Your Daughter’s First Gynecological Exam
As mothers of teenage woman it is hard to know when to initiate that first gynecological visit. The American College of Obstetrics and Gynecology (ACOG) recommends that young women have their first visit with a GYN provider between the ages of 13 and 15. The main purpose of this first visit is for the young woman to establish a relationship with a GYN provider and for the provider to address issues that may not have been addressed by her pediatrician. It also ensures that your daughter knows where to turn for information and care including irregular periods, sexually transmitted infections, contraception, and other issues. It is important to note that the gynecologic visit does not replace the pediatrician but compliments it.
Before your daughter’s first gynecological visit, it is important to know what to expect. Armed with information, you can help your daughter feel more at ease and both of you can come prepared with questions. Before her visit, you should talk with your daughter about whether or not she would like for you to be in the exam room with her during her physical. Be prepared for her to ask that you wait in the waiting room during this time. This will give your daughter the opportunity to openly discuss personal issues that she may not feel comfortable asking you such as issues with her periods, breast discomfort, or how her body should look.
During the first visit, the provider will meet with you and your daughter. This allows them to obtain information pertaining to her lifestyle and health habits, including nutrition, exercise, school, and medications. They will also ask about her menstrual, reproductive, and family history. The provider will also want to talk with your daughter alone to hear her concerns and establish a confidential relationship. Stress to your daughter the importance of answering any questions truthfully, even though she may feel uncomfortable. It is also important to encourage her to ask any questions she may have, no matter how embarrassing she fears they will be. Once her detailed history is taken and concerns are addressed, the health care provider will perform a general exam.
The physical exam has in some ways stayed the same through the years; however, it has changed in some areas when it comes to young women and their health. This part of the visit can be very intimidating and it is important for you to give your daughter a sense of what she should expect and how she may feel during this time. Your daughter has probably experienced a physical before, so most of what she is to expect will be familiar territory. What may be different and a little embarrassing for her is the breast and external vulvar exam. These two areas are very important in making sure that there are no abnormalities and also important in teaching your daughter what is normal for her and how to care for her body. By talking with your daughter prior to the exam about staying relaxed, she will find that this portion of the exam is over quickly.
There are two parts of the exam that are no longer required for women under the age of 21. The first is that she no longer needs a pap smear even if she has been sexually active prior to this time. However, this does not exclude her from having an STD screening, which can include a urine test and blood draw. The second is a pelvic exam. The pelvic exam is not indicated unless a problem has been established that requires further pelvic assessment. Once the physical exam is complete, the three of you will rejoin to discuss any concerns and follow up questions as well as what future visits should be scheduled.
Once your daughter has experienced her first exam, encourage her to talk about her experience and share her feelings. It is a great time for the two of you to bond over this “rite of passage” into womanhood. Remind her that should she have questions about her health, she can, at any time, pick up the phone and get answers to the questions she may have. As the mother of a young woman, know that you set a solid foundation for a great relationship between your daughter and her gynecologist.
Additional posts by Laura Burnham, CRNP
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