No woman really looks forward to her annual gynecology visit, which often brings back memories of discomfort, probing, and cold stirrups. As your daughter grows and develops, you may wonder when is the right time to start taking her to a women’s health specialist. “According to the American College of Obstetricians and Gynecologists, it is recommended that the first visit be between the ages of thirteen and fifteen,” said Dr. Erin Best, obstetrician/gynecologist, A Place for Women (Florida Physicians Medical Group). All information shared with the gynecologist is confidential and, for most girls, the consultation is sparked by questions about menstrual cycles or sexual activity. “She can have her family member present if she prefers, but she does not have to,” says Dr. Best.

Allow your daughter to participate in the selection of a gynecologist. Will she feel more comfortable seeing a female physician over a male? Maybe an older, nurturing specialist versus a young doctor? Would she connect with the same or different gynecologist as her mother? As the parent, your guidance can help your daughter to trust the professional, which is especially important during the maturity stages and transitions of an adolescent girl. Other considerations include board-certified qualifications, approach surrounding sexual behavior, experience with young patients, and miscellaneous practice components (such as nursing and support staff).

An initial visit is usually focused on gathering and providing information as well as helping the patient understand her body. “She may want to share some health concerns ─ like cramps or problems with her period ─ or other issues including acne, sex and sexuality, birth control, sexually transmitted diseases, alcohol, drugs/smoking, and emotional ups and downs,” said Dr. Christine Greves, obstetrician/gynecologist, Orlando Regional Medical Center. “I allow my patients the opportunity to ask questions; then, I ask questions in a non-intimidating manner.” The initial visit does not necessarily need to include a physical exam.

Expect the gynecologist to inquire about medical and reproductive history, including your daughter’s first and last period, inconsistencies of her menstrual cycle, discharge, pain, and engagement in sexual behaviors (and if so, relevant discussion on protection and pregnancy).  It is essential to answer questions honestly so the gynecologist can conduct appropriate evaluations and exams, if necessary. Your daughter will likely be asked to undress and wear a gown, even if an exam is not likely.

As with most medical appointments, the gynecologist will check height, weight, and blood pressure. “A pelvic exam is usually not needed unless the girl is having abnormal bleeding or pain,” said Dr. Mary Beth Lewis-Boardman, obstetrician/gynecologist, Women’s Care Florida. Should an exam be appropriate, she explains, “Physicians exam the external aspect, vulva, vagina, and cervix with the speculum. Then, we check the internal organs with a gloved hand.” Dr. Lewis-Boardman continues, “If she becomes sexually active, we can order STD tests, some possible with a urine sample.” It is important that girls are aware that vaginal intercourse is not the only way of contracting a sexually transmitted infection.

Annual Pap smear screenings should begin at the age of twenty-one. “It is a sampling of cells on the cervix,” said Dr. Greves. The cells are scraped using a small brush and spatula and analyzed in a lab. The breast exam may also start at this age, unless the patient has specific concerns. “The incidence of breast cancer is rare at a younger age but it is important that girls learn about their breasts, including self-breast exams, which can be discussed during the first visit,” said Dr. Greves.

Vaccines may also be addressed. “We want to make sure that she has received the tetanus-diphtheria- pertussis booster within the guidelines,” said Dr. Best. The HPV vaccine will likely be discussed. “This three-shot series can be given to girls between the ages of nine and twenty-six, ideally before becoming sexually active,” explains Dr. Best. The earlier it is administered, the better likelihood of effectiveness. “It can prevent the specific virus strains that cause cervical dysplasia, which is basically pre-cancer of the cervix, that can lead to cervical cancer or genital warts.”

Lifestyle is also relevant to the patient’s general wellness. “We discuss weight, exercise, refraining from alcohol and smoking, and consequences of such choices,” said Dr. Lewis-Boardman. Teens are advised to be seen by a gynecologist annually as a means of prevention and detection. “There are benefits just from checking basics (height, weight, and blood pressure), discussing changes to the body, and any health concerns,” adds Dr. Greves. Following the first visit, be sure to ask your daughter for feedback on how the appointment went. If for any reason she is not comfortable with the gynecologist, consider trying a different physician so she can maintain the recommended plan for annual visits. While some may stereotype this specialist as the person who only performs Pap smears, remind your daughter that a gynecologist can be a true advocate for her overall wellbeing.