PAG patterns by year and season
In terms of PAG patterns over time, genital inflammation was the most common reason for PAG visits consistently over the 13-year period (Figure S2). The proportion of patients with genital inflammation increased from 48·1% in 2006 to 68·0% in 2018. Furthermore, the proportion of patients that presented with early puberty and gynecological examination fluctuated over time with a decreasing trend after 2009. The percentage of patients visiting for a consultation on growth and development increased over time and remained around 10% after 2010. The percentage of menstrual disorder cases also increased over time, while the proportion of the other diseases was relatively stable. Summer was the peak season for clinical visits for most PAG problems (Figure 2). The number of genital inflammation cases was consistently higher than other PAG problems across the four seasons (Figure S3).