Pub Date : 2026-02-01Epub Date: 2025-09-30DOI: 10.1016/j.jpag.2025.09.007
Natalie Hickerson MD , Hadar Lev-Tov MD, MAS , Sara Danker MD , Judith Simms-Cendan MD
Hidradenitis suppurativa (HS) is a complex disease that manifests with nodules, abscesses, and tunnels in the intertriginous regions of the body. Symptoms often begin after adrenarche and may progress to severe disease with draining tunnels and permanent scars, leading to a significant reduction in quality of life and mental health. Diagnostic delays are common, increasing the risk of disease progression. Timely diagnosis and effective management are essential to the prevention of complications in the pediatric and adolescent population. This review will cover the currently available information on pathophysiology, risk factors, presentation, diagnosis, and management of HS in this population.
{"title":"Hidradenitis Suppurativa in the Pediatric and Adolescent Population","authors":"Natalie Hickerson MD , Hadar Lev-Tov MD, MAS , Sara Danker MD , Judith Simms-Cendan MD","doi":"10.1016/j.jpag.2025.09.007","DOIUrl":"10.1016/j.jpag.2025.09.007","url":null,"abstract":"<div><div>Hidradenitis suppurativa (HS) is a complex disease that manifests with nodules, abscesses, and tunnels in the intertriginous regions of the body. Symptoms often begin after adrenarche and may progress to severe disease with draining tunnels and permanent scars, leading to a significant reduction in quality of life and mental health. Diagnostic delays are common, increasing the risk of disease progression. Timely diagnosis and effective management are essential to the prevention of complications in the pediatric and adolescent population. This review will cover the currently available information on pathophysiology, risk factors, presentation, diagnosis, and management of HS in this population.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"39 1","pages":"Pages 17-24"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213155","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}
Pub Date : 2026-02-01Epub Date: 2025-10-26DOI: 10.1016/j.jpag.2025.10.013
Perihan Güner PhD, RN , Tuğba Ulukaya RN
Study Objective
To explore coping strategies among women with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome following McIndoe vaginal reconstruction, focusing on how they adapt emotionally, cognitively, relationally, and spiritually.
Methods
A descriptive phenomenological study was conducted at a tertiary university hospital in Türkiye. Ten women with MRKH syndrome who underwent McIndoe vaginoplasty were recruited. Data were collected through semi-structured, in-depth interviews and analyzed using Colaizzi’s seven-step framework. Reporting adhered to the COREQ checklist.
Results
Six overarching themes and twelve subthemes were identified:1 managing silence and avoidance,2 reframing and positive reappraisal,3 spiritual coping,4 relational dynamics of support and stigma,5 disclosure dilemmas, and6 pathways to empowerment. Coping strategies were dynamic, shifting from avoidance to eventual empowerment, and were shaped by family dynamics, cultural norms, spirituality, and relational contexts.
Conclusion
Coping following McIndoe reconstruction extends beyond surgical success to encompass psychological adjustment, relational support, and the creation of cultural and spiritual meaning. Holistic interventions-including psychoeducation, culturally sensitive counselling, family- and couple-based approaches, and structured peer networks-may strengthen resilience and promote well-being in this population.
研究目的：探讨McIndoe阴道重建术后MRKH （mayer - rokitansky - k ster- hauser）综合征女性的应对策略，重点关注她们在情感、认知、关系和精神方面的适应情况。方法：采用描述性现象学研究方法在浙江省某三级大学附属医院进行。10名患有MRKH综合征的女性接受了McIndoe阴道成形术。通过半结构化的深度访谈收集数据，并使用Colaizzi的七步框架进行分析。报告遵循COREQ检查表。结果：确定了6个总体主题和12个副主题：(1)管理沉默和回避，(2)重构和积极的重新评价，(3)精神应对，(4)支持和耻辱的关系动力学，(5)披露困境，(6)赋权途径。应对策略是动态的，从回避到最终的授权，并由家庭动态、文化规范、精神和关系背景形成。结论：McIndoe重建术后的应对不仅仅是手术成功，还包括心理调整、关系支持以及文化和精神意义的创造。整体干预措施——包括心理教育、文化敏感咨询、以家庭和夫妻为基础的方法，以及结构化的同伴网络——可能会增强这一人群的适应力，促进他们的福祉。
{"title":"From Avoidance to Empowerment: Coping Strategies in Women With Müllerian agenesis (MRKH) After McIndoe Reconstruction: A Descriptive Phenomenological Study","authors":"Perihan Güner PhD, RN , Tuğba Ulukaya RN","doi":"10.1016/j.jpag.2025.10.013","DOIUrl":"10.1016/j.jpag.2025.10.013","url":null,"abstract":"<div><h3>Study Objective</h3><div>To explore coping strategies among women with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome following McIndoe vaginal reconstruction, focusing on how they adapt emotionally, cognitively, relationally, and spiritually.</div></div><div><h3>Methods</h3><div>A descriptive phenomenological study was conducted at a tertiary university hospital in Türkiye. Ten women with MRKH syndrome who underwent McIndoe vaginoplasty were recruited. Data were collected through semi-structured, in-depth interviews and analyzed using Colaizzi’s seven-step framework. Reporting adhered to the COREQ checklist.</div></div><div><h3>Results</h3><div>Six overarching themes and twelve subthemes were identified:<span><span><sup>1</sup></span></span> managing silence and avoidance,<span><span><sup>2</sup></span></span> reframing and positive reappraisal,<span><span><sup>3</sup></span></span> spiritual coping,<span><span><sup>4</sup></span></span> relational dynamics of support and stigma,<span><span><sup>5</sup></span></span> disclosure dilemmas, and<span><span><sup>6</sup></span></span> pathways to empowerment. Coping strategies were dynamic, shifting from avoidance to eventual empowerment, and were shaped by family dynamics, cultural norms, spirituality, and relational contexts.</div></div><div><h3>Conclusion</h3><div>Coping following McIndoe reconstruction extends beyond surgical success to encompass psychological adjustment, relational support, and the creation of cultural and spiritual meaning. Holistic interventions-including psychoeducation, culturally sensitive counselling, family- and couple-based approaches, and structured peer networks-may strengthen resilience and promote well-being in this population.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"39 1","pages":"Pages 101-108"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145390737","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}
Pub Date : 2026-02-01Epub Date: 2025-10-04DOI: 10.1016/j.jpag.2025.09.008
Nicholas R.W. Cleland MD , Charlie E. Graves BS , Lauren M. Reade BS , Natalie J. Nokoff MD, MS , Ryan P. O’Connell MS, CHES , Nancy Z. Fang MD, MS
Introduction
The transgender and gender diverse (TGD) population continues to face unmet healthcare needs, especially when pertaining to sexual and reproductive health (SRH). When receiving care, TGD individuals may face discrimination or receive care that does not affirm their gender identity or is rooted in cisgender, heteronormative assumptions. This qualitative study sought to understand the experiences and perspectives of TGD youth surrounding contraceptive use and counseling, and investigate acceptability of self-administered subcutaneous depot medroxyprogesterone acetate (DMPA-SC).
Methods
We conducted semi-structured focus groups and individual interviews to understand what drove initiation and discontinuation of contraceptives, specifically DMPA-SC. We recruited 35 TGD individuals assigned female at birth, with median (IQR) age of 17.5 (2.75) years. Twenty-one participants completed focus groups and 10 completed individual interviews. Interviews were conducted virtually and analyzed using rapid thematic analysis.
Results
We identified 4 themes: (1) Dysmenorrhea and dysphoria associated with menses that were alleviated by DMPA; (2) DMPA seen as the best method for menstrual suppression; (3) Negative experiences with previous primary care providers (PCPs); the importance of language and a desire for individualized care regarding SRH.
Discussion
The SRH needs of TGD individuals differ from their cisgender counterparts. Historically, the primary endpoint for contraceptive studies focused on preventing pregnancies. Assuming this as the primary goal for TGD individuals can be harmful to the provider-patient relationship and lead to avoidance of care. When providing contraceptives at the intersection of gender identity and sexual orientation, counseling should be tailored towards an individual’s unique SRH needs.
{"title":"Providing Contraception to Trans Youth: A Qualitative Study Investigating the Acceptability of Subcutaneous Depot Medroxyprogesterone Acetate and Prior Experiences With Contraceptive Counseling","authors":"Nicholas R.W. Cleland MD , Charlie E. Graves BS , Lauren M. Reade BS , Natalie J. Nokoff MD, MS , Ryan P. O’Connell MS, CHES , Nancy Z. Fang MD, MS","doi":"10.1016/j.jpag.2025.09.008","DOIUrl":"10.1016/j.jpag.2025.09.008","url":null,"abstract":"<div><h3>Introduction</h3><div>The transgender and gender diverse (TGD) population continues to face unmet healthcare needs, especially when pertaining to sexual and reproductive health (SRH). When receiving care, TGD individuals may face discrimination or receive care that does not affirm their gender identity or is rooted in cisgender, heteronormative assumptions. This qualitative study sought to understand the experiences and perspectives of TGD youth surrounding contraceptive use and counseling, and investigate acceptability of self-administered subcutaneous depot medroxyprogesterone acetate (DMPA-SC).</div></div><div><h3>Methods</h3><div>We conducted semi-structured focus groups and individual interviews to understand what drove initiation and discontinuation of contraceptives, specifically DMPA-SC. We recruited 35 TGD individuals assigned female at birth, with median (IQR) age of 17.5 (2.75) years. Twenty-one participants completed focus groups and 10 completed individual interviews. Interviews were conducted virtually and analyzed using rapid thematic analysis.</div></div><div><h3>Results</h3><div>We identified 4 themes: (1) Dysmenorrhea and dysphoria associated with menses that were alleviated by DMPA; (2) DMPA seen as the best method for menstrual suppression; (3) Negative experiences with previous primary care providers (PCPs); the importance of language and a desire for individualized care regarding SRH.</div></div><div><h3>Discussion</h3><div>The SRH needs of TGD individuals differ from their cisgender counterparts. Historically, the primary endpoint for contraceptive studies focused on preventing pregnancies. Assuming this as the primary goal for TGD individuals can be harmful to the provider-patient relationship and lead to avoidance of care. When providing contraceptives at the intersection of gender identity and sexual orientation, counseling should be tailored towards an individual’s unique SRH needs.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"39 1","pages":"Pages 57-62"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238831","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}
Pediatric primary ovarian torsion (POT) is a rare condition related to anatomical predispositions and hormonal triggers. The high recurrence rate of laparoscopic ovarian detorsion (LOD) has led to the consideration of primary oophoropexy (OPX). This study aims to investigate OPX indications in POT and evaluate the efficacy of different fixation techniques.
Methods
A retrospective review was conducted on all pediatric patients (1-14 years) with POT treated with LOD or LOD+OPX at our tertiary care center between 2010 and 2024. The sites of fixation were round ligament, ovarian fossa, utero-ovarian ligament, and uterine body. The data collected included demographic, clinical, imaging, surgical, and follow-up results. Statistical analyses were performed to identify factors associated with recurrence and to compare LOD with LOD+OPX.
Results
Eighteen patients (median age 9.4 years) were included in the study. LOD was performed in 56% of cases, while LOD+OPX was performed in 44%. The overall recurrence rate was 44%, with 40% recurrence after LOD and 50% after LOD+OPX (p = 1). Notably, all OPX cases involving the round ligament relapsed (100%), compared to a significantly lower recurrence rate for other OPX sites (20%). Statistical analysis confirmed the round ligament as an inadequate fixation site (P = .027). Follow-up ultrasound revealed normal ovarian morphology in 62% of patients and signs of progressive ovarian atrophy in 38%.
Conclusion
In our experience, POT predominantly occurred in premenarchal patients with hypermobile utero-ovarian ligaments. Given the high POT recurrence rate after LOD, adjunctive OPX effectively reduced the recurrence rate, except when fixation was performed at the round ligament.
{"title":"Primary Ovarian Torsion in Pediatric Patients: Is Oophoropexy Still an Option? A 14-Year Single-Center Experience","authors":"Giacomo Mandarano MD , Filippo Parolini MD , Michele Bosisio MD , Simona Gramaglia MD , Daniela Maria De Previde Prato MD , Giovanni Boroni MD , Claudia Stegher MD , Franco Edoardo Odicino MD , Daniele Alberti MD","doi":"10.1016/j.jpag.2025.10.008","DOIUrl":"10.1016/j.jpag.2025.10.008","url":null,"abstract":"<div><h3>Study objective</h3><div>Pediatric primary ovarian torsion (POT) is a rare condition related to anatomical predispositions and hormonal triggers. The high recurrence rate of laparoscopic ovarian detorsion (LOD) has led to the consideration of primary oophoropexy (OPX). This study aims to investigate OPX indications in POT and evaluate the efficacy of different fixation techniques.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted on all pediatric patients (1-14 years) with POT treated with LOD or LOD+OPX at our tertiary care center between 2010 and 2024. The sites of fixation were round ligament, ovarian fossa, utero-ovarian ligament, and uterine body. The data collected included demographic, clinical, imaging, surgical, and follow-up results. Statistical analyses were performed to identify factors associated with recurrence and to compare LOD with LOD+OPX.</div></div><div><h3>Results</h3><div>Eighteen patients (median age 9.4 years) were included in the study. LOD was performed in 56% of cases, while LOD+OPX was performed in 44%. The overall recurrence rate was 44%, with 40% recurrence after LOD and 50% after LOD+OPX (<em>p</em> = 1). Notably, all OPX cases involving the round ligament relapsed (100%), compared to a significantly lower recurrence rate for other OPX sites (20%). Statistical analysis confirmed the round ligament as an inadequate fixation site (<em>P</em> = .027). Follow-up ultrasound revealed normal ovarian morphology in 62% of patients and signs of progressive ovarian atrophy in 38%.</div></div><div><h3>Conclusion</h3><div>In our experience, POT predominantly occurred in premenarchal patients with hypermobile utero-ovarian ligaments. Given the high POT recurrence rate after LOD, adjunctive OPX effectively reduced the recurrence rate, except when fixation was performed at the round ligament.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"39 1","pages":"Pages 84-87"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145329602","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}
Pub Date : 2026-02-01Epub Date: 2026-02-03DOI: 10.1016/j.jpag.2026.01.010
Paula J. Adams Hillard MD (JPAG Editor-in-Chief)
{"title":"Adolescents and Induced Abortions: The Issue Has Not Gone Away","authors":"Paula J. Adams Hillard MD (JPAG Editor-in-Chief)","doi":"10.1016/j.jpag.2026.01.010","DOIUrl":"10.1016/j.jpag.2026.01.010","url":null,"abstract":"","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"39 1","pages":"Pages 1-3"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146102410","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}
Pub Date : 2026-02-01Epub Date: 2025-09-27DOI: 10.1016/j.jpag.2025.09.013
Maja Cehic MD , Tatjana Milenkovic MD, PhD , Sladjana Todorovic MD , Katarina Mitrovic MD, PhD , Sanja Panic Zaric MD , Dimitrije Cvetkovic MD , Rade Vukovic MD, PhD
Background
Insulin resistance (IR) is commonly seen in adolescent polycystic ovary syndrome (PCOS). However, severe IR with polycystic ovaries in non-obese adolescent girls should prompt suspicion for causes other than typical PCOS.
Case
A 16-year-old normal-weight girl presented with polyuria and polydipsia, along with irregular periods, hirsutism, and acanthosis nigricans. Her clinical presentation, laboratory results and ultrasound findings suggested severe PCOS with type 2 diabetes, but the pronounced degree of IR prompted further investigations. Genetic testing identified a heterozygous deletion in the INSR gene, confirming type A insulin resistance syndrome (TAIRS).
Summary
This case highlights the importance of considering genetic insulin receptor abnormalities in atypical PCOS presentations, especially in non-obese adolescents with severe IR. Early recognition is crucial for appropriate management and genetic counselling.
{"title":"Beyond PCOS: An Unusual Presentation of Type A Insulin Resistance Syndrome","authors":"Maja Cehic MD , Tatjana Milenkovic MD, PhD , Sladjana Todorovic MD , Katarina Mitrovic MD, PhD , Sanja Panic Zaric MD , Dimitrije Cvetkovic MD , Rade Vukovic MD, PhD","doi":"10.1016/j.jpag.2025.09.013","DOIUrl":"10.1016/j.jpag.2025.09.013","url":null,"abstract":"<div><h3>Background</h3><div>Insulin resistance (IR) is commonly seen in adolescent polycystic ovary syndrome (PCOS). However, severe IR with polycystic ovaries in non-obese adolescent girls should prompt suspicion for causes other than typical PCOS.</div></div><div><h3>Case</h3><div>A 16-year-old normal-weight girl presented with polyuria and polydipsia, along with irregular periods, hirsutism, and acanthosis nigricans. Her clinical presentation, laboratory results and ultrasound findings suggested severe PCOS with type 2 diabetes, but the pronounced degree of IR prompted further investigations. Genetic testing identified a heterozygous deletion in the INSR gene, confirming type A insulin resistance syndrome (TAIRS).</div></div><div><h3>Summary</h3><div>This case highlights the importance of considering genetic insulin receptor abnormalities in atypical PCOS presentations, especially in non-obese adolescents with severe IR. Early recognition is crucial for appropriate management and genetic counselling.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"39 1","pages":"Pages 131-134"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191671","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}
Pub Date : 2026-01-29DOI: 10.1016/j.jpag.2026.01.004
Cambray Smith, Christina Cobos, Renee Odom-Konja, Elizabeth Pleasants, Sneha A Makhijani, Eleanor Hummel, Eliza Dolgins, Layla Leo, Rolando Rodriguez, Betsy Sleath, Christopher M Shea, Melissa Gilkey, Bianca A Allison, Leah Frerichs
Study objective: To summarize contraceptive information shared and sought by adolescents and young adults (AYAs) and caregivers on Reddit.
Methods: Posts were collected from 8 subreddits (June 2022 to September 2024) using contraception-related keywords. Eligible posts were in English and authored by self-identifying AYAs (<26 years) or caregivers; comments from 10% of posts were included. We used hybrid inductive-deductive qualitative content analysis to characterize each post's primary purpose and to summarize common methods, side effects, medical and access questions, confusion/misconceptions, and sentiments.
Results: Of 607 posts, 297 met inclusion. Over half were authored by teens (<20 years, 59%), followed by young adults (32%) and caregivers (10%). The pill (47%) and intrauterine devices (25%) were most discussed. Common side effects included menstrual changes (36%) and mood/mental health (29%). Teens (n = 174) frequently discussed condoms (23%) and emergency contraception (12%). Teens and young adults (n = 268) shared sex/contraception education (13%) and opinions on contraceptive rights/behaviors (12%). They sought medical/behavioral advice (38%), contraceptive knowledge (15%), pregnancy scare advice (11%), and communication/access advice (9%). Caregivers (n = 29) sought method recommendations (38%), shared moral/ethical concerns (35%), and sought knowledge (17%) or communication advice (10%). Overall (N = 297), 15% contained misconceptions and 16% featured antihormonal sentiment. Few expressed positive emotions (10%) or trust (10%), while many conveyed negative emotions (60%) or mistrust (28%).
Conclusion: Reddit posts about contraception from AYAs and caregivers cover diverse topics, are often negative, and sometimes feature misconceptions that may influence decision-making. Clinicians should address online contraceptive information during counseling to better respond to patient concerns.
{"title":"Contraception-Related Posts from Adolescents, Young Adults, and Caregivers on Reddit: A Qualitative Content Analysis.","authors":"Cambray Smith, Christina Cobos, Renee Odom-Konja, Elizabeth Pleasants, Sneha A Makhijani, Eleanor Hummel, Eliza Dolgins, Layla Leo, Rolando Rodriguez, Betsy Sleath, Christopher M Shea, Melissa Gilkey, Bianca A Allison, Leah Frerichs","doi":"10.1016/j.jpag.2026.01.004","DOIUrl":"10.1016/j.jpag.2026.01.004","url":null,"abstract":"<p><strong>Study objective: </strong>To summarize contraceptive information shared and sought by adolescents and young adults (AYAs) and caregivers on Reddit.</p><p><strong>Methods: </strong>Posts were collected from 8 subreddits (June 2022 to September 2024) using contraception-related keywords. Eligible posts were in English and authored by self-identifying AYAs (<26 years) or caregivers; comments from 10% of posts were included. We used hybrid inductive-deductive qualitative content analysis to characterize each post's primary purpose and to summarize common methods, side effects, medical and access questions, confusion/misconceptions, and sentiments.</p><p><strong>Results: </strong>Of 607 posts, 297 met inclusion. Over half were authored by teens (<20 years, 59%), followed by young adults (32%) and caregivers (10%). The pill (47%) and intrauterine devices (25%) were most discussed. Common side effects included menstrual changes (36%) and mood/mental health (29%). Teens (n = 174) frequently discussed condoms (23%) and emergency contraception (12%). Teens and young adults (n = 268) shared sex/contraception education (13%) and opinions on contraceptive rights/behaviors (12%). They sought medical/behavioral advice (38%), contraceptive knowledge (15%), pregnancy scare advice (11%), and communication/access advice (9%). Caregivers (n = 29) sought method recommendations (38%), shared moral/ethical concerns (35%), and sought knowledge (17%) or communication advice (10%). Overall (N = 297), 15% contained misconceptions and 16% featured antihormonal sentiment. Few expressed positive emotions (10%) or trust (10%), while many conveyed negative emotions (60%) or mistrust (28%).</p><p><strong>Conclusion: </strong>Reddit posts about contraception from AYAs and caregivers cover diverse topics, are often negative, and sometimes feature misconceptions that may influence decision-making. Clinicians should address online contraceptive information during counseling to better respond to patient concerns.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146097297","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}
Pub Date : 2026-01-29DOI: 10.1016/j.jpag.2026.01.045
Stephanie Harlow, Elizabeth Anderson, Ilana Cass
Purpose: Historically, the Human Papilloma Virus (HPV) vaccine has been the subject of vaccine hesitancy. In 2020, the introduction of a COVID-19 vaccine incited a new wave of vaccine hesitancy. We investigated whether introducing the COVID vaccine correlated with changes in HPV vaccine initiation compared to Tdap in a large New England health system.
Methods: Initial doses only of HPV as well as first recorded doses of the Tdap vaccine administered to individuals ages 9 to 18 between March 2019 and May 2023 were analyzed. Linear trends and per-day rates of each vaccine were assessed in three periods: prior to the pandemic (3/19-2/20); during the pandemic (3/20-5/21); and post-COVID vaccine (5/21-5/23), with a secondary analysis performed to account for seasonality. Daily vaccination rates were stratified by sex and population density (urban versus rural).
Results: Records from 15,696 patients who received 10,502 HPV initiation vaccines and 10,282 Tdap vaccines were analyzed. No difference was noted in HPV initiation rates during the pandemic (7.05 vs. 7.30, p=0.203), though a significant decrease was noted post-vaccine compared to pre-pandemic (7.05 vs. 6.63, p=0.011).This post-vaccine decrease was driven primarily by the male (3.68 vs. 3.43, p=0.035) and urban (3.48 vs. 2.73, p<0.001) populations. Tdap rates were unchanged during the pandemic (6.60 vs. 6.34, p=0.148), but increased post-vaccine (6.60 vs. 7.11, =0.003).
Discussion: HPV initiation rates declined following the introduction of the COVID vaccine in a large health system in New England, driven mostly by a decline among males and the urban population.
目的：历史上，人乳头瘤病毒（HPV）疫苗一直是疫苗犹豫的主题。2020年，COVID-19疫苗的推出引发了新一轮对疫苗的犹豫。我们调查了在新英格兰大型卫生系统中，与Tdap相比，引入COVID疫苗是否与HPV疫苗启动变化相关。方法：分析2019年3月至2023年5月期间9至18岁个体仅接种HPV疫苗的初始剂量以及首次记录的Tdap疫苗剂量。在三个时期评估了每种疫苗的线性趋势和每日接种率：大流行之前（3月19日至2月20日）；大流行期间（3/20-5/21）；和covid后疫苗（5/21-5/23），并进行二次分析以考虑季节性。每日疫苗接种率按性别和人口密度（城市与农村）分层。结果：分析了15696例接种了10502支HPV起始疫苗和10282支Tdap疫苗的记录。在大流行期间，HPV起始率没有差异（7.05 vs. 7.30, p=0.203），尽管与大流行前相比，接种疫苗后显着降低（7.05 vs. 6.63, p=0.011）。这种疫苗接种后的下降主要是由男性（3.68 vs. 3.43, p=0.035）和城市（3.48 vs. 2.73, p）驱动的。讨论：在新英格兰的一个大型卫生系统引入COVID疫苗后，HPV起始率下降，主要是由于男性和城市人口的下降。
{"title":"Changes in HPV vaccine uptake following the COVID Vaccine.","authors":"Stephanie Harlow, Elizabeth Anderson, Ilana Cass","doi":"10.1016/j.jpag.2026.01.045","DOIUrl":"https://doi.org/10.1016/j.jpag.2026.01.045","url":null,"abstract":"<p><strong>Purpose: </strong>Historically, the Human Papilloma Virus (HPV) vaccine has been the subject of vaccine hesitancy. In 2020, the introduction of a COVID-19 vaccine incited a new wave of vaccine hesitancy. We investigated whether introducing the COVID vaccine correlated with changes in HPV vaccine initiation compared to Tdap in a large New England health system.</p><p><strong>Methods: </strong>Initial doses only of HPV as well as first recorded doses of the Tdap vaccine administered to individuals ages 9 to 18 between March 2019 and May 2023 were analyzed. Linear trends and per-day rates of each vaccine were assessed in three periods: prior to the pandemic (3/19-2/20); during the pandemic (3/20-5/21); and post-COVID vaccine (5/21-5/23), with a secondary analysis performed to account for seasonality. Daily vaccination rates were stratified by sex and population density (urban versus rural).</p><p><strong>Results: </strong>Records from 15,696 patients who received 10,502 HPV initiation vaccines and 10,282 Tdap vaccines were analyzed. No difference was noted in HPV initiation rates during the pandemic (7.05 vs. 7.30, p=0.203), though a significant decrease was noted post-vaccine compared to pre-pandemic (7.05 vs. 6.63, p=0.011).This post-vaccine decrease was driven primarily by the male (3.68 vs. 3.43, p=0.035) and urban (3.48 vs. 2.73, p<0.001) populations. Tdap rates were unchanged during the pandemic (6.60 vs. 6.34, p=0.148), but increased post-vaccine (6.60 vs. 7.11, =0.003).</p><p><strong>Discussion: </strong>HPV initiation rates declined following the introduction of the COVID vaccine in a large health system in New England, driven mostly by a decline among males and the urban population.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146097304","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}
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