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First Visit to Gynecologist
Q: At what age should I bring my daughter to a gynecologist? I have been told that she should wait until she is around 21 for her first visit. I went when I was 11! What do you suggest?
A: The timing of a young woman's first pelvic exam depends on many factors, and the exam doesn't necessarily need to be performed by a gynecologist. The pelvic exam is done to assess the health of the uterus and ovaries, and to get a Pap smear, which is a screening test for cervical cancer. These days, many pediatricians, adolescent medicine specialists, and family practice doctors are well trained in providing routine gynecological care to teenage girls.
A girl who is healthy, has no symptoms or history of gynecologic problems, has not started her periods yet, or is having routine menstrual cycles, and has not started to have sexual activity, does not really need to have a pelvic exam until college age.
A teenager who has already started to have sexual intercourse should have a gynecological exam and Pap smear. This evaluation will also include screening for sexually transmitted diseases, and education about prevention of these diseases, as well as education about preventing pregnancy. Early sexual activity does put a young woman at higher risk for cervical cancer, so it is important that a full examination is done.
Teenagers who have had any history of menstrual problems (not just cramps), should also be evaluated to make sure there are no structural problems or hormonal abnormalities present.
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Shari Nethersole is a physician at Children's Hospital, Boston, and an instructor in Pediatrics at Harvard Medical School. She graduated from Yale University and Harvard Medical School, and did her internship and residency at Children's Hospital, Boston. As a pediatrician, she tries to work with parents to identify and address their concerns.