PAG over Pastries
A review podcast covering pediatric and adolescent gynecology (PAG). It was started by a fellow for residents, fellows, and others who want to learn more about PAG topics. Hosts Camille Imbo and Susan Kaufman discuss relevant clinical issues in this subspecialty.
Episodes
21 - Pediatric Vulvovaginal Conditions
Dr. Susan Kaufman and Dr. Kirsten Das walk through how and why prepubertal vulvar and vaginal symptoms happen so often, then show how small hygiene and toileting changes can resolve many cases without antibiotics. We also cover the high-stakes diagnoses you cannot miss, from lichen sclerosus to painful non-sexually transmitted vulvar ulcers and labial adhesions.What is PAG?Pediatric and Adolescent
20 - Contraception For Medically Complex Teens
Dr. Susan Kaufman and Dr. Bianca Allison take on contraception for teens whose chronic conditions and medications make standard options unsafe or ineffective. They discuss how we protect confidentiality, apply CDC guidance, and still center teen autonomy.• assessing pregnancy-related risks tied to chronic disease and treatment• protecting confidentiality with evolving minor consent laws and caref
19 - Endometriosis in the Adolescent
We trace the line from “bad cramps” to a careful, compassionate evaluation for endometriosis, showing how physiology, history, and practical treatment choices restore a teen’s daily life. Evidence, empathy, and clear steps help shorten the long road to relief and reduce missed school and stress.• defining primary and secondary dysmenorrhea and why prostaglandins matter• prevalence figures and diag
18 - Menstrual Concerns in the Adoelscent
We walk through a clear roadmap for evaluating heavy menstrual bleeding in teens, from what counts as normal to when labs and treatment should start. A case of a 15-year-old with 10-day periods and nosebleeds anchors a practical workup and evidence-based care plan.• Normal adolescent cycle ranges and red flags for heavy bleeding• Definitions that guide when to test and treat• Key causes in teens:
17 - Normal Menstrual Cycle
walk through what a healthy teen menstrual cycle looks like, why early cycles are often irregular, and how to recognize red flags that need care. We share practical ways to track flow, choose products, reduce pain, and support teens with sensitivity and clarity.• menarche timing, influences, and normal ranges• early anovulatory cycles and HPO axis maturation• typical cycle intervals and expected v
16 - The Pediatric Gynecological Exam
Dr. Susan Kaufman, pediatric gynecologist at Virtua Health, is joined by Dr. Tania Dumont, pediatric gynecologist from CHEO and the University of Ottawa, to break down how to perform a pediatric gynecologic exam with empathy, clarity, and evidence, from newborn anatomy to adolescent assessment. We show how language, positioning, and choice reduce fear while improving visualization, diagnosis, and
15 - Laparoscopic Considerations in Pediatric & Adolescent Gynecology
Dr. Susan Kaufman, PAG physician at Virtua health in New Jersey, and Dr. Olga Kciuk, PAG physician at Stanford University, walk through laparoscopic care for pediatric and adolescent patients from consent and anatomy to entry, pain control and recovery. The focus stays on safety, physiology, and teen-centered decisions that protect fertility and speed return to life.Reference: NASPAG Essentials of
14 - Urogenital Anomalies
Venture into the intricate world of complex genitourinary anomalies with pediatric and adolescent gynecologists Drs. Susan Kaufman and Megan Sumida. Their discussion unravels the challenges and approaches to conditions that fundamentally alter the anatomical landscape for young patients.ReferenceNASPAG Essentials of Pediatric and Adolescent Gynecology: Chapter 25What is PAG?Pediatric and Adolescen
13 - Care for the Transgender Adolescent
Dr. Susan Kaufman and Dr. Yossie Ahmadieh, an adolescent medicine doctor with Physicians for Reproductive Health, explore the vital topic of gender-affirming care for transgender and gender-diverse adolescents, discussing how appropriate medical interventions can be life-saving for these vulnerable youth.OutlineIntroduction to Transgender Healthcare BasicsBarriers and Mental Health ConsiderationsC
12 - Labial Concerns in Adolescents
Dr. Vrunda Patel, a PAG physician at Nemours Children's Hospital in Wilmington, Delaware, and Dr. Camille Imbo PGY6 PAG fellow discuss the increasing trend of teenage patients seeking evaluation for labial concerns, often driven by appearance rather than medical issues. Many teens and parents lack understanding about what constitutes normal genital appearance.OutlineNormal Vulvar Development
11 - Fertility Preservation
Fertility preservation options have dramatically expanded for children and adolescents in recent decades, offering hope to patients undergoing gonadotoxic therapies for cancer and other conditions. Dr. Stephanie DuFour, PAG and REI attending at CHEO in Ottawa, Canada, joins Dr. Susan Kaufman to discuss the latest advances in preserving reproductive potential for young patients facing treatments th
10 - Primary Ovarian Insufficiency & Turner's Syndrome
Dr. Jane Su, a PGY4 OBGYN resident at university of Ottawa, joins Dr. Susan Kaufman to discuss POI with a special emphasis on Turner's syndrome. Both important and life changing diagnoses that cannot be missed!OutlineCase PresentationIntroduction to POI Defining POI: Causes and PrevalenceClinical Presentation and Diagnostic ApproachTreatment Strategies for POITurner Syndrome: Characteristics
9 - Primary & Secondary Amenorrhea
Dr. Julie Cron, an OBGYN with PAG certification at Presbytarian and Cornell, joins Dr. Camille Imbo PGY6 to explore amenorrhea - the absence of menstruation - breaking down how to evaluate and diagnose this important vital sign in adolescent patients.OutlineIntroduction to Amenorrhea TypesPhysical Exam ImportanceHormonal Evaluation & CausesUnderstanding Lab ResultsGenetics and Structural Cause
8 - Sexually Transmitted Infections
This episode, we are joined by Dr. Aliah Fonteh, a PGY2 resident, and Dr. Alla Vash-Margita a PAG attending at Yale to break down what every provider should know about sexually transmitted infections. OutlineIntroducing STIs in Adolescent CareConfidential Interviews with Teen PatientsCommon STIs: Chlamydia, Gonorrhea, TrichomonasSyphilis: Screening and Diagnostic ChallengesHPV and Vaccination: Pre
7 - What is PAG?
Dive into the fascinating world of Pediatric and Adolescent Gynecology (PAG) with this week's guest, Dr. Lissa Yu from Seattle Children's Hospital. This conversation shatters common misconceptions about what PAG specialists actually do - far beyond just teen pregnancy and contraception.OutlineWhat is PAG? History and ScopeWhy Choose PAG as a Specialty?Common Conditions and Patient CareRe
6 - Relative Energy Deficiency in Sports (RED-S)
Dr. Susan Kaufman is joined by Dr. Mary Romano, a PAG physician from Vanderbilt and the current president of NASPAG, to discuss Relative Energy Deficiency in Sports (RED-S) previously knows as the Female Athlete Triad. Outline:• Highlights of a case study involving a 17-year-old athlete• Identifying high-risk sports for developing energy deficiency• Psychological and physiological impacts of inade
5 - Prepubertal Bleeding
Camille Imbo, MD PGY6 and Susan Kaufman, MD talk about how to work up and examine prepubertal bleeding, as well as differential diagnoses. OutlinePatient and Family HistoryExamination techniques and consentpositioning and observation techniquesdifferential diagnoses of prepubertal bleedingCommon CausesRare CausesCase reviewCheck out the episode visuals on YouTube.References:Clinical Review: Prepub
4 - Puberty (Part 3): Delayed Puberty
Camille Imbo, MD PGY6 and Susan Kaufman, MD discuss delayed puberty, the last in their series on puberty. The episode provides an in-depth exploration of delayed puberty, discussing key signs and the clinical evaluation process for young teens facing this challenge. It addresses common causes, the importance of physical exams, and appropriate treatments while offering reassurance and guidance for
3 - Puberty (Part 2): Precocious Puberty
In this next part of the puberty series, Camille Imbo, MD and Susan Kaufman, MD discuss precocious puberty including isolated, peripheral, and central precocious puberty. They also discuss treatment and management goals. Outline- Understanding Abnormal Puberty- Types of precocious puberty- Peripheral precocious Puberty- McCune Albright Syndrome- Central Precocious Puberty- Treatment- Case discussi
1 - Welcome to PAG over Pastries!
A short introduction to what is PAG over Pastries, its format, and what we hope you get out of it. Check out the visual post on YouTube. What is PAG?Pediatric and Adolescent Gynecology is a subspecialty of OBGYN (2 year fellowship) focusing on reproductive healthcare for children and young adults. It fills the overlap between general gynecologists and pediatricians. It is a multi-disciplinary fiel
2- Puberty (Part 1): Normal puberty
Camille Imbo, MD PGY6 and Susan Kaufman, MD talk about normal puberty, the many axes involved, the milestones, and expected timing of each.References:Essentials of Pediatric and Adolescent Gynecology: Chapter 5Check out the visual post on YouTube.What is PAG?Pediatric and Adolescent Gynecology is a subspecialty of OBGYN (2 year fellowship) focusing on reproductive healthcare for children and young
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