It is another rite of passage – a first visit to a gynecologist. For most young women there is some anxiety, uncertainty and embarrassment about the exam and even talking to the doctor about menstrual periods, sexual activity and sexually transmitted infections (STIs).

But, establishing a good, trusting relationship with a gynecologist will set your daughter up for a lifetime of health care that will last her through the many stages of womanhood.

The American College of Obstetricians and Gynecologists recommends teenage girls start seeing a gynecologist between the ages of 13 to 15. Annual breast exams should begin at age 19, and Pap tests usually begin at 21.

Hopefully, talking about the upcoming appointment will show her that there is nothing to fear or to be embarrassed about. 

Before the exam:

* Think about what type of doctor is preferable – male or female? Younger or older? A gynecologist or an obstetrician gynecologist?  Your doctor or someone new?

* If possible, avoid scheduling the appointment during her menstrual period and ask the nurse if the appointment should be rescheduled if she is actively bleeding.

* The doctor is going to ask many questions.  Help her to gather and write down her medical history in advance including family history, medications and her first as well as her most recent menstrual period.

* In this same vein, have your daughter write down a list of questions she would like to ask the doctor. Writing down questions will make them easier to remember and ease some of the nervousness when entering the GYN office.

* Topics she could bring up: cramps; heavy or light periods; weight; acne; sexual activity; birth control; STIs; emotional ups and downs; alcohol, drugs or cigarette usage; sleep and exercise.

* Ask her if she would like you to be in the exam room with her and do not be offended if she wants to do this alone.

* Let your daughter know what to expect in the exam room, why the procedures are done and how any discomfort she is feeling can be minimized. 

What to expect at the first visit:   

* As with most doctor visits the receptionist will ask for ID and the insurance card.  Next a clipboard will be provided with a questionnaire and a couple of housekeeping forms.

* The nurse will escort your daughter to the doctor’s office or the exam room so she can have a conversation with her gynecologist and they can get to know each other. The doctor will ask your daughter questions about family health history and vaccinations. Encourage your daughter to be honest.

* Remind her not to be embarrassed, as doctors ask these questions every single day and have heard it all. No topic is off limits! The doctor is not there to judge but to offer medical care and educate her. Doctors have a network of colleagues that can help with these concerns. Some topics that a patient can bring up if the doctor does not:

  • How the examination is performed and any concerns about the examination
  • The timing of her periods
  • Any discomfort
  • Any other health concerns
  • Medications and vitamins including over-the-counter
  • Allergies
  • How to communicate about tests results; communication preferences

* A physical exam is going to be performed. Anxiety is normal, but there is really nothing fear.  It is up to your daughter to decide if she wants you to stay with her during the exam.

* The nurse will ask your daughter to undress and give her a hospital gown. During this exam, the doctor will use her fingers to perform palpation of the breasts checking for any abnormalities. Pelvic and abdominal exams will be performed as well. She should be informed, none of these exams should be painful and if they are, the doctor should know right away.

* If your daughter is 21 years old, a pelvic exam with a Pap test should be performed. Cells are swiped from the cervix with a brush to be tested for sexually transmitted diseases. Spotting is normal following a Pap smear.

Encouraging a personal relationship between your daughter and her gynecologist now will prepare her for a healthy, long-term partnership. Help your daughter take charge and start her healthy lifestyle!

Julia Johnson, M.D. is chair of the Department of Obstetrics and Gynecology, UMass Memorial Medical Center.