The first visit – a girl’s guide to her first gynecologist visit
Nowadays puberty starts earlier than it used to. And I’m not just talking about the start of menarche or the age at which a girl needs to get her first bra. Nowadays, girls are exposed to lots of different content online already at the age of 10. It could be through their own personal phones or through their friends’ phones.
What hasn’t changed, however, is how embarrassing it is for teenage girls to talk to adults about this stuff. Changes in their bodies, content they see online, their feelings and certainly anything to do with sexual intercourse and the use of contraceptives – all of these topics are sensitive topics, and our daughters will usually not talk to us about them.
It is easier, and less embarrassing, to simply google this stuff and search for the information online rather than to talk to mom or a teacher about it, even if the girl’s relationship with her mother is tight and their communication is good. And then what ends up happening is that girls are exposed to plenty of information, but it is from an unreliable source, and the content is often not age appropriate and unsupervised.
That is why the American College for Women’s Health and the World Health Organization (WHO) advise all parents to take their daughter/s to their first gynecologist visit between the ages 12 and 15. There are lots of gynecology specialists that are able to provide good care to adolescents, but today’s modern medicine works better in ‘niches’.
Therefore, consider taking you daughter to a gynecologist who specialises in adolescent medicine. That way, you will ensure your daughter has a positive experience.
The following post was written by Dr Natalie Koren, a senior gynecologist and a specialist in children and adolescent gynecology at Meir Medical Center. You can find her contact information here.
When is the best time for a girl to have her first gynecologist visit?
As mentioned above, according to the WHO the first gynecologist visit should happen between the age 12 and 15 years. However, if a girl suffers from issues such as early puberty (breast buds development or growth of pubic hair under the age of 9), early menarche (prior to age 10), abnormal vaginal discharge and lower abdominal pain, consider seeing a pediatrician and gynecologist earlier.
What is the purpose of the first visit?
This first visit has three main goals:
1. To obtain a medical history and family history and to confirm a girl’s gynecological health as well as to get to know the gynecologist and to establish a bond of trust. It is also important to identify any medical problems that require management or monitoring during this visit.
2. To teach the young girl how to get to know her body – all the way from the structure of the genitals to the reproductive system and also what is expected to occur when she starts menstruating. The girl is also taught to be aware of what is normal and to take joint responsibility (together with her physician) over her body and health when something is not right.
3. To teach the young girl what healthy sexuality means – sexual education should not begin in the 10th grade! Children are curious about this topic from a young age, and there is information and knowledge that is appropriate for all the different age groups. It is important for children to be able to ask questions and get a response from a reliable and professional source. Obviously, it is important to start discussing sexual contact, intercourse, contraceptives and sexually transmitted diseases when an adolescent hits puberty.
What kind of problems are discussed in a gynecologist’s office?
Depending on the age of the patient and their family, some of the topics that may be discussed include:
Problems related to menstruation – irregular menses, heavy bleeding and secondary anemia (find out more about iron deficiency anemia in adolescents here), painful menstruation or ovulation and premenstrual syndrome, structural issues related to the ovaries, uterus or genitals.
Acne, hirsutism (excessive hair), and polycystic ovarian syndrome.
Early onset or late onset of puberty.
And the different types of contraceptives available, as needed.
Does the gynecologist perform a physical examination during the first visit?
Usually, there is no need for a physical examination during the first visit.
A physical examination is required only if the girl has complaints that require assessment (physical examination or ultrasound). Even then, the examination performed is not invasive.
Are parents present during the visit?
That is a decision that needs to be taken by the young girl and the parent/s accompanying here. If the girl would like her parent/s to be there, they can remain for the full encounter. We always recommend the girl have a short conversation with the gynecologist in private, in order to talk about more intimate and private matters, if she agrees to it.
Are we obliged to inform parents when their daughter seeks a gynecologist consultation?
This can get slightly complicated and depends when your are living. In many countries, when it comes to pregnancy and contraceptives (the pill) and termination of a pregnancy – a girl can seek medical help without her parents’ knowledge or consent starting the age of 14. So, when it comes to these matters, we are not obliged to inform her parents.
When it comes to matters that are not related to pregnancy – theoretically speaking a physician must inform the girl’s parents of every encounter. Nonetheless, most physicians will not actively inform parents when the girl is over the age of 16.
In summary, the purpose of the first visit is to establish a relationship of trust between the girl and her gynecologist.
Visiting a clinic that specialises in children and adolescents is recommended as these clinics are often well trained at discussing private and sensitive topics with young girls. Part of the goal behind this visit is to promote awareness of the body and reproductive organs, to teach sexual health and to teach the girl how to take responsibility over her own body, together with her physician and parent.
For comments and questions, please register