The idea of seeing a gynecologist or having a pelvic exam can make any young girl feel nervous, embarrassed or scared. But just like any other part of her body, it’s important to make sure it’s as healthy as it can be.
“If something abnormal is going on and it’s worrying your daughter, explain the importance of getting it examined just like she would if she had a sore throat or a belly ache,” said Dr. Jessica Castonguay, an adolescent medicine physician at Akron Children’s Hospital. “We can help. Young women should treat a concern in her vaginal area the same way she would anywhere else on her body.”
The American College of Obstetrics and Gynecology recommends that young women have their first visit with an obstetrician-gynecologist between the ages of 13 and 15. However, if your daughter has irregular, heavy or painful periods, unusual vaginal secretions or is sexually active, an appointment sooner rather than later may be necessary.
“It’s not so much based on a number, but more on a girl’s health and menstrual status, and sexual activity,” said Dr. Castonguay.
When the time comes, you can help your daughter feel more comfortable in taking this important step by explaining why the visit is necessary, giving her a sense of what to expect, and addressing any questions or fears she might have.
“If she’s nervous or anxious, your daughter can talk to her doctor about her concerns when she gets there,” said Dr. Castonguay. “We’re not going to do anything that she doesn’t want us to do. We won’t force her to get an internal exam. Also, reassure her much of the visit, especially the first one, is more informational rather than physical.”
For most teens, the first visit will include an external examination of the genitals to make sure there are no sores, swelling or other issues. Unless the teen is experiencing problems with her reproductive health, the physician will not perform an internal examination.
“We don’t recommend Pap smears for healthy women until age 21 now, so a speculum exam is not common,” Dr. Castonguay said. “We realized we don’t need to do this invasive pelvic exam to help girls control their periods or evaluate problems they may be experiencing.”
Your daughter should be prepared to answer questions from the doctor about her medical and reproductive history, including when her last period was, if she’s having any menstrual problems and whether she’s sexually active.
Through this discussion, the doctor will decide which tests to run and what issues to discuss. If she is having sex, the physician will talk to her about contraception.
“Encourage your daughter to ask any and all questions she has — no matter how embarrassing she fears they may be,” said Dr. Castonguay. “Let her know that nothing she says will be something that the doctor or nurse hasn’t heard before. Also, remind her that this information is confidential.”
In addition, the physician will perform a breast examination to make sure she’s developing normally and to detect lumps, cysts or other breast issues.
Lastly, testing for STDs is not automatically included in a gynecological exam. However, girls who have been sexually active should be tested for STDs. Some STDs can be tested for with blood or urine tests, while others require a sample (just like during the Pap smear) from a pelvic exam.
“Encourage your daughter not to work herself up before the appointment by watching videos online,” said Dr. Castonguay. “Most girls I talk to say it’s not near as bad as they thought it’d be.”
Once you and your daughter have gone to the first visit, encourage her to talk about the experience. Once she starts, your daughter should continue to go for gynecologic visits every year to keep her informed and healthy.
Akron Children’s Division of Adolescent Medicine offers first pelvic exams and other routine gynecologic care to any female adolescent from age 12 to 25.