Teen Counseling Specialist

At what age should I schedule my daughter’s first well-visit with a gynecologist?

The American College of Obstetrics and Gynecology advises that girls should have their first gynecologic well-visit between the ages of 13 and 15. Physiologically, most girls begin having periods between 12 and 13 years old and ideally, a girl should start seeing a gynecologist soon after her first period.

For many, periods will be irregular for the first three to four years; for some very uncomfortable and possibly excessive.  Fortunately, in most cases, simple and safe solutions are available to regulate menstruation and greatly improve the quality of life. 

Also, unless contradicted, girls who have not received the human papillomavirus (HPV) vaccine from their pediatrician, which the Center for Disease Control (CDC) recommends to be done at the age of 11 or 12, should receive it at this time.  HPV vaccine is a safe and effective vaccine that protects against certain types of HPV, the most common sexually transmitted infection in the United States.

Additionally, if your daughter hasn’t started her period by age 14-15, it’s a good idea to schedule a gynecologist appointment to rule out any health problems that may be delaying the onset of menstruation.

What can a girl expect at her first visit?

This is a very unfamiliar time in a young woman’s life.  In addition to the medical evaluation, the initial visit is meant to establish a foundation for a strong patient-physician relationship built on openness and trust. This includes both, education about development and hygiene, as well as a conversation about making smart decisions and any other questions or concerns which the girl might have. Especially, answering questions which she is too embarrassed or uncomfortable discussing with her parents. Because of this, you’ll likely start the visit in the exam room with your teen, but may be asked to step out later.  For the parent, it helps you get used to your child having another trusted adult to talk to about problems.

For the mom, dad, or daughter who are understandably anxious about the first visit, it is usually comforting to know that for most patients, only a general physical and sometimes external genital exam are performed at this age. Internal exams and pap smears are not typically performed until the age of 21 and breasts exams become recommended around the age of 20.

What are some of the reasons a gynecologist would recommend birth control for a teenager who is not sexually active?

When it comes to menstrual irregularities or side effects, birth control can be used to manage hormones. Issues surrounding a teen’s menstrual cycle, including hormonal or mood changes, acne, pain, or heavy periods, can all be reasons we place a teen on birth control. Birth control can also help irregular and unpredictable bleeding.

What are some birth control options when you think (or know) your teen is sexually active?

Most teens and parents prefer options that the teens don’t have to remember to take daily or even weekly. There’s a category of birth control called long-acting reversible contraceptives, or LARCs, which include the arm implant and intrauterine device (IUD). They can help with many menstrual issues we see in teenagers, and this form of birth control can last from 3 to 10 years and have been proven safe and highly effective in teens. The pill, the patch, the ring, or the injection are more user-dependent options that are also effective if the teen is reliable at using it daily, weekly, monthly, or every few months respectively. 

Why is it important for a girl to see a gynecologist in addition to her yearly check-up with a pediatrician?

As an adolescent girl becomes a young adult, a gynecologist can help bridge the transition.  Ideally, a trusting relationship between the girl and her gynecologist should already exist before she becomes sexually active.

Further, while some pediatricians will feel very comfortable answering your questions and your teen’s questions about things like general gynecological health, contraception, menstrual cycles, and sexual activity, most pediatric practices will be very limited in the options that they are able to offer for managing hormones (i.e. birth control).

After her initial visit, how often should a teenager see a gynecologist?

Depending on what was discussed, it could be yearly, but we sometimes recommend following up in three to six months, especially when starting a new medication.

What are some tips for calming a girl’s nerves before the first visit?

Most visits will not require an invasive examination.  Discussing this visit with someone she trusts like her mother, another family member or friend who has been to the gynecologist may help as well. If she want to bring a parent or another support person at least for the initial discussion, we more than welcome them. We can excuse anyone she would prefer not to be in the room for discussions or exams that are more sensitive or private in nature.

What tips do you have for parents if they discover their teen is sexually active?

Staying calm and inviting a safe space for discussion is important. The more comfortable your teen feels with you and the conversation at hand, the more likely she is to be open with you. Chances are, she’s just as scared to discuss this matter with you as you might be with her. Making the conversation a judgement-free zone will help further foster the relationship you have with her and build trust to allow for safe decisions. A gynecologist can also help facilitate any discussion, but things she may reveal to us in the exam will remain confidential unless she decides otherwise.

If appropriate, ensuring she’s having safe and consensual sex is something we’ll address.