Gynecologic care of medically complicated adolescents

Gynecologic care of adolescents presents a challenge under the best of circ umstances, but when the patient has significant medical processes that inte ract with the process of puberty, the care of these patients may become ext remely difficult. A review of the more common medical illnesses of adolesce nts and the interaction on the events of puberty and normal menstrual funct ion is presented with emphasis on contraception and future fertility. Altho ugh many of the contraceptive options present a possible increased risk to these patients, it must be kept in mind that these adolescent patients will develop emotionally and become sexually active at some point in their live s, and the potential risk of the resultant pregnancy must be weighed carefu lly. The various options of management for gynecologic problems are discuss ed.