By Bernard Logan, M.D.
Hallmark Health Medical Associates
Dr. Bernard Logan
From an early age, young women must learn about their bodies and understand the waves of change that happen as they develop and mature. One need is constant from adolescence through every stage of adulthood: the need for gynecological care from an OB/GYN.
Many women think of the OB/GYN as someone they visit when they’re having a problem, like trying to avoid pregnancy, trying to become pregnant, or having complications such as heavy periods or menopause symptoms. But really, it’s important for young women to start visiting the OB/GYN as teenagers, regardless of whether they’re sexually active.
A lot of my patients who are moms say, “My daughter wants to come visit you, but she is afraid of getting a pelvic exam.” I can’t say I blame them, but the good news is young women likely won’t need one. Let’s take a closer look at when those annual visits should start, and what happens during the visits.
When should annual visits start?
Current recommendations are for young women to start seeing an OB/GYN annually at around age 15. From ages 15 to 21, OB/GYN visits are usually more of a conversation than a physical exam. In most cases, a pelvic exam is not necessary. That’s why we call it an annual visit, and not an annual exam.
But if something develops, we want her to feel comfortable enough to call and get the care she needs. Just like with her annual school physical, it’s better to see someone she knows and feels comfortable with rather than taking her to someone she hasn’t met if she develops a problem.
Starting at age 15 and all the way up to age 21, the annual visit is more about getting comfortable with seeing a physician developing a patient/doctor relationship than it is being physically examined. This is a time of physical and hormonal changes, and it’s important that young women develop a relationship with an OB/GYN they can trust.
What happens at the annual visit?
As a young woman, your daughter is getting used to her changing body and identifying the hormonal and physical changes that are taking place. She’s likely had her menstrual cycle for a few years, so we’ll discuss questions about her changing body and her periods. We’ll also cover some of the basics of teen health that her pediatrician or family physician covers, like nutrition and exercise.
This also is a good time to talk about birth control options, teen pregnancy, protection from and counseling for sexually transmitted diseases (STDs), and other related issues as they arise. It’s important to discuss these issues regardless of whether your daughter is currently sexually active. It’s often hard for parents to accept that their daughters are developing into young women, but it’s better for girls to be prepared than to run into problems and medical complications later that could have been avoided with precautions taken now. Parents may sit in on the visit but may be asked to step out of the room when we start to talk about these personal topics.
If your daughter is experiencing problems with her periods (heavy bleeding, excess cramping, or extreme irregularity) or another issue like a vaginal infection, we may need to perform a physical exam to determine what’s going on or rule out potential problems. But we have ways of doing that without giving her a complete exam like an adult woman would have. We can focus your daughter’s exam on whatever area her particular problem is associated with, and that’s it.
Starting at age 21, your daughter should begin to receive a standard pelvic exam at her annual OB/GYN visit, which we recommend for all women. She also should get her first pap smear at age 21. At her annual visits from then on, we’ll discuss how her physical and hormonal needs change as she moves through the stages of womanhood.
Staying on schedule
Teens are really busy with school, sports, friends, and part-time jobs. It can be difficult to keep track of all of their activities, let alone adding an annual visit with the OB/GYN to the mix.
When your daughter’s visit is complete, we’ll give her the opportunity at check-out to automatically schedule her appointment for next year, just like we do with our adult patients. Sometimes it’s difficult to keep busy young women on the annual schedule. Once they’ve missed a year, they likely won’t make it in the next year, either.
More often than not, we won’t see our young adult patients outside of annual visits until a need arises, such as if they’ve developed a medical issue or they’re having trouble with their periods. When a young woman comes in for those reasons, of course we’re happy to visit with her. It gives us a chance to help her feel better, which is one of our top goals. But it also gives us an opportunity to gently remind her that it’s important to come in annually. If she does, we can achieve our other important goal – preventing medical issues before they start.