By Saifuddin T. Mama, MD, MPH
Pediatric and Adolescent Gynecologist
By scheduling your “tween” or teenage daughter for her first gynecologic visit, you are crossing a bridge that acknowledges her change from a little girl to a young woman. It can be very overwhelming for a parent to cross that bridge. As you prepare yourself – and, of course, her – for the appointment, it may be helpful to consider the following ideas.
The age for a first gynecologic visit ranges widely and depends upon your daughter’s needs. It can be as early as the pre-menstrual years of ages 7 through 10, up to age 21. However, a first appointment should be made if:
- There are questions about early or late puberty and development.
- Your daughter asks to see a gynecologist so she can ask questions.
- You as her parent feel she is ready or that an physician may make answering questions about puberty, development, menstrual cycle, sexuality and safety easier.
- There are particular problems, such as very heavy, irregular or painful menses.
- There is pelvic pain before, during or after the menses.
- There is any concern regarding appropriate internal development of vagina, cervix, uterus, ovaries and tubes.
- There is any concern regarding appropriate development of the breasts.
- Your daughter has become sexually active and wants birth control, or if she just wants information about birth control because she is considering initiating sexual activity.
- There is a possibility of polycystic ovarian syndrome or an incidental finding of an ovarian cyst (whether or not it is accompanied by pain).
During her first gynecologic examination, there is an emphasis on history-taking – asking and getting accurate answers especially as it relates to normal development. Also, there is a focus on the physician providing an overview of puberty, development, sexuality and safety, and answering questions. An internal pelvic examination is very rarely required. This helps a young woman feel more comfortable about that first gynecologic visit. If concerns are identified, lab studies with a blood draw and a trans-abdominal pelvic ultrasound may be ordered.
As a parent accompanying your daughter on her first visit, come prepared and bring a list of questions, even ones you think might be simple or trivial. Also, be ready to allow your daughter private time with the physician without your presence so she can comfortably express whatever might be on her mind and have personal questions answered.