A Note to Teens & Their Parents

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.

Real talk about periods

Young patients, their parents and even their doctors are often unsure what represents normal menstrual patterns during adolescence. Our own Dr. Merritt joined the St. Louis Children’s Hospital Radio Rounds podcast to talk about the first few years of menstruation, including cramps, tampon use and when you may need to talk to your doctor.

Listen to the podcast:

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 parents 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 and the reasons for your visit. 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. Many young teens do not need a speculum exam (a speculum is a special instrument designed to help your doctor look into the vagina), and the current recommendations for a pap smear have been changed to age 21.

Additional reasons for teens to see a pediatric and adolescent gynecologist, besides these routine annual visits, 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 that 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).

Meet our gynecologists

Our doctors have specialized training and are highly experienced in gynecologic treatment and care for teens and young women.
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Assistant Professor, Obstetrics and Gynecology

Division: Pediatric & Adolescent Gynecology

Learn more about Dr. Hoefgen

Dr. Hoefgen is an assistant professor of obstetrics & gynecology at Washington University School of Medicine and an attending physician at St. Louis Children’s Hospital and Barnes-Jewish Hospital. Dr. Hoefgen received her medical degree in 2008 from Southern Illinois University School of Medicine, Springfield, IL, where she also completed her residency training in obstetrics and gynecology. She completed her clinical fellowship specializing in pediatric and adolescent gynecology at Washington University School of Medicine in St. Louis, MO in 2014.

In addition to providing general and specialty gynecologic care to girls and young women, Dr. Hoefgen is the co-founder and co-director of the Integrated Care & Fertility Preservation Program at Washington University, focusing on fertility preservation in patients with medical illness or treatments that threaten the function of their ovaries. She assists with the long-term gynecologic needs of cancer survivors.

AWARDS
Cincinnati Children’s Hospital Annual Faculty Awards, Clinical Team Award (Comprehensive Fertility Care & Preservation Program), 2017

PROFESSIONAL SOCIETIES, ORGANIZATIONS, & COMMITTEE INVOLVEMENT
American College of Obstetrics and Gynecology (ACOG), 2006– present, Fellow 2/2016 – present
American Society for Reproductive Medicine (ASRM), 2016-present
North American Society for Pediatric and Adolescent Gynecology (NASPAG), 2013 – present
International Fertility Preservation Guidelines Working Group
Oncofertility Consortium Pediatric Initiative Network

To make an appointment with Dr. Hoefgen, call 314-362-4211

Chief, Pediatric & Adolescent Gynecology
Professor, Ob/Gyn
Fellowship Director, Pediatric & Adolescent Gynecology

Division: Pediatric & Adolescent Gynecology

Learn more about Dr. Merritt

Dr. Merritt is a professor of obstetrics and gynecology and has been an attending physician at St. Louis Children’s Hospital for four decades. She is the recipient of a numerous awards and consistently ranked as a Best Doctor in America and America’s Top Doctor. She is a fellow of the American College of Obstetricians and Gynecologists and served as chair of the Committee on Adolescent Health Care. She was a founding member of the North American Society for Pediatric and Adolescent Gynecology and served on the board and as president. She is currently the chief of the Division of Pediatric and Adolescent Gynecology and is a fellowship director in Pediatric and Adolescent Gynecology at Washington University. Dr. Merritt is a consultant for the Beautiful You MRKH Foundation and has expertise in the care of women born with congenital absence (atresia) of the uterus and vagina (MRKH). She has expertise in the management of menstrual suppression and cycle control for patients with developmental disabilities and underlying medical disorders. She is also an expert in the management of congenital anomalies of the reproductive tract as well as genital injuries and repair.

AWARDS AND HONORS
Distinguished Faculty Award, Distinguished Service Teaching Award, the Humanism in Medicine Award, Alumni Achievement Award,

Best Doctor in America 1996-2017
America’s Top Doctor 2000-2017

PROFESSIONAL SOCIETIES, ORGANIZATIONS
American College of Obstetrics and Gynecology (ACOG), Fellow 1985 – present
American Society for Reproductive Medicine (ASRM), 1986 – present
Society for Adolescent Health and Medicine (SAHM) 1984 – present
North American Society for Pediatric and Adolescent Gynecology (NASPAG), 1987 – present
Alpha Omega Alpha

To make an appointment with Dr. Merritt, call 314-362-4211

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