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.