We offer evaluation and treatment for children and adolescents who have problems with:
- Heavy, frequent, or painful menstrual periods
- Irregular or infrequent menstrual periods
- Signs of early sexual maturation
- Signs of delayed sexual maturation
- Breast abnormalities, asymmetry or pain
- Chronic genital rashes or itching
- Vaginal discharge, drainage or odor
- Unusual appearance of the genitals
- Abdominal pain
- Ovarian cysts, or pelvic masses
- Abdominal pain, pelvic endometriosis
- Birth defects involving the reproductive organs
- Injuries involving the reproductive organs
A patient may be referred to the Washington University Center for Pediatric and Adolescent Gynecology by her physician, or parents may call for appointments. We offer consultations to primary care physicians re: problems unique to pediatric and adolescent gynecology.
Working closely with the referring physicians and other specialists at St. Louis Children's Hospital, we are able to address the special gynecologic needs of children with chronic illnesses and disabilities.
Why should my daughter be seen by a pediatric or adolescent gynecologist?
The gynecologic examination of a child is completely different from that of an adult. The prepubertal child is susceptible to injuries and infections which are unique due to the unestrogenized state of the tissues of the introitus, hymen and vagina. Dr. Merritt and Dr. Ratts have expertise in the variations of normal prepubertal anatomy and physiology, as well as the ability to communicate both with the infant/ child and her parents. The examination will take place in a matter which is reassuring, non-threatening and without discomfort. We have special instruments and equipment which allow us to examine young children and teens.
Adolescents also have special needs in their examination, especially if this is a first pelvic examination. The first examination is a golden opportunity to educate young patients about the breast and pelvic examination, answer questions about development, and provide medical reassurances and information about issues of health and sexuality. We provide abstinence counseling as well as contraceptive counseling and pregnancy prevention strategies. We are able to address the special gynecologic needs of the child or teen with physical or mental disabilities, or chronic underlying health problems. Our office is specially equipped to allow easy access for patients with physical disabilities.
Dr Merritt, and Dr. Ratts are skilled in the medical evaluation and surgical management and correction of gynecologic disorders of this age group. Laparoscopy for evaluation of abdominal masses, pelvic pain, and pelvic endometriosis, laser surgery, vaginoscopy for removal of foreign objects and assessment of bleeding and injuries, as well as colposcopy for evaluation of abnormal bleeding and abnormal pap smears are available for young patients. The pediatric and adolescent gynecology service works in close coordination with the referring physicians as well as the pediatric specialty groups at St. Louis Childrens' Hospital.