酮治疗，(3)TGD个体不接受性别肯定睾酮治疗。方法：本回顾性队列研究纳入13 ~ 21岁寻求宫内节育器植入的青少年。数据通过预先存在的多机构共享质量改进（QI）协作从电子健康记录中获得。患者群体特征采用描述性统计；推断统计学比较了手术并发症、结果和患者报告的副作用。未调整的Kaplan-Meier和Cox比例风险模型评估了延续率。结果：在683例尝试插入宫内节育器的参与者中，623例为顺性别个体，18例为使用性别确认睾酮的TGD个体，54例为未使用睾酮的TGD个体。插入指征无差异（p=0.25）。使用睾酮的TGD患者更有可能经历手术不良事件（17%,p=0.04），并报告超出预期的疼痛（p=0.003），尽管插入成功率在两组之间没有显著差异（p=0.22）。结论：TGD患者寻求宫内节育器的原因与顺性患者相似。虽然接受睾酮治疗的TGD患者更有可能出现疼痛或不良手术事件，但插入成功率并无差异。在所有组中，1年的宫内节育器延续率相似地高。

{"title":"Nonsedated Intrauterine Device Experiences Among Transgender and Cisgender Adolescents and Young Adults in the Outpatient Setting","authors":"Liz Abernathey MD, MS , Morgan E. Ryan MS , Carly E. Milliren MPH , Kym Ahrens MD, MPH , Amy D. DiVasta MD, MMSc , Sarah Pitts MD , Michelle Escovedo MD , Sofya Maslyanskaya MD , Sarah A. Golub MD, MPH","doi":"10.1016/j.jpag.2025.08.007","DOIUrl":"10.1016/j.jpag.2025.08.007","url":null,"abstract":"<div><h3>Study Objective</h3><div>This study compares the demographic characteristics and experiences of three different groups of adolescent and young adults (AYAs) seeking nonsedated intrauterine device (IUD) insertion in the outpatient setting: (1) cisgender individuals, (2) transgender and gender diverse (TGD) individuals receiving gender-affirming testosterone therapy, and (3) TGD individuals not receiving gender-affirming testosterone therapy.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included AYAs age 13-21 years seeking IUD insertion. Data were obtained from the electronic health record via a pre-existing, multi-institutional shared quality improvement collaborative. The patient population was characterized by descriptive statistics; inferential statistics compared procedural complications, outcomes, and patient-reported side effects. Unadjusted Kaplan–Meier and Cox proportional-hazard modeling assessed continuation rates.</div></div><div><h3>Results</h3><div>Of the 683 participants attempting IUD insertion, 623 were cisgender individuals, 18 were TGD individuals on gender-affirming testosterone, and 42 were TGD individuals not on testosterone. There was no difference in insertion indication (<em>P</em> = .25). TGD patients on testosterone were more likely to have experienced a procedural adverse event (17%; <em>P</em> = .04), and to have reported pain beyond expectation (<em>P</em> = .003), although insertional success did not differ significantly between groups (<em>P</em> = .22).</div></div><div><h3>Conclusion</h3><div>TGD AYAs had similar reasons as cisgender patients for seeking the IUD. While TGD individuals on testosterone were more likely to have pain or an adverse procedural event, insertional success did not differ. One-year IUD continuation rates were similarly high in all groups.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"39 1","pages":"Pages 63-68"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015611","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}

引用次数: 0

Bridging the Gap between Hypothyroidism and Precocious Puberty: A Case Report of Van Wyk Grumbach Syndrome 弥合甲状腺功能减退与性早熟之间的差距：Von Wyk Grumbach综合征1例报告。

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2026-02-01 DOI: 10.1016/j.jpag.2025.09.005

Om Kumari MBBS, MS, Neetu Sharma MBBS, MS, Megha Jindal MBBS, Kanak Dubey MBBS, DNB, Latika Chawla MBBS, MD

Introduction

Van Wyk Grumbach syndrome (VWGS) is a rare clinical entity that presents with the triad of precocious puberty, polycystic ovaries, and severe hypothyroidism. VWGS is an uncommon cause of precocious puberty characterized by the dissociation of gonadarche and adrenarche. Unlike other etiologies of precocious puberty, VWGS is associated with absent growth acceleration and delayed bone maturation due to prolonged, untreated hypothyroidism. The diagnosis is often delayed or overlooked, as the overt or unusual pubertal manifestations may overshadow the subtle signs of hypothyroidism. Failure to identify hypothyroidism as the cause of ovarian cysts and precocious puberty may lead to catastrophic ovary resection and oophorectomy in prepubertal girls and adolescents.

Case Presentation

We present a case of VWGS in a 7-year-old girl presenting with a painful abdomen with precocious puberty and menarche. A relevant review of the literature on this uncommon clinical entity is also presented.

Conclusion

This study underscores the importance of recognizing the atypical presentation of prolonged hypothyroidism with precocious puberty in young children. This emphasizes the need for clinicians to consider the rare entity of VWGS, which could help prevent delays in appropriate management.

简介：Von Wyk Grumbach综合征（VWGS）是一种罕见的临床症状，表现为性早熟、多囊卵巢和严重甲状腺功能减退。VWGS是一种罕见的性早熟的原因，其特征是性腺和肾上腺素的分离。与其他性早熟的病因不同，VWGS与长期未经治疗的甲状腺功能减退症导致的生长加速缺失和骨成熟延迟有关。诊断常常被延误或忽视，因为明显或不寻常的青春期表现可能掩盖了甲状腺功能减退的微妙迹象。未能确定甲状腺功能减退是卵巢囊肿和性早熟的原因可能导致青春期前女孩和青少年灾难性的卵巢切除术和卵巢切除术。病例介绍：我们报告了一例VWGS在一个07岁的女孩表现为腹部疼痛，性早熟和月经初潮。相关的文献回顾，这一罕见的临床实体也提出。结论：本研究强调了认识到幼儿性早熟伴慢性甲状腺功能减退的非典型表现的重要性。它强调临床医生需要考虑VWGS的罕见实体，这可以帮助防止适当管理的延误。

{"title":"Bridging the Gap between Hypothyroidism and Precocious Puberty: A Case Report of Van Wyk Grumbach Syndrome","authors":"Om Kumari MBBS, MS, Neetu Sharma MBBS, MS, Megha Jindal MBBS, Kanak Dubey MBBS, DNB, Latika Chawla MBBS, MD","doi":"10.1016/j.jpag.2025.09.005","DOIUrl":"10.1016/j.jpag.2025.09.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Van Wyk Grumbach syndrome (VWGS) is a rare clinical entity that presents with the triad of precocious puberty, polycystic ovaries, and severe hypothyroidism. VWGS is an uncommon cause of precocious puberty characterized by the dissociation of gonadarche and adrenarche. Unlike other etiologies of precocious puberty, VWGS is associated with absent growth acceleration and delayed bone maturation due to prolonged, untreated hypothyroidism. The diagnosis is often delayed or overlooked, as the overt or unusual pubertal manifestations may overshadow the subtle signs of hypothyroidism. Failure to identify hypothyroidism as the cause of ovarian cysts and precocious puberty may lead to catastrophic ovary resection and oophorectomy in prepubertal girls and adolescents.</div></div><div><h3>Case Presentation</h3><div>We present a case of VWGS in a 7-year-old girl presenting with a painful abdomen with precocious puberty and menarche. A relevant review of the literature on this uncommon clinical entity is also presented.</div></div><div><h3>Conclusion</h3><div>This study underscores the importance of recognizing the atypical presentation of prolonged hypothyroidism with precocious puberty in young children. This emphasizes the need for clinicians to consider the rare entity of VWGS, which could help prevent delays in appropriate management.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"39 1","pages":"Pages 124-127"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091933","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}

引用次数: 0

Comparing Medical Abortion Outcomes and Experiences Between Young and Adult Women: Evidence From Urban Cambodia 比较年轻和成年妇女的药物流产结果和经验：来自柬埔寨城市的证据。

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2026-02-01 DOI: 10.1016/j.jpag.2025.07.007

Erin Pearson PhD, MPH , Paige Logan MPH , Elisabeth Eckersberger PhD, MPA , Jamie Menzel MPH , Bunsoth Mao MD , Sovanthida Suy MAppStat, MSc , Vonthanak Saphonn MD, PhD, MSc , Nathalie Kapp MD, MPH

Introduction

Self-managed abortions are increasingly common globally, but little is known about young women’s experiences.

Methods

Secondary analysis of data from 1847 women accessing MA in urban Cambodia in 2018-2019 and in-depth interviews with seven women aged 15-19. Descriptive statistics compared young and adult women on self-reported abortion outcomes and experiences in clinics and pharmacies, and qualitative data contextualized quantitative findings.

Results

Young women were better represented among clinic clients (30.0%) compared to pharmacy clients (20.2%). Young women had comparable MA success rates and better MA experiences across settings, but young pharmacy clients were more likely to seek support from friends and family.

Discussion

Young women had comparable MA outcomes and experiences as adult women in both clinics and pharmacies, but young women self-managing their abortions may require information and support beyond the pharmacist.

导言：自我管理堕胎在全球越来越普遍，但对年轻女性的经历知之甚少。方法：对2018-2019年柬埔寨城市1847名接受MA治疗的女性的数据进行二次分析，并对7名15-19岁的女性进行深度访谈。描述性统计比较了年轻妇女和成年妇女在诊所和药房自我报告的堕胎结果和经历，定性数据将定量结果纳入背景。结果：年轻女性在诊所客户（30.0%）中比药房客户（20.2%）更具代表性。年轻女性在不同的环境中有相似的MA成功率和更好的MA体验，但年轻的药房客户更有可能从朋友和家人那里寻求支持。讨论：在诊所和药房，年轻女性的MA结果和经历与成年女性相当，但年轻女性自我管理堕胎可能需要药剂师以外的信息和支持。

{"title":"Comparing Medical Abortion Outcomes and Experiences Between Young and Adult Women: Evidence From Urban Cambodia","authors":"Erin Pearson PhD, MPH , Paige Logan MPH , Elisabeth Eckersberger PhD, MPA , Jamie Menzel MPH , Bunsoth Mao MD , Sovanthida Suy MAppStat, MSc , Vonthanak Saphonn MD, PhD, MSc , Nathalie Kapp MD, MPH","doi":"10.1016/j.jpag.2025.07.007","DOIUrl":"10.1016/j.jpag.2025.07.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Self-managed abortions are increasingly common globally, but little is known about young women’s experiences.</div></div><div><h3>Methods</h3><div>Secondary analysis of data from 1847 women accessing MA in urban Cambodia in 2018-2019 and in-depth interviews with seven women aged 15-19. Descriptive statistics compared young and adult women on self-reported abortion outcomes and experiences in clinics and pharmacies, and qualitative data contextualized quantitative findings.</div></div><div><h3>Results</h3><div>Young women were better represented among clinic clients (30.0%) compared to pharmacy clients (20.2%). Young women had comparable MA success rates and better MA experiences across settings, but young pharmacy clients were more likely to seek support from friends and family.</div></div><div><h3>Discussion</h3><div>Young women had comparable MA outcomes and experiences as adult women in both clinics and pharmacies, but young women self-managing their abortions may require information and support beyond the pharmacist.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"39 1","pages":"Pages 114-120"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718083","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}

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Journal of pediatric and adolescent gynecology

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀