When is the best time for a young woman, adolescent teenager, to come in to see a
gynecologist? That depends on several things. Many pediatricians provide
adolescent and teenage care for young women into their 20s, and if a teenager
is having pelvic exams, getting birth control from her pediatrician, then
there's really no reason to transition to a gynecologist until the pediatrician
no longer feels comfortable taking care of her; or family practitioner or a primary
care provider. For most women, they are going to feel most comfortable
transitioning to a gynecologist before they really need to see a gynecologist;
before there's any problem. And the first visit to a gynecologist doesn't
necessarily even need to include a pelvic exam.
There's often just things we can talk about: questions to answer, make sure that
she's very aware of anatomy, make sure she knows that a gynecologist is a great
resource for her if there are times when she doesn't feel comfortable talking to
a mother or family friend, then the gynecologist is the person she should be
going to to ask those questions rather than her other teenage friends. And it's
important for her to know that anything we talk about is confidential. Of course
I want young women to be talking to their mothers and families about
questions and concerns they have, but it's good to know that there's another
resource for them if they need it. So as a 17 year old as a teenager with
your first gyn exam, what you can expect is really to be able to talk to your
doctor and decide what you need at that visit. Your very first visit may or may
not even include a pelvic exam. It may be talking about questions you
have -- concerns. If there aren't any problems, if we're there to talk about
fairly normal things and do something like a general physical, then the pelvic
part of the exam could be incredibly minimal. It's not necessarily going to
entail a full gyn exam and the conversation that you have is completely
confidential, so anything that you want to bring up with your gynecologist
don't hesitate to. A teenager's knowledge about her anatomy, sexuality,
medical care related to gynecology can vary. There can be women who are young
women who are very mature for their age and understand a lot about their bodies
and what they need and should be doing, and there are women who really don't
understand much about that and exams and the things we talk about can be catered
towards where their knowledge base is. There's no such thing as a silly or
embarrassing question. I approach all teens the first time I'm seeing them,
with the same kind of information regardless of whether I think they have
that information or not because there's a lot of misinformation out there too.
You hear about what a gynecologic exam is like from your best friend who went
last week, and that may not be what we're going to do at all. Even women in their
20s and 30s don't always understand what we're doing and why and what the
different parts of a gynecologic exam are.
A gynecologic or pelvic exam essentially has three different parts. The first part
is looking externally at the external genitalia -- the labia the vulva -- and making
sure there's no problem skin changes, anatomies normal. The second part is the
part that usually everybody is worried about and gets uptight about and that's the
speculum exam using the equipment to actually go inside the vagina look at
the cervix. It literally takes about a minute; it's very fast it's not nearly as
uncomfortable as sometimes people make it out to be, and it sometimes doesn't
even be done. It's the way we actually obtain a pap smear, which is the screen
for cervical cancer, but not all women need that test every time, and it's also
a way again to look at the anatomy of the cervix. It's a way to obtain samples
for sexually transmitted disease screening and see if there's any problems
with infections, but it's a very quick part of the exam. And then the final part
is actually a feeling exam feeling the anatomy internally: the uterus and
ovaries and tubes. It's important for young women to know
that when they are even under the age of 18, gyn care is completely confidential,
including a treatment for concerns for pregnancies, birth control, and sexually
transmitted infections.