The menstrual cycle is as regular as clockwork, or at least it should be. But for many adolescent patients, what should be a manageable monthly event turns into a full-blown disruptor of school, sports, sleep and sanity. As we explore the world of adolescent gynecology, we take a closer look at the intricate details: how cramps can hide endometriosis and 'normal' isn't always what it seems. These symptoms are not just part of puberty. These are signals that deserve attention, validation, and thorough evaluation.

This episode was recorded live on the exhibit floor at the 2025 Pediatric Academic Societies Conference in Honolulu, Hawaii. Joining us for this episode is Elizabeth Alderman, MD, Chief of the Division of Adolescent Medicine at The Children's Hospital at Montefiore. She is also a professor at the Albert Einstein College of Medicine.

Some highlights from this episode include:

• First-line treatments for painful periods in adolescents
• Red flags in menstrual history that could lead to further concerns
• Primary care diagnostic steps before referring to gynecology
• How to create a comfortable environment for discussing these uncomfortable topics for adolescents

Charting Pediatrics is in the running for a People's Choice Podcast Award, and we need your help to get nominated! Starting July 1, you can head to www.podcastawards.com and nominate us for the "science and medicine" category, as well as the "people's choice" category. Listeners like you are the reason we have become one of the top pediatric podcasts for providers around the world. Your nomination could make all the difference in us receiving this recognition! Nominate us by July 31st and help Children's Hospital Colorado lead the way in pediatric podcasting. Thank you for your support!

For more information on Children's Colorado, visit: childrenscolorado.org.