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.