A question I often get from patients has nothing to do with them – it’s regarding their daughters. “When do I need to bring my daughter in to see a gynecologist?”
This can be a horrifying thought for both the patient – “mom” — and their daughter. The one can’t believe that they have a child old enough to need gynecologic care, and the other is already self-conscious enough being a teenager without going to a doctor to talk about that type of “stuff”.
The answer to the initial question can be a win-win for mother and daughter. The American College of Obstetricians and Gynecologists (ACOG) recommends that adolescent girls have their first gynecologic visit between 13-15 years of age.
This visit RARELY requires a pelvic exam. However, if the young lady is having complaints that could indicate a severe underlying problem, an exam may be warranted. So many people equate going to the gynecologist with a pelvic exam that they are surprised the first appointment may not include one. So, there is the win for our young patient. We are mostly just going to talk.
The “win” for mom? Well, I get to review and reiterate the discussion that the two of them hopefully have already started. If it hasn’t been started then, I will start it.
I must mention that many pediatricians are comfortable doing this and do it well. But, there are some that are not as comfortable starting “the conversation”. That is one reason why ACOG recommends seeing girls between ages 13-15. We do not want there to be a gap in education for them just because the topic can be awkward. That gap could lead to life-altering consequences.
So what needs to be talked about? Most assume that the focus is sexual activity and its potential consequences. That needs covered, but to stop there would be naive. We love to be critical of our teenagers because let’s face it, they can drive us nuts! But let’s put ourselves in their shoes.
My wife and I often joke about how awkward and stressful adolescence was for us. There were a lot of external pressures coupled with our own insecurities. Today’s world of internet, texting, Facebook, and Instagram has exponentially increased the complexity of the gauntlet that our children are trying to navigate. Adolescents are a healthy group in general, but it is primarily their behaviors and decision-making that put them at risk.
So when we talk, we discuss school, friends, and activities. We also talk about the common causes of injury and death in the adolescent age group. These are suicide, motor vehicle accidents, and drug/alcohol related issues. Risks of sexual activity are also discussed even if they say they are not sexually active. Making good decisions and learning from our mistakes is important no matter what your age is.
I encourage these young girls to be empowered. The goal is for them to emerge from adolescence as a wonderful, confident young woman with an understanding of their own health and development.Steven M. Gorsuch, M.D.
Division Chief of Gynecology Partner, Women’s Health Group Inc. Summa Women’s Health Institute
Summa Health System