If you have not scheduled your adolescent daughter for her first appointment with a gynecologist, you may be missing out on a key opportunity. Here’s how to prepare her for that first visit.
You’ve dutifully scheduled your daughter for every visit to the pediatrician, and perhaps you even sailed through a discussion of the birds and the bees with confidence and grace. But did you know that it’s just as important to make a gynecologist a part of your adolescent daughter’s health team?
Both the North American Society for Pediatric and Adolescent Gynecology and the American College of Obstetricians and Gynecologists recommend a first visit with the gynecologist at age 15, reports Fatima Naqvi, MD, an OB/GYN at Atlantic Medical Group Women’s Health at Westfield.
“Pediatricians take care of the whole child and deal with a lot of other issues,” she says. “We don’t ever want to take away from the pediatrician or adolescent medicine doctor. We work to create a partnership between the pediatrician and gynecologist.”
The 3 Most Important Things About an Adolescent's First GYN Visit
1. It should be about conversation and education, not examination. This is the adolescent’s time to learn about her body and her sexuality, and the doctor’s time to learn about the patient.
2. It’s not just about body parts. The gynecologist is also looking for red flags pertaining to anxiety and depression, eating disorders and unhealthy habits.
3. You’re setting up your daughter not just for a first appointment, but for taking charge of her health for the rest of her life.
What to Expect
Dr. Naqvi – who has a 15-year-old daughter of her own – explains that she regards initial visits as educational opportunities. There is no exam at this visit, unless it’s necessary; the new patient does not even get undressed. Instead, this is a time for introductions and information. “I introduce myself to the patient, and then to the parent. I address the patient first, because I want her to know she is my priority,” she says. “I want her completely in her comfort zone.”
She provides an overview of a speculum, so it’s not completely foreign to a patient during a future visit. She also does a breast exam over the patient’s clothing and teaches her how to do one, so she feels more secure. “I explain it’s just about learning about your body and how to take care of your body,” she says.
While parent and child are in the room together, Dr. Naqvi will have a full conversation about safe sex and contraception. “I do this in front of the parent, so everybody is informed,” she says. She then asks the parent to leave the room for a more private and more open interaction. (A staff member can serve as a chaperone in the room if that makes the parent feel more comfortable.)
Beyond Puberty and Periods
During a first visit, Dr. Naqvi screens for physical conditions like bleeding disorders and polycystic ovary syndrome, which may affect fertility in later years. She also screens for psycho-abnormalities that a young woman may experience when she hits puberty – anxiety, depression, eating disorders and body dysmorphic disorder, among others – and for sexual abuse and sexual assault.
She looks, too, for warning signs in body language and nonverbal cues, and assesses social activity. “I’ll ask, ‘What are you doing to reduce stress and anxiety? Are you involved in sports or other activities?’ We know that social media has a huge impact on adolescents,” she says. “Adolescents need an outlet other than screen time.”
Throughout the appointment, Dr. Naqvi asks if the patient has questions or if she is curious about anything. “I want her to know I’m here for her if she has any questions. I’ll tell her, ‘Maybe not even for you; maybe for a friend.’ The goal,” says Dr. Naqvi, “is to engage her and gain her trust and confidence. We want everyone to have a positive experience. That’s how you create a patient for a lifetime.”