There are many misconceptions surrounding a teenager’s first visit with the gynecologist. Parents may be under the impression that a gynecologist is only needed if there is a medical concern or if an adolescent is sexually active, but, in fact, the American College of Obstetricians and Gynecologists recommends that all girls between ages 13 and 15 have an initial gynecology appointment.
“Parents don’t have to wait until there is something wrong to bring their daughter in for a visit; the first gynecology appointment is an opportunity for the family and the doctor to establish a relationship and to discuss issues like puberty and periods, and to make sure things are developing typically,” says Samantha Erin Vilano, M.D., the medical director of pediatric and adolescent gynecology at Riley Hospital for Children at Indiana University Health. What else can you expect from that first visit? Dr. Vilano explains here.
A safe place to talk
“I see the girl with her parent or guardian, and we have a discussion about her general health and any concerns. And then I usually talk with the girl without her parent present—and that part of the conversation is confidential,” says Dr. Vilano. “We always encourage teen girls to be open and honest with their parents but we want to take the best care of them that we can, and sometimes there are things that teens are more comfortable discussing without parents present.” During this one-on-one time, Dr. Vilano talks with girls about breast development, body image, what a period is (if they haven’t gotten one yet), how to handle it, contraception, STD prevention, and sexual health, among other things. “It’s also a chance to make sure kids feel safe at school and at home, and again we keep this information confidential unless there is something illegal we need to report,” says Dr. Vilano. She also notes that she is always willing to help navigate conversations between teenagers and parents if the teen wants that.
A simple exam
For girls who may be worried about an invasive examination, rest assured that an internal exam is generally not part of this first visit. A pelvic exam with the speculum occurs after age 21, when a first Pap test is recommended. “The initial exam consists mostly of looking at the genital area and breasts, feeling the belly, and listening with a stethoscope,” says Dr. Vilano. “And it’s the girl’s choice whether she’d like to have a parent present for the exam or not.” If the teen is sexually active, STD screening is recommended. Most STDs can be detected either through a vaginal swab sample or a urine sample.
“If a girl has not yet had the HPV vaccine, which is suggested between ages 9 and 11, we offer the vaccine,” says Dr. Vilano. “I’m also happy to field questions about the HPV vaccine and cervical cancer.”
A chance to get questions answered
Dr. Vilano recognizes that many of the changes that adolescent girls experience can seem scary, so one of her primary goals during this visit is to put any fears to rest. For instance, girls might not realize that it’s normal to have clear vaginal discharge as they reach puberty; it’s the way the vagina cleans itself. “For teen girls who are not used to that, it may be alarming, so I am able to explain to them why that happens and that it’s normal,” says Dr. Vilano. She also frequently reassures girls that it’s common for one breast to develop slightly earlier than the other one—and that it doesn’t mean there is a problem.
The beginning of a relationship
Dr. Vilano emphasizes that the first visit is the start of a long-term doctor-patient relationship. “I think a lot of parents might worry that a visit to a gynecologist opens the door to questions about sex and may possibly trigger their daughter to start considering sexual activity, but research shows that’s not the case,” says Dr. Vilano. “In fact, teenagers who have knowledge and a trusted adult they can go to are less likely to engage in risky behaviors and more likely to know how to get themselves out of unhealthy situations.”
-- By Rachel Rabkin Peachman