MADISON, Wis. – Addressing the gynecological needs of girls and young women requires a different set of skills – talents Dr. Katie O’Brien has been honing for years.
Diagnosing common female pelvic conditions sooner and leveraging social media to connect better with adolescent patients are two of O’Brien’s main goals as one of only two specialty-trained pediatric adolescent gynecologists in Wisconsin, and the first with UW Health Kids.
To get there, she took extra training after residency, called a fellowship, to help her treat rare conditions and perform advanced procedures and surgeries.
It is a growing field that specializes in caring for the unique gynecological needs of children and adolescents. The extra training has only been offered since the 1990s, and there are only a few hundred in the United States, but more fellowships are being offered each year, according to O’Brien.
“A lot of women in this country don’t feel comfortable or validated by their experience with providers,” said O’Brien, who is also an assistant professor of obstetrics and gynecology, University of Wisconsin School of Medicine and Public Health. “So, I think starting on a positive note, where you can talk to your doctor about anything without fear and shame, sets up for a successful interaction with the medical system long term.”
O’Brien joined UW Health in 2024 and began offering this much-needed care for girls and women at the Teenage and Young Adult Clinic in Middleton. The clinic sees patients from birth to 26 years old, treating more common issues with adolescents like painful periods and ovarian cysts, as well as rare conditions for people with congenital anomalies in the reproductive tract, like being born without a uterus or a duplicated uterus.
“Helping women feel seen and fostering a good relationship with a doctor early on are essential,” O’Brien said.
One area her practice hopes to improve is the time to diagnosis for a common pelvic condition called endometriosis, in which cells from the lining of the uterus migrate to other areas outside the uterus, such as the fallopian tubes or ovaries. This can cause severe pelvic pain and reduced quality of life and can lead to infertility. It takes an average of six to 10 years to receive a diagnosis, according to O’Brien.
Vague symptoms and lack of physician training are reasons why there can be a delay, but the main reason is that women’s pain isn’t often taken as seriously as it should, she said.
“I think women and girls are sometimes taught to minimize the symptoms they have or that it is shameful to talk about a period,” O’Brien said. “I’ve had patients come to my practice with very severe symptoms with their period, but had been told those symptoms were normal.”
Having a period should not impact sports, school or quality of life, and there are treatments available to help.
“Ten years is way too long to wait for a diagnosis,” she said. “It must be sooner.”
Another way O’Brien helps connect with her patients is through social media.
“We know that most adolescents get their medical information from social media, especially TikTok, so I talk about social media every day in the clinic,” she said. “I usually ask them what they saw on TikTok and watch it with them so we can have a jumping off point to either validate concerns or sometimes dispel myths.”
It is challenging to evaluate information on social media, so O’Brien recommends that patients write down what they have learned or any questions they may have and bring them to their physician.
“Take information from online with a grain of salt, but I think there is great value in social media,” O’Brien said. “It can be hard to start a conversation with doctors, particularly in gynecology, so this is a powerful way to relate.”
One ongoing topic of discussion on social media is about adequate pain control for the placement of a birth control intrauterine device, or IUD, which are often used to help with heavy or painful periods in adolescents. While the procedure to insert an IUD only takes a few minutes in a clinic setting, it can be painful for the patient, according to O’Brien.
“The talk online is about having different ways to control the pain, like sedation, numbing injections and anxiety medication,” she said. “These are not talked about enough, and I have had really excellent conversations with my patients about it because of TikTok.”
The ultimate goal of O’Brien’s practice is to make patients feel comfortable.
“When a patient opens up, it is the best part of my job,” she said.
