Gynecological concerns in young and adolescent physically active girls

Young girls should be advised to develop the regular exercise habit and to maintain it throughout life. Prepubertal athletes are more likely than their sedentary friends to experience menarcheal delay. Postmenarcheal athletes have increased susceptibility to oligomenorrhea and amenorrhea. Athletes with delayed puberty deserve examination and possibly further evaluation. Adolescent athletes with oligomenorrhea or amenorrhea deserve examination and hormonal evaluation. Hormonal replacement therapy is unnecessary prior to age 16, is optional between ages 16 and 18, and is recommended after age 18.     

Acceptability of computer-acquired sexual histories in adolescent girls

We investigated the acceptability and reliability of sensitive data collected via computer in adolescent patients. Subjects were 108 adolescent girls (ages 14 to 20 years), randomly assigned to one of three groups: (1) interactive computer interview, (2) face-to-face interview, or (3) self-administered questionnaire. Subjects were queried about their general health and sexual behavior. Adolescents interviewed by computer were more likely than subjects in other groups to state that they enjoyed the survey (P less than 0.001). There were no differences in anxiety or the reporting of sexual behavior among subjects in the three groups. Adolescents who stated that they would prefer a computer interview (40%) said they would be more comfortable with the computer, and perceived the method as being fun, interesting, confidential, private, and easy. Computer interviews cannot replace the skills of a sensitive physician, but may be an acceptable and valid means of collecting information from adolescents under certain conditions.     

The impact of the sexual maturation stage on body mass index in adolescent girls

Body mass index (BMI) is used in the clinical assessment of adiposity in children and adolescents. Population-based, race-specific and age-specific curves of BMI for children and adolescents exist, but there are noknown sexual maturation-based BMI curves. The aim of this study was to investigate the effects of pubertal development (assessed according to the Tanner breast stage) on BMI in adolescent girls in a cross-sectional study. The study group comprised 167 healthy girls, between the ages of nine and 16 years, attending school near a hospital in Gerede, Bolu. A significant positive correlation was found between the Tanner stage of breast development and BMI (r = 0.79, p < 0.001). Age also had a significant influence on BMI (r = 0.69, p < 0.001). After controlling the effects of age, BMI was highly correlated with weight (r = 0.82, p < 0.001) and the Tanner breast stage (r = 0.49, p < 0.001), but not with height. The correlation between BMI and the sexual stage was also found to increase with increasing age. But when breast development was taken as a control parameter, BMI was not statistically associated with age or height. As a result, there was a significant variation in BMI with the Tanner breast stage in addition to the well known change with increasing age in adolescent girls. Developmental differences occurring in the same age may require that BMI be evaluated only within the same sexual stages in adolescence. This study indicates that the curves of BMI need to take into account the sexual maturation stage of adolescents.     

Study of pattern of sexual growth and factors influencing it in adolescent girls in Nagpur

Summary The pattern of sexual growth was studied in 1039 girls in Nagpur. The mean age at the first sign of breast development was 11.2 years. It appeared 1.77 years before the first sign of pubic hair and 2.75 years before the advent of the menarche The mean age at peak height velocity war 11.5 years, 0.3 years before the first external manifestation of sexual development. Nutrition and socio-economic status of the girl seemed to have good correlation with age at menarche while no correlation appearch between family size and age at menarche. From the Department of Preventive and Social Medicine, Government Medical College, Nagpur.     

Asymptomatic rickets in adolescent girls

Objective Inadequate sunlight exposure and calcium intake during rapid growth at puberty lead to hypocalcemia, hypovitaminosis D and eventually to overt rickets. To determine serum biochemical findings of rickets in healthy 11–15 yr old girls, the effect of sunlight exposure and oral vitamin D supplementation on serum 25-hydroxy vitamin D and calcium administration in girls with abnormal findings during December 2002 through March 2003 in Tehran, Iran. Methods Healthy middle school girls were selected for estimation of vitamin D, calcium and phosphorus intake by a three-day food recall. And measurement of serum calcium, phosphorus, parathyroid hormone, alkaline-phosphatase and 25-hydroxyvitamin D concentration. The girls with abnormal findings divided in two groups. Hypovitaminosis D girls subdivided into two groups, supplementary sunlight exposure and vitamin-D administrated for them and calcium administration for the second group for 20 days. Results Of 414 girls, the mean daily vitamin D acquirment and calcium intake were 119 ± 52 IU and 360 ± 350 mg among all girls respectively. Mean serum 25-hydroxyvitamin D with two or more abnormal biochemical findings in 15 (3.6%) girls (group I) were 7.8 ng/ml and alkaline phosphatse with normal or low calcium in 29 (7%) girls (group II) was 1187 IU/L. Mean serum calcium was 8.2 mg % in 8 of 29 girls. Serum 25-hydroxyvitamin D before and after sunlight exposure was 7.1 ± 1.9 ng/ml and 13.9 ± 2.4 ng/ml and vitamin D administration was 7.4 ± 1.8 ng/ml (group la) and 27.9 ± 4.2ng/ml (group lb) respectively. Serum alkaline phosphatase before and after calcium administration were 1187 IU/L and 666 IU/L respectively. Conclusion We conclude that low daily calcium intake, and vitamin D acquirement are two important problems in Iranian girls during rapid growth at puberty; therefore, for prevention of overt rickets calcium and vitamin D Supplementation appear to be necessary.     

Obesity amongst affluent adolescent girls

Objective  To assess the prevalence and type of obesity in affluent schoolgirls aged 16 and 17 yr. Methods  A cross-sectional study was conducted in 2002, in 4 randomly selected public schools of Delhi. All girls from randomly chosen classes were included. Weight, height, and waist and hip circumferences were measured for all 414 schoolgirls and their socio-demographic profile was recorded. Body mass index [BMI] and waist hip ratio [WHR] were calculated for all the girls. BMI ≥ 30 (i.e. ≥ 95^th percentile) denotes obesity and BMI ≥ 25 (i.e. ≥ 85^th percentile) denotes overweight as according to International Obesity Task Force (IOTF) criteria. WC ≥ 80 cm or WHR > 0.85 denote central obesity. Results  Prevalence of obesity and overweight amongst the study subjects was 5.3% and 15.2% respectively (IOTF). Out of the 22 obese girls central obesity was present in 21 girls (95.4%) [WC ≥ 80 cm] and 12 girls (54.5%) [WHR > 0.85]. Conclusion  There is significant prevalence of obesity in affluent schoolgirls in Delhi and more than half of them have central obesity.     

Differences in hymenal morphology between adolescent girls with and without a history of consensual sexual intercourse

OBJECTIVE: To compare the morphology of the hymen in adolescent girls who have and have not had sexual intercourse involving penile-vaginal penetration. SUBJECTS: Female patients aged 13 to 19 years, recruited from an urban adolescent medicine practice. METHODS: Subjects were interviewed in private after completing detailed questionnaires and then underwent a physical examination. External genital inspections were performed using a colposcope with an attached 35-mm camera to document the appearance of the hymen. The presence of notches or clefts was recorded during the examination, and photographs taken at x10 magnification were used to take measurements of the width of the posterior hymenal rim. RESULTS: Posterior hymenal notches and clefts were more common among girls admitting past intercourse (13/27 [48%]) than in girls who denied intercourse (2/58 [3%]; P =.001), but the mean width of the posterior hymenal rim was not significantly different between the 2 groups (2.5 mm vs 3.0 mm; P =.11). Two subjects who denied intercourse but had posterior hymenal clefts described a painful first experience with tampon insertion. CONCLUSIONS: Deep notches or complete clefts in the posterior rim of the hymen were rare in girls who denied intercourse. Subjects who admitted past intercourse still had nondisrupted, intact hymens in 52% of cases.     

Health concerns of university women with a history of child physical and sexual maltreatment

Three health symptom checklists were used to measure physical health concerns among university women in relation to prior child physical maltreatment (CPM) (20%, n = 153) and child sexual abuse (CSA) (19%, n = 143). A history of CPM was related to all three general areas of health concerns as well as to many of the specific subscales comprising the measures (e.g., muscular-skeletal symptoms and gynerological problems), whereas an interaction between CSA and CPM was linked to greater premenstrual distress subscale scores (particularly emotional and behavioral symptoms). Overall, although CSA was not related to health symptoms, within the CSA subgroup, greater duration and severity of CSA was predictive of higher premenstrual distress even after controlling for CPM. This study emphasizes the need for greater awareness of the physical health-related correlates of both physical and sexual maltreatment in childhood and their associated implications for women's health care needs.     

Nutrition of adolescent girls in Lorraine

A survey concerning the nutritional habits, using the method of the dietary history, was undertaken among 273 girls aged 10 to 16 and examined at the Preventive Medicine Center in Nancy. The energy amount, on average 2,363 calories/day (9.88 MJ) and the distribution among the various nutriments differed little from the French recommendations. Energy intakes varied with bone ages and the socio-cultural level of parents. No intake changes were found with respect to the degree of overweight or to the growth peak. The study of the distribution of intakes according to the main groups of aliments showed the important place of dairy products (14.6%), breads (13.9%) as well as sweets and pastries (11.8%, 12.9%), distribution independent of age. Lunch represents the most important meal of the day (35.7%). Snacks provide as much energy as breakfast. The latter is insufficient in 20% of cases. However, this insufficiency is compensated during the day.     

Fear of obesity among adolescent girls

The perceptions concerning weight, dieting practices, and nutrition of 326 adolescent girls attending an upper middle-class parochial high school were studied in relation to their body weight. Underweight or overweight students were those with greater than 10% body weight differential for height. The high school students reported an exaggerated concern with obesity regardless of their body weight or nutrition knowledge. Underweight, normal weight, and overweight girls were dieting to lose weight and reported frequent self-weighing practices. As many as 51% (n = 60) of the underweight adolescents described themselves as extremely fearful of being overweight and 36% (n = 43) were preoccupied with body fat. A distorted perception of ideal body weight was documented, particularly among the underweight students; the greater the underestimation of perceived ideal body weight, the greater the actual deficit in ideal body weight for height of the students (r = .73; P less than .001). Normal weight and overweight girls had better concordance between their actual and perceived ideal body weight for height. The frequency of bingeing and vomiting behaviors was similar among the three weight categories. The data suggest that fear of obesity and inappropriate eating behaviors are pervasive among adolescent girls regardless of body weight or nutrition knowledge.