Young Teen Genital
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Young Teen Genital
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Accurate descriptions of normal adolescent female genital anatomy are lacking in the literature. The purpose of this study was to examine a small sample of normal female adolescents to obtain measurements and descriptors of the external genital structures, with a focus on the size and morphology of the labia minora.
What is important to note is that, unlike wet dreams and acne, there is no specific age by which the genitals will start to grow. It can be difficult to know exactly when puberty will start and how it will develop. 4 For some, it may appear as an almost single event. In others, it may develop in fits and starts right through early high school.
Genital Examination of Young Girls 6 In a pubescent or post-pubertal girl, digital or instrumental examinations of the genitalia should only be performed with the consent of their parent/guardian or in the case of a mature minor, their consent. There should always be an agreement with the girl or young woman to examine her genitalia (assent). ...
However, in young children, genital stimulation is not associated with sexual activity. Genital stimulation can take the form of rubbing with hands or rubbing against other objects such as a pillow, stuffed animal or the bed. Exploring his or her genitals provides a feeling of pleasure, that once discovered, the child will most likely repeat.
Non-sexually acquired genital ulcers (NSGUs) in adolescent females are uncommon, painful skin lesions on the mucous membranes of the vulva and vaginal structures, unrelated to sexual activity. NSGUs are caused by an autoimmune response following a viral illness and are unrelated to sexual activity.
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To foster healthy sexual identity and help a child be proud of the body he or she is developing, give genitalia the proper names, beginning with naming body parts when changing your toddler's diaper. When your son grabs his penis say, "That's your penis" (instead of "thingy"). Tell your daughter, "That's your vulva" (instead of "bottom").
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Many parents are alarmed to find their young child engaged in genital stimulation. It can feel as though part of the child’s innocence is lost. However, in young children, genital stimulation is not associated with sexual activity. Genital stimulation can take the form of rubbing with hands or rubbing against other objects such as a pillow, stuffed animal or the bed. Exploring his or her genitals provides a feeling of pleasure, that once discovered, the child will most likely repeat.
Children should never be punished or shamed for playing with their genitals, as this can have major effects on their self-esteem and comfort with sexual activity as adults.
Babies often tug on their genitals, just as they tug on their toes or ears.
Boys often find their penises accidentally, possibly during a diaper change around six to seven months of age and become curious (just like their fascination with other parts of their bodies, such as fingers, toes and ears).
Girls often don’t discover their vulva (female external genitalia) until about ten to eleven months of age.
Potty training can be another time when there is curiosity about the genital area. Boys will play with their penises. Girls may even insert things into their vaginas.
Most children—both boys and girls—play with their external sex organs or “private parts” fairly regularly by the age of 5-6 years. By age 15, almost 100% of boys and 25% of girls have masturbated to the point of orgasm.
Again, it is important to remember that children do not generally associate this activity with sexuality or adult relationships until closer to puberty. Genital play is often used simply as a form of self-comfort.
Most often, genital stimulation is a normal part of childhood development. There are some cases, however, when it may be a signal for something more concerning. In these cases, you should discuss your concerns with your pediatrician:
If genital play becomes a time consuming activity for your child, look for possible underlying reasons. Is your child stressed and in extra need of comfort? Or are they stressed and need time to be calm? Is your child bored? Is the behavior being reinforced by adults over-reacting to activity? If any of these seem to be the case, the underlying reason should be addressed.
Toddlers and preschoolers do not really understand the social implications of genital stimulation, because, as noted earlier, they don’t associate it with private behaviors that occur between adults. To them, it may be no different than playing with their ears, twirling their hair or picking their nose. Don't make a big deal out of it. Children enjoy attention of any sort, whether it is negative or positive. If you make genital stimulation into a big deal, you could end up reinforcing the behavior and actually see more of it. Here are some positive ways for parents to keep their kids from playing with genitals in public:
Reviewed by Sara Laule, MD Updated November 2020
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We’re here to deliver safe, thoughtful, high-quality care for kids who need it. Learn about visitation policies and all the ways we’re keeping patients safe , including face covering requirements . Or, explore our COVID-19 resources for families .
We’re passionate about providing answers, treatment and care for the full range of female reproductive health concerns, from infancy through adolescence and into adulthood.
Experts in Children's Hospital Colorado's Department of Pediatric and Adolescent Gynecology are dedicated to advancing the field to improve the care and lives of all young females with gynecologic conditions. That's why we conduct research to advance care techniques that can be used for our patients and kids anywhere. Watch the gynecology medical education videos below for protocols and research from our experts to help improve the care of your patients.
Acute genital bleeding in girls is most caused by accidental trauma, such as straddling a bicycle or falling on playground equipment. These minor accidents result in injury because the genital tissues in children, without estrogen, are very thin and easily traumatized.
In this video, Veronica Alaniz, MD , provides guidelines for examining and understanding genital lacerations and hematomas resulting from vulvovaginal trauma, including blunt trauma or straddle injury and penetrating.
Non-sexually acquired genital ulcers (NSGUs) in adolescent females are uncommon, painful skin lesions on the mucous membranes of the vulva and vaginal structures, unrelated to sexual activity. NSGUs are caused by an autoimmune response following a viral illness and are unrelated to sexual activity. The lesions are often mistaken for bacterial cellulitis or lesions associated with other viral infections, such as herpes simplex virus.
In this video, Stephen Scott, MD , provides an overview of how to properly identify and manage NSGUs and the timeline for healing. While the ulcers generally resolve on their own and most patients never experience another outbreak, about 25% will have subsequent occurrences. These patients require immunology or rheumatology consultations to prevent more serious and chronic autoimmune conditions, such as Behcet’s syndrome.
Teens with complex medical issues, including developmental and physical disabilities, may have concerns about their periods. Similar to their peers, they can experience problem periods, such as heavy and painful bleeding. In addition, periods may exacerbate other medical issues or they may prefer to have no periods due to hygiene or other concerns. Health providers are the key source of accurate information on puberty and menstrual periods and can offer safe and effective treatment.
In this video, adolescent gynecologist Eliza Buyers, MD , reviews options for menstrual suppression , how they work, and various considerations for teens with complex medical issues. The importance of patient/family preference along with individualization based on medical history and treatment goals is reviewed. Options covered in the video include: the levonorgestrel IUD, norethindrone acetate, the subdermal implant, combined hormonal contraception and depot medroxyprogesterone acetate. After viewing, providers will be better able to counsel patients and their families on treatment methods as well as provide them with updated resources on this topic.
Polycystic ovary syndrome (PCOS) is one of the most common metabolic conditions affecting at least 10% of women of reproductive age. PCOS occurs due to a complex interaction of genetic and environmental factors can affect the menstrual cycle, hair growth, skin, weight and the ability to have children. Early identification and treatment can lead to improved quality of life for individuals with PCOS and prevention of diabetes and cardiovascular disease.
In this video, adolescent gynecologist Eliza Buyers, MD , reviews the pathophysiology and diagnosis of PCOS in adolescent patients. She discusses how diagnosis requires both ovulatory dysfunction and hyperandrogenism, and she shares recommendations for PCOS treatment – from lifestyle changes to possible medications.
In 2019, there were over 1.7 million new cases of cancer, with 10,270 cases occurring among children ages 0 to 14 years of age and 70,000 occurring in adolescents and young adults. With a five-year survival rate of 84%, there are 100,000 annual survivors of reproductive age. Of these survivors, 75% will experience at least one adverse effect, termed late effects of cancer therapy.
In this video, the Director of the Fertility Preservation and Reproductive Late Effects Program , Leslie Appiah, MD , discusses the prevalence of reproductive late effects and female risk stratification based on age and therapy doses. Dr. Appiah also reviews the expert consensus position statements that provide guidance on how providers should care for this population, including informing patients about options for fertility preservation and future reproduction prior to treatment. She reviews the services that the Program provides, such as inpatient and outpatient consults, fertility preservation services and reproductive healthcare, and how to request consultation.
Menstrual bleeding in adolescents can be chaotic. When is it best to reassure, and when is it necessary to evaluate? Although anovulatory cycles are common in the years after menarche, there are established norms and, alternatively, abnormal findings that require further investigation. Uterine bleeding that is coming more often than every three weeks, lasting longer than seven days in a row, or resulting in excessive product use and frequent bleeding through clothes should be evaluated.
In this video, adolescent gynecologist Eliza Buyers, MD , discusses the management of abnormal uterine bleeding (AUB) in adolescent patients. She provides an overview of the physiology and evaluation of AUB, including recommendations on when to consider referring patients to our Spots and Dots Clinic . Dr. Buyers also reviews treatment options, including menstrual suppression , with a focus on key counseling points to help patients and families decide which method is best for them.
Cystic ovarian masses commonly occur in infants, children and adolescents. They may be discovered due to symptoms, during a routine physical exam or incidentally through imaging studies. Historically, these masses were surgically removed, often involving removal of the entire ovary. Over the last decade, however, the management of ovarian masses has shifted toward a more conservative approach with the goal of ovarian preservation.
In this video, Chief of Pediatric and Adolescent Gynecology, Tricia Huguelet, MD , discusses the epidemiology, clinical features and management of ovarian cysts that may occur during the fetal and neonatal periods, and on through adolescence. She also discusses the preferred diagnostic modality and when to consider surgery. In addition, she reviews the potential for ovarian torsion , including signs and symptoms, evaluation and management.
Menstrual pain and cramps are very common in women and affect 50% to 90% of female teens. However, it is when the pain gets progressively worse and occurs outside the menstrual cycle, that it might be time to consider a pathological cause, such as endometriosis . Watch the video to learn the differences between primary and second dysmenorrhea and how to diagnose and treat endometriosis.
Tricia Huguelet, MD , Chief of Pediatric and Adolescent Gynecology , describes the typical presentation of hymen imperforations in adolescents and young adults, as well as obstructing and non-obstructing müllerian anomalies. Dr. Huguelet also reviews the basic embryology and treatment approach for these cond
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