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Simple Summary: Anal human papilloma virus (HPV) is the leading etiology of anal and cervical cancer. While cervical HPV screening for women is well established, anal HPV screening is restrained to a limited population and specific indications. Our group performed concomitant anal and cervical screening in 275 women at a single gynecologic appointment and revealed high-risk anal HPV in 91 women (33%). The present follow-up study intended to analyze the outcomes of these women during a specialized follow-up in a dedicated high-resolution anoscopy (HRA) outpatient clinic. Independent risk factors for anal HPV were anal intercourse and the presence of cervical HR-HPV with a three- and fourfold increased risk, respectively. Background: This study represents a follow-up analysis of the AnusGynecology (ANGY) study. Methods: This prospective, cross-sectional, single-center study recruited women for concomitant cervical and anal screening of HPV genotypes and cytology during a single appointment. All women with findings of either HPV or any type of dysplastic lesions on anal smears were offered follow-up in a specialized high-resolution anoscopy (HRA) outpatient clinic, representing the study cohort for this follow-up study. Results: Overall, 275 patients (mean age 42 ± 12) were included. Among them, 102 (37%) had cervical high-risk (HR) HPV. In total, HPV was (incidentally) revealed in 91 patients (33%) on anal smears, while any degree of anal squamous intraepithelial lesion (SIL) was found in 30 patients (11%), 6 if which were high-grade SIL (H-SIL). Furthermore, 10 out of 19 biopsies were positive (3 H-SIL lesions). Only half (48/91, 53%) of the women agreed to undergo the recommended specialized follow-up evaluation. Of them, 18 (38%) were diagnosed with dysplastic lesions (9 low grade (L-SIL) and 9 H-SIL, respectively) on biopsies, while the remaining visits revealed no abnormalities. Multivariable analysis revealed cervical HR-HPV infection (OR 4, 95% CI 2.2–7.5) and anal intercourse (OR 3.1, 95% CI 1.7–5.9) as independent risk factors for anal HR-HPV infection. Conclusions: Close follow-up of these women is hence strongly recommended. [ABSTRACT FROM AUTHOR]

Sexual violence constitutes a form of gender-based violence, to the extent that the victims are mainly women. Other groups of vulnerable people are also more affected, in particular gender and sexual diversity persons. Sexual and gender-based violence can also occur in healthcare. To respect the legal framework and people's rights, but also to promote safety and quality in healthcare, it is essential to obtain and respect consent. Consent must be informed, explicit, freely given, and reiterated throughout the consultation. This article reviews the concept of consent and offers practical tools for its application in healthcare., Competing Interests: Les auteures n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

This article outlines the management of transgender and non-binary adolescents at CHUV. The current rise in visibility of this topic is associated with an increased demand for intervention and at the same time with an increased generation of continuously expanding medical evidence to guide interventions. The close collaboration among various specialized adolescent health services enables an interdisciplinary evaluation of diagnostic elements and indications for potential psychological, social or medical interventions. This article underscores the significance of an interdisciplinary and individualized approach to transgender and non-binary adolescents, respecting the diversity of the human being., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Early pregnancy is frequently accompanied by abnormal symptoms such as pelvic pain and metrorrhagia. In these situations, it is quite frequent to be unable to identify the pregnancy and in particular its location, even if the pregnancy test is clearly positive. Many clinical, biological and ultrasound approaches have been proposed to try to predict the location and development of the suspected pregnancy, without the individualization of a truly reliable tool. Currently the HCG dosage at 48 heures-interval remains one of the best tools available, but it is challenged by mathematical models such as the M6 model. The M6 model has shown in our experience a very good predictive value with also an ability to reduce the follow-up of patients with low progressive risk, thus allowing a reduction in costs and anxiety for patients and caregivers., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Cervical cancer is preventable through primary and secondary prevention. Vaccination against the human papillomavirus (HPV), the virus necessary for the development of precancerous lesions, can prevent most of them. Screening by cytology for these precancerous (or cancerous) lesions can be replaced by screening for certain types of HPV, high risk (HR-HPV), causing cervical cancer. The presence of HR-HPV on the cervix should raise suspicion of concomitant infection in the anus, as both epithelia are highly susceptible. This attitude is dictated by the increase incidence in anal cancer in the population, which is also HPV-dependent and therefore also potentially preventable through vaccination and screening., Competing Interests: La Dre Martine Jacot-Guillarmod est membre du comité consultatif sur la vaccination HPV chez MSD. L’entier des honoraires est reversé au CHUV. Les autres auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Women have made a place for themselves in sport, but there are still inequalities and specific characteristics compared to men. Puberty is marked by hormonal changes that give the female athlete advantages and disadvantages. She then goes through various periods of life that condition her relationship to her body and her performance. Anatomical and hormonal factors influence certain injuries. Proper management of the menstrual cycle can optimize performance. She is more at risk of nutritional deficiencies or energy deficit. Moreover, she suffers more from a negative body image, aggravated by the pressure of the perfect sportswoman! All of these aspects should be considered when taking care of her and following up regularly, in order to avoid long-term consequences., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Sexual health is an integral part of overall health. Every individual who wishes to do so should have the opportunity to experience safe, enjoyable sex, free of coercion, discrimination and violence. These sexual rights mean not only being able to protect oneself from STIs and unwanted pregnancies when appropriate, but also feeling good about one's sexuality. Adolescence is a time of discovery and exploration of sexuality. The purpose of this article is to provide health professionals with strategies for reflection and action in order to conduct an inclusive sexual health history with adolescent patients, particularly with respect to sexual and gender diversity issues, so that everyone has optimal access to sexual health information and care., Competing Interests: Les auteures n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

The deaf and hard of hearing population suffers from difficulties in accessing the health care system due to communication barriers with health care and administrative personnel who are often insufficiently trained in deafness issues. Gynecology-obstetrics consultations represent a gateway to the health system. Since 2011, there is a gynecology and obstetrics consultation dedicated to deaf people at the CHUV. This article presents the means of communication support put in place within the context of this specific consultation as well as the experience of a group of patients. Awareness of deafness among all staff in contact with patients as well as the use of professional interpreters are the key elements of care that respects the needs and rights of deaf people., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

The vaginal examination is too often part of the routine in periodic gynecological consultations. However, its performance as a screening examination for gynecological diseases such as cancers and infections is poor when performed in the asymptomatic patient. It is appropriate for cervical cancer screening every 3 years from the age of 21. Moreover, the intrusive nature of the vaginal examination, which is sometimes experienced as traumatic by patients, encourages the targeting of indications for its practice. Fear of this examination may also result in avoidance of care. The gynecological consultation is a privileged setting for screening for sexual risk taking or domestic violence, but also for exploring overall sexual health and promoting women's health., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Chlamydia trachomatis (CT) infection is the most frequent notifiable sexually transmitted infection (STI) in Switzerland. The infection is most frequently observed in 15 to 24 year-old-women and in 25 to 34 year-old-men. 50-75 % of the Chlamydia trachomatis carriage are asymptomatic, making the infection difficult to diagnose and increasing the untreated specimen, leading to complications like infertility, ectopic pregnancy or pelvic inflammatory disease. Despite having a sexual prevention at school, the youths seem to have a lack of knowledge about CT, her transmission and her complications. We performed a survey, which showed that 60.5 % of the participants ignored that this bacteria is mostly asymptomatic. We also found that 11 % of the participants believed that there is no possible relapse of the infection. The prevention must be strengthened, mostly because there is no program in Switzerland, letting every physician to his own beliefs. The medical consultation is an ideal opportunity for this prevention and the youths shared their wish to discuss more about it with health professionals., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

The female athletic triad refers to the interaction between menstrual function, energy availability and bone density. When an imbalance appears between energy input and output, the global health of the athletic teenager is at risk of somatic and/or psychological complications as defined by the RED-S (Relative Energy Deficiency in Sports). In athletic girls menstrual disorder should be seen as an alert. It may be difficult to distinguish it from menstrual irregularity due to immature hypothalamic-hyphophysic-gonadal axis, which can be physiological at that age. A multidisciplinary approach is needed. The challenge is to find a balance between sport practice and prevention of complications due to lack of estrogens., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Background: Securing the adherence over time to contraception by adolescent girls is a challenge. Until now little was known about this topic in Switzerland. The aim of our study was to determine contraceptive continuation rates among adolescents in this country and assess possible predictive factors for discontinuation., Methods: A prospective observational cohort study of 12- to 19-year-old girls starting contraception was performed. Patients were interviewed again after 1 year by phone, email or postal mail., Results: A total of 204 patients were included, of whom 85.8% chose a combined oestrogen-progestogen pill. The answer rate 1 year later was 71%. Among these, continuation of the initially prescribed contraceptive method was observed in 73.1%. Factors statistically affecting the continuation rate were the initial contraceptive method, the place of residence and sexual activity after 1 year. Classification of contraceptive methods in decreasing order of continuation rate was the following: long acting reversible contraception (LARC) methods, oestrogen-progestogen pills, injections, progestogen pills, patches and rings. Major reasons reported for stopping the prescribed contraceptive method were ending sexual relations (54.3%), developing side effects (34.3%) or changing to another contraceptive method (22.9%). Neither age, nationality, smoking, occupation, nor the legal representative's knowledge of the contraception influenced adherence., Conclusion: Contraceptive continuation rate was high among the adolescent population studied. The only predictive factor of discontinuation was the contraceptive method. Our study also reveals that respecting teenagers' confidentiality is essential as it does not negatively impact the continuation rate. The significant impact of the type of contraception on continuation rates stresses the importance of individualised counselling.

Adolescent's sexual health, in particular the risk of unwanted pregnancies and sexually transmitted infections (STIs), is a complex topic that deserves special attention. Confidential care and non-stigmatizing attitude as well as working with sexual health counsellors are strongly recommended. If an adolescent consults with an adult, it is beneficial to proceed stepwise in order to promote patient's autonomy and to build a relationship of trust with both of them. A focused approach of the teenager, adapted to its needs, as well as techniques such as Quick start and bridging, can improve compliance to contraception. Regarding the risk of STIs, primary prevention remains essential. The most effective prevention currently consists in systematic condom use.