For those of us past 25 or 30, an ObGyn well-woman visit is likely a routine ho-hum to tick off every year. In fact, we may not even remember the first time we went, let alone any apprehension we felt about it. But visiting the gynecologist for the first time can be stressful, particularly as a teen, the time doctors recommend for the first visit.
A pap smear (cervical cancer screening) isn't generally recommended until a woman is 21, but the American College of Obstetricians and Gynecologists (ACOG) recommends an initial gynecology "well" visit for girls between the ages of 13 and 15.
Anyone around a teenage girl for more than 30 seconds understands that virtually anything can lead to embarrassment or social anxiety. The mere thought of going to a gynecologist and showing someone your "business" can be more angst-ridden than a bad social media post. Therefore it's up to us as parents, guardians, older sisters, favorite aunts or other confidantes to calm a teen's anxiety about the doctor visit and let her know it's a good idea to go. How? By explaining why it's important, and what to expect in that first visit.
The good news is, you don't have to feel alone, because the doctor is just as invested in making your teen feel comfortable as you are.
"Most girls are actually pleasantly surprised when they learn how the doctor or nurse conducts the first visit," Overland Park Regional Medical Center's Margaret "Dr. Maggie" Smith, MD, says reassuringly. "There really is no reason for embarrassment and we always try to make young patients feel at ease, so they feel comfortable reaching out to us if and when they have problems."
She doesn't want to go; is it really that important?
Starting a relationship with a trusted ObGyn - a primary goal of an initial gynecology visit - is one of the best things a teen (and her mom) can do for long-term health, says Overland Park Regional Medical Center ObGyn Sara Talken, MD.
"We always recommend that a girl begin to see a gynecologist while in her teens," she says. "Aside from offering her the opportunity to meet a gynecologist (and learn we aren't as scary as some people might think) we provide many services important for the teen years - sex education, managing periods, birth control counseling, and HPV counseling and prevention, with the HPV vaccine. Those are all very important for overall reproductive health now and in the future."
Getting ready for that first visit
Eliminating the stress of an ObGyn initial visit starts by talking openly about it and involving your teen in the decision process. From choosing a doctor with whom she feels comfortable to jotting down questions and potential concerns, it's a good time for her to play a role in her health.
Be clear on what the visit might entail, letting your teen know the doctor will provide information and discuss things that affect her both now and in the future such as safe sex, weird symptoms "down there" and any kind of period issues. Depending on any problems, there may or may not be a physical exam.
"It is a great idea for the teen to jot any questions she has in her phone so all of her questions get answered," advises Dr. Smith. "And because a parent usually accompanies her for at least part of the visit, we recommend he or she writes questions down as well."
THAT first visit
Doctors say a first visit can generally be scheduled at any time during a teen's cycle. For some teens, the initial visit will simply be talking with the provider, while for others, it may include an exam, possibly a physical or a pelvic exam. Calling the doctor's office in advance and asking what the visit will entail helps you set expectations. In general, the doctor will discuss:
- Period regularity and frequency
- Cramping
- Safe tampon usage to protect against Toxic Shock Syndrome
- High Risk HPV vaccine
- Weight issues and vitamin sufficiency
- Social, athletic and academic issues
- Staying safe and awareness of drug and alcohol dangers
"I normally start with any questions the patient has," says Dr. Talken. "If a teen doesn't ask questions about periods, I always take a menstrual history because there is a lot of information to gain from this. We can identify signs and symptoms for common gyn concerns like endometriosis and polycystic ovarian syndrome (PCOS) and start treatment and education early so as to hopefully prevent complications, like infertility and chronic pelvic pain, in the future."
Between your teen and the doctor: Privacy
Patients under the age of 18 are not required to have a parent in the room during the visit unless that is the patient's preference, so after the initial part of the visit accompanying adults are generally asked to leave the room. Your teen should know that any conversation she has with the doctor is confidential unless there is an immediate risk to her or someone else.
"Once the adult leaves the room, we ask the teen if she has any questions to ask privately," Dr. Smith says. "And we always reassure her that this is a confidential conversation and explain about HIPAA privacy policy as to whether it is okay or not okay to share information or test results with a parent. We really try to respect a teen's wishes on this matter so we as clinicians can obtain truthful information from her."
No judging here - alleviating embarrassment
Depending on your teen, she may be very embarrassed about the topics the doctor will raise, her physical appearance, or someone she doesn't know seeing her without clothes. That's all normal, doctors say and he or she will take pains to relieve that embarrassment and set the stage to talk openly with your teen.
"I tell my patients there is nothing to be embarrassed about," Dr. Talken says. "My job is to educate and care for patients and not to judge or reprimand. The more honest a patient is during our visit, the more she will get out of it."
Women's care for all ages
Whether a teen's first ObGyn visit or any other women's healthcare need, HCA Midwest Health offers board-certified expertise for comprehensive gynecologic care. Our physicians can help whether you simply need an annual exam or are experiencing gynecologic issues. Our physicians can also consult via telemedicine.
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