From the Editor
Vulnerable Adolescents
Reading the titles of the articles in this issue of the Journal of Pediatric and Adolescent Gynecology (JPAG), the concept of adolescent vulnerability comes to mind. I am far from an expert on this topic that includes various models of health and risk behavior, but my colleagues in adolescent medicine and psychology have taught me several things: that there is a relationship between adolescent development and the development of poor health outcomes; that there are subpopulations of adolescents who might be particularly vulnerable to morbidities and mortality; and that behavioral risk factors contribute to those vulnerabilities.Dilators for the Vajayjay
I have long been on a campaign to use anatomically correct names for body parts. My daughter will attest that she knew about her vagina from a young age; when we were teaching her the names of other body parts, I made sure to also talk about her vagina. I can say that she was as proud of her vagina as her younger brothers were about their penises. But those of us who see young girls for gynecologic concerns may need to ask moms about the colloquial words that are used in their family to describe the female genitals.A Research Agenda for Adolescent Menstrual Cycles
Yes, I'm talking about menstrual cycles—again. I'm back on my soapbox, addressing the importance of the menstrual cycle. This time, it's prompted by an excellent review in this issue of the Journal of Pediatric and Adolescent Gynecology (JPAG) from Carlson and Shaw, “Development of ovulatory menstrual cycles in adolescent girls,” that deserves your attention.1 The authors summarize what we know about the anovulatory cycles that occur during the early gynecologic years—the first few years after menarche.Pediatric and Adolescent Gynecology: The Potpourri of Our Clinical Practices
Greetings dear readers. Once again I collate the content for another issue of the Journal of Pediatric and Adolescent Gynecology (JPAG). Some months, as I review the list of articles that have successfully navigated the peer review process and have been accepted to JPAG I see major themes emerging that help me group the submissions. Typically there are several submissions relating to prepubertal gynecologic problems, several addressing contraception, a number that report on ovarian masses and surgeries, and typically some that pertain to medical issues such as heavy menstrual bleeding.Conflicts of Interest and Trust in the Journal of Pediatric and Adolescent Gynecology
I state at the outset: there is no scandal brewing at the Journal of Pediatric and Adolescent Gynecology (JPAG). Yet my editorial is prompted by an article in the Sunday New York Times (Times), titled, “‘Broken’ system lets doctors omit industry ties in journals.”1 This piece raises concerns about the influence of pharmaceutical, medical device, and biotech companies on medical research. In the article on the front page of the Times, a number of prominent physicians are called out for having failed to disclose financial relationships when their studies were published in medical journals as prominent as the New England Journal of Medicine.Menstrual Cycles: Who Cares? We All Should
The first and most obvious answer to the question, “Who cares about menstrual cycles?” is that at least half of the world's population cares. In keeping with my penchant for true facts, as opposed to alternative ones, I fact-checked that percentage and found that according to data from the United Nations Population Division, reported by the World Bank, in 2017, women made up 49.558% of the world's population—basically close enough to half.1 Menstruation is a defining event for women, and its onset signals the beginning of the potential for reproduction.The Peer Review Process and Celebrating Journal Reviewers
The Journal of Pediatric and Adolescent Gynecology (JPAG) and other scientific journals could not publish high-quality scientific reports without the behind-the-scenes work of individuals who contribute considerable time and effort to reviewing manuscripts. These peer reviewers receive little recognition beyond the Editors' heartfelt gratitude and the yearly publication of a list of the names of all of the individuals who provided reviews during the past year. Does anyone look at this list of names? I'm not sure, as JPAG hasn't tracked this, but I will confess that, I DO look at this list for other journals, to find the names of recognized leaders in the field as an indicator of the quality of the journal.Puberty, Menarche, and the Menstrual Cycle: What Do We Know, and What Do We Teach?
The process of pubertal development that ultimately leads to menarche is a critical process in the lives of all women. Understanding normal puberty and normal menstrual function is essential to understanding health and disease among girls and young women. It is crucial to the care that we, as pediatric and adolescent gynecologists and adolescent medicine specialists, provide. There is certainly a great deal about pediatric endocrinologic function that we currently understand, but our understanding is still evolving, and there are fascinating aspects of pubertal growth and trajectory that we do not fully understand.Fired Up, Ready to Go-- Pediatric and Adolescent Gynecology
In my editorials for this journal, I get the opportunity to address the universe of Pediatric and Adolescent Gynecology (PAG) specialists—you, dear Readers. As I write my editorial today, I am returning from the Annual Clinical and Research Meeting (ACRM) of the North American Society for Pediatric and Adolescent Gynecology (NASPAG). I have attended this meeting almost every year since 1988, and invariably, when I return to my home institution, I am “fired up, ready to go”.What is Pediatric and Adolescent Gynecology?
When people ask me what I do, I gauge their time and interest. Are they asking out of general politeness, or do we have time for me to share more of what I do? I may answer that I am a physician, which can lead to their telling me a story about their latest encounter with the medical profession, or they may be curious and ask for clarification. If they express interest, I may respond that I am a gynecologist. I am sometimes parsimonious with even this information; I have learned that if I am speaking to a man, the conversation may quickly turn to another topic.Resident Education in Pediatric and Adolescent Gynecology
The Resident Education Committee of the North American Society for Pediatric and Adolescent Gynecology (NASPAG) is to be congratulated for publishing guidelines and curriculum content for resident education in pediatric and adolescent gynecology (PAG). In this issue of the Journal of Pediatric and Adolescent Gynecology, Wheeler and colleagues present the rationale for the development of a multispecialty graduate medical education PAG curriculum, and describe the processes by which the committee developed the curriculum.Surgical Decision-Making in Pediatric and Adolescent Gynecology: Just Because You Can, Doesn't Mean You Should
Surgical decision-making is complex. It is among the most important things that we practice as surgeons, and among the most important skills that we teach our resident trainees. Surgical decision-making involves considering many factors beyond whether the procedure can technically be performed. We also consider whether the evidence and our current state of knowledge provide sufficient information to indicate that a given procedure is the most appropriate one for our individual patient. Still, we need to ask, should the procedure be done.What You Need to Know about Pediatric and Adolescent Gynecology: Clinically Relevant Reviews Published in the Journal of Pediatric and Adolescent Gynecology
The Journal of Pediatric and Adolescent Gynecology (JPAG) is the premier journal of the specialty of pediatric and adolescent gynecology. It is the official journal of the North American Society of Pediatric and Adolescent Gynecology and of the International Federation of Infant and Juvenile Gynecology. The journal publishes articles on topics related to prepubertal and adolescent girls. Clinicians who care for these girls also frequently care for young adult women as well. We are now talking more about issues that affect adolescents and young adults.Adolescent Reproductive Health Without Planned Parenthood
How would the health of adolescents in the United States be affected if Planned Parenthood (PP) were to be “defunded”? I know that in writing about this possible eventuality and the problems it would cause for adolescents and young adults that we care for and care about, I risk angering some of my colleagues who firmly believe that this “defunding” would be a very positive thing. And honestly, I hesitated briefly before writing this editorial for that reason. There are also people who believe that there would be little effect on girls' and women's health if PP were to go away—that that other publicly-funded clinics would be able to provide care.Pediatric and Adolescent Gynecology: The Science
By the time this editorial appears in print, the 31st Annual Clinical and Research Meeting of the North American Society for Pediatric and Adolescent Gynecology (NASPAG) in Chicago will have come and gone. At the time I write this editorial, I am eagerly anticipating that meeting. My network of colleagues and friends from around the country and around the globe has grown to be a real community. My NASPAG colleagues have encourage my professional growth, and they have brought an increasing rigor to the science of pediatric and adolescent gynecology (PAG).Adolescents and Contraception: The Updated US Medical Eligibility Criteria for Contraceptive Use
The Journal of Pediatric and Adolescent Gynecology marks and celebrates the release of the latest update to the US Centers for Disease Control and Prevention (CDC) US Medical Eligibility Criteria for Contraceptive Use, often referred to as the US MEC, and its companion, the US Selected Practice Recommendations for Contraceptive Use, the US SPR. The North American Society for Pediatric and Adolescent Gynecology has endorsed these documents. This issue of the Journal of Pediatric and Adolescent Gynecology includes an excellent, timely, and thorough mini-review by Drs Andrea Hoopes, Katharine Simmons, Emily Godfrey, and Gina Sucato,1 which highlights the recommendations contained in these documents as they pertain to our adolescent patients.Greetings from the Journal of Pediatric and Adolescent Gynecology
Greetings, esteemed friends and colleagues. In the last issue of the Journal of Pediatric and Adolescent Gynecology (JPAG) in 2016, after serving nearly 30 years as the journal's Editor-in-Chief, Dr Joe Sanfilippo published his last editorial as Editor-in-Chief of JPAG. He graciously thanked the many others who have contributed to the journal's growth and success. He described the vision of the founding fathers and mothers of the North American Society for Pediatric and Adolescent Gynecology (aka NASPAG) that the society needed a journal.
