Adolescent and pediatric gynecology最新文献

Osteopenia is common in gonadal dysgenesis when no sex steroid replacement therapy is carried out. Four patients with gonadal dysgenesis, one with ovarian hypoplasia, and one with androgen insensitivity syndrome, all having osteopenia, were treated by high-dose estrogen-progestogen injections (so-called “pseudopregnancy”) for 6 months. Each patient showed considerable increase in lumbar spine bone mineral density and impressive secondary sexual development during therapy.

Study Objective: Although tampons first became commercially available in 1936, there have been few studies concerning tampon usage in general and less so in the adolescent population. As this product became more popular with women, the issue of safety did not seem pertinent until tampons became associated with the toxic shock syndrome in the late 1970s. In addition, toxic shock syndrome was a disease that affected adolescents disproportionately. Although the incidence of menstrual toxic shock syndrome has decreased, the use of tampons are still associated with an increased risk of this particular entity. The purpose of this study was to determine the incidence of tampon usage in an adolescent population in a private practice setting, as well as who influenced initiation of usage.

Design: One hundred adolescent females between 11 and 18 years of age anonymously filled out a questionnaire regarding the usage of tampons and pads.

Participants: Subjects presented to Scripps Clinic and Research Foundation for either health maintenance examination or minor illness.

Main Outcome Measures: The percentage of subjects who used tampons was measured. In addition, the individual or individuals who influenced initial usage were listed.

Results: Twenty-six percent of these young women used tampons exclusively during their menses. Pads were exclusively used by another 30%. A combination of pads and tampons were used by the remaining 44%. Tampons were first recommended or suggested by mothers in 49% of these females. A girlfriend first suggested their usage in another 36%, and a female sibling in 11%. In an additional 11%, the girl herself decided to start using tampons without consultation from anyone specifically.

Conclusions: We observed that 70% of the adolescent females surveyed used either tampons alone or in combination with pads.

The most influential individual to promote tampon usage in teenagers is the adolescent's mother.

Although most family practitioners, obstetricians, gynecologists and pediatricians state that they discuss feminine hygiene products with their patients at least on some occasion, no one in this particular study initially started using tampons on a physician's recommendation.

As more younger women use tampons, it is even more likely that there will be a higher percentage of adolescent females in the next generation using them. As physicians dealing with adolescents, we should become knowledgeable about tampons, both their beneficial aspects as well as any health risks. It is likely that a significant number of our adolescent patients are using these products without any physician input.

Previous research has demonstrated that the sisters of adolescent mothers have an increased risk of becoming teenage parents. From our experience in caring for over 600 teenage mothers in a comprehensive family-oriented teen-tot clinic, we have developed a conceptual model, based on social cognitive theory, which describes the influence of teenage mothers on their sisters' decisions about pregnancy and childbearing. Our model focuses on the direct effects of both intrafamilial and social-cultural factors on adolescents' childbearing attitudes and their individual sexual values. Intrafamilial factors include the impact of sibling teenage parents and influences of parenting styles. Social-cultural factors include social norms that favor early sexual behavior and childbearing. These interact with peer influence to directly affect social and self-regulative skills, feeling of self-efficacy, and the individual's sexual values. Personal factors, such as hopelessness and depression, are influenced by multigenerational poverty. These personal factors are integrated with intrafamilial and social-cultural factors to produce the adolescent's personal meaning and cognitive assessment of pregnancy and childbearing. Clinicians can use this model when developing interventions that focus on the various factors that influence an adolescent sister's decisions about becoming pregnant.