Nichole Tyson, MD

  • Nichole Andrea Tyson
  • “It's incredibly rewarding to see girls and young women experience joy and resiliency despite difficult health circumstances.”

As an experienced pediatric and adolescent gynecologist, my mission is to help empower girls and young women to flourish by advancing their reproductive and sexual health while also managing their health concerns and conditions. I find it extremely gratifying to get to the crux of a complex health challenge and watch my patients grow, evolve, and become excited about their futures.


Pediatric Gynecology

Adolescent Gynecology


Obstetrics & Gynecology

Work and Education

Professional Education

Tufts University School of Medicine, Boston, MA, 05/21/1995


UC Davis Dept of Obstetrics and Gynecology, Sacramento, CA, 06/30/1999

Board Certifications

Obstetrics & Gynecology, American Board of Obstetrics and Gynecology

Obstetrics and Gynecology Designation, American Board of Obstetrics and Gynecology

Conditions Treated

Abnormalities of Puberty

Adolescent Sexual Health

Anomalies of the Hymen

Breast Problems and Abnormalities

Congenital Reproductive Tract Anomalies of the Uterus, Cervix, and Vagina


Disorders of Sexual Differentiation (DSD)


Fertility Preservation

Gender Identity D/O

Genital Injuries

Gynecologic Care for Cancer Survivors

Gynecologic Endocrine Disorders

Gynecologic Surgery

Mayer-Rokitansky-Kuster-Hauser (MRKH) Syndrome

Menstrual Disorders

Menstrual Suppression

Ovarian Cyst

PCOS (Polycystic Ovarian Syndrome)

Pelvic and Vaginal Infections

Pelvic Masses

Pelvic Pain

Pregnancy (Teen)

Primary Ovarian Insufficiency and Hormone Therapy

Sexually Transmitted Infections

Vaginal Abnormalities

Vulvar Disorders

All Publications

Evaluation and Management of Endometriosis in the Adolescent. Obstetrics and gynecology Shim, J. Y., Laufer, M. R., King, C. R., Lee, T. T., Einarsson, J. I., Tyson, N. 2023


Endometriosis is a chronic condition, with debilitating symptoms affecting all ages. Dysmenorrhea and pelvic pain often begin in adolescence, affecting school, daily activities, and relationships. Despite the profound burden of endometriosis, many adolescents experience suboptimal management and significant delay in diagnosis. The symptomatology and laparoscopic findings of endometriosis in adolescents are often different than in adults, and the medical and surgical treatments for adolescents may differ from those for adults as well. This Narrative Review summarizes the diagnosis, evaluation, and management of endometriosis in adolescents. Given the unique challenges and complexities associated with diagnosing endometriosis in this age group, it is crucial to maintain a heightened level of suspicion and to remain vigilant for signs and symptoms. By maintaining this lower threshold for consideration, we can ensure timely and accurate diagnosis, enabling early intervention and improved management in our adolescent patients.

View details for DOI 10.1097/AOG.0000000000005448

View details for PubMedID 37944153

Going with the flow: the emergence of menstrual science. BMJ sexual & reproductive health Tyson, N., Kciuk, O., Blumenthal, P. D. 2023

View details for DOI 10.1136/bmjsrh-2023-201972

View details for PubMedID 37643875

An adolescent with adnexal torsion presenting with severe hyponatremia JOURNAL OF PEDIATRIC SURGERY CASE REPORTS Brookhart, C., Kciuk, O., Debiec, K., Smith, C., Tyson, N. 2023; 92
Adolescent Contraception The Global Library of Women's Medicine (GLOWM) Tyson, N., Labovsky, M., Oizerovich, S., Liu, S. 2023

View details for DOI DOI 10.3843/GLOWM.418433

Corrigendum to NASPAG Position Statement: Eliminating Period Poverty in Adolescents and Young Adults Living in North America [Journal of Pediatric and Adolescent Gynecology Journal of Pediatric and Adolescent Gynecology Harrison, M., Davies, S., Tyson, N., et al 2023: 260

View details for DOI 10.1177/00099228221142125

View details for PubMedID 36475328

Pediatric Tubal Torsion and Bilateral Hydrosalpinx as Upper Abdominal Masses. Clinical pediatrics Khorshid, A., Tyson, N. A. 2022: 99228221142125

View details for DOI 10.1016/j.jadohealth.2022.08.007

View details for PubMedID 36096900

Elevating the Needs of Minor Adolescents in a Landscape of Reduced Abortion Access in the United States. The Journal of adolescent health : official publication of the Society for Adolescent Medicine Hoopes, A. J., Maslowsky, J., Baca, M. A., Goldberg, J., Harrison, M. E., Hwang, L. Y., Romano, M., Tebb, K., Tyson, N., Grubb, L. K. 2022


Diagnosis of gynecologic emergencies in the pediatric and adolescent population requires a high index of suspicion to avoid delayed or incorrect diagnoses. This article aims to dispel common misunderstandings and aid with diagnosis and management of 3 common pediatric and adolescent gynecologic emergencies: adnexal torsion, vulvovaginal lacerations, and nonsexually acquired genital ulcers.

View details for DOI 10.1016/j.ogc.2022.02.017

View details for PubMedID 36122983

Pediatric and Adolescent Gynecologic Emergencies. Obstetrics and gynecology clinics of North America Cizek, S. M., Tyson, N. 2022; 49 (3): 521-536


PURPOSE OF REVIEW: To review the current literature on the multiple types and uses of progestins in reproductive healthcare.RECENT FINDINGS: Progestins for contraceptive use are available in multiple forms, with the ongoing development of transdermal, intravaginal, and male contraception formulations. Noncontraceptive use of progestins often overlaps with contraceptive indications, which allows for simultaneous multipurpose progestin use, especially in reproductive-aged patients. More studies are needed to determine contraceptive doses of progestins used for noncontraceptive purposes. Side effect profiles of progestins are dependent on their formulation and cross-reactivity with other steroid receptors. Development of newer progestins includes manipulating pharmacologic properties to avoid undesired side effects.SUMMARY: Progestins have multiple uses in reproductive healthcare, including contraception, menstrual suppression, endometrial protection, and hormonal replacement therapy. The development of progestins for these indications can expand therapy for people with contraindications to estrogen-based hormonal therapy.

View details for DOI 10.1097/GCO.0000000000000819

View details for PubMedID 36036464

Progestins of today and tomorrow. Current opinion in obstetrics & gynecology Liu, S., Kciuk, O., Frank, M., Tyson, N. 2022


The recently announced decision of the Supreme Court in the Dobbs v. Jackson case has left health care providers, researchers, and administrators struggling to defend reproductive health care against legal restrictions. Although some hospital-based providers may not consider reproductive health care as part of their "wheelhouse," anyone who cares for adolescents and young adults must see this as a call to action. Reproductive health screening is often missed in the primary care setting1 which has led to recommendations to provide this care wherever adolescents and young adults present for care.2 As adolescents are under the legal age of majority and typically have less experience, education, and resources to help them access reproductive health care when needed, these new abortion laws will create disproportionate burdens on the adolescent population. For low-income youth and adolescent and young adults of color, this will likely worsen the disparities that already exist with regard to access to reproductive health care.3 Adolescents have the highest rates of unintended pregnancy4 and these pregnancies are more likely to end in abortion than adult pregnancies.5,6 Adolescents younger than age 20 make up 12% of individuals who have abortions in the US; minors who are 17 years or younger account for about 4% of all abortions in the US.7.

View details for DOI 10.1542/hpeds.2022-006829

View details for PubMedID 35799327

Dobbs v. Jackson Decision: It's Time to Get Uncomfortable. Hospital pediatrics Goldstein, R. L., Carlson, J. L., Tyson, N. A. 2022

View details for DOI 10.1002/ijgo.14311

View details for PubMedID 35781656

Menstruation: Environmental impact and need for global health equity. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics Harrison, M. E., Tyson, N. 2022
Elevating the Needs of Minor Adolescents in a Landscape of Reduced Abortion Access in the United States Journal of Adolescent Health Hoopes, A., Maslowsky, J., Baca, M., Goldberg, J., Harrison, M., Hwang, L., Romano, M., Tebb, K., Tyson, N., Grubb, L. 2022

View details for DOI 10.1016/j.jpag.2020.12.015

View details for PubMedID 33485521

NASPAG/SAHM Statement: The 21st Century Cures Act and Adolescent Confidentiality. Journal of pediatric and adolescent gynecology Carlson, J., Goldstein, R., Hoover, K., Tyson, N. 2021; 34 (1): 35

View details for DOI 10.1016/j.jadohealth.2020.10.020

View details for PubMedID 33541602

NASPAG/SAHM Statement: The 21st Century Cures Act and Adolescent Confidentiality. The Journal of adolescent health : official publication of the Society for Adolescent Medicine Carlson, J., Goldstein, R., Hoover, K., Tyson, N. 2021; 68 (2): 42628


Vulvar masses in adolescents have a broad differential diagnosis, yet few reports exist detailing masses of mammary origin.A nulliparous, healthy 16-year-old adolescent presented with a longstanding, ulcerated, 17-cm vulvar mass of unknown origin and pronounced inguinal lymphadenopathy. The patient underwent a left radical partial vulvectomy, with pathology revealing terminal duct lobular units consistent with polymastia.Differential diagnosis of a vulvar mass in an adolescent should include polymastia.

View details for DOI 10.1097/AOG.0000000000004563

View details for PubMedID 34735404

Differential Diagnosis of a Unique Vulvar Mass in an Adolescent. Obstetrics and gynecology Chow, S., Doyle, A., Hammer, P., Tyson, N. A. 2021


PURPOSE: There is growing advocacy for use of long-acting reversible contraception among sexually active adolescents. Our primary aims were to evaluate etonogestrel subdermal contraceptive implant (SCI) insertion trends among adolescents, as well as SCI retention at 1, 2 and 3 years, indications for removal, and to identify pregnancies occurring during SCI use.METHODS: A retrospective cohort study was conducted of adolescents aged 13-19 with SCI insertions in 2008-2014 within a large integrated healthcare system. Demographic and clinical characteristics included age, race/ethnicity, BMI, gravidity, parity, insertions, reinsertions, indications for removal, and pregnancy. Electronic medical record review was conducted on a randomized sample of 540 adolescents with insertions during 2008-2011 for the retention objective to validate electronically extracted variables. Analyses included descriptive statistics, survival analysis with Kaplan-Meier estimates for implant retention and Cochran-Armitage trend test for insertions by year during 2008-2014.RESULTS: Most adolescent SCI users were non-Hispanic White (43%), or Hispanic (34.2%) and 16 years or older (84.2%) at the time of insertion. Overall, 1-, 2- and 3-year retention rates were 78.6%, 59.4% and 26.2% respectively, with retention at 44.3% at 2 years 9 months (indicative of removal of method for near expiration of 3- year device). The insertion rate trend demonstrated statistically significant increases annually, from 0.14% in 2008 to 0.91% in 2014, p< 0.0001. No pregnancies were documented during implant use. The most common indication for SCI removal was device expiration.CONCLUSIONS: SCI insertions increased annually among adolescents, with more than a six-fold increase over the 6-year study period, and over half of the SCIs retained through 2 years of use.

View details for DOI 10.1016/j.jpag.2020.12.019

View details for PubMedID 33388444

Subdermal Contraceptive Implant Insertion Trends and Retention in Adolescents. Journal of pediatric and adolescent gynecology Lopez, M., Merchant, M., Postlethwaite, D., Tyson, N. 2020


IMPORTANCE: Catamenial epilepsy (CE) is exacerbated by hormonal fluctuations during the menstrual cycle. Approximately 1.7 million women have epilepsy in the United States. CE affects more than 40% of women with epilepsy. There is a paucity of literature addressing this condition from a clinical standpoint, and the literature that does exist is limited to the neurological community. This article reviews the diagnosis and management of CE for the non-neurologist. Women with CE have early touch points in their care with numerous health care providers before ever consulting with a specialist, including OB/GYNs, pediatricians, emergency department physicians, and family medicine providers. In addition, women affected by CE have seizures that are more recalcitrant to traditional epilepsy treatment regimens. To optimize management in patients affected by CE, menstrual physiology must be understood, individualized hormonal contraception treatment considered, and adjustments and interactions with antiepileptic drugs addressed.OBSERVATIONS: CE is a unique subset of seizure disorders affected by menstrual fluctuations of progesterone and estrogen. The diagnosis of CE has been refined and clarified. There is an ever-increasing understanding of the importance and variety of options of hormonal contraception available to help manage CE. Furthermore, antiepileptic drugs and contraception can interact, so attention must be directed to optimizing both regimens to prevent uncontrolled seizures and pregnancy.CONCLUSION AND RELEVANCE: CE can be diagnosed with charting of menstrual cycles and seizure activity. Hormonal treatments that induce amenorrhea have been shown to reduce CE. Optimizing antiepileptic drug dosing and contraceptive methods also can minimize unplanned pregnancies in women affected by CE.

View details for DOI 10.7812/TPP/19.145

View details for PubMedID 33482944

A Clinical Approach to Catamenial Epilepsy: A Review. The Permanente journal Frank, S., Tyson, N. A. 2020; 24: 13
Provision of Reproductive Health for Teens During a Pandemic J Pediatr Adolesc Gynecol Tyson, N. 2020; 33 (4): 331


The current article explores some of the more complex subtopics concerning adolescents and long-acting reversible contraceptives (LARC).Recent research has highlighted ways in which LARC provision can be optimized in adolescents and has identified gaps in adolescent LARC access and utilization.Contraceptive counseling for adolescents should be patient-centered, not necessarily LARC-first, to avoid coercion. There are increasing applications for the noncontraceptive benefits of LARC for several unique patient populations and medical conditions.

View details for DOI 10.1097/GCO.0000000000000668

View details for PubMedID 33002953

Reproductive effects of obesity in adolescents Textbook of Pediatric and Adolescent Gynecology Wellenstein, W., Tyson, N. CRC Press. 2020; second: 256264.


Contraception is paramount to the overall health and longevity of women. Most women in the United States use birth control in their reproductive lifetimes. All options should be available and easily accessible to permit individualization and optimization of chosen methods. Current contraceptive methods available in the United States are reviewed. Emergency contraception, contraception in the postpartum period, and strategies to tailor methods to those affected by partner violence are also addressed. Tables and flow charts help providers and patients compare various contraceptive methods, optimize the start of a method, and identify resources for addressing safety in those with underlying medical conditions.

View details for DOI 10.1016/j.ogc.2019.04.002

View details for PubMedID 31378285

A clinical approach to catamenial epilepsy Perm J Frank, S. E., Tyson, N. A. 2020; 24 (19)


Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare multisystem necrotizing vasculitis associated with eosinophilia and extravascular granuloma and classically involving the upper and lower airways. There have only been a few reported cases of gynecologic involvement in EGPA.We present an 8-year-old girl diagnosed with EGPA with a vulvar granuloma in what is, to our knowledge, the first reported pediatric gynecologic manifestation of EGPA. Interestingly, the vulvar granuloma did not respond to initial immunosuppressant treatment with prednisone and methotrexate and required treatment regimen modification with mycophenolate mofetil resulting in granuloma resolution.EGPA in the pediatric population has a relatively high mortality rate compared with in the adult population thus it is important that vulvar granulomas associated with EGPA should be included in the differential diagnosis of a vulvar mass allowing for the prompt diagnosis and treatment of this potentially fatal disease in children.

View details for DOI 10.1016/j.jpag.2019.03.002

View details for PubMedID 30904627

Adolescents and long-acting reversible contraceptives: beyond the basics. Current opinion in obstetrics & gynecology Stanton, T. n., Cizek, S. n., Tyson, N. n. 2020


In North America, 30% of children are overweight or obese. Child obesity is a precursor to adult health risks. Diagnosis of childhood obesity is difficult. The best measurement is BMI percentile charts. Obesity in children and adolescents can be treated by diet and activity changes. Family involvement in healthy lifestyle changes is best for weight loss and prevention.

View details for DOI 10.1016/j.bpobgyn.2017.06.003

View details for PubMedID 28838829

Reproductive Health: Options, Strategies, and Empowerment of Women. Obstetrics and gynecology clinics of North America Tyson, N. A. 2019; 46 (3): 409-430

View details for DOI 10.1016/j.jpag.2016.10.009

View details for PubMedID 27989918

Childhood-Onset Eosinophilic Granulomatosis with Polyangiitis with a Vulvar Granuloma: A Case Report and Review of the Literature. Journal of pediatric and adolescent gynecology Swain, C. A., Sherry, T. R., Tyson, N. 2019; 32 (4): 425-428


Although adnexal masses and ovarian torsion are common causes of acute pain in the female adolescent, fibroids are an uncommon etiology and little is reported in the literature. Because of the rarity of adolescent leiomyomas, the best surgical management is still unknown.To our knowledge, this is the first case report of a laparoscopic myomectomy in the adolescent population. The removed fibroid is one of the largest documented cases of uterine leiomyoma in adolescents.Degenerative fibroids, albeit less common, should be kept on the differential diagnosis, as a possible cause of pelvic mass and pain in the adolescent population. Fibroids in the adolescent patient, like the adult, can be managed with minimally invasive surgery with excellent clinical outcomes.

View details for DOI 10.1016/j.jpag.2016.05.007

View details for PubMedID 27262836

Childhood and adolescent obesity definitions as related to BMI, evaluation and management options. Best practice & research. Clinical obstetrics & gynaecology Tyson, N., Frank, M. 2018; 48: 158-164


Long-acting reversible contraceptive methods are the most effective reversible contraceptives and have an excellent safety record. Although uncommon, possible long-acting reversible contraceptive complications should be included in the informed consent process. Obstetrician-gynecologists and other gynecologic care providers should understand the diagnosis and management of common clinical challenges. The American College of Obstetricians and Gynecologists recommends the algorithms included in this document for management of the most common clinical challenges.

View details for DOI 10.1097/AOG.0000000000001644

View details for PubMedID 27548557

HPV Update. Journal of pediatric and adolescent gynecology Tyson, N. 2017; 30 (2): 262-264


Obstetrician-gynecologists are responsible for promoting healthy eating and physical activity in adolescents during annual screening examinations. Adolescents with a body mass index for age greater than or equal to the 95th percentile should undergo an in-depth health assessment to determine psychosocial morbidity and risk of cardiovascular disease. Further research is needed to determine the most efficacious approach to the prevention and treatment of obesity in adolescents. For now, it is best to extrapolate an approach from data pertaining to children and adults, while being cognizant of the special psychosocial and physical needs of adolescents.

View details for DOI 10.1097/GRF.0b013e31816d2282

View details for PubMedID 18463456

Laparoscopic Myomectomy of a Symptomatic Uterine Leiomyoma in a 15-Year-Old Adolescent. Journal of pediatric and adolescent gynecology Salehi, P. P., Tyson, N. 2016; 29 (6): e87-e90
Committee Opinion No 672: Clinical Challenges of Long-Acting Reversible Contraceptive Methods. Obstetrics and gynecology 2016; 128 (3): e69-77
Contraception Adolescent Medicine Today A Guide to Caring for the Adolescent Patient Tyson, N., Simpson, E., Berlan, E. 2011: 233253
Care of the overweight adolescent including polycystic ovarian syndrome. Clinical obstetrics and gynecology Zidenberg, N., Wright, S. 2008; 51 (2): 249-56
Breast Disorders in Females Adolescent Medicine: the Requisites in Pediatrics Huppert, J., Tyson, N. Mosby Inc. 2008: 146151