When do I start coming to the Gynecologist?
This is a tough question for most people. To the general population, annual well-woman exams are thought of as just coming in for a pap smear. The recommendations for cervical cancer screening are to start pap smears when a patient is 21 years old. However, there is much more performed at the well-woman exam aside from pap smears.
Many patients have heard of these new recommendations and assume that means an appointment is not necessary until 21 years old. According to ACOG (American College of Gynecology) the recommendation is to have your first GYN exam between the ages of 12-14 years old. At this appointment there will not be a pelvic exam performed unless there are medical problems that warrant evaluation.
We recommend that as long as an adolescent female is not experiencing any medical concerns, you as a mother should schedule an appointment for your daughter to come in the same day that you come in for your annual exam. This exam is essentially like when a parent and daughter go to the dentist for the first time. The child watches mom get her teeth cleaned and then it’s her daughter’s turn to sit in the chair to count teeth. Of course we are not saying that your daughter needs to be present for your Pap smear and pelvic exam though. The goal is that she becomes familiar with coming to our office and discussing appropriate health promotion, normal menstrual cycles, diet and exercise, immunizations, normal development, drug and alcohol prevention and injury prevention. A quick visualization of the breasts may be performed to determine normal development if necessary.
The next appointment should be done between the ages of 15-17 years and will discuss the same issues as above but will also likely include an exam of the external genitalia for normal development and annual screening for sexually transmitted infections if the patient is sexually active. There is typically a more age appropriate discussion about sexual behavior, contraception, driving safety, and piercing/tattooing safety that there is at the previous exam.
The third adolescent exam should be performed between the ages of 18-21 years old. This appointment will include STI testing if patient is sexually active and even more extensive discussion about the above issues.
It is encouraged that a parent comes along for the visits as well. We do like to be able to talk with the adolescent patient in private, as the information she gives is typically more honest and truthful once they are aware that all information discussed is confidential (this is true even if the patient is a minor). We then would like a parent present for discussion as well and if an exam is necessary it would be up to the patient if she prefers a parent with her or not.
Once again to recap the recommended adolescent appointment schedule:
First visit to an OB/GYN should be once between 12-14 years old
Second visit to an OB/GYN once between ages 15-17 years unless medical condition warrants more frequent visits
Third visit to an OB/GYN once between ages 18-21 years unless medical conditions warrant more frequent visits.
Annual exams starting at age 21 years old.
MAY