The Paediatric and Adolescent Gynaecology Team focuses on the menstrual disorder of adolescents, HPV vaccination in adolescents and Polycystic ovarian syndrome in teenage girls.
Menstrual Disorder of Adolescent
The prevalence of menstrual problems is high among Chinese teenage girls. Chung reviewed the presentations and outcomes of 577 adolescents aged between 14 and 19 years old. 47% presented with menorrhagia, prolonged menstruation, and short menstrual cycles; 38% had secondary or oligo-amenorrhoea, 12% had dysmenorrhoea, and 3% had primary amenorrhoea. 24% of these patients had abnormal menstrual cycles 4 years later. Long cycle, diagnosis of polycystic ovarian syndrome at first consultation, and a current body mass index of 23 kg/m2 or higher were statistically associated with persistent long cycle length (Chung et al HKMJ 2011). The prevalence of menstrual symptoms and dysmenorrhoea increased with gynaecological age and might adversely affect their education and daily activities. 1 in 8 girls reported having been absent from school whilst only 6.4% had sought medical care because of a menstrual problem. Our study indicated that medical seeking behaviors largely depended on the opinion of family members, severity of dysmenorrhoea and fear for embarrassment (Chan et al HKMJ 2009).
Polycystic Ovarian Syndrome
Polycystic ovarian syndrome was diagnosed in 16% of a cohort in Hong Kong Chinese adolescents (Chung et al HKMJ 2011). One of our studies looked at the treatment effects between medroxyprogesterone acetate and Diane-35. Diane -35 was found to significantly decrease acne score (p<0.003) and LH/FSH ratio (p<0.001) (Chung et al J Pediatr Adolesc Gynecol 2014).
Human Papilloma Virus Vaccination in Adolescent
The acceptance rate of HPV vaccination by daughters of Chinese women has been statistically significantly improved by reading information pamphlets (p<0.001) (Chan et al J Adolesc Health 2007). While acceptance rate of HPV vaccination by adolescent girls and knowledge score have also been significantly improved by reading information pamphlets (p<0.001) (Chan et al al J Pediatr Adolesc Gynecol 2009).
Highlights of Some Studies
Studies on menstrual problems of adolescents
Menstrual disorder is the most common gynaecological problem of adolescents. A survey of more than 5000 girls from 10 secondary schools was conducted in which the prevalence of menorrhagia, dysmenorrhea and menstrual symptoms were 18%, 69% and 38% respectively. The prevalence of menstrual symptoms and dysmenorrhea increased with gynaecological age. Although one in eight girls reported having been absent from school, only a minority had sought medical care.
Menstrual disorder is also one of the most common causes for adolescents to seek consultation from paediatric and adolescent gynaecology clinics. Overall, 47% presented with menorrhagia, 27% secondary amenorrhoea, 12% dysmenorrhea, 11% oligomenorrhoea and 3% had primary amenorrhoea. Significant diagnoses included congenital genital tract anomalies, premature ovarian failure, anorexia nervosa, and polycystic ovarian syndrome. Longitudinally, 24% of them had abnormal menstrual cycles 4 years later. Adolescents who were screened out with a definitive diagnosis after initial assessment were at low risk of persistent long menstrual cycles at follow-up. Adolescent menstrual disorders should not be ignored.
Studies on women’s and adolescents’ attitude towards HPV vaccination in Hong Kong
Before the implementation of HPV vaccination in Hong Kong, the Department has conducted research on women’s and teenager’s attitude towards HPV vaccination.
Women’s acceptance to HPV vaccination for their daughters was evaluated before and after reading information pamphlets. It was shown that the pamphlets increased their self-perceived knowledge on cervical cancer and HPV in women, hence casting a positive influence on their attitude towards HPV vaccination for their daughters.
The attitude on HPV vaccination of adolescents, aged 12 to 19 years, was also studied. The study showed that before reading an educational pamphlet, their intentions to receive the vaccination positively correlated with their knowledge, health belief and belief in who should receive the vaccine, but correlated negatively with their belief that other people would approve of their vaccination (normative belief). After reading the pamphlet, their knowledge on HPV vaccination expanded. Their health beliefs and belief in who should be vaccinated became more positive.