As most parents of teens and pre-teens know, adolescence can be the most difficult stage in the journey towards adulthood. Pressures from school, friends and society, along with the inevitable body changes, can be a lot for a kid to deal with. But for adolescent girls, the first trip to the gynecologist – while often nerve wracking – can be a therapeutic initial step towards empowering young girls to take control of their health and feel more comfortable and secure with their own bodies.
“A good time for the first gynecologist appointment is usually between 13 and 15 years old,” said Andrea Zuckerman, MD
, Chief of Pediatric and Adolescent Gynecology
at Tufts Medical Center. “But girls should not hesitate to see a doctor earlier if they experience certain issues such as vaginal irritation or heavy bleeding during their period.”
Medical History and Physical Exam
At the first visit, the gynecologist will take a complete medical history and perform a routine physical exam - checking the patient’s height, weight, blood pressure and skin, and listening to her heart and lungs. The doctor may also examine the outside of the vagina (vulva), depending on the reason for the appointment. The patient will have the opportunity to talk to the doctor privately about expectations for follow-up appointments and tips on general health and wellness.
“We tell our patients that we will never ask or do anything that makes them feel uncomfortable,” said Dr. Zuckerman. “If they prefer to have mom in the room at any point during the visit, that’s completely fine. And our discussions remain strictly confidential, unless the patient asks us to share with a parent or guardian.”
Tests such as a pap smear or a pelvic exam usually would not be done until age 21, unless other risk factors (such as immunosuppression or HIV) are present.
Although typically administered by pediatricians, the gynecologist will also check to make sure that patient has received her HPV vaccines
– the best protection available against cervical cancer – and counsel her about the dangers of HPV and the importance of the vaccine.
“The best time to start receiving the HPV vaccines are before becoming sexually active – ideally at 11 or 12 years old,” said Dr. Zuckerman. “If the patient receives the vaccine before age 14, it requires only two shots; after age 14 necessitates three shots. Either way, the vaccine is extremely important, as it covers nine different types of HPV and reduces the risk of both cervical cancer and genital warts by nearly 90 percent.”
Comfort is Key
The first trip to the gynecologist is an important step, both in an adolescent girl’s reproductive health and to create a relationship and build trust with her doctor.
“The first appointment is a good opportunity for the patient to meet her gynecologist, learn about how her body is changing, understand what is normal and what is not, and discuss things such as periods, birth control and other health concerns,” said Dr. Zuckerman. “We want our patients to feel comfortable talking with us about anything, including personal subjects that they might not want to discuss with their parents.”