Adolescence is a critical developmental phase characterized by the transition from childhood to adulthood, involving comprehensive physical, hormonal, psychological, and social changes. Health issues that emerge during this period can have lasting effects on adulthood if not addressed with a timely and accurate approach. The Adolescent Health Unit is a specialized clinical field that evaluates the medical, developmental, and psychosocial needs of individuals between the ages of 10 and 21 from a holistic perspective.
Evaluation of Pubertal Development
The normal pubertal process begins with the activation of the hypothalamic-pituitary-gonadal axis and is completed within an average of two to five years. In girls, it begins with breast development (thelarche) and reaches the maturation stage with menarche (first menstrual period), while in boys, an increase in testicular volume is observed as the first sign.
Conditions evaluated regarding puberty in the adolescent health clinic include:
- Precocious puberty: Hormonal evaluation, bone age analysis, and diagnosis via GnRH stimulation test when necessary, in cases where secondary sexual characteristics appear before the age of eight in girls and nine in boys.
- Delayed puberty: Endocrinological and genetic investigations if pubertal signs have not begun by age thirteen in girls and fourteen in boys.
- Pubertal variants: Differential diagnosis and long-term follow-up of isolated findings such as premature thelarche, premature adrenarche, and premature menarche.
- Gynecomastia: Distinguishing between physiological and pathological causes of breast tissue enlargement in male adolescents.
Growth and Development Follow-up
The pubertal growth spurt is a critical phase in determining final height. A systematic evaluation process is applied to adolescents with slowed growth velocity or significant short stature compared to their peers.
- Anthropometric evaluation: Comparison of height, weight, body mass index, and growth velocity with age- and sex-specific percentile curves.
- Bone age determination: Evaluation of skeletal maturation via left hand-wrist radiography and calculation of predicted final height.
- Hormonal profile: Examination of growth hormone, IGF-1, thyroid function tests, and sex hormone levels.
- Genetic evaluation: Screening for Turner syndrome, Klinefelter syndrome, and other chromosomal anomalies.
- Nutritional evaluation: Detection of nutritional deficiencies by checking iron, zinc, vitamin D, B12, and calcium levels.
Obesity and Metabolic Syndrome
The prevalence of obesity in the adolescent period has increased significantly in recent years. A body mass index above the 95th percentile for age is defined as obesity. In obese adolescents, metabolic complications such as insulin resistance, dyslipidemia, fatty liver, and type 2 diabetes can emerge at an early age. A multidisciplinary treatment approach including an individualized nutrition plan, exercise prescription, and behavioral interventions is applied.
Adolescent Mental Health and Psychological Support
Adolescence is a period where psychosocial challenges such as identity formation, peer relationships, academic pressure, and changes in family dynamics intensify. Providing psychological support integrated with medical evaluation is the fundamental principle of a holistic adolescent health approach.
Mental health issues evaluated in the adolescent health unit include:
- Depression and anxiety disorders: Early detection of mood disorders underlying social withdrawal, loss of motivation, sleep disturbances, and somatic complaints common in adolescents.
- Eating disorders: Diagnosis, nutritional rehabilitation, and psychotherapy planning for anorexia nervosa, bulimia nervosa, and binge eating disorder.
- Attention deficit and hyperactivity: Neuropsychological evaluation of complaints regarding low academic performance, difficulty concentrating, and impulsivity.
- Substance use: Early screening, risk assessment, and referral for alcohol, tobacco, and drug use.
- Cyberbullying and social media impact: Evaluation of the effects of negative experiences in digital environments on mental health.
- Suicide risk screening: Identification of risk factors and creation of a preventive intervention plan.
Chronic Disease Management and Transition Care
The management of chronic diseases diagnosed during childhood brings unique challenges during adolescence. Chronic conditions such as type 1 diabetes, asthma, epilepsy, inflammatory bowel disease, and rheumatological diseases require a special approach to improve the adolescent's self-care skills and ensure treatment adherence.
Within the scope of the transition care program, a gradual empowerment process is carried out to help the adolescent take responsibility for their own health. The transition from pediatric teams to adult health services is conducted in a planned and coordinated manner.
Adolescent Gynecology
Gynecological issues such as menstrual irregularities, dysmenorrhea (painful periods), amenorrhea (absence of periods), and polycystic ovary syndrome are common clinical presentations in female adolescents. These complaints are investigated systematically through hormonal evaluation, pelvic ultrasonography, and advanced testing when necessary.
Sexual health education, protection from sexually transmitted infections, and reproductive health information constitute the preventive medicine dimension of adolescent gynecology.
Vaccination and Preventive Health Services
The vaccination schedule and preventive health screenings that should be completed during adolescence include:
- Completion of missing doses of Hepatitis B vaccine
- HPV (Human Papilloma Virus) vaccination
- Meningococcal vaccine
- Td/Tdap booster doses
- Vision and hearing screening
- Scoliosis screening
- Blood pressure measurement and lipid profile screening (in the presence of familial risk factors)
Sports Health and Physical Activity Counseling
Health evaluation prior to participation in sports activities is important in preventing sudden cardiac death and musculoskeletal injuries in adolescents. Cardiovascular screening, orthopedic evaluation, and nutritional counseling are offered as part of the pre-participation examination. The management of sports-specific health issues such as overtraining syndrome, athlete anemia, and stress fractures is also included in this scope.
At the Koru Hospital Adolescent Health Center, our expert staff evaluates the physical, hormonal, and psychological health needs of individuals during adolescence with a holistic approach. Our multidisciplinary team, consisting of specialists in pediatrics, endocrinology, psychiatry, gynecology, and nutrition, provides diagnosis, treatment, and counseling services tailored to each adolescent's individual development process.