Filling the Unmet Need: Cook Children’s First Pediatric and Adolescent Gynecology Department Opens

For many parents, the thought of taking their young daughter to a gynecologist can be scary. It can also be difficult to know when and why to make such an appointment. Cook Children’s hopes to alleviate some of this fear and uncertainty with the launch of its new Pediatric and Adolescent Gynecology department.

The specialty, led by pediatric gynecologist Shanna M. Combs, M.D., FACOG, began taking appointments this week. The goal is to provide young females care related to reproductive health and development, including menstrual concerns like heavy bleeding or irregular periods, hormonal imbalances, pelvic pain, concerns about development, ovarian cysts or masses.

“Unfortunately, a lot of gynecologists don't want to take care of young ladies under the age of 18, and it's not necessarily an area of expertise for pediatricians,” said Dr. Combs. “There's a huge unmet need here in the greater Tarrant County area that our clinic is going to help fill.”

Dr. Combs began practicing as an OB-GYN in Fort Worth in 2012. While she was seeing mostly adults, she says she enjoyed caring for younger patients and built a reputation for serving adolescents and teens. She says she’s excited to join Cook Children’s where she will be able to serve young females fulltime.

When to see a pediatric gynecologist

“A lot of times, we suggest doing an initial reproductive health visit around age 13 to 15. If the patient is having problems or concerns with pubertal development at any age, I encourage parents to make an appointment,” said Dr. Combs.

Available services:

• Initial reproductive health visit
• Contraception counseling and initiation (including birth control implant/IUD insertion)
• Menstrual regulation or suppression
• STD testing and treatment
• Surgery for ovarian cysts or masses
• Minimally invasive surgeries and fertility preservation

There is no age limit for visits at Cook Children’s Pediatric and Adolescent Gynecology, and patients do not need to be referred by a pediatrician to schedule an appointment. Parents and guardians can simply call the office to request an appointment.

What to expect during an appointment

Dr. Combs understands that going to see a gynecologist can be nerve-racking for younger patients and hopes to ease some of that anxiety through education.

“One of the biggest things I want people to know is that an appointment does not necessarily mean a pelvic exam,” said Dr. Combs. “Most of the time with younger patients, the first visit is a conversation. If an exam is needed, we will discuss what that means and what to expect.”

She says her appointments are much like other doctor’s visits. Dr. Combs will address health history, medications the patient is on, as well as any concerns the patient might have.

Why pediatric gynecologists are important

“When it comes to women’s health, there is a lot of misinformation out there, especially on the internet,” said Dr. Combs. “I want to be able to share reliable information, because there are some things that happen to young ladies as they’re going through puberty or having problems with their period that can affect them later in life.”

In the world of women’s health, Dr. Combs says puberty development is considered a vital sign. Abnormalities that occur at a young age can lead to long-term health problems and even create challenges for women wanting to get pregnant.

"Women have suffered a lot when it comes to their reproductive health, and they don’t need to,” she said. “Establishing a relationship with a pediatric gynecologist can help create a safe place to talk about these issues and find ways better to cope. It’s like having a gynecologist in your back pocket, so to speak. We’re here to help.”