tailieunhanh - Adolescent Gynecology

Co–hosted by Realizing Rights: The Ethical Globalization Initiative, the Council of Women World Leaders, and the Columbia University Mailman School of Public Health, the meeting addressed the most fundamental chal- lenges facing women’s health. Participants shared their experiences of what policies have proven successful in providing access to health care, and com- mitted themselves to develop and promote leadership in implementing health care policies that effectively provide fundamental services to women. They discussed creative efforts to promote, manage, support and monitor local health care systems in poor countries, with a particular focus on provision of care to reduce maternal mortality and HIV/AIDS, and on reproductive health services and rights | 33 Clinical Expert Series Continuing medical education is available online at Adolescent Gynecology Joseph S. Sanfilippo MD MBA and Eduardo Lara-Torre MD Given new developments in the field of adolescent reproductive health this review focuses on highlighting new guidelines and practice patterns in evaluation and management of adolescent gynecologic problems. First understanding the proper techniques for the initial examination is key to establishing a long-term relationship with this age group. Reservations about the first gynecologic examination are common and the practitioner s goal is foremost to make the patient as comfortable as possible. Preventive health in this patient population is key and practitioners should become comfortable with providing education about topics as diverse as sexuality eating disorders and dating violence. Furthermore the frequency with which teenagers report sexual activity and the high unintended pregnancy rate in this age group makes counseling regarding effective contraception essential. Additionally practitioners are encouraged to take the opportunity to discuss the availability of the human papillomavirus HPV vaccine with adolescents. In 2007 adolescents were designated as a special population given the frequency with which they acquire and clear mild HPV-related cervical dysplasia. More conservative treatment in this population is generally favored. During their transition through puberty disorders of menstruation become the most common complaint requiring the attention of the gynecologist. Most commonly anovulation serves as the cause behind such abnormal bleeding. Polycystic ovarian syndrome can develop in early puberty and carry its consequences into adulthood. Infertility diabetes and hirsutism mark the most important components of the syndrome and require age-appropriate management. Finally the consequences of endometriosis on the future fertility of adolescents have brought early intervention to .

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