Young women should have their first pediatric gynecologic visit between the ages of 13 and 15, but some conditions may prompt the need for an earlier referral.

A pediatric gynecology referral may be warranted for patients with symptoms such as unusual vaginal bleeding or discharge; painful or irregular periods; congenital anomalies or ovarian masses; or other conditions.

Whether routine or not, the first visit is an opportunity to establish a relationship between the gynecologic provider and the young woman. Young women may visit with the provider alone or with a parent — the idea is to create a place where it’s OK to ask questions that patients may not feel comfortable asking elsewhere.

“I consider it a privilege to introduce adolescent females — to discuss the importance of annual visits or their specific concerns —  to women’s health,” said Lucy Koroma, APRN, nurse practitioner with Norton Children’s Gynecology, affiliated with the UofL School of Medicine.

While adult gynecologists treat many conditions that also are seen in younger patients, pediatric and adolescent gynecologists have advanced training not only in the unique anatomy of a young woman, but how to put her at ease during what may be a scary day.

Painful or irregular periods are conditions frequently treated by pediatric gynecologists.

“Pain colors your whole entire world and how you’re able to engage throughout your daily functions,” Lucy said. “When a person has less pain and they feel better, they can see a difference in their confidence level. I find that very rewarding.”

Less common conditions treated by pediatric and adolescent gynecologists include

• Ambiguous genitalia
• Colorectal and pelvic disorders
• Fertility and reproductive health
• Ovarian masses, cysts and tumors
• Pediatric vulvovaginitis
• Pelvic pain
• Polycystic ovary syndrome
• Pubertal aberration
• Vaginal agenesis (surgical/nonsurgical creation of neovagina)