Problems related to the sexual system in children and adolescents are relatively rare. In the case of small children, parents are the ones who follow the correct development and establish in the presence of disorders related to them. Synechiae – a common problem already in the first months after birth The fusion between the labia minora is referred to as synechiae. This disorder most often develops after 3 months to 3 years of age. The formation of adhesions is the result of the anatomical and physiological features during this period. The low level of estrogens during the pre-pubertal period is one of the prerequisites for the appearance of the condition. During the first months, maternal hormones have a protective effect. Synechiae in the genital area can be formed as a result of trauma or after vulvovaginitis. Formation of the adhesion is usually centrally located and may cover only part of the labia, most often their middle or posterior part. The condition can occur both without visible complaints and accompanied by pain and discomfort. With the formation of adhesions between the labia minora, a space can be formed in which urine falls and is retained. This is a prerequisite for some children to observe frequent infections of the excretory system. Very often, with smaller adhesions, the condition passes without specific treatment, only by observing hygiene habits. If necessary, moisturizing creams as well as those with estrogen content can be used. Menstrual disorders that often accompany the puberty period The attainment of sexual maturity and the release of eggs from the ovaries begins during the period of puberty around 12 – 14 years of age. The absence of the first period after the age of 16 is referred to as primary amenorrhea. Despite the absence of menstruation, hormonal changes may have occurred and the absence of genital bleeding may be the result of genital malformations. Disrupted development may occur in the vagina, cervix or hymen, which is why, despite the cyclical changes in the lining of the uterus, the formed blood cannot pass. Pain in the pelvic area is also observed in these cases. Through operative manipulation, this violation can be restored. NEWS_MORE_BOX During the period of puberty, very often the neurohormonal regulation of the menstrual cycle is immature and disturbances may occur. Any absence of menstruation for more than 3 months is referred to as secondary amenorrhea. Menstrual disorders can occur in girls during puberty as a result of situations related to emotional stress or after applying diets. The menstrual cycle is hormonally dependent, and for this reason, during the first years, disturbances in its duration and abundance may be observed. The release of eggs during puberty can be delayed, which also determines a longer interval between cycles – hypomenorrhea. In the conditions of hypermenorrhea,cycles that occur at smaller time intervals, as well as those associated with profuse blood loss, may cause an anemic condition that requires treatment. Injuries in the genital area in children In young children, genital injuries are relatively common. Depending on the type and force with which the trauma occurred, it can lead to an open wound associated with a violation of the integrity of the skin and mucous membranes or only a hematoma is formed at the site. The treatment is accompanied by cleaning and disinfection.
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