Adölesan Jinekolojisi
Özet
Adölesan dönem, çocukluktan yetişkinliğe geçiş sürecini kapsayan, biyolojik, fiziksel, psikolojik ve sosyal değişikliklerin yaşandığı önemli bir gelişim evresidir. Bu dönemde çeşitli jinekolojik hastalıklar ortaya çıkabilir. Bu jinekolojik hastalıklar; üreme siklusu anomalileri, puberte ile ilişkili hastalıklar, iyi huylu (benign) jinekolojik değişimler, jinekolojik kanserler, genital organ anomalileri, cinsellik ve üreme sağlığı hastalıklarıdır. Adölesanların büyük çoğunluğunda menstrual siklusa bağlı rahatsızlıklar görülmektedir. Bu jinekolojik hastalıklar önemsiz fizyolojik değişiklikler sonucu ortaya çıkabildiği gibi bazen de bir hastalığın belirtisi olarak görülebilir. Adölesanlar arasında jinekolojik sorunların ele alınmasında erken teşhis ve müdahalenin önemi, adölesanların özel ihtiyaçlarını karşılayan özel sağlık hizmetlerinin önemliliğini göstermektedir. Sürecin sağlıklı bir şekilde yönetilmesi ve genç bireylerin bilinçli bir şekilde yönlendirilmesi, sadece bireylerin sağlığını korumakla kalmayıp, aynı zamanda toplum sağlığını ve gelecekteki nesillerin refahını da doğrudan etkiler. Adölesanların genel refahını ve üreme sağlığını geliştirmek, gelişimin bu kritik aşamasında uygun bakım ve desteği almalarını sağlamak için çok önemlidir. Sağlık profesyonellerinin adölesan jinekolojisi konusunda güncel bilgilere sahip olması ve okullarda bu konuda adölesanlara eğitim verilmesi önerilmektedir.
Adolescence is a critical developmental phase that encompasses the transition from childhood to adulthood, characterized by significant biological, physical, psychological, and social changes. During this period, various gynecological disorders may emerge. These gynecological disorders include reproductive cycle anomalies, puberty-related conditions, benign gynecological changes, gynecological cancers, genital organ anomalies, and sexual and reproductive health disorders. The majority of adolescents experience menstrual-related discomfort. These gynecological issues may arise as minor physiological changes or sometimes as indicators of an underlying disease. The importance of early diagnosis and intervention in addressing gynecological issues among adolescents highlights the necessity of providing specialized healthcare services that cater to the unique needs of this population. Properly managing the process and guiding young individuals in an informed manner not only safeguards their health but also directly impacts public health and the well-being of future generations. Improving the overall well-being and reproductive health of adolescents is crucial to ensure they receive appropriate care and support during this critical stage of development. It is recommended that healthcare professionals stay updated on adolescent gynecology and that educational programs in schools provide adolescents with information on this topic.
Referanslar
Henry LM, Watson KH, Cole DA, et al. Mean-level correspondence and moment-to-moment synchrony in adolescent and parent affect: Exploring associations with adolescent age and internalizing and externalizing symptoms. Dev Psychopathol; 2023;35(2): 809-822. doi:10.1017/S0954579422000062
Taşkın, L. Doğum ve kadın sağlığı hemşireliği. Ankara: Akademisyen Kitabevi; 2019
Agarwal M, Singh S, Jyoti C, Sinha S, Simran S. Understanding adolescent gynecological ıssues: a cross-sectional study at a tertiary care center. Cureus. 2024;16(4):e57713. Published 2024 Apr 6. doi:10.7759/cureus.57713
ACOG Clinical: The initial reproductive health visit 2020. https://www.acog.org/en/clinical/clinical-guidance/committee-opinion/articles/2020/10/the-initial-reproductive-health-visit
Sachedina A, Todd N. Dysmenorrhea, endometriosis and chronic pelvic pain in adolescents. J Clin Res Pediatr Endocrinol; 2020;12(Suppl 1): 7-17. doi:10.4274/jcrpe.galenos.2019.2019.S0217
Critchley HOD, Babayev E, Bulun SE, et al. Menstruation: science and society. Am J Obstet Gynecol; 2020;223(5): 624-664. doi:10.1016/j.ajog.2020.06.004
Mitsuhashi R, Sawai A, Kiyohara K, Shiraki H, Nakata Y. Factors associated with the prevalence and severity of menstrual-related symptoms: a systematic review and meta-analysis. Int J Environ Res Public Health; 2022;20(1): 569. doi:10.3390/ijerph20010569
McGuire TC, McCormick KC, Koch MK, Mendle J. Pubertal Maturation and Trajectories of Depression During Early Adolescence. Front Psychol; 2019;10: 1362. doi:10.3389/fpsyg.2019.01362
Maurya P, Meher T, Muhammad T. Relationship between depressive symptoms and self-reported menstrual irregularities during adolescence: evidence from UDAYA, 2016. BMC Public Health, 2022;22(1):758. Published 2022 Apr 14. doi:10.1186/s12889-022-13196-8
Döneray, H., & Özden, A. Adölesanlarda menstrüasyon bozuklukları. Turkiye Klinikleri Pediatric Endocrinology-Special Topics; 2022;3(1): 31-38.
Sasamoto N, Shafrir AL, Wallace BM, et al. Trends in pelvic pain symptoms over 2 years of follow-up among adolescents and young adults with and without endometriosis. Pain; 2023;164(3): 613-624. doi:10.1097/j.pain.0000000000002747
Swift B, Taneri B, Becker CM, et al. Prevalence, diagnostic delay and economic burden of endometriosis and its impact on quality of life: results from an Eastern Mediterranean population. Eur J Public Health; 2024;34(2): 244-252. doi:10.1093/eurpub/ckad216
Tsonis O, Gkrozou F, Barmpalia Z, Makopoulou A, Siafaka V. Integrating lifestyle focused approaches into the management of primary dysmenorrhea: Impact on quality of life. Int J Womens Health; 2021;13: 327-336. Published 2021 Mar 17. doi:10.2147/IJWH.S264023
Nalgirkar SP, Vinchurkar SA, Saoji AA, Mohanty S. Yoga as a Therapeutic ıntervention in the management of dysfunctional uterine bleeding: A controlled pilot study. J Midlife Health; 2018;9(1): 8-13. doi:10.4103/jmh.JMH_76_17
Yang H, Fan Y, Cheng J, et al. Network pharmacology-based prediction of active ıngredients and potential targets of shengdihuang decoction for treatment of dysfunctional uterine bleeding. Evid Based Complement Alternat Med; 2020;2020:7370304. doi:10.1155/2020/7370304
Sahu HD, Varma AV, Karmarkar S, Malukani K, Khanuja A, Kesharwani P. Endometrial histopathology in abnormal uterine bleeding and ıts relation with thyroid profile and endometrial thickness. Cureus; 2023;15(4): e37931. doi:10.7759/cureus.37931
Liguori F, Saraiello E, Calella P. Premenstrual syndrome and premenstrual dysphoric disorder's ımpact on quality of life, and the role of physical activity. Medicina (Kaunas); 2023;59(11): 2044. doi:10.3390/medicina59112044
Bhandari S, Dwa Y, Maharjan M, Maskey S, Thakur M, Sharma S. Premenstrual syndrome among medical students of a medical college: a descriptive cross-sectional study. JNMA J Nepal Med Assoc; 2023;61(260):347-350. doi:10.31729/jnma.8136
Abay, H., & Kaplan, S. Current approaches in premenstrual syndrome management. Bezmialem Sci; 2019;7(2): 150-6.
Barcikowska Z, Rajkowska-Labon E, Grzybowska ME, Hansdorfer-Korzon R, Zorena K. Inflammatory markers in dysmenorrhea and therapeutic options. Int J Environ Res Public Health; 2020;17(4): 1191. doi:10.3390/ijerph17041191
López-Liria R, Torres-Álamo L, Vega-Ramírez FA, et al. Efficacy of physiotherapy treatment in primary dysmenorrhea: a systematic review and meta-analysis. Int J Environ Res Public Health; 2021;18(15): 7832.doi:10.3390/ijerph18157832
Nagy H, Carlson K, Khan MAB. Dysmenorrhea. In: StatPearls. Treasure Island (FL): StatPearls Publishing; November 12, 2023.
Manotas MC, González DM, Céspedes C, Forero C, Rojas Moreno AP. Genetic and epigenetic control of puberty. Sex Dev; 2022;16(1): 1-10. doi:10.1159/000519039
Banerjee S, Bajpai A. Precocious puberty. Indian J Pediatr; 2023;90(6): 582-589. doi:10.1007/s12098-023-04554-4
Alghamdi A. Precocious puberty: Types, pathogenesis and updated management. Cureus; 2023;15(10): e47485. doi:10.7759/cureus.47485
Calcaterra V, Rossi V, Massini G, et al. Precocious puberty and microbiota: The role of the sex hormone-gut microbiome axis. Front Endocrinol (Lausanne); 2022;13: 1000919. doi:10.3389/fendo.2022.1000919
Lanciotti L, Cofini M, Leonardi A, Penta L, Esposito S. Up-To-Date review about minipuberty and overview on hypothalamic-pituitary-gonadal axis activation in fetal and neonatal life. Front Endocrinol (Lausanne); 2018;9: 410. doi:10.3389/fendo.2018.00410
Cheuiche AV, da Silveira LG, de Paula LCP, Lucena IRS, Silveiro SP. Diagnosis and management of precocious sexual maturation: an updated review. Eur J Pediatr; 2021;180(10): 3073-3087. doi:10.1007/s00431-021-04022-1
Valadares LP, Meireles CG, De Toledo IP, et al. MKRN3 Mutations in central precocious puberty: A systematic review and meta-analysis. J Endocr Soc; 2019;3(5): 979-995. doi:10.1210/js.2019-00041
Xie Q, Kang Y, Zhang C, et al. The role of kisspeptin in the control of the hypothalamic-pituitary-gonadal axis and reproduction. Front Endocrinol (Lausanne); 2022;13: 925206. doi:10.3389/fendo.2022.925206
Aguirre RS, Eugster EA. Central precocious puberty: From genetics to treatment. Best Pract Res Clin Endocrinol Metab; 2018;32(4): 343-354. doi:10.1016/j.beem.2018.05.008
Canton APM, Seraphim CE, Brito VN, Latronico AC. Pioneering studies on monogenic central precocious puberty. Arch Endocrinol Metab; 2019;63(4): 438-444. doi:10.20945/2359-3997000000164
Latronico AC, Brito VN, Carel JC. Causes, diagnosis, and treatment of central precocious puberty. Lancet Diabetes Endocrinol; 2016;4(3): 265-274. doi:10.1016/S2213-8587(15)00380-0
Haddad NG, Eugster EA. Peripheral precocious puberty including congenital adrenal hyperplasia: causes, consequences, management and outcomes. Best Pract Res Clin Endocrinol Metab; 2019;33(3): 101273. doi:10.1016/j.beem.2019.04.007
Raivio T, Miettinen PJ. Constitutional delay of puberty versus congenital hypogonadotropic hypogonadism: Genetics, management and updates. Best Pract Res Clin Endocrinol Metab; 2019;33(3): 101316. doi:10.1016/j.beem.2019.101316
Zhu J, Kusa TO, Chan YM. Genetics of pubertal timing. Curr Opin Pediatr; 2018;30(4): 532-540. doi:10.1097/MOP.0000000000000642
Gohil A, Eugster EA. Delayed and Precocious Puberty: Genetic Underpinnings and Treatments. Endocrinol Metab Clin North Am; 2020;49(4): 741-757. doi:10.1016/j.ecl.2020.08.002
Suzuki E, Miyado M, Kuroki Y, Fukami M. Genetic variants of G-protein coupled receptors associated with pubertal disorders. Reprod Med Biol. 2023;22(1): e12515. doi:10.1002/rmb2.12515
Howard SR. The genetic basis of delayed puberty. Front Endocrinol (Lausanne); 2019;10: 423. doi:10.3389/fendo.2019.00423
Howard SR, Quinton R. Outcomes and experiences of adults with congenital hypogonadism can inform improvements in the management of delayed puberty. J Pediatr Endocrinol Metab; 2023;37(1): 1-7. doi:10.1515/jpem-2023-0407
Rathore R, Sharma S, Arora D. Spectrum of childhood and adolescent ovarian tumors in ındia: 25 years experience at a single ınstitution. Open Access Maced J Med Sci; 2016;4(4): 551-555. doi:10.3889/oamjms.2016.090
Tarca E, Trandafir LM, Cojocaru E, et al. Diagnosis difficulties and minimally ınvasive treatment for ovarian masses in adolescents. Int J Womens Health; 2022;14: 1047-1057. doi:10.2147/IJWH.S374444
Birbas E, Kanavos T, Gkrozou F, Skentou C, Daniilidis A, Vatopoulou A. Ovarian masses in children and adolescents: A review of the literature with emphasis on the diagnostic approach. Children (Basel); 2023;10(7): 1114. doi:10.3390/children10071114
User İR, Karakuş SC, Özokutan BH, Akçaer V, Burulday B, Ceylana H. Can preoperative findings help to interpret neoplastic and non-neoplastic lesions of ovary and affect surgical decisions in children and adolescents?. Arch Argent Pediatr; 2019;117(5): 294-400. doi:10.5546/aap.2019.eng.294
Mobeen S, Apostol R. Ovarian Cyst. In: StatPearls. Treasure Island (FL): StatPearls Publishing; June 5, 2023.
Dai Y, Luo H, Zhu L, et al. Dysmenorrhea pattern in adolescences informing adult endometriosis. BMC Public Health; 2024;24(1): 373. doi:10.1186/s12889-024-17825-2
Amro B, Ramirez Aristondo ME, Alsuwaidi S, et al. New Understanding of diagnosis, treatment and prevention of endometriosis. Int J Environ Res Public Health; 2022;19(11): 6725. doi:10.3390/ijerph19116725
DiVasta AD, Vitonis AF, Laufer MR, Missmer SA. Spectrum of symptoms in women diagnosed with endometriosis during adolescence vs adulthood. Am J Obstet Gynecol; 2018;218(3): 324.e1-324.e11. doi:10.1016/j.ajog.2017.12.007
Dunselman GA, Vermeulen N, Becker C, et al. ESHRE guideline: management of women with endometriosis. Hum Reprod; 2014;29(3): 400-412. doi:10.1093/humrep/det457
Laufer MR. Helping "adult gynecologists" diagnose and treat adolescent endometriosis: reflections on my 20 years of personal experience. J Pediatr Adolesc Gynecol; 2011;24(5 Suppl): S13-S17. doi:10.1016/j.jpag.2011.07.005
Yahya Abdelrahman, Mohamed, et al. "Polycystic ovary syndrome in adolescents." Current Women's Health Reviews 2010;6(2): 108-122.
Tsikouras P, Spyros L, Manav B, et al. Features of polycystic ovary syndrome in adolescence. J Med Life; 2015;8(3): 291-296.
Teede HJ, Tay CT, Laven JJE, et al. Recommendations from the 2023 ınternational evidence-based guideline for the assessment and management of polycystic ovary syndrome. J Clin Endocrinol Metab; 2023;108(10): 2447-2469. doi:10.1210/clinem/dgad463
Lujan ME, Chizen DR, Pierson RA. Diagnostic criteria for polycystic ovary syndrome: pitfalls and controversies. J Obstet Gynaecol Can; 2008;30(8): 671-679. doi:10.1016/S1701-2163(16)32915-2
Saleh HA, Shawky Moiety FM. Polycystic ovarian syndrome and congenital uterine anomalies: the hidden common player. Arch Gynecol Obstet; 2014;290(2): 355-360. doi:10.1007/s00404-014-3193-9
Polotsky, Alex J., and Nanette Santoro. "The Role of Body Weight in Menstrual Disturbances and Amenorrhea." Amenorrhea: A Case-Based, Clinical Guide (2010): 127-139.
Ibáñez L, de Zegher F. Adolescent PCOS: a postpubertal central obesity syndrome. Trends Mol Med; 2023;29(5): 354-363. doi:10.1016/j.molmed.2023.02.006
Lala SV, Strubel N. Ovarian neoplasms of childhood. Pediatr Radiol. 2019;49(11): 1463-1475. doi:10.1007/s00247-019-04456-8
WHO Classification of Tumours Editorial Board. Female genital tumours. International Agency for Research on Cancer, World Health Organization. 2020.
Morowitz M, Huff D, von Allmen D. Epithelial ovarian tumors in children: a retrospective analysis. J Pediatr Surg. 2003;38(3):331-335. doi:10.1053/jpsu.2003.50103
Hazard FK, Longacre TA. Ovarian surface epithelial neoplasms in the pediatric population: incidence, histologic subtype, and natural history. Am J Surg Pathol; 2013;37(4): 548-553. doi:10.1097/PAS.0b013e318273a9ff
Terzic M, Rapisarda AMC, Della Corte L, et al. Diagnostic work-up in paediatric and adolescent patients with adnexal masses: an evidence-based approach. J Obstet Gynaecol; 2021;41(4): 503-515. doi:10.1080/01443615.2020.1755625
Heo SH, Kim JW, Shin SS, et al. Review of ovarian tumors in children and adolescents: radiologic-pathologic correlation. Radiographics, 2014;34(7): 2039-2055. doi:10.1148/rg.347130144
Lam CZ, Chavhan GB. Magnetic resonance imaging of pediatric adnexal masses and mimics. Pediatr Radiol, 2018;48(9): 1291-1306. doi:10.1007/s00247-018-4073-4
Maeda K, Terai Y, Terada S, et al. A case of ovarian clear cell carcinoma arising from ovarian mature cystic teratoma. J Ovarian Res; 2018;11(1): 74. doi:10.1186/s13048-018-0446-4
Kanneganti A, Bhadiraju P, Tong PSY. Extragonadal teratomas in women and adolescent girls: A systematic review. Eur J Obstet Gynecol Reprod Biol; 2021;262: 134-141. doi:10.1016/j.ejogrb.2021.05.005
Gkrozou F, Tsonis O, Vatopoulou A, Galaziou G, Paschopoulos M. Ovarian Teratomas in Children and Adolescents: Our Own Experience and Review of Literature. Children (Basel); 2022;9(10): 1571. doi:10.3390/children9101571
van Heerden J, Tjalma WA. The multidisciplinary approach to ovarian tumours in children and adolescents. Eur J Obstet Gynecol Reprod Biol; 2019;243: 103-110. doi:10.1016/j.ejogrb.2019.10.032
Fresneau B, Orbach D, Faure-Conter C, et al. Sex-Cord stromal tumors in children and teenagers: results of the tgm-95 study. Pediatr Blood Cancer; 2015;62(12): 2114-2119. doi:10.1002/pbc.25614
Roth LM. Recent advances in the pathology and classification of ovarian sex cord-stromal tumors. Int J Gynecol Pathol; 2006;25(3): 199-215. doi:10.1097/01.pgp.0000192271.22289.e6
