Adolescent Gynecology

When should I have my first gynecologic visit?

An obstetrician–gynecologist (ob-gyn) is a doctor who specializes in the health care of women. Girls should have their first gynecologic visit between the ages of 13 years and 15 years.

Is it normal to be nervous before the first visit?

It is normal to feel nervous about your first visit. It may help if you talk about it with your parents or someone else you trust. You may want to let your doctor know you are nervous. He or she can help put you at ease.

What should I expect at the first gynecologic visit?

The first visit may be just a talk between you and your doctor. You can find out what to expect at future visits and get information about how to stay healthy. You also may have certain exams.

Your doctor may ask a lot of questions about you and your family. Some of them may seem personal, such as questions about your menstrual period or sexual activities (including vaginal, oral, or anal sex). If you are concerned about confidentiality, you and your doctor should talk about it before you answer any questions. Much of the information you share can be kept confidential.

What exams are performed?

You may have certain exams at the first visit. If you choose, a nurse or family member may join you for any part of the exam. Most often, these exams are performed:

  • General physical exam
  • External genital exam

You usually do not need to have a pelvic exam at the first visit unless you are having problems, such as abnormal bleeding or pain. If you are sexually active, you may have tests for certain sexually transmitted diseases (STDs). Most of the tests that teens need can be done by the doctor with a urine sample. You also may have certain vaccinations.

What happens during a general physical exam?

During the general exam, your height, weight, and blood pressure will be checked. You also will be examined for any health problems you may have.

What happens during an external genital exam?

In this exam, the doctor looks at the vulva. He or she may give you a mirror so that you can look at the vulva as well. This exam is a good way to learn about your body and the names for each part.

What are the pelvic exam and Pap test?

Even though you probably will not have a pelvic exam, you should know what one is. Another test that you will have later (at age 21 years) is a Pap test. This test checks for abnormal changes in the cervix that could lead to cancer.

The pelvic exam has three parts:

  1. Looking at the vulva
  2. Looking at the vagina and cervix with a speculum
  3. Checking the internal organs with a gloved hand

pelvic-exam-pap-test

The doctor will use a speculum to look at your vagina and cervix. When you have a Pap test, a sample of cells is taken from your cervix with a small brush.

To check your internal organs, the doctor will place one or two gloved, lubricated fingers into the vagina and up to the cervix. The other hand will press on the abdomen from the outside.

What are vaccinations?

Vaccinations or immunizations protect against diseases caused by bacteria and viruses. Some are given on a routine basis. Other vaccinations are offered to women who are at an increased risk of certain diseases. Your doctor may ask you about your medical history and suggest you receive certain vaccinations.

What vaccines do teens need?

The following vaccines are given to all young women aged 11–18 years on a routine basis:

  • Tetanus–diphtheria–pertussis (Tdap) booster (once between ages 11 years and 18 years for those who have never had a dose of tetanus–diphtheria [Td] booster; those who have had a Td booster should get a dose of Tdap 5 years after they received Td)
  • Hepatitis B virus vaccine (one series for those who have not been vaccinated)
  • Meningococcal vaccine (once between ages 11 years and 12 years; once at about age 15 years for those who have not been vaccinated)
  • Varicella (chickenpox) vaccine (once between ages 11 years and 12 years for those who have not had chickenpox or have not been vaccinated)
  • Measles–mumps–rubella vaccine (once between ages 11 years and 12 years for those who did not receive the two-shot vaccine during childhood)
  • Human papillomavirus vaccine (one series between ages 11 years and 12 years; one series between ages 13 years and 26 years for those who have not been vaccinated; it also can be given to girls aged 9 years or 10 years)

In addition to routine vaccines, special vaccines may be given to young women who are at an increased risk for certain diseases. Listed are some of these vaccines:

  • Influenza vaccine
  • Hepatitis A virus vaccine
  • Pneumococcal vaccine

What special concerns can be discussed with my ob-gyn?

Many young women share the same health concerns. Most of these concerns are a normal part of growing up:

  • Cramps and problems with menstrual periods
  • Acne
  • Weight
  • Sex and sexuality
  • Birth control
  • STDs
  • Alcohol, drugs, and smoking
  • Emotional ups and downs

What can I do to stay healthy?

Making good lifestyle choices can help you to be strong and healthy for years to come:

  • Maintain a healthy weight by eating a well-balanced diet and exercising often.
  • Avoid smoking, drinking alcohol, and using illegal drugs.
  • Seek help if you have emotional ups and downs or feel depressed.
  • Use birth control if you are having sex and do not want to have a baby.
  • Protect yourself from STDs by using a latex condom. Know your partners and limit their number.
  • Keep up with routine exams, tests, and immunizations.

Glossary

Birth Control: Prevention of pregnancy.

Cervix: The lower, narrow end of the uterus, which protrudes into the vagina.

Condom: A thin sheath used to cover the penis during sex to prevent sexually transmitted diseases and pregnancy.

Menstrual Period: The discharge of blood and tissue from the uterus that occurs when an egg is not fertilized (also called menstruation).

Obstetrician–gynecologist (ob-gyn): A physician with special skills, training, and education in women’s health.

Pap Test: A test in which cells are taken from the cervix and vagina and examined under a microscope.

Pelvic Exam: A manual examination of a woman’s reproductive organs.

Sexually Transmitted Diseases (STDs): Diseases that are spread by sexual contact.

Speculum: An instrument used to hold open the walls of the vagina.

Vagina: A tube-like structure surrounded by muscles leading from the uterus to the outside of the body.

Vulva: The external female genital area.

Graphic Disclaimer: Designed as an aid to patients, this document sets forth current information and opinions related to women’s health. The information does not dictate an exclusive course of treatment or procedure to be followed and should not be construed as excluding other acceptable methods of practice. Variations, taking into account the needs of the individual patient, resources, and limitations unique to institution or type of practice, may be appropriate.

Credit: https://www.acog.org/Patients/FAQs/Your-First-Gynecologic-Visit-Especially-for-Teens

 

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