The influence of youth on the epidemiology, pathophysiology, and manifestations of STDs has only recently been appreciated. Although the clinical manifestations of STDs are essentially the same in adolescents and adults, the maturing female reproductive system is often more susceptible to STD organisms than during later life. In some instances chlamydial infections in adolescents lead to more severe manifestations as well as to more severe complications and late sequelae. For instance, the immature metaplastic epithelial cells in the squamocolumnar junction of the cervix are less well differentiated than cells from other areas of the cervix. Therefore adolescent women have increased susceptibility to selected STD organisms and increased vulnerability to the action of oncogenic agents (Briggs and Paavonen, 1984). Cervical ectopy with endocervical columnar cells extending well out on the ectocervix may increase this susceptibility to C. trachomatis.
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