Adolescent medicine is a medical subspecialty that deals primarily with the care and treatment of patients who are in the adolescent stage of development. This period typically starts between the ages of nine to 11 for females and 11 to 14 for males. Considered as a primary care subspecialty, adolescent medicine integrates various iatrical aspects including dermatology, endocrinology, gynecology, nutrition, psychology and sports medicine. It is likewise an integral component of internal medicine, family practice, pediatrics, and youth health.
Medical practitioners who delve in the practice of adolescent medicine often address issues and disorders with a high prevalence during adolescence. These include the following:
§ Precocious puberty
§ Birth control
§ Substance abuse
§ Acne vulgaris
§ Unintended pregnancy
§ STDs or sexually transmitted diseases
§ Eating disorders such as anorexia and bulimia
§ Menstrual disorders like amenorrhea, dysfunctional uterine bleeding and dysmenorrhea
§ Mental illnesses, particularly anxiety disorders, personality disorders, bipolar disorder, major depression, suicidal ideation and certain types of schizophrenia
Healthcare providers who deal with adolescents normally take a holistic approach as they try to gather information relevant to the patient’s well-being. The approach closely resembles the biophysical model which is epitomized in the HEADSS assessment. It is a screening acronym for adolescent patients and stands for Home, Education, Activities, Drugs, Sex, and Suicidality.
Aside from a comprehensive medical history, adolescents ought to undergo a thorough physical examination as well as a mental health status exam at least once a year. The physical exam should include sexually transmitted infections (STI) testing, a neurological assessment, and a reproductive system exam. In addition, developmental progression should be documented on an annual basis, and endocrinological tests should be considered especially among patients who fail to develop in a normal manner.
Young women must be properly educated on how to examine their breast for signs of breast cancer, and young men should know how to examine their penis and testicles for STDs and cancer. Laboratory tests, including a CBC to screen for anemia, and a fasting lipid profile or a spot cholesterol check to screen for hyperlipidemia should be undertaken at least once during the adolescent period.
For those who are sexually active, especially patients who are living in areas of high prevalence, screening tests for STDs should be done, including rapid plasma reagin (RPR) or venereal disease research laboratory (VDRL) test for syphilis, screening for HIV, chlamydia and gonorrhea. Females who are sexually active must have a pelvic exam, including a Pap smear to screen for cervical cancer.
In terms of immunizations, the following are deemed imperative: a meningitis vaccination, a tetanus vaccination or booster shot, the Gardasil vaccine against HPV particularly for sexually active young women, and an annual influenza inoculation.