Managing Gynecological Problems in Indian Adolescent Girls-A Challenge of 21st Century

Abstract

Objectives: India's mean age according to the census 2011 is 24 years. Half of India's population is below 25 years and around 32% are in the 10 to 24 age group. Now a days a significant number of adolescent girls have started visiting health professionals. In view of this, we undertook a study to assess the clinical profile of adolescent girls in the age group of 10 to 19 years attending our Gynecology clinic at P. D. Hinduja Hospital. The objective was to evaluate various presentations and different modalities of management required in this age group. Method(s): Adolescence can be divided into early and late adolescence. Early adolescence stretches between the ages of 10 to 14 years. Late adolescence includes the age group of 15 to 19 years. We analyzed 100 consecutive adolescent girls, who visited our Gynecology clinic from March 2014 to February 2015. They were evaluated prospectively at every visit. Specific proforma was filled for each of the patient including personal details and complaints, menstrual history, family history etc. Examination findings, investigations, details of treatment were also recorded. The statistics thus obtained was analyzed and results were as follows. Result(s): Out of 100 girls, 27 were in the age group of 10-14 yrs while 73 girls were between 15-19 yrs. Oligomenorrhoea was the most common complaint as 50 girls presented with it. The second common complaint was of Menorrhagia as 28 girls had this complaint. Few complained of leucorrhoea, vulvar pruritus, mastalgia, breast lump, pregnancy, primary amenorrhea. 26 were anaemic, 2 had hypothyroidism, 10 had hyperprolactinemia, 9 had elevated fasting insulin & blood sugar levels, whereas 9 had hyperandrogenism. 32 girls had features of PCOS on sonography. Majority i.e 66 required hormonal treatment. 4 cases required major surgical intervention. Conclusion(s): The most common complaint was that of oligomenorrhoea followed by menorrhagia. Other complaints included leucorrhoea, mastalgia, pruritus vulvae, breast lump, pregnancy etc. Over last few years, "Adolescent Gynecology" has emerged as a subspecialty in developing countries. Health Professionals dealing with adolescent age group should have empathy, friendliness and nonjudgmental attitude towards their clients. Confidentiality of young people should be maintained. We need to give special attention to adolescent population as they will be the citizens and parents of tomorrow !.