What is Adolescent Medicine & The Need of Adolescent Medicine

While we often hear the term adolescent being used widely today, very few people are actually aware of what the term exactly means.

Adolescence is a transitional phase of psychological and physiological development between childhood and adulthood. Typically, the period of adolescence is defined to be between 12 years to 22-25 years old. Biologically, though, adolescence is marked by the start of puberty and the end of physical growth such as changes in sex organs and other features like weight, height, muscle mass, etc.1

There are several cognitive changes as well during adolescence. Cognitively, this period is marked by an improvement in knowledge, abstract thinking, and logical reasoning. If you look at it socially, then adolescence is a period that marks the coming of age and slowly moving towards adult roles such as being a worker or having a romantic partner.

This dramatic changing phase is often identified with challenges such as identity crisis, dealing with bullying, feelings of self-doubt, and an intense need for social acceptance.2

Adolescence is a special phase of life where specific health and developmental needs may need to be addressed. Learning to manage new emotions, relationships, developing knowledge and skills, and acquiring abilities and attributes that will last throughout the adult life, can be a stressful time.3

Often, parents find themselves struggling to provide adequate help to a growing adolescent who is struggling with many issues and also trying to fit into a social circle and gain social acceptance. It is also rare to find an adolescent who is ready to have an open channel of communication with their parents. Due to this, it is better if the many challenges faced during this adolescent period of development are addressed by a professional who is trained and specializes in adolescent medicine.4

What is Adolescent Medicine?

Adolescent medicine is an upcoming and fast-growing medical subspecialty that focuses explicitly on caring for patients who are in their adolescent phase of development. People who are in the last years of their elementary school all the way up to high school are treated under adolescent medicine. In fact, some adolescent medicine specialists even treat young adults who are attending college in their locality, but this usually falls under the specialty of college health rather than adolescent medicine.5

Traditionally in most countries, medicine and healthcare are usually categorized simply in two areas that is pediatric and adult. While the pediatric category typically covers the period right from birth till ages 16 to 18, and from there one, doctors would term the patient as being an adult.

However, such type of categorization limits the specialization of doctors. Modern medical science now believes that such a simple classification is a thing of the past. It should be further divided into more deeper and clearer contexts so that adolescent medicine can be more focused on the adolescent age group. At the same time, geriatrics will focus more on treating issues faced by older adults, instead of just clubbing it under adult medicine or adult healthcare.6

The Need of Adolescent Medicine

The rise of adolescent medicine has been because of the many issues and challenges faced by adolescents that need to be addressed by specialized doctors. Some of these issues include:

  • Eating Disorders Such As Bulimia Nervosa And Anorexia Nervosa: An adolescent medicine specialist approaches the treatment for eating disorders in adolescents by working together with a team of dieticians and nutritionists, along with pediatric mental health counselors, specialists in pediatric psychiatry, and clinical psychology. Together, they work with adolescents to help them overcome common eating disorders.7
  • Delayed or Precocious (early) Puberty: Early puberty or precocious puberty happens when girls develop signs of puberty before 8 years of age, and boys experience these signs before 9 years of age. Delayed puberty happens when boys do not experience any signs of testicular development even by 14 years of age, and girls do not develop breasts by 13 years of age. While some girls may have developed breasts, but they might not have started their periods by the time they turn 15 years. Adolescent medicine doctors work with specialists in adolescent, pediatric endocrinology, andrology, and urology to treat such type of conditions.8 Adolescents with delayed puberty are also more prone to have self-image issues, requiring specialized help from adolescent medicine specialists.9
  • Menstrual disorders in girls such as dysmenorrhea, amenorrhea, menorrhagia, and dysfunctional uterine bleeding: Adolescent girls in the age group of 13 to 19 years often experience various types of menstrual disorders including dysmenorrhea (painful periods or intense menstrual cramps), amenorrhea (the absence of menstruation), dysfunctional uterine bleeding, or menorrhagia (abnormally heavy or prolonged bleeding).10
  • Unintended Pregnancy: An adolescent medicine specialist will work together with specialists in adolescent obstetrics and gynecology, particularly an expert who specializes in maternal-fetal medicine and neonatology. Adolescent pregnancies may be medically risky or high-risk cases owing to the age of the mother, and also pose certain psychosocial and socioeconomic challenges. Such specialists also work in helping prevent unintended pregnancies among adolescents.11 An adolescent medicine specialist is also the right person to enable access to prescription or non-prescription birth control methods. They can also effectively deal with questions on sexual activity that most adolescents have, including doubts on sexual intercourse and masturbation. An adolescent medicine specialist also serves as a safe haven to report cases of sexual abuse.
  • Sexually Transmitted Diseases (STDs): Adolescent medicine also focuses on the prevention of sexually transmitted diseases in adolescents, along with the safe treatment of such infections. Generally, if there is no adolescent medicine specialist present, an adolescent would have to work with specialists in obstetrics and gynecology, immunology and infectious diseases, reproductive medicine, and urology. Dealing with so many different doctors can prove to be a daunting task, causing many adolescents to simply avoid seeking the medical help they need when they contract a sexually transmitted infection. It is also essential that the correct prevention tips and information regarding safe sexual behavior reaches adolescents. In such cases, having access to a single adolescent medicine specialist solves many issues for adolescents. An adolescent medicine specialist also helps remove the stigma often associated with STDs.12
  • Acne: This time period of life is marked with the onset of the dreaded acne and pimples. Having access to a separate specialty on adolescent medicine means that teenagers and young adults can work with specialists in dermatology who are equipped to treat adolescents.

The need for adolescent medicine is not only restricted to the challenges mentioned above. There is a rising trend of chronic conditions in adolescents nowadays, which can also cause problems such as delayed puberty, changes in the hormonal cycle, impediments to growth (either temporary or permanent), and many other issues that need to be addressed by a medical professional.

Lifestyle diseases such as diabetes are also now being observed at a younger age, for which also an adolescent medicine specialist comes in handy.13,14

Summing Up

Specialists in adolescent medicine are typically taken from different specialties, including pediatrics, family medicine, internal medicine, gynecology, and obstetrics. Various certifying boards worldwide have varying requirements to allow a specialist in one field to become a specialist in adolescent medicine.

While the adolescent phase of life can feel like you are on a roller coaster, but consulting an adolescent medicine provider can help you maintain a positive outlook and deal with the many challenges of this phase in a more constructive manner. An adolescent medicine specialist can help both children and their parents understand and deal with the problems of this period in a better way and function as a reliable support system throughout the adolescent years.

References:

  1. Drury, J., 2019. The nature of adolescence and its family, societal, community, cultural and developmental challenges. Substance Misuse and Young People: Critical Issues.
  2. Cicchetti, D. and Toth, S.L. eds., 1996. Adolescence: Opportunities and challenges (Vol. 7). University Rochester Press.
  3. Zarrett, N. and Eccles, J., 2006. The passage to adulthood: Challenges of late adolescence. New directions for youth development, 2006(111), pp.13-28.
  4. Blechman, E.A. and Culhane, S.E., 1993. Aggressive, depressive, and prosocial coping with affective challenges in early adolescence. The Journal of Early Adolescence, 13(4), pp.361-382.
  5. Santelli, J.S., Rosenfeld, W.D., DuRant, R.H., Dubler, N., Morreale, M., English, A. and Rogers, A.S., 1995. Guidelines for adolescent health research: a position paper of the Society for Adolescent Medicine. Journal of adolescent health, 17(5), pp.270-276.
  6. Klein, J.D., Slap, G.B., Elster, A.B. and Schonberg, S.K., 1992. Access to health care for adolescents: a position paper of the Society for Adolescent Medicine. Journal of Adolescent Health, 13(2), pp.162-170.
  7. Golden, N.H., Katzman, D.K., Kreipe, R.E., Stevens, S.L., Sawyer, S.M., Rees, J., Nicholls, D. and Rome, E.S., 2003. Eating disorders in adolescents: position paper of the Society for Adolescent Medicine. Journal of adolescent health, 33(6), pp.496-503.
  8. Reiter, E.O. and Lee, P.A., 2002. Delayed puberty. Adolescent Medicine Clinics, 13(1), p.101.
  9. Apter, A., Galatzer, A., Beth-Halachmi, N. and Laron, Z., 1981. Self-image in adolescents with delayed puberty and growth retardation. Journal of Youth and Adolescence, 10(6), pp.501-505.
  10. Sharma, P., Malhotra, C., Taneja, D.K. and Saha, R., 2008. Problems related to menstruation amongst adolescent girls. The Indian Journal of Pediatrics, 75(2), pp.125-129.
  11. Rickert, V.I., Tiezzi, L., Lipshutz, J., León, J., Vaughan, R.D. and Westhoff, C., 2007. Depo now: preventing unintended pregnancies among adolescents and young adults. Journal of adolescent health, 40(1), pp.22-28.
  12. Cunningham, S.D., Kerrigan, D.L., Jennings, J.M. and Ellen, J.M., 2009. Relationships between perceived STD‐related stigma, STD‐related shame and STD screening among a household sample of adolescents. Perspectives on sexual and reproductive health, 41(4), pp.225-230.
  13. Hotu, S., Carter, B., Watson, P.D., Cutfield, W.S. and Cundy, T., 2004. Increasing prevalence of type 2 diabetes in adolescents. Journal of paediatrics and child health, 40(4), pp.201-204.
  14. Di Battista, A.M., Hart, T.A., Greco, L. and Gloizer, J., 2009. Type 1 diabetes among adolescents. The Diabetes Educator, 35(3), pp.465-475.

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