Chronic genital rashes or itching
Complaints of genital redness, itching, discharge, and/or bleeding are relatively common in young girls before the onset of puberty. Most of these problems have benign causes and respond to the removal of irritants.
Vaginal discharge, drainage or odor
Normal vaginal discharge has several purposes: cleaning and moistening the vagina, and helping to prevent and fight infections. Although it’s normal for the color, texture, and amount of vaginal fluids to vary throughout a girl’s menstrual cycle, some changes in discharge may indicate a problem
Unusual appearance of the genitals
Female genital abnormalities are uncommon and often do not present until, or well after, puberty. Although genital abnormalities may be isolated, careful assessment for possible underlying disorders, particularly chromosomal or metabolic, is essential.
Abdominal or pelvic pain
Pelvic pain can be a common complaint for adolescent girls. Pain can be acute (sudden and severe) or chronic (constant or continually comes and goes). Pelvic pain can be due to a number of factors including gynecological disorders, urologic disease, gastrointestinal problems, musculoskeletal abnormalities and psychosocial problems (such as stress, abuse, or eating disorders).
Ovarian cysts or pelvic masses
Ovarian masses are uncommon findings in adolescent females. Most of these masses are benign, but doctors should be aware of how they can present and should include ovarian masses in their differential diagnosis of lower abdominal pain, which is a common complaint in this patient population.
Endometriosis causes different symptoms in young women. Pelvic pain and/or severe period cramps are the most common symptoms.
There can be pain before, during or after your period. The pain may occur at regular times in your cycle or it may occur at any time during the month. It is often referred to as “chronic” pelvic pain. The location of the endometrial implants and the way in which the lesions affect the pelvic organs contribute to the symptoms teens may have.
Some teens may have pain with exercise, sex, and/or after a pelvic exam. Although not as common, some teens may have painful or frequent urination, diarrhea or constipation with pelvic pain. It’s important to remember that some teens have a lot of endometriosis and have very little pain, while others may have a small amount of endometriosis and severe pain.
Birth defects involving the reproductive organs
Birth defects of the reproductive system are common, occurring in approximately 1 in 400 women. The reproductive system is derived from two tubes (the Mullerian ducts) which fuse in the midline followed by absorption of the central portion. The upper portion forms the fallopian tubes and uterus, the lower portion forms the vagina. Defects in this developmental process may include absence of the structures (Mullerian agenesis) and abnormalities in fusion and absorption.
Injuries involving the reproductive organs
Injury to the genitals can be very painful. It may cause a lot of bleeding. Such injury can affect the reproductive organs, bladder and urethra. It may be caused by placing items into the vagina.
For sexually active adolescents who use contraception, the role of the health care professional is to educate and support compliance, to assist in managing adverse effects or, alternatively, to counsel the patient regarding a new contraceptive method as circumstances require and to provide referrals and follow-up with periodic screening for STIs.