Suicide is a leading cause of death for adolescents. Medical professionals are increasingly being asked to screen for depressive symptoms and suicidal ideation with little training. The purpose of this paper is to review factors related to suicidal thoughts and actions, assessment of symptoms, and initial suggestions for treatment for medical providers ..read more

Telemedicine for long-acting reversible contraception (LARC) care is understudied given the rapid implementation of these services in response to the COVID-19 pandemic. We compared outcomes over 1 year of adolescents and young adults (AYAs) attending a LARC post-insertion visit via telemedicine versus in person ..read more

Endometriosis is associated with pelvic pain, which increases the risk of depression. While endometriosis-related symptoms often develop in adolescence, little is known about psychiatric comorbidities in this age group. This study compared the prevalence of depression in adolescents and adults with endometriosis, and examined factors that may be associated with depression in affected women, including pain interference, history of mood disorders, and duration of disease relative to age ..read more

The levonorgestrel intrauterine device (LNG-IUD) is a treatment for abnormal uterine bleeding or menstrual suppression. It can be used in postmenarchal (PM) patients with developmental delay (DD), complex medical syndromes, short stature, or low body weight. This study examines uterine length (UL) and outcomes in perimenarchal patients with IUD placement under anesthesia ..read more

Pubertal induction (PI) is indicated for those with pubertal delay, gonadal removal or concern for primary ovarian insufficiency and allows for development of secondary sexual characteristics, height optimization, protection of bone and long-term cardiac health [1, 2]. Typically, female-reared patients are initiated on either transdermal or oral estrogen with limited options for those with contraindications to estrogen. We present a case of hypergonadotropic hypogonadism with puberty successfully induced with oral norethindrone acetate (NETA ..read more

Youth experiencing homelessness (YEH) have high rates of both mental and physical health concerns, including a higher rate of sexual assault, pregnancy and STIs as compared to youth in the general population. YEH face multiple barriers in accessing care, resulting in reliance on Emergency Departments (ED). The use of the pediatric ED by YEH in Canada, including for sexual and reproductive (SRH) concerns, is not well described; additionally, there is no Canadian data exploring the effects of the COVID-19 pandemic/lockdown on ED presentations by this population ..read more

Hydrocolpos is cystic distention of the vagina caused by accumulation of fluid due to a congenital obstruction such as imperforate hymen, transverse vaginal septum, or distal vaginal atresia. Urinary obstruction associated with this anomaly typically presents at birth. This case describes acute urinary retention with presumed hydrocolpos, though the cystic mass was ultimately found to be a sacrococcygeal teratoma ..read more

Adolescents with significant dysmenorrhea may have endometriosis. When medical management is unsuccessful or unsatisfactory, some choose laparoscopy alone or with other procedures to potentially diagnose and/or treat endometriosis. ACOG calls for a shared medical decision making regarding diagnostic laparoscopy. However, risks associated with laparoscopy specific to this patient population are not well described. This multi-institutional study sought to characterize intraoperative management and complications for adolescents with pathology confirmed endometriosis ..read more

In 2021, the Centers for Disease Control (CDC) revised the treatment recommendation for chlamydia trachomatis from single dose azithromycin to a 7-day course of doxycycline. Given the high risk of chlamydia infection in adolescents and young adults (AYA), this study evaluated reinfection rates before and after the change in CDC treatment guidelines ..read more

Patients with primary ovarian insufficiency (POI) prior to spontaneous onset of puberty require appropriately timed exogenous estrogen replacement therapy (ERT) to initiate appropriate pubertal development. The optimal ERT regimen for puberty induction has not been established. This study aimed to assess patterns of puberty induction by analyzing final adult height, time to maintenance estrogen dose, and time to menarche. The secondary aims were to compare outcomes based on age of initiation, as well as underlying POI diagnosis ..read more