Preparing patients and families for the first gynecological visit

A first gynecological exam between the ages of 13 and 15 helps a teen understand that there is a provider dedicated to their reproductive health.

As children assigned female at birth approach or start menstruating around age 12, parents often start asking their pediatricians about the first gynecology visit, Pap smear and why someone who is not sexually active needs to see a gynecologist.

A teen’s first gynecological exam between the ages of 13 and 15 helps them understand that there is a doctor dedicated to their reproductive health.

“The first exam is usually conversational, “said  Kimberly S. Huhmann, pediatric and adolescent gynecologist with Norton Children’s Gynecology, affiliated with the UofL School of Medicine. “It’s about building a relationship so that the young person knows they have a health care provider dedicated to their reproductive health system. Having a relationship with a pediatric gynecologist can help a teen take ownership of their health as they age.”

For part of the visit with the gynecologist, the patient will have the opportunity to speak with the doctor alone — pediatricians can prepare the child and parent to expect this.

“This is the opportunity for an adolescent patient to discuss topics that they may have a hard time talking to their parent or guardian about,” Dr. Huhmann said. “Usually, those discussions are about topics such as puberty, issues with periods, acne, hygiene, contraception, exercise, and mental health. It’s really about the young person’s needs and concerns.”

What age is recommended for a first pelvic exam and Pap smear?

According to Dr. Huhmann, a general physical is part of that first gynecological exam, with height, weight and blood pressure being measured. However, a pelvic exam is usually not part of that first visit. Pelvic exams are recommended starting at age 21, according to the American College of Obstetricians and Gynecologists (ACOG).

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A Pap test checks for abnormal changes in the cervix that could possibly lead to cancer. During the test, a sample of cells is taken from the cervix. ACOG guidelines state that patients should have their first Pap test at age 21.

“If a patient is experiencing certain symptoms or issues, an external genital exam or pelvic exam may be needed,” Dr. Huhmann said. “Rarely is a pelvic exam needed during that first visit, unless symptoms are present such as abnormal bleeding, vaginal discharge or pain.”

Yearly gynecological exam? It depends

Adult patients often associate gynecological exams with the pelvic exam and Pap smear schedule based on their age and health. For younger patients, it’s based on their needs.

“Even though these examinations are not needed in most patients under 21 years old, we do recommend annual visits to the gynecologist,” Dr. Huhmann said. “This allows us to check in with the young person and their family about reproductive health questions, needs and concerns.

“Ask for an appointment should any issues come up. If a child is experiencing irregular periods, excessive menstrual pain or bleeding, frequent or infrequent periods, they need to be evaluated.”

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