Treatments
Paediatric gynaecology
Paediatric gynaecology is a field within gynaecology for girls aged 0 to 18 with symptoms or questions about their body, their periods or their hormonal development.
At Femmecare we provide this care in a small, calm clinic, where young girls and their parents often feel safer and more at ease than in a large hospital.
Our expertise
Not a sideline, but one of our specialisms
At Femmecare, care for girls is not a sideline but one of our specialisms. It is led by gynaecologist Dr. Céline Lardenoije, who previously worked as a gynaecologist specialising in paediatric gynaecology at a university hospital.
In figures
What is normal?
Many questions from girls and parents are about what is normal during puberty. This is what the guidelines say about the first period and the cycle.
- 11 to 16 yearsis the age at which girls normally have their first period.
- 16 yearsand no period yet, or none five years after breast development began? Then it is worth investigating.
- The 1st yearafter the first period, an irregular cycle is normal: the body still has to settle into its rhythm.
- 95%of cycles last between 21 and 45 days in the third year after the first period.
Sources: Dutch guideline Primaire amenorroe (richtlijnendatabase.nl), start page; Dutch PCOS guideline (adapted from the international guideline, richtlijnendatabase.nl), module on irregular cycles and ovulatory dysfunction.
Symptoms
Symptoms and questions
Girls can be referred to a paediatric gynaecologist at different ages. Common reasons are:
- No periods despite normal pubertal development
- Heavy, painful or irregular periods
- Abdominal or pelvic pain with no clear cause
- Discharge, itching or recurrent infections
- Changes to the external genitals
At Femmecare we take these symptoms seriously, with care that suits the age and world of young patients.
Your visit
What happens during an appointment?
-
A calm, open conversation
Every appointment starts with a calm, open conversation. We take more time than a hospital setting allows, leaving room for explanation, reassurance and building trust.
With older girls, part of the conversation can take place without a parent present, if the gynaecologist feels that is appropriate.
-
Examination only when needed
An examination is only carried out when it is really necessary, and always with a clear explanation and consent.
- No internal examination in young girls; an ultrasound through the abdomen if needed
- A parent, carer or second healthcare professional is always present
- Only female healthcare professionals are present in the treatment room
-
Treatment plan
We explain what we see and what is needed in plain language suited to her age. We then discuss the treatment plan together.
Treatment
What can treatment consist of?
Treatment depends on the cause of the symptoms.
- Explanation and reassurance for normal variations in development
- Medication or hormone treatment, for example for period problems
- Treatment of infections or skin conditions
- Longer-term support, where needed, in familiar surroundings
- Referral to, and collaboration with, other specialists in complex situations
Good to know
What we do and do not do
We offer paediatric gynaecology as consultations only. If more is needed, we refer on in good time to a hospital or a specialist centre.
Available at Femmecare
- Consultations for girls up to 18
- Investigation of the cause of symptoms, with an abdominal ultrasound and blood tests if needed
- Treatment of period problems, infections and skin conditions
- Initial investigation when periods do not start
- Support and follow-up for long-term symptoms
Not at Femmecare
- Operations or procedures in girls under 16For these we refer to a hospital with a children's department.
- Treatment of congenital differences of the genitalsFor these we refer to a specialist centre.
- Further investigation of abnormal pubertal development or abnormal hormone results, such as an MRI scan or genetic testingThis takes place at a specialist centre.
- Emergency careFor urgent problems, contact your GP; in a life-threatening emergency call 112.
For parents
Who has a say?
For under-18s, who gives consent for tests and treatment depends on age. Dutch law sets this out as follows:
Our approach
What can you expect?
- A calm, small-scale setting that feels less clinical
- Child-friendly, specialist care with extra time for explanation
- Tailored care from an experienced gynaecologist with paediatric gynaecology expertise
- Quick access to appointments and follow-up tests
- An approach in which both your daughter and you feel heard
See also
For GPs
Referring for paediatric gynaecology
Consultations for girls under 18 with gynaecologist Dr. Céline Lardenoije, previously a gynaecologist specialising in paediatric gynaecology at a university hospital. Paediatric gynaecology consultations are carried out by medical specialists only.
ZorgDomein: ‘Femmecare Clinics’
What we offer
- Menstrual disorders, in line with the Dutch NVOG guidelines
- Vulvovaginitis and vulval skin conditions
- Primary amenorrhoea: initial work-up in line with the NVOG guideline (physical examination including Tanner staging, hormone tests, abdominal ultrasound)
- Transabdominal ultrasound only; no speculum examination in young girls
Not at Femmecare
- Surgical procedures under 16 (referral to a hospital with a children's department)
- Anatomical differences, abnormal pubertal development, MRI or karyotyping (referral to a specialist centre)
Care that suits young girls
We take your daughter's symptoms seriously and take time for explanation and trust. Would you like an appointment? First discuss with your GP whether a referral to Femmecare is appropriate.