An informative and comfortable first gynecology visit for a teen can influence her doctor-patient relationships for years to come.
A girl’s first visit to the gynecologist can be an intimidating event – meeting with a new doctor, talking about the changes her body is going through, discussing reproductive health, and possibly a very personal physical exam. The American College of Obstetricians and Gynecologists (ACOG) recommends girls have their first OB-GYN visit between 13 and 15 years old.
This is a vulnerable age for girls, and it is important to understand what will happen in this first appointment. Many pediatricians and family practice providers are comfortable discussing the issues mentioned in this article. They are knowledgeable about the changes going on in a young woman’s body.
So, starting the conversation with these providers is a great idea. But after getting a start in the direction of the coming changes, a girl needs to establish a relationship with a gynecologist who specializes in the women’s health and reproductive issues she will experience the rest of her life.
Let’s talk about your teen’s health. Set up her first gynecological visit so we can talk about healthy habits to adopt.
The first gynecologist appointment
The first appointment for a young woman should be a conversation, preferably with a parent present. The gynecologist will discuss the teen’s medical and family health history, and ask the teen and her parent about any questions or issues they wish to bring up. The decision to perform a gynecologic exam will be made based on any symptoms the patient may be experiencing and her comfort level. A routine gynecologic exam is not required until the age of 21, and many women do not need to have a pelvic exam until then as well.
This first visit with an adolescent patient will involve a conversation about some things that are very personal. The gynecologist will discuss many issues, including normal and abnormal menstrual periods, safe sex and possible options for birth control, if appropriate. Helping young women understand what is happening with their bodies is one of the most valuable points of this first appointment.
A physical exam and an external genital exam may be recommended. Pap smears are not performed until age 21, but many girls do have questions about them.
This appointment should not be scary, to the teen or parent. The visit is a great way for a young woman to begin developing a relationship with her gynecologist. The goal is to educate the young woman and get her comfortable speaking with the doctor about things women don’t often talk about with anyone else.
Confronting the confusion of puberty
For a young woman, puberty can be a very confusing time. For instance, young women may have one period and assume their periods will all be the same or occur at regular intervals. This is often not the case. Throughout puberty, the physiologic system is still developing, so irregularities in menstruation are common and may take years to become predictable. This is sometimes due to an active, athletic lifestyle but often is simply because things are still developing and maturing.
A gynecologist can explain these changes during a first visit and offer counsel on difficult topics. Addressing concerns and helping a young woman feel comfortable talking with her gynecologist can pay off in the long run.
Having the talk about birth control pills, plus their noncontraceptive benefits
Birth control certainly isn’t the main focus of our appointments with our younger patients, but it is valuable information for our OB-GYN to give to a teen. Providing teens with accurate and comprehensive information is the goal so they can make appropriate decisions about their bodies. For teenage girls who are, or are considering becoming, sexually active, excellent medical advice and counsel is crucial.
Hormonal contraceptives, such as birth control pills or the Nuvaring, are not only for contraception. Many adolescents take birth control to help manage other conditions. For example, hormonal contraception is used to manage heavy and painful periods or irregular periods. According to the Guttmacher Institute’s study, one-third of teens take birth control pills for noncontraceptive reasons.
Hormonal birth control can often help prevent acne, a common concern for many teens. Contraceptive pills typically contain the hormones estrogen and progestin, which can help treat hormonal acne. While the pill certainly can help with acne problems, there are other medications to treat the problem directly. Certain birth control pills have been FDA approved to treat acne.
Calming cramps & menstrual pain
Managing menstrual cramps and pain is one of the main benefits of hormonal contraception. Cramps are not only uncomfortable but also may cause teenagers to miss out on academic, social or athletic activities. Some contraceptives are a great treatment option for the pain associated with cramps. Allowing teens to participate in school and social activities is the goal, not being at home using a heating pad or taking ibuprofen.
Educating and vaccinating against HPV
A teenager’s first visit with a gynecologist is an opportune time to talk about human papillomavirus (HPV), and for us to encourage the teen and her parent to begin the vaccination series. HPV is so common that nearly all women, and men, will get at least one type of HPV infection in their lives. The Centers for Disease Control and Prevention (CDC) found that approximately 15 million people in the United States will be infected each year.
There are more than a hundred types of HPV, and most HPV infections do not become cervical cancer and will go away by themselves. Still, it’s hard for an OB-GYN to argue against taking the one vaccine that can prevent most cases of cervical cancer.
The HPV vaccine works very well, with close to 100 percent protection against cervical precancers and genital warts associated with HPV. The vaccination series should be administered to both boys and girls around age 11 or 12, but can be started as early as 9 years old. There is no need for HPV testing before getting the vaccine. We would be happy to talk with you and your teen about the HPV vaccine and answer any questions you may have.
At CU Medicine OB-GYN East Denver (Rocky Mountain), we believe that a young woman’s first gynecology appointment should make her feel more comfortable with her changing body, and with her gynecologist.