A very common question that I get asked as an OB/GYN is, “when should my daughter start seeing the gynecologist?” It is a good question with a nuanced answer that deserves some explanation.
First, it’s important to discuss and understand the components that can make up the different kinds of gynecological exams and why someone would need a gynecologist. There are two main categories of gynecological visits. The first is a well-woman exam and the second being a problem-based visit.
A well-woman exam is a yearly recommended exam that is comparable to the yearly recommended physical at your primary care doctor’s office. It is where we take the opportunity to make sure that you are up to date on your health maintenance, which can include tests like pap smears, mammograms, colonoscopies, bone density scans, and other possible indicated tests. The general recommendation is to start pap smears at age 21, so we would recommend establishing care with an OB/GYN at that time if you have not already found one.
The other type of visit that people have with their OB/GYN is a problem-based visit. This kind of visit is for when people have gynecological issues. This can include things like heavy or irregular periods, vaginal discharge or itching, pelvic pain, to name a few.
So, when should a teenager start visits with a gynecologist?
Any time a patient asks me this question, my answer is the same. I always say that a teenager should start seeing the gynecologist when they have a gynecological issue, when they want to talk about contraception, or when they turn 21, whichever comes first. We often see teenagers to talk about birth control and safe sex practices. This is one of my personal favorite visits when I see it on my schedule. I did not feel that I had great guidance on the uses and purpose of contraception as a teenager, and I wish I had established care with a gynecologist to help me sort through all of that. Additionally, many teenagers will have heavy or abnormal periods. It would be totally appropriate to talk about the management of these issues with a gynecologist.
What else will happen at that first visit?
Many of my adolescent and teen patients will come into my office very anxious. They often believe that they are going to have a painful pelvic exam. I always make it one of my first goals at the visit to explain that I will only perform a pelvic exam on a patient if they need one. Unless a teenager is having vulvar or vaginal issues, they generally do not need a pelvic exam.
Most conversations about contraception or menstrual cycles are just that…conversations. Once we get through that part of the conversation, I can often feel the anxiety in the room start to decrease.
A pelvic exam is necessary for things like pap smears or IUD placements, but this is always something that should be explained in detail if it is going to be performed so that the patient understands what the exam is and why. Most of the time, a gynecology visit with a teenager is just talking and counseling as well as a physical exam consisting of things like listening to the heart and lungs and palpating the abdomen.
How often does a teenager need to see a gynecologist?
In my practice, I will tell my teenage patients that if they are doing well without problems, I would recommend coming to my office for a wellness/check-in visit yearly. That way, we can review any updates in the gynecological history that have occurred since their last visit and make sure that any birth control or medications I may be prescribing are still working and meeting our goals
One last thing…
I think that probably the most important thing when considering making an appointment with an OB/GYN for a teenager is to find a doctor with whom you are comfortable! It is so important that teenage girls feel that their doctors are people whom they can not only relate to, but also can be honest and open to share information and come to if they need help. This may mean recommendations from friends, family, or the internet, but definitely don’t forget this component of things when looking to find a gynecologist for the teenagers in your life!
To find an OB/GYN that is right for your teenager, visit www.bjc.org/obgyn/gynecology.
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