As girls grow into teens, it's important that they receive appropriate medical care. The American College of Obstetrics and Gynecology (ACOG) recommends that young women have their first visit with an obstetrician-gynecologist (OB/GYN) between the ages of 13 and 15.
For most teens, the first visit will include an external examination of the genitals but not an internal examination of the reproductive organs, which is recommended beginning at age 21 for healthy women. However, if your daughter has abnormal vaginal bleeding, painful periods, unusual vaginal secretions, or other problems that may be associated with her reproductive health, she may need a pelvic exam sooner.
The idea of seeing a gynecologist or having a pelvic exam can make a girl feel nervous, embarrassed, or scared. By explaining why the visit is necessary, giving your daughter a sense of what to expect, and addressing any questions or fears she might have, you can help her feel more comfortable about taking this step.
Chances are, your daughter has associated visits to the doctor with health problems. She may not understand why she would go to the doctor when she feels perfectly fine.
Explain that the visit serves at least three main purposes:
Also, you may want to reassure your daughter that even though there are a lot of different parts of the gynecological visit, the actual physical exam — and the part she might feel most uncomfortable about — doesn't take long.
The doctor or nurse practitioner that your daughter sees should be someone who takes the time to make her feel as comfortable as possible. Though you have probably been the dominant force in making your daughter's health decisions up until now, it's wise to involve her in this one.
Here are some ways to consider your daughter's preferences:
Your needs are important, too — you should trust this person with giving your daughter appropriate information about important decisions in her life.
Once you have your daughter's input, use these suggestions to find a doctor who best fits your family's needs:
Other questions you may want to ask:
Share the answers to these questions with your daughter. And don't hesitate to interview several health practitioners before deciding on the best fit.
Your daughter should be prepared to answer questions the doctor asks relating to her medical and reproductive history, including:
Through this discussion, the doctor will decide which tests to run and what issues to discuss. Stress to your daughter the importance of answering these questions truthfully, even though she might feel uncomfortable about it. For example, the health professional can help determine, based on your daughter's sexual history, whether she is at risk for sexually transmitted diseases (STDs). If she is, the doctor will know to test for them.
Encourage your daughter to ask any and all questions she has — no matter how stupid or embarrassing she fears they may be. Let her know that nothing she says will be something that the doctor or nurse hasn't heard before or will share with anyone else. Remind her that this information is confidential.
Your daughter has probably experienced a physical before, so most of this will be familiar territory for her.
One of the health care workers, probably an assistant or nurse rather than the doctor, will measure your daughter's vital signs, including weight and blood pressure. The doctor may examine her neck, breasts, heart, lungs, and abdomen. Your daughter may also provide a urine sample.
This examination gives the doctor background on your daughter's general health and a baseline to use for comparisons in future exams.
Though breast cancer is very rare in teens, the breast exam is still an important part of a GYN visit. During this part of the exam, the doctor or practitioner will do a breast exam to make sure that your daughter is developing normally and to detect lumps, cysts, or breast problems.
Before the exam, try to give your daughter a sense of what will happen in the exam room. It's important for your daughter not only to know what to expect, but why the doctor is doing it and how any discomfort she is feeling can be minimized. If applicable — and both of you are comfortable with the idea — consider letting your daughter see these steps firsthand by sitting in on one of your exams.
If she hasn't already, your daughter will undress and put on an examination gown. Her pelvis and thighs will be draped with a sheet. She may be asked to lie on the table with her knees bent and spread apart. The doctor may have her place her feet in stirrups. In this position, the doctor will check the vulva (the external genitalia).
The purpose of this part of the exam is to make sure there are no sores, swelling, or any other problems with the external genitalia.
If an internal pelvic exam is needed, the doctor will place one hand on the outside of your daughter's abdomen and one or two fingers inside the vagina.
The clinician's hands are used to feel the size and position of the ovaries and uterus. An instrument that opens the vaginal walls (speculum) allows the doctor to visually examine the walls and cervix and to perform screening tests, such as a Pap smear and tests for some STDs.
Let your daughter know that she may feel some pressure, but this shouldn't hurt. She may be able to decrease any discomfort by taking slow, deep breaths and relaxing her stomach and vaginal muscles. In addition, the clinician will likely make efforts to make her feel more comfortable by starting up a conversation or having interesting posters in the room to look at.
During the internal exam, the doctor or nurse may take a Pap smear. Gynecologists recommend a Pap smear beginning at age 21, and then typically every 3 to 5 years.
In a Pap smear, cells are gently scraped from the cervix using a small brush and a small spatula. The specimen is sent to a lab to check for abnormal cell changes and cervical cancer.
The practitioner may recommend the human papillomavirus (HPV) vaccine. This vaccine protects against the main types of HPV that cause genital warts and certain types of cancer, especially cervical cancer. Even if your daughter receives the HPV vaccine, she should still get regular Pap smears beginning at age 21 to screen for forms of cervical cancer not covered by the vaccine.
Testing for STDs is not automatically included in a gynecological exam. However, girls who have been sexually active should be tested for STDs. Some STDs can be tested for with blood or urine tests. Sometimes, the clinician obtains a sample with a cotton swab (just like during the Pap smear) during a pelvic exam.
The samples are sent to a lab, where they are tested for STDs like gonorrhea and chlamydia. When talking to your daughter about whether she should get tested, it's important that she know that vaginal intercourse isn't the only way to contract these infections — they can be passed through oral and anal sex as well.
The office staff can let you know different options for your daughter to get the results confidentially. For instance, instead of calling the patient or sending a letter with the results, some offices require the patient to call in.
Once you and your daughter have gone to the first visit, encourage her to talk about the experience (as much as she is comfortable). If she indicates that the doctor or nurse practitioner made her feel uncomfortable, discuss finding a new one. Once she starts, your daughter should continue to go for gynecologic visits every year to keep her informed and healthy.
Reviewed by: Elana Pearl Ben-Joseph, MD
Date reviewed: October 2013
|Planned Parenthood Federation of America Planned Parenthood offers information on sexually transmitted diseases, birth control methods, and other issues of sexual health.|
|American College of Obstetricians and Gynecologists (ACOG) This site offers information on numerous health issues. The women's health section includes readings on pregnancy, labor, delivery, postpartum care, breast health, menopause, contraception, and more.|
|American Academy of Family Physicians This site, operated by the American Academy of Family Physicians (AAFP), provides information on family physicians and health care, a directory of family physicians, and resources on health conditions.|
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|Do I Need a Pelvic Exam if I Had the HPV Vaccine? Find out what the experts have to say.|
|About Birth Control: What Parents Need to Know Talking to your kids about sex can be daunting. But discussing issues like abstinence, STDs, and birth control can help lower teens' risk of unintended pregnancy or contracting an STD.|
|What Can I Expect From the Gynecologist? Find out what the experts have to say.|
|Primary Care Doctors: Who's Who A primary care physician is your first stop for medical care. Find out more about the primary care doctors who treat teens.|
|About Sexually Transmitted Diseases (STDs) You've probably heard lots of discouraging news about sexually transmitted diseases. The good news is that STDs can be prevented. Find out how to protect yourself.|
|Gyn Checkups Girls should get their first gynecological checkup between ages 13 and 15. Find out what happens during a yearly gyn visit -- and why most girls don't get internal exams.|
|Talking to Your Child About Menstruation Kids reaching puberty should already know what's going to happen to their bodies. Here are some tips for talking to your daughter about menstruation.|
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