HPV; about 100 types of DNA virus; infecting epithelial cells only; gynecologically important types HPV-6, -11, -16 and -18. Incubation period: 1 - 20 months, 2 - 3 months on average.

Epidemiology. Infections by…

Prevention as the most effective strategy to avoid spreading STDs among adolescents can be divided into three components.

Basic prevention is focused on sexual education as the key to ensure that adolescents get…

HSV-1 and -2; DNA viruses; persistently infecting regional ganglion. Incubation period: initial infection 2 - 7 days.

Epidemiology. Infection with HSV is one of the most common viral infections. Based on reports on antibody…

N. gonorrhoeae; fastidious gram-negative diplococcus; infecting mucous membranes. Incubation period: 2 - 7 days.

Epidemiology. Gonorrhea is the second most frequently occurring STD and its incidence, although not comparable with that of chlamydiae, is also…

Because the goal of this section is to deal with the closely defined STDs, as opposed to HIV and hepatitis B, stress is put on the former only. Although new cases of…

At the beginning of puberty, LH pulsatility is only present during sleep. It then extends to the daytime, with amplification of pulse amplitude and acceleration of frequency. This is accompanied by an…

Mild symptoms of hyperandrogenism, such as acne or hyperseborrhea, are frequent in adolescent girls, and are often associated with irregular menstrual cycles. In most instances, these symptoms are transient and only reflect the…

The Polycystic Ovary Syndrome
Pediatric and adult endocrinologists may encounter PCOS as a mildly virilizing state since it is the most frequent cause of hyperandrogenism in female teenagers and in…

Clinical Assessment
When an adolescent girl is referred for hyperandrogenism, the first visit must include a thorough record of history and a careful physical examination.

Although infrequent, some clinical symptoms…

Primary or functional dysmenorrhea in the adolescent is a painful paroxysmal syndrome that precedes and may accompany menses, but it is without pelvic pathology. Secondary or acquired dysmenorrhea, on the other hand, is caused by…

We conducted an epidemiological study of the prevalence of dysmenorrhea in the middle and high schools in Montpellier, France. As part of a systematic medical examination, participating school physicians established a medical record for…

Evidence supports the concept that dysmenorrhea arises through the excess in prostaglandin synthesis from the endometrium itself: elevated levels of PGF_2α have been found in the menstrual fluid, as well as in the blood,…

NSAIDs are the most common pharmacologic treatment for dysmenorrhea: NSAIDs, which are able to inhibit prostaglandin synthetase, have significantly alleviated symptoms of dysmenorrhea in 75% of adolescents.

Propionates such as ibuprofen (400 mg/4…

Adolescent dysmenorrhea has long been considered a minor problem of menarche. Its relative frequency, the various degrees of severity, the minimizing attitudes of other family members, multigenerational patterns of selfmedication -  all these are…

Definition: Bleeding intervals longer than 35 days. Oligomenorrhea may be transient during the transition to a normal cycle. Evaluation of the physical status, sexual development, and the bleeding pattern is sufficient in this setting.

But oligomenorrhea…

Menstrual irregularities are common in puberty and adolescence during the development of ovarian function and until a regular ovulatory cycle. Most irregularities are transient and self-limited but some are severe and prolonged and…

Definition: Bleeding intervals shorter than 21 days. This anomaly is quite frequent in puberty and adolescence and is caused by hormonal imbalance within an unstable cycle. There may be an estrogen deficit in an anovulatory cycle…

Metrorrhagia, characterized by bleeding episodes without a recognizable cycle, is a frequent form of irregular bleeding in adolescence. Bleeding occurs at different intervals with different durations and differs in amount from spotting to severe. The reason…

Definition: Severe until excessive bleeding within a quite regular cycle, blood loss >80 ml. Severe bleeding is clinically important, particularly if it is combined with menorrhagia. Blood loss and resulting symptoms can be considerable. The reason…

A diagnostic work-up should be initiated if there are symptoms of pathology, i.e., if the menstrual disturbance is beyond the normal spectrum of physiological variability. Most mild and moderate disturbances during adolescence are…

Menorrhagia
Menorrhagia is defined as prolonged bleeding (longer than 7 days) within a more or less normal interval. The flow may be severe. It is caused…

During the transition from menarche to a normal ovulatory cycle, a number of influences and noxae may cause abnormalities. The hypothalamicpituitary- ovarian axis is complex, unstable and vulnerable. This lability, particularly in puberty…

Abnormalities of the type of bleeding may be a serious problem for adolescent girls. Menorrhagia or metrorrhagia are disturbing in daily life and may contribute to psychological insecurity. Hypermenorrhea and menorrhagia are…

Sexual development in puberty begins with activation of the gonadotropinreleasing hormone (GnRH) pulse generator and the hypothalamic-pituitary system. GnRH secretion in the hypothalamic centers promotes the secretion of gonadotropins (FSH and LH)…