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Pediatricians Can Often Manage Gynecologic Issues

Most patients do not require pelvic exam; those who do may be more comfortable with pediatrician

TUESDAY, Aug. 31 (HealthDay News) -- Among pediatric patients, most medical gynecologic issues can be managed in the primary care office setting, usually without a pelvic examination; although, when a pelvic exam is required, the primary care office may be the best setting, according to a clinical report published online Aug. 30 in Pediatrics.

Paula K. Braverman, M.D., of the Cincinnati Children's Hospital Medical Center, and colleagues write that gynecologic issues among adolescents are commonly addressed by primary care providers, with common concerns involving pubertal development, menstrual disorders, contraception, and sexually and non-sexually transmitted infections. Most adolescents do not require a pelvic examination involving a speculum or bimanual examination, the authors write, but the primary care office with a trusted physician may be the best environment for pelvic examination when more extensive examination is required.

Adolescents who may require more extensive examination include those who are pregnant, present with suspected or reported rape or sexual abuse, or experience menstrual disorders. The authors also write that pediatricians must be able to identify abnormalities that warrant referral of a patient to a gynecologist.

"With appropriate backup from a gynecologist, most medical gynecologic issues can be managed by the clinician in the primary care office setting," the authors conclude.

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