Adolescent Care

Adolescents are the perfect picture of what biological, emotional and intellectual change can do in a relatively brief period of time. In this way, adolescence is truly a marvel of human development, but it can leave parents shell shocked. In early childhood, children look to their parents as heroes and seemingly idolize everything mom and dad do. This, of course, is not how things go as children move through their preteen and teenage years. Fortunately, that shift is all a part of growing up. Unfortunately, growing up is occasionally met with medical conditions. With so many changes to the brain and body going on, it’s not uncommon for adolescents to be faced with trying physical and emotional issues. This is where the family physician can provide much needed support. Family doctors are tuned into the medical concerns that trouble budding adults, and can help families steer their way through the teenage years.

Why is adolescent care so important?

It’s normal for parents to give their children more independence as they grow. After all, independence is a good thing. However, there are a number of serious medical conditions that teenagers may face, so the relationship between the family doctor and parents is particularly important during this time. Some of the most common risks for adolescents include:

1. Sexually transmitted disease and early pregnancy – Sexual development is one of the primary markers of adolescence, but even as sexual interest emerges, it will still be years before most teenagers are able to control the impulsivity that can lead them into unhealthy situations. Nowhere is this more apparent than in teenagers who expose themselves to sexually transmitted diseases or who become pregnant before they have reached maturity.

Clearly parents have great influence in educating their children in how to handle themselves sexually, but even teenagers under close supervision occasionally get pregnant or contract a sexually transmitted disease. Family physicians can both educate their teenage patients in how to protect themselves if they are sexually active, and provide treatment and support options in the event that their patient becomes pregnant or develops an STD. As STDs can manifest debilitating symptoms, some of them permanent if not treated, it is critical that parents communicate to their children the importance of seeing the doctor if they are sexually active.

Early pregnancy is not something that teenagers plan for, and it goes without saying that it can greatly alter an adolescent’s course. Still, it is important that a pregnant adolescent pursue gynecological care as their pregnancy develops, as there are additional risks that come with early pregnancy.

2. Menstrual disorders – In some ways, adolescence is harder on teenage girls than boys. One of those ways is moving into a menstrual cycle, which can have profound effects on a teenager’s physical and social well-being. Not only is it hard to adjust to at first, there are several menstrual disorders that can produce difficult to handle symptoms.

Amenorrhea is a menstrual condition marked by an absence of menstrual periods. Specifically, three consecutive missed periods is a sign that amenorrhea may be present. The condition is classified as primary, which means menstruation never began and likely never will, or secondary, which means that there is a disruption from a previously normal menstrual cycle. There are several causes of amenorrhea, including pregnancy, and the treatment will have to fit the cause, so a comprehensive examination is required to ensure the patient is able to return to some normalcy regarding their cycle.

On the other end of the spectrum is dysmenorrhea, which is usually the more debilitating condition. Dysmenorrhea is marked by several severe symptoms, including enduring and painful cramping, radiating pain, nausea, vomiting, fatigue, weakness, headaches and even fainting spells. Like amenorrhea, dysmenorrhea is classified as primary, which means it has always been present during menstruation and probably always will be, and secondary, which means it emerged later and is typically due to another physical issue. Some of the underlying causes of dysmenorrhea are quite serious, such as pelvic inflammatory disease, tumors or an ectopic pregnancy, so it merits immediate attention from the family doctor.

Premenstrual syndrome, well known as PMS, is a common condition that affects up to 85 percent of teenagers and women, to some extent. There are many symptoms associated with PMS, including psychological, respiratory, visual, dermal, gastrointestinal and neurological symptoms. For the vast majority of patients with PMS, these symptoms will be minor, manageable and brief. Some, though, are wracked with much more severe symptoms that are capable of producing disability. About five percent of patients fall under this category. PMS is believed to be caused by changing levels of estrogen and progesterone, but there are plenty of preventative and treatment options for patients, so it is possible to address the condition. Treatment will be selected depending on the patient’s age, health, medical history, symptoms and tolerance or preference for various therapies.

3. Growth disorders – Along with sexual and mental growth comes the much more noticeable physical growth. In most cases, both girls and boys rocket up during their teenage years, especially boys. It’s common for boys to grow several inches in a single year, and that kind of explosive growth can put a great deal of stress on the body.

This can result in pain and deformity in some extreme cases. Conditions like pain syndromes, reflex sympathetic dystrophy, fibromyalgia, benign hypermobility syndrome and regular old growing pains can disrupt an adolescent’s life and affect their ability to participate in social and educational activities.

4. Traumatic and sports injuries – Although sports are available to young children, the added weight, strength and speed of teenagers means injuries are more likely to occur. Annually, healthcare providers treat about 15 million sports and traumatic injuries in adolescents. These injuries, of course, vary greatly in their severity and long-term prognosis.

It is extremely important that parents bring their child to the doctor before beginning any athletic activities. A physician can screen for any conditions that might be exacerbated by athletic activity, and can also provide treatment options should an injury occur. If an injury results in long-term or permanent complications, the doctor can offer insight in treatment and therapy options.

5. Mental and emotional disorders – One of the most significant risks to teenagers isn’t physical at all – it’s psychological. According to the National Institute of Mental Health, about 20 percent of teenagers suffer from a mental or mood disorder that is severe enough to affect their ability to function normally. While that number looms large, it is well accepted that teenagers are susceptible to emotional and mental disturbance with all of the changes going on in their brains and with their place in society.

Anxiety disorders, which include social phobia and panic disorders, are the most common. Behind them are behavior disorders like attention-deficit/hyperactivity disorder (or ADHD), mood disorders, which include depression, and disorders related to substance abuse.

Teenagers often feel a sense of isolation, especially if they are having trouble with their peers, self-esteem or with their studies. As self-harm and suicidal ideation appears to peak during adolescence, it is important that parents take note of any worrying behavioral changes in their children and seek the assistance of their physician if they emerge.

6. Sleep disorders – The body’s circadian cycles change during adolescence, and the result can often look something like insomnia. Known as sleep phase delay, it can cause teenagers to stay up well past their normal bedtime, often by a few hours or more. This change is not something that teenagers can fight, so changes to day to day life will need to be made to ensure adequate sleep is still achieved. Even though teenagers go to bed later than younger children, they still need between eight and 10 hours of sleep a night, so don’t be fooled into thinking that a late bedtime means less sleep is required.

Unfortunately, sleep deprivation is practically ubiquitous among U.S. teenagers. More than 90 percent are believed to be chronically sleep deprived, according to some studies, and this can profoundly affect behavior, mood, cognition and weight gain, among other things.

Growing up and achieving some measure of independence is exciting, but it doesn’t come without its risks. With the help of a family doctor, though, those risks can be managed, ensuring teenagers and their parents are able to find their way through the adolescent years.