We can help with the wide range of menstrual irregularities that can occur in young women, including:

• Bleeding or spotting between periods
• Frequent periods less than 21 days apart
• Heavy periods with excessive bleeding
• Irregular periods with extreme cycle-to-cycle variation
• No periods or infrequent periods more than 35 days apart
• Painful periods causing severe menstrual cramps
• Prolonged periods lasting more than 8 days

Severe medical conditions, such as cerebral palsy, can make managing menstruation challenging. In these situations, we can offer young women treatment to manage or stop their periods.

PCOS is a common, yet complex, condition that is caused by a hormone imbalance. Diagnosis requires two of the following criteria:

• Irregular release of eggs from the ovaries (ovulation)
• Too much androgen, a male hormone that females typically make in small amounts

PCOS symptoms vary widely, but may include:

• Irregular, missed or no periods
• Excess hair growth, especially on the face, chest and back
• Thinning hair on the head
• Severe acne or oily skin
• Trouble getting pregnant (infertility)
• Weight gain

Managing PCOS often takes a team of providers. Our team includes adolescent medicine specialists, endocrinologists (doctors who treat hormone-related conditions) and registered dietitians. We work together to ease symptoms and prevent future health problems that can occur with PCOS.

Puberty in girls typically occurs between ages 8 and 13. The most common signs of delayed puberty are:

• Lack of breast development by age 13
• Lack of menstruation by age 16 or within four years of breast development

Our approach focuses on determining the extent of the delay, the underlying cause and a plan for care. Often, delayed puberty runs in families, and patients may catch up without treatment.

We offer confidential pregnancy testing and all types of birth control, including:

• Birth control patch
• Birth control pill
• Birth control shot (Depo-Provera)
• Intrauterine device (IUD)
• Hormonal implant (Nexplanon)
• Vaginal ring

Our providers help patients understand the pros and cons of each birth control option so they can choose the type that best suits their needs.

STIs spread from person to person through vaginal, oral and anal sex. Many people with STIs have no symptoms. When symptoms do occur, they can range from mild to severe and include:

• Abnormal vaginal discharge that may have a fishy odor
• Burning when urinating
• Itching, pain or burning in or around the vagina
• Pain or bleeding during or after sex
• Sores, blisters or growths around the genitals, rectum, lips or mouth

If not treated, STIs can cause infertility, long-term pelvic pain and other complications. For those experiencing STI symptoms, we provide testing and treatment.

We also offer STI testing if someone has no symptoms. Experts recommend annual STI testing for sexually active young women under age 25. Doctors may recommend other tests for those with an increased risk of STIs due to:

• Recent sexual contact with someone with a known STI
• Multiple sex partners
• Drug misuse
• History of paid sex work
• Past STIs
• Previous incarceration

Many patients come for their visit thinking it will involve a gynecological exam. Whether a patient needs an exam depends on the issue. In some cases, we can diagnose and treat problems based on symptoms alone. For STI testing, it may be possible for patients to do a self-swab in the bathroom or a urine test.

If an exam is necessary, patients can choose to have a parent or medical assistant in the room. Our providers are caring and make exams as easy as possible. They describe what to expect, explain what’s happening and why, and check in often.

Patients 18 or older don’t need parental permission to see us. Those younger than 18 can access pregnancy testing, STI testing, and birth control services without parental permission. Other services require a parent to be present.

Please note that insurance companies may require a referral from a primary care provider for reproductive health services. And if we bill insurance, the policyholder will receive a statement that includes general information about the visit.

All healthcare services are confidential as outlined in our HIPAA Privacy Notice. State and federal laws limit confidentiality in certain situations, including:

• Communicable disease diagnosis
• Risk of a patient harming themself or others
• Suspicion or evidence of abuse

After the visit, tests may be needed or there may be a prescription to pick up at the pharmacy. We'll likely schedule a follow-up visit to see us again.

If we make a referral to another provider, we'll connect with that provider during the visit to request an appointment. Often, patients leave with an appointment already scheduled.

Most breast masses in pediatric patients are noncancerous (benign), but they can cause stress and embarrassment. Treatment depends on the type of mass, its size and whether it’s causing symptoms. Surgical removal may be the right approach for masses that are large and symptomatic.

Other breast conditions we treat surgically include breast asymmetry, large breasts and anomalies present at birth or caused by other conditions.

Different types of masses can form in the ovaries, vulva and pelvic area. Most are noncancerous. We may recommend surgical removal for masses that are large or causing symptoms.

Ovarian torsion occurs when an ovary twists, constricting the tissues that support it. The rotation can cut off blood supply and damage the ovary.

The most common symptoms are pain in the lower abdomen, nausea and vomiting. Treatment involves surgery to untwist the ovary or remove it if it’s damaged.

Reproductive anomalies can affect the vagina, hymen, cervix and uterus. They're present at birth but may not show up or need treatment until adolescence. Surgery is a common treatment.