Adolescent gynecology focuses on conditions of the uterus, ovaries, vagina and vulva in females during their teenage years.  Adolescent Gynecologists have significant experience in caring for adolescents with gynecologic concerns/problems.

Our physicians provides comprehensive evaluation and specialized treatment for gynecological conditions in adolescents of all ages. When needed, she works closely with experts from other clinics to provide the best care possible. She is experienced in a broad range of gynecologic conditions affecting adolescents, including:

• abnormal vaginal discharge
• delayed puberty
• amenorrhea (absent periods)
• menstrual problems 
• labial differences
• ovarian cysts and tumors
• pelvic pain
• endometriosis
• congenital anomalies of the reproductive system
• vaginitis and vulvovaginitis
• skin conditions of the vulva
• sexuality and gender identity issues
• sexually transmitted diseases
• urinary tract infections (UTI)

Our physicians provide specialized care geared toward adolescents, including:

• initial reproductive health visit (recommended between the ages of 13-15)
• comprehensive gynecologic and reproductive health care
• consultation and administration of reproductive healthcare for those with special needs
• contraceptive management
• STD testing
• HPV vaccination
• evaluation and treatment of acute and chronic pelvic pain 
• management of menstrual abnormalities (heavy menstrual bleeding, irregular menses, painful periods)
• surgical management of ovarian, adnexal, uterine, vaginal, and perineal abnormalities
• management of vulvar disorders
• questions about sexuality
• questions about appearance of genitals
• diet / nutrition / vitamins 
• hygiene
• HPV vaccination

Dr. Worley provides non-judgmental and sensitive care to address all concerns which adolescents may experience. 

The American College of Obstetrics and Gynecology (ACOG) recommends that young women have their first visit with an OBGYN between the ages of 13 and 15.  This visit provides an opportunity for guidance regarding reproductive health care, including an age-appropriate discussion of anatomic development, body image, self-confidence, weight management, immunizations, contraception, and sexually transmitted infections.

A visit at this age establishes an environment where patients feel confident and comfortable discussing their reproductive health in a confidential and supportive setting, and allows physicians to screen for numerous issues which may affect adolescents. A pelvic exam is not necessary at this visit. 

In patients younger than 21 who are healthy and asymptomatic, a pelvic examination is not required. Additionally, a pelvic examination is not necessary to obtain birth control. 

Speculum and bimanual exams are indicated in patients younger than 21 years old only if they are symptomatic or have concerns suggestive of female genital tract, pelvic, urologic or rectal problems. Dr. Worley has pediatric instruments available for use in these instances. All examinations are performed in a comfortable, modest, and empowering manner. A parent may be present if desired by the adolescent. 

Routine cervical cancer screening starts at age 21, regardless of sexual activity.  Pap smears are not performed before age 21, except under rare circumstances.  

STD testing is recommended for all sexually active adolescents. Depending on the type of infections you want screened, testing may include:

• physical exam (looking at the genitals and/or anus for rash, discharge, sores, or warts)
• blood sample (can check for HIV, syphilis, hepatitis)
• urine sample (can check for gonorrhea, chlamydia, trichomonas)
• vulvovaginal cultures (a swab is used to collect discharge or cells to check for gonorrhea, chlamydia, trichomonas, bacterial vaginosis, herpes)

STD results are confidential.

A cyst is a round collection of tissue or fluid contained within a sac which develops in any organ.  Ovarian cysts are very common and there are over a dozen different types of ovarian cysts. 

There are two main types of cysts:

• functional cysts
• pathologic cysts

Functional cysts are normal and physiologic meaning that they naturally occur. Functional cysts typically resolve on their own.  Cysts that are not causing symptoms, are less than 4 cm in size, are only fluid filled (have no solid components) are not worrisome.

Pathologic cysts are those which are abnormal and not routinely formed during month-to-month cycles. Worrisome cysts or cysts that need further evaluation are those that cause symptoms, are larger than 5 cm, have solid components, or persist.

Initially, ovarian cysts are best evaluated by an ultrasound.

Parents and guardians are very important for ensuring the growth and development of adolescents into healthy adults.  We always encourage opening communication with adolescents and their parents/guardians about their health. 

As providers, we are also dedicated to helping adolescents and young adults develop independence and practice being involved in medical decisions.  As recommended by the American College of Obstetrics and Gynecology (ACOG), the American Academy of Pediatrics (AAP), and the Society for Adolescent Health and Medicine (SAHM), we offer our adolescent patients time to speak with their provider alone. Additionally, under Florida law, adolescents have the right to seek medical care for the following conditions, even without parent or guardian consent, if they are capable of making sound decisions:

• birth control
• pregnancy-related treatment
• sexually transmitted disease testing/treatment (including HIV)
• mental health conditions (if 13 years or older)
• alcohol and drug problems  

Adolescent’s medical records are private and confidential.  They will need to consent to releasing medical information to anyone, including their parents /guardians. If an adolescent’s health or wellbeing (or that of someone they know) is in immediate danger, however, the law permits confidentiality to be waived and parents/guardians will be immediately notified and included in the plan to keep everyone safe.