Teenage / Adolescence Care

The physicians at A.H. Barhoush M.D.P.A consider it a special privilege when we are asked to see your daughters, or any young woman, as they begin the transition through adolescence into womanhood. We take seriously the skill and trust that is needed to help these patients understand how the life-long habits of good preventive care and thoughtful reproductive health choices will enhance their quality of life long into their later years.

Our Doctors follow current adolescent health care guidelines recommended by the American College of Obstetricians and Gynecologists, as well as those from other accepted authoritative sources. We will, of course, provide the screening and care specific to the patient’s individual needs, however, these guidelines recommend the following:

Women’s Health Initial Visit For Teenagers

The first visit is recommended between ages 13-15, and should be followed by annual visits.

  1. The initial visit does include a thorough medical history, and examination as appropriate and necessary. Generally, it does NOT involve a pelvic examination, although certain circumstances may indicate that one is appropriate.
  2. The visit allows establishment of a relationship, and open discussion and education regarding the patient’s role as a part of the healthcare team. Other topics discussed include, but are not limited to:
    1. Menstruation
    2. Normal development
    3. Sexual activity and safe sexual practices
    4. Contraception
    5. Smoking, drugs and alcohol
    6. Screening for emotional and behavioral issues, hypertension, substance abuse/issues, sexual activity, depression, and school performance
  3. Generally, a Pap smear is performed by age 21, or 3 years after the onset of sexual activity.
  4. HIV screening is recommended annually for all patients from age 13 to 64 (per CDC, 9/2006)
  5. Once sexually active, annual screening for chlamydia and gonorrhea is performed.

Please feel free to ask any of us about initial or subsequent services available for your daughter. Keep in mind that doctor-patient confidentiality as to the content of the visit must be observed in keeping with federal and state privacy laws.

What about HPV vaccination and testing?

In the summer of 2006, the FDA approved the use of Gardasil®, a vaccine for 4 types of HPV (human papilloma virus). This virus is responsible for virtually all cases of cervical dysplasia, cervical cancer, and genital warts. The vaccine is highly effective against the 4 types of HPV that account for 70% of cervical cancers and 90% of genital warts. HPV is commonly acquired when women become sexually active, and it is estimated that up to 80% of women are exposed at some point in their lives. WHILE MOST INFECTIONS ARE SILENT AND TRANSIENT, MANY LEAD TO FUTURE DISEASE THAT CAN BE LARGELY PREVENTED BY VACCINATION.

  1. HPV vaccination is best given between ages 11-13, as it is most effective before sexual activity. It can be given between ages 9 to 26.
  2. Vaccination is still appropriate after sexual activity, up until age 26.
  3. Vaccination does not prevent the need for annual pap smears once sexually active.
  4. Vaccination is NOT treatment.
  5. Vaccination gives immunity for 5 years, and perhaps more; it is not known if a booster is needed at this time.
  6. HPV testing is not appropriate in adolescents, whether sexually active or not.

Vaccination Details

  1. The vaccination is an injection given at 0, 2 and 6 months.
  2. A woman must establish care here in order to receive the vaccine.
  3. We will request insurance information for the patient IN ADVANCE of the appointment so that we can verify coverage beforehand. The information is best obtained by a photocopy of the insurance card sent via mail, fax, or brought in to the office.
  4. The patient is responsible for payment if the insurance company ultimately does not pay for the vaccination.
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