Girls with rheumatic diseases may have longer periods or menstrual cycles, indicating ovary-related problems, Dr. Hertweck said. Pediatric rheumatologists should use the menstrual cycle as a vital sign and discuss timing or duration of periods.
She recommends using questionnaires designed for screening sexual behaviors in adolescents and speaking with patients without parents present. “You are the people on the front lines seeing these patients, she said. “So, you need to worry about STIs and pregnancy prevention.”
Susan Bernstein is a freelance medical journalist based in Atlanta.