By Dr Alfred Murage
Adolescence is the transition between childhood and adulthood. The age interval is between 10 to 24 years, spanning through puberty and teenage.
It is one of the most dynamic stages of human growth and development, second only to infancy in the rate of developmental changes that take place. Adolescents go through physical, intellectual and social-emotional developments, often mandating them to try and understand the immense bodily changes taking place.
The main gynecological risks to adolescent girls relate to early onset of sexual activity. The age at first sexual intercourse has been declining in many countries, with some reports indicating 30 per cent of adolescents have had sex before the age of 16.
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This predisposes them to sexually transmitted infections including HIV, teenage pregnancy with consequential unsafe abortions, unplanned motherhood and social exclusion.
Teenage pregnancy is associated with poor socio-economic status, and is less common in countries with economic prosperity, better education and employment opportunities. There are adverse medical and psychosocial outcomes for teenage parents and their children. Such problems are related to gynecological immaturity and other biological and social-cultural factors.
Adolescents experience more pregnancy related complications, and are more likely to deliver preterm and low birth weight babies. Both the teenage mother and her child are predisposed to long-term general and mental health problems.
Adolescents seeking unsafe abortions are at grave risks of severe pelvic infections, future fertility problems and even death. Sexually transmitted infections like syphilis and HIV have long-term health implications, while chlamydia and gonorrhea may affect future fertility as well.
Preventive measures should be put in place to ensure optimal sexual adolescent health. Such measures may be through parental upbringing, societal or public health initiatives.
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There must be clear and unambiguous messages to adolescents about risks of early sexual intercourse, taking into account their sexual desires and development. This is achievable through formal or informal sexual health education, counselling and advice.
Adolescent services must be available to provide information on sexual infections and contraception. Such services must be easily accessible to adolescents, and staffed by appropriately trained health care workers. Young men must be included in health measures addressing adolescent girls, and neither should be socially excluded should preventive measures fail.
As adolescents mature into adults, they should be guided into taking over decisions affecting their reproductive health. They should have had the recommended vaccinations, like HPV vaccine, in the teenage years, or before commencing sexual activity.
They should take appropriate steps to avoid sexually transmitted infections, and seek prompt sexual health screening and treatment if infection is suspected.
Unwanted pregnancies should be avoided by use of suitable contraceptive choices. General gynecological health screening should commence by the age of 25. This should be combined with other healthy measures that include a healthy diet, physical exercises, reduction of alcohol intake and avoidance of cigarette smoking and other drugs.
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