"I really enjoy the office staff and the doctors. I am having twin boys and feel I am in competent hands with all the doctors and staff."


Our patients: While most of our patients are referred in from the greater St. Louis area, it is not unusual for a family to travel hundreds of miles to be cared for by Dr. Merritt or Dr. Ratts. It is important to bring a set of medical records with any relevant laboratory tests or diagnostic images with you to your appointment.

Children are generally cared for by their pediatrician or family physician.  The pediatric gynecologist is a resource person for your primary care physician and can be called to assist with difficult or challenging medical conditions.  Common reasons why children are seen by pediatric gynecologists include vulvar and vagina irritation that will not improve despite hygiene and medications, congenital anomalies of the genitalia, labial adhesions, lichen sclerosus, pelvic masses, and early signs of puberty (breast development) or vaginal bleeding. 

Teens: Part of growing up is learning to take care of your body.  This means making good choices for your health, avoiding things that can hurt you, and seeing a doctor for routine health care.  If you have never visited an obstetrician-gynecologist (ob-gyn) before, you may have questions about what will happen at your first visit.

Young women should have their first gyn visit between the ages of 13 and 15 years.  The first visit may be just a talk between you, your parents, and your doctor. Your doctor may ask a lot of questions that seem very personal about your menstrual period.  It is important to be as honest as possible with your doctor, and it is also important to ask any questions that you may have.  Your doctor will also give to the opportunity to speak to her without your parent if you would like more privacy.  Most mothers understand, and will respect your need for confidentiality (privacy). Your doctor will explain important health issues to you and your family at the end of your visit.

You may or may not have an examination at your first visit.  It will depend on your age, your problems and if you have ever had sex.  If you choose, a nurse or family member may be with you for any part of your exam.  Your doctor will probably review the anatomy of the pelvic area.  A speculum is a special instrument designed to help your doctor look into the vagina.  Many young teens do not need a speculum exam, and the current recommendations for a pap smear have been changed to age 21 or three years from the first intercourse. 

Reasons for teens to see the pediatric and adolescent gynecologist include: problems with menstrual periods (pain, nausea, heavy or irregular bleeding, frequent or absent periods), hirsutism and acne (which may be signs of polycystic ovarian syndrome or other endocrine problems), pelvic pain which is not responding to standard treatments, pelvic masses, ovarian tumors, or congenital anomalies of the reproductive orders.  The pediatric and adolescent gynecologist is experienced with medications for problem menstrual periods, polycystic ovarian syndrome, contraception  (birth control), treatment of sexually transmitted infections, endometriosis, and the new vaccine which can prevent cervical cancer and genital warts (HPV vaccine).