Is It Time For Your Teen To See a Gynecologist?

If you’re the parent of a teenage daughter, you may be wondering if it’s time for her first visit to the gynecologist. Some parents may find the thought of taking their teen to a gynecologist uncomfortable, awkward, or pre-mature, but the American College of Obstetricians and Gynecologists (ACOG) recommends that girls have their first gynecologic visit between the ages of 13 and 15.

What happens at the first visit?

While 13 to 15 may seem young for the first visit, it is the perfect time to make sure your daughter is healthy and physically developing as she should. The first appointment is about establishing rapport and a healthy doctor/patient relationship; the goal being open communication and creating a baseline for care.

Among the topics the gynecologist may discuss with your teen are: smoking, drug and alcohol abuse, unprotected sex, puberty, hygiene, sexually transmitted diseases/infections, contraception, exercise, and mental health. And, unless your daughter is doing something that could hurt her or someone else, the private conversation remains strictly confidential.

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Typically, the first gynecologic visit for a teen doesn’t involve an internal pelvic exam or pap smear, unless the teen is sexually active. Many gynecologists will just do a regular health exam, ask health related questions, take the teen’s vitals (like height, weight, blood pressure), discuss familiarity with her breasts, and talk about her physical development. During the first visit, the doctor may ask you (parents or guardian) to be in the examination room at the beginning of the appointment to provide support, but will likely ask you to leave when it’s time for exams or more personal questions.

Why does a teen need a gynecologist?

As girls grow into teens and teens into young adults, it’s important that they get the right health care, including yearly checkups that focus on their reproductive system. These annual visits increase the chances of detecting and diagnosing small issues before they become major health concerns.

It is highly recommended that your daughter visit a gynecologist if she is having sex (or plans to soon) or having problems with her period. Here are some of the many reasons why a parent and their child may decide that the time is right for a first visit.

She has early, late or irregular periods.

In the United States, most girls start their period between 12 and 13 years of age. If your daughter’s first period doesn’t come between 12 and 13, you may consider an appointment with a gynecologist. If she has developed breasts and pubic hair, but has not had her first period by age 15, she should definitely see a gynecologist. Once her period starts, if it is irregular after more than a year or two, she should see a gynecologist.

She has exceptionally painful cramps or heavy periods.

If your daughter has pain and cramps that keep her from enjoying her normal daily activities and are not easily managed by over-the-counter medication, she may need to visit a gynecologist. Or, if she experiences a heavy period, one that lasts longer than a week or soaks more than 1 to 2 pads in an hour, she needs to see a gynecologist.

You want to protect her against the human papillomavirus (HPV):

Your teen should also receive the human papillomavirus (HPV) vaccine if she did not receive it between the ages of 11 and 12. The human papillomavirus is a very common sexually transmitted infection and nearly all cervical cancer is caused by this virus. The HPV vaccine is a series of two injections (if given before 15), given at least six months apart, which serves as protection against the virus. The HPV vaccine is more effective if given before your teen becomes sexually active; however, it is still recommended if she is already sexually active.

She’s sexually active.

As soon as your daughter becomes sexually active, she should begin receiving regular sexually transmitted disease screenings and vaginal health exams. A report by the Center for Disease Control (CDC) states that over half of U.S. teens have had sexual intercourse by age 18. Therefore, it’s important that they practice safe sex, stay healthy, be informed and educated. If your teen is sexually active, birth control options can be discussed. A visit to the gynecologist is encouraged if she has had any form of sex (e.g., vaginal, oral, anal), sexual contact, or if she has been having sex and missed her last period.

She may have a disease or infection.

Symptoms like stomach pain, fever and fluid coming from her vagina that is yellow, gray, or green with a strong smell are signs of a serious condition called pelvic inflammatory disease (PID) that requires immediate treatment. Or, if there are signs of a yeast infection or sexually transmitted disease, call the doctor right away. A delay in treatment could be harmful to your daughter.

How can you and your daughter prepare for her first visit?

Talk with your daughter to set expectations and ease fears.

Let her know that you will be with her during the first part of the visit, but at some point, you will be asked to leave the room so the doctor can have a more private conversation with her. If she would prefer you to stay in the room during the exam or throughout the entire visit, that is perfectly acceptable, too. Explain that if she is not sexually active, the visit is often a conversation and does not always involve a pelvic exam. To further ease fears, you may see if the doctor is willing to conduct a telehealth visit (via telephone or video), before scheduling the in-person visit. During the telehealth visit, your daughter can meet the doctor and ask questions that will ease her mind prior to going to the office.

Share what will happen during the visit.

Let her know that it is safe to talk with the doctor or provider about private matters so she can get the best possible care. She can have her mom, sibling or a friend stay in the room with her during the visit if that would make her more comfortable. She can ask all the questions she wants so that she understands what is going to happen to her. Inform her that a general physical exam, which includes height, weight and blood pressure measurements, will be conducted. And, the provider may perform a brief external pelvic exam as well as a breast exam. A female nurse or assistant will also be in the room if an exam is necessary, and if she prefers, she can ask to see a female doctor.

Ask the doctor for reading materials and resources.

Reading materials, diagrams, pictures, articles and other resources may be helpful for your daughter. She may be more comfortable reading about a gynecologic visit, than talking with you about the particulars. So, contact your doctor to see what resources she recommends for your daughter prior to her visit.

Introducing your daughter to a gynecologist at the right time will help her understand the importance of self-care and building a relationship with a healthcare provider. That’s something that will help her stay healthy now and in the future.

Kellen Goldschmidt, MD, is an obstetrician/gynecologist with ProMedica Physicians practicing at Levis Commons in Perrysburg. View her provider profile.

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