As your child grows, their primary care provider will monitor their development. Routine care typically includes a visual exam of your child’s breasts and outer genital area. Age-appropriate education about puberty, menstruation and healthy behaviors is also a standard part of care.

Your primary care provider may treat gynecologic conditions and provide reproductive health services such as birth control and STI testing. When necessary, they may refer you to a general gynecologist, a pediatric and adolescent gynecologist or adolescent medicine specialist. We coordinate in-network referrals and appointments to ensure a streamlined transition of care.

Many pediatric and adolescent problems do not require an internal vaginal exam. If an internal exam is needed, our provider will discuss this with you. If a young person needs, but is unable to tolerate an internal exam, we may offer general anesthesia or conscious sedation to reduce anxiety and discomfort.

Across UVM Health, adolescents have access to all birth control (contraception) methods we offer. We provide contraceptive counseling and education to help them understand their options. We also offer advanced contraceptive counseling and care for young people who:

• Have developmental disorders
• Request an intrauterine device (IUD) as their birth control method
• Seek birth control for treatment of menstrual disorders or other medical conditions

Adolescent medicine specialists provide nonsurgical gynecologic care and sexual and reproductive health services, such as:

• Birth control
• Management of periods/menstrual conditions, endometriosis and PCOS
• STI testing and treatment
• Care for gender diverse youth

Confidentiality is essential for adolescent patients and promotes trust and honest discussions. In accordance with federal and state laws, we always offer adolescent patients the opportunity to speak to us privately, without a parent or guardian present in accordance with state laws for minors’ rights to confidentiality.

Reproductive endocrinology is a subspecialty of obstetrics and gynecology. Our reproductive endocrinologists have unique training and experience in providing care to adolescents. UVM Health is home to one of the only board-certified pediatric and adolescent gynecologists in Vermont and northern New York. 

Reproductive endocrinologists diagnose and treat hormone-related gynecologic conditions, such as:

• Endometriosis
• Menstrual problems
• Ovarian cysts
• PCOS

Treatment may include hormone therapy or nonhormonal medications. Surgery may also be an option to:

• Diagnose and treat endometriosis
• Remove ovarian cysts while preserving your child’s fertility
• Repair congenital abnormalities of the uterus, cervix or vagina
• Separate labial adhesions that block urine flow

Whenever possible, we offer minimally invasive laparoscopic surgery. Because this approach uses small incisions, your child experiences less pain and heals faster.

We offer fertility preservation for young people who are going through cancer treatment or gender transition. This process involves collecting and freezing their eggs so they can attempt to have a biological child in the future.

Pediatric endocrinologists, who specialize in conditions related to growth and development, often lead the care for children who start puberty too early (precocious puberty).

Your child may see a pediatric surgeon if they have a complex congenital abnormality that requires reconstructive surgery.