Delaware County Medical Society Winter 2017 - 12

FEATURE

Understanding
the Pediatric
and Adolescent
Gynecology
Specialty
By Rachael Leigh Polis, D.O., MPH,
Crozer-Keystone Health System

Pediatric and adolescent gynecology (also
known as PAG) is a unique subspecialty of
obstetrics and gynecology. The PAG physician's
specialized training helps to bridge the gap
between pediatrics and adult gynecology.

C

hildren and adolescents have specialized
needs compared to their adult counterparts.
A PAG physician has the sensitivity
and knowledge to provide comprehensive
gynecologic care from birth to young adulthood.
Patients are seen with varying needs, including
special needs and developmental delays.

What are some conditions seen in a pediatric
and adolescent gynecology (PAG) practice?

To become a pediatric and adolescent gynecologist, physicians
must complete a residency program in obstetrics and
gynecology followed by a PAG fellowship-training program.
Currently, 11 fellowship programs are offered in the United
States and two in Canada. I attended the two-year Louisville
Pediatric and Adolescent Gynecology Fellowship Program,
which is the longest-running fellowship in the country and
is affiliated with the University of Louisville School of
Medicine and Norton Children's Hospital in Louisville, Ky.

Adolescent patients will often present with menstrual
concerns such as heavy, frequent, irregular or painful
periods. They may have delayed puberty, ovarian cysts,
endometriosis, breast abnormalities including pain or
asymmetry, polycystic ovarian syndrome (PCOS), or
vulvar ulcers or lesions. Patients may present for menstrual
suppression to eliminate or minimize menstrual cycles.

10 DELAWARE COUNTY MEDICINE & HEALTH

Pediatric patients may present to the office with congenital
malformations of the reproductive tract, skin conditions of
the vulva, vulvovaginitis, labial adhesions, retained foreign
body (most commonly toilet paper) or signs of early puberty.

winter 2017



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