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Your Daughter’s First Trip to the Gynecologist

It won’t be as traumatic as you both think.

A doctor in bright blue scrubs speaks with a patient dressed in a pink medical robe. The patient is sitting on an examination table with her back to the camera and her brown hair is pulled back in a low ponytail.
Photo credit: Audrey C Tiernan/Northwell Health
A female doctor with glasses, a white lab coat and a pink stethoscope looks toward a patient and smiles.

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I’m a grown woman. Yet the thought of stripping down, putting on a paper gown, lying on a cold, hard table, and placing my bare feet in stirrups is enough to make me shudder. But I do it every year (and only complain a little) because I know it’s one of the ways I can take a proactive step toward keeping my body healthy.

As the mother of a teen and a tween, I’ve been thinking about how I can empower my girls to take control of their wellness. I began to wonder how it will be for them that first time they visit a gynecologist. And at what point would they need to do it. As my anxiety about their sexual health and how to set them up for success grew, I decided to talk to Dr. Gianni Rodriguez-Ayala about when is the right time to take your daughter for her first visit to a gynecologist and what happens during that appointment. Here’s what she said.

At what age do you recommend a young woman see a gynecologist for the first time?

The American College of Obstetricians and Gynecologists recommends that a young woman schedule her first visit to the gynecologist between the ages of 13 and 15 years old—right around the time that she gets her first period. They usually have a lot of questions, and issues often arise that need to be dealt with—everything from PMS symptoms to what is considered excessive bleeding to questions about sexually transmitted diseases. We won’t necessarily cover all of those topics during the very first visit, but I think it’s important for a young woman to know there is a safe and private place she can go to talk about these things.

Do you do pelvic exams on teens?

I don’t do pelvic exams on young women under 21 years old unless I think it is medically necessary. Generally, a first visit would just involve a lot of talking—about her menstrual cycle, her medical history, her family history of diseases and whether she is having any problems or concerns. My goal is to get a pretty detailed picture of my patient as a whole. So the first visit usually feels more like a meet-and-greet. The patient is always welcome to bring her mother along if that makes her feel more comfortable, and often it’s helpful to have mom there because they may be able to provide valuable information, not only about the patient’s development, but pertinent family history as well.

Then eventually I will ask mom to step out and give us some privacy so the young woman knows that this is a safe place and everything we discuss is just between us. This opens things up for questions the young woman might have that she is too embarrassed to ask her mother or friends. And the mom is usually perfectly happy to give us some privacy.

What do you talk about once a mom leaves the room?

Once we are alone, young patients usually have tons of questions they are eager to get answered. Everything from what is considered a normal amount of discharge to whether inserting a tampon should hurt to how to prevent pregnancy. I always answer questions as honestly and openly as I possibly can.

Then I ask some questions of my own. I try to get a sense of who this young woman is and how she views herself. Is she happy? Does she feel good about herself? Is she involved in healthy relationships? Does she partake in risky behaviors? Is she sexually active? I also ask her if there is anything she wants to show me. Sometimes young women are concerned because their breasts are different sizes or they have bumps on the skin of their vaginal areas. I will take a look if they want me to. But because these young women are usually still being followed by a pediatrician, they may be more comfortable coming to us with their “grown up” questions. We talk about how it’s time for someone her age to start taking charge of her own health and ways that she can do that.

Then, if the patient initially came to see me because she was having a specific issue, like pelvic pain, spotting, or something like that, I would talk to her about performing an exam. But that would only happen once we talked about it and I felt that it was necessary and the patient was comfortable.

In terms of taking control of her own health, does that include birth control?

Absolutely. Many young patients have questions about birth control and they are entitled to get counseling and prescriptions for birth control if that’s what they want. A woman is not required to have a pelvic exam or parental permission to receive birth control.

Once a young woman comes in to see you, does she have to come back regularly?

We recommend once every year. Some patients will need more frequent visits based on their symptoms and treatment required. For example, if there’s an issue with her cycle, I will want to see her in a few months to make sure that whatever we did to correct the situation is working.

Are there any routine tests that you would want to perform?

Again, we would most likely just talk on the first visit. But eventually we will need to discuss things like risk factors for certain diseases and based on our discussion, I might recommend blood work or other specific tests.

Women don’t need to start getting Pap tests that screen for cervical cancer until they are 21 years old. And even then, as long as the results are normal, we only do them every three years until age 30.

We would also discuss the benefits of the HPV vaccine. We recommend that girls AND boys get the vaccine between the ages of 9 and 26. So, if we give the patient a vaccine, she will need to come back for either one or two more doses, depending on when she got the first dose.

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Published January 23rd, 2018
A female doctor with glasses, a white lab coat and a pink stethoscope looks toward a patient and smiles.

Learn More About OB/GYN Services