Specialized Gynecologic Care for Children and Adolescents

From taking their first steps to attending their first day of middle school, it can seem as though your child reaches a new milestone every day. As your child enters adolescence, anticipating their changing health needs can help you and your child focus on the significant “firsts” that matter most to them.

The American College of Obstetricians and Gynecologists recommends teenagers have their first routine ob-gyn appointment between the ages of 13 and 15. However, younger children with specific obstetric or gynecologic concerns may need to visit an ob-gyn sooner. Pediatric and Adolescent Gynecology services are available to treat and manage gynecologic conditions affecting children and adolescents aged 21 and younger through a clinical partnership between Dell Children’s Medical Center and UT Health Austin.

Nationally Recognized Experts Attuned to Your Child’s Unique Needs

“The pediatric and adolescent population requires specialized clinical and surgical care from providers with training centered on this age group,” shares UT Health Austin pediatric and adolescent gynecologist Noor Zwayne, MD.

Pediatric and adolescent gynecologists are board-certified obstetrician-gynecologists who have completed subspecialty training in pediatric and adolescent gynecology and minimally invasive surgery in children. They follow treatment guidelines provided by the American College of Obstetricians and Gynecologists and the North American Society for Pediatric and Adolescent Gynecology.

“Specialists in our field are trained to manage sensitive obstetric and gynecologic issues in children ranging from birth to young adulthood,” explains Dr. Zwayne. “After our ob-gyn residency training, we refine our skills through a pediatric and adolescent gynecology fellowship training program. There, we are exposed to unique surgical cases that may not have been covered during our residency training, affording us additional knowledge and experience in treating young patients.”

Common concerns addressed by a pediatric and adolescent gynecologist may include:

• Contraception
• Congenital anomalies
• Delayed or early puberty
• Menstrual abnormalities
• Menstrual suppression
• Pelvic pain
• Sexually transmitted infections
• Sexual abuse
• Vulvovaginal conditions, including skin conditions

View a more extensive list of conditions treated at Pediatric and Adolescent Gynecology.

<br>Many conditions treated by pediatric and adolescent gynecologists become apparent as a child enters puberty and experiences difficulties with their menstrual cycle. “Much of our job involves educating young patients about their changing bodies,” shares Dr. Zwayne. “We teach our patients to recognize what’s normal and what’s not normal.”

Initially, your child’s menstrual cycle may be irregular, meaning their period occurs outside the range of every 28 to 35 days that is typical for adults. “While it is common for your child’s period to be irregular during the first few years after their first period, certain indicators of an abnormal period would warrant an appointment with a pediatric and adolescent gynecologist to investigate underlying causes.”

Signs of an abnormal menstrual cycle in adolescents may include:

• Heavy menstrual bleeding, such as the need to change a pad every hour
• Menstrual cycle shorter than 21 days or longer than 45 days
• Menstrual pain not relieved by over-the-counter medication
• Period lasting longer than 7 days

Earlier warning signs of a potential gynecologic condition include abnormal pain and itching. “Vaginal itching and discomfort tend to be overlooked in young children, but they could indicate a condition with long-term implications for your child’s health,” warns Dr. Zwayne. “Seeking immediate treatment from a pediatric and adolescent gynecologist can help prevent these outcomes.”

Specialized Care for Surgical Conditions

In addition to providing routine gynecologic care and addressing abnormalities associated with puberty, the Pediatric and Adolescent Gynecology care team treats a range of gynecologic disorders, including congenital anomalies, which are gynecologic conditions present at birth, though sometimes not detected until puberty.

“These days, we can diagnose many patients with congenital anomalies before puberty because of advances in imaging technology,” notes Dr. Zwayne. “Many of these congenital conditions can cause tremendous amount of pain, delay the onset of puberty, and may require certain surgical procedures that a pediatric and adolescent gynecologist is trained to manage.”

“In other cases, surgery may not be needed to correct a congenital anomaly but to address a gynecologic condition related to hormonal activity, physical trauma, or some other cause,” adds Dr. Zwayne.

Dr. Zwayne treats many of her surgical patients aged 10 and older at UT Health Austin’s Ambulatory Surgery Center (ASC), a state-of-the-art facility equipped with the latest technology and IT integration for outpatient and select short-stay procedures. “My experience with the ASC has been fantastic,” shares Dr. Zwayne. “The staff has done a wonderful job of arranging surgeries for my patients in a timely fashion, taking care of my patients during the procedure, and working with us surgeons to deliver the highest standard of treatment.”

If you’re a physician interested in performing surgery at the Ambulatory Surgery Center, please call 1-855-352-2900 for more information.

<br>A Seamless Transition to Adult Ob-Gyn Services

The many rites of passage your teen will encounter as they enter adulthood may seem daunting, but switching to an adult ob-gyn doesn’t have to be. The Pediatric and Adolescent Gynecology care team provides a multifaceted continuum of care, coordinating patient care with referring physicians and other care team members to ensure patients receive the highest level of specialized care and experience a seamless transition from pediatric to adult care.

“While I stay involved in caring for patients with certain congenital anomalies, most patients transfer to a general ob-gyn provider as they enter adulthood,” notes Dr. Zwayne.

For adults and teens aged 13 and older, Obstetrics and Gynecology services are available through Women’s Health, a clinical partnership between Ascension Seton and UT Health Austin. If a higher level of care is needed to treat your condition, Women’s Health offers access to Maternal-Fetal Medicine (high-risk obstetrical care), Comprehensive Fetal Care, Gynecologic Oncology, Minimally Invasive Gynecologic Surgery, Pelvic Floor Physical Therapy, and Urogynecology services.

Clinical Expansion on the Horizon

The Pediatric and Adolescent Gynecology care team employs a multidisciplinary treatment model in which pediatric and adolescent gynecologists work alongside a team of pediatric experts, including pediatric psychiatrists, advanced practice providers, dietitians, social workers, child life specialists, and more. The Pediatric and Adolescent Gynecology care team plans to extend their team to include additional experts on complex conditions such as bleeding disorders that may affect menstruation.

Beginning next year, the clinic will offer a fellowship program to train the next generation of pediatric and adolescent gynecologists. “Just as your child can expect a lot of growth and change during their adolescent years, our clinic is looking forward to new and exciting programs in the near future,” says Dr. Zwayne.

For more information or to schedule an appointment with Pediatric and Adolescent Gynecology, visit here.