Young Women's Health

Young Women’s Health

Pediatric female health care topics often revolve around puberty, hormone changes, mood changes, menstrual cycles, growth, reproductive health, contraception, and transition to adult OB/GYN care. 

Common questions discussed in female adolescent primary care:

1. How to know if puberty has started?
2. How old will my daughter be when she has her first period?
3. Will my daughter grow taller after she starts her period?

These topics are reflected by the American College of Obstetrics and Gynecologists, which has an abundance of resources for teens and parents regarding women’s health. 

Breast development is one of the first signs of puberty, something we often refer to in primary care as “breast buds”. The average age in America is around 10, although some females develop these earlier and some later. After breast buds, there are many changes that follow including hair growth, darkening, and thickening, growth spurts, and finally menarche, which is commonly referred to as a female’s period. 

Speaking of periods, the average age of a female’s first period in the U.S. is about 12 and a half. Also of note, an estimated time between onset of puberty (breast budding) and first menstrual cycle is about 2 years, on average. However, this can vary from female to female and depends on a variety of factors both genetic and environmental. 

Finally, a common topic in primary care that both parents and patients ask about is growth! Specifically revolving around puberty. Generally speaking, a young female’s most significant “growth spurt” happens just before the onset of her period. Females may grow after starting her period, but large growth spurts are not as common after menarche.  

Other common topics pediatricians often come across in young women’s care include typical adolescent menstrual cycles and establishing OB/GYN care. 

“Menstrual cycles are often irregular during adolescence, particularly the interval from the first cycle to the second cycle. Most females bleed for 2–7 days during their first menses. Around 90% of cycles will be within the range of 21–45 days, although short cycles of less than 20 days and long cycles of more than 45 days may occur. By the third year after menarche, 60–80% of menstrual cycles are 21–34 days long, as is typical of adults.”

 

A wonderful infographic is linked below for more information:

https://www.acog.org/womens-health/infographics/the-menstrual-cycle

(Menstruation in girls and Adolescents, 2021)

 

Gynecological Care: 

A timeline for establishing gynecological care can differ for every young woman. ACOG has recommendations for a young female’s first visit to be between the ages of 13-15. However, most specialists will defer pelvic exams (unless necessary) until first Pap smear around age 21. Gynecologists will use these visits to discuss puberty, menstruation, and breast health. Many women defer visiting a specialist until later in adolescence or entering adulthood, but it’s important to talk with your pediatrician about women’s health concerns if you have not established gynecological care. (When Should My Daughter First Go to the Gynecologist? (for Parents), 2021)

 

ACOG has a great list of reasons a young women may want to visit a gynecologist before age 21:

https://www.acog.org/womens-health/infographics/21-reasons-to-see-a-gynecologist-before-you-turn-21

 

References:

Menstruation in girls and Adolescents: Using the menstrual cycle as a vital sign. (2021). ACOG. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2015/12/menstruation-in-girls-and-adolescents-using-the-menstrual-cycle-as-a-vital-sign

The top 3 questions parents ask about their daughters and puberty. (2020). ACOG. https://www.acog.org/womens-health/experts-and-stories/the-latest/the-top-3-questions-parents-ask-about-their-daughters-and-puberty

When should my daughter first go to the gynecologist? (for parents). (2021). https://kidshealth.org/en/parents/first-gyn-exam.html#:~:text=What%20is%20the%20right%20age%20to%20take%20this%20step%3F&text=The%20American%20College%20of%20Obstetricians,during%20this%20first%20visit%2C%20though.

21 Reasons to see a gynecologist before you turn 21. (n.d.). ACOG. https://www.acog.org/womens-health/infographics/21-reasons-to-see-a-gynecologist-before-you-turn-21

Emily Mastromatteo (Corridon), FNP-BC, is a board-certified Family Nurse Practitioner at Advanced Pediatrics. Emily is a Northern Virginia native. She earned her Bachelor of Science in Nursing (BSN) from James Madison University in Harrisonburg, Virginia. After graduating, she attended George Washington University in Washington, D.C., earning her Master of Science in Nursing (MSN). Emily worked as a nurse at MedStar Georgetown Hospital and then at INOVA Children’s Hospital in the Pediatric ICU. She is excited about transitioning from acute care to primary care and is passionate about acute illness management, pediatric surgery, and child and adolescent development. Emily lives in Fairfax, Virginia, with her husband and new puppy. Outside work, she loves cooking, golfing, spending time with family and friends, and boating off the Chesapeake Bay.