Do you think of your teen’s first visit to an obstetrician-gynecologist (ob-gyn) as one of the milestones of adolescence? If not, it’s an important one to add to the list. Ob-gyn visits are a safe space for teens to talk about their changing health needs.
When should the first ob-gyn visit be?
The American College of Obstetricians and Gynecologists (ACOG) recommends that the initial reproductive health visit should take place between the ages of 13 and 15 years. Adolescents deserve the opportunity to discuss their sexual and reproductive health with a medical professional one-on-one.
As a parent, your teen’s first ob-gyn visit can seem like a direct off-ramp to adulthood. Watching your kids grow up can be as exciting and confusing for you as it is for them. But keep in mind that the average age of menarche (when the first period starts) in the United States is about 12 and a half. It makes sense that reproductive health care should follow close behind.
It is perfectly acceptable and recommended to make an appointment “just because.” There’s no need to wait for a problem. The first visit sets the stage for a lifetime of talking about reproductive and sexual health. Of note, if your teen hasn’t gotten a first period by 15, it’s worth checking with an ob-gyn.
What to expect at a first ob-gyn visit
The first visit will focus on talking and assessment. Healthy lifestyles, what an average period looks like, gender identity, and what a consensual relationship means, among other topics, can be discussed. Your teen may be given a questionnaire that will be reviewed to get the conversation flowing. Your teen will have time without you in the room to talk with the provider.
As far as exams go, there will be a general health exam checking blood pressure, heart rate, and weight. But the thing that can cause anxiety is the close association of ob-gyn visits with pelvic exams and Pap tests. A first visit won’t include an internal pelvic exam with or without a speculum unless absolutely necessary — and even then, only with your teen’s consent. Furthermore, Pap tests aren’t recommended for anyone under age 21. An exam of the external genitals — the vulva — may be performed dependent on concerns raised.
How to prepare your teen
Explain what an ob-gyn does.
We often jump ahead on a topic without explaining the basics. It’s human nature, especially if we come to the discussion with our own experiences. There’s a world of health care under the umbrella of obstetrics and gynecology.
Explain that an ob-gyn provider manages and cares for the reproductive health of a person with female reproductive organs. A provider can be a nurse practitioner or a doctor. Care provided ranges from first gynecological visits to pregnancy care and delivery, Pap tests and other cancer screenings, and surgery.
Discuss what will happen during your teen’s visit.
Emphasize it will be a time to get their questions answered about their periods, menstrual pain, sex, sexually transmitted infections (STIs), birth control, and any other topic they have concerns about. The American College of Obstetricians and Gynecologists, or ACOG, has a useful resource, “21 Reasons to See a Gynecologist Before You Turn 21,” which gives an overview of topics that can be covered.
Reassure your teen that an internal exam is not a routine part of an adolescent exam. If there is an indication for one, they will be welcome to discuss it with you or even refuse. The provider may want to do an external exam of the vulva but will explain why and what it will entail.
Encourage your teen to open up.
Let’s face it, talking about reproductive health is personal and can cause embarrassment. Reassure your teen that their provider has heard it all before, and it is their actual job description to talk about sex and periods. Their entire career, let alone their day, is filled with it. Inform them you will not be in the room for these discussions. They will have privacy and confidentiality. This is an excellent opportunity for teens to start practicing managing their healthcare priorities and decisions.
Talk about how to prepare for the visit.
Teens may be concerned about their pubic hair and body odors. There is no need to wax or shave before a visit. Pubic hair is not part of reproductive health and does not concern providers. It’s totally up to them how they groom. Also, deodorant sprays, powders, and douching (rinsing the vagina) are discouraged. They can be irritating and harm the natural balance of your body. Just their normal daily shower is fine.
What they should work on is a list of questions and concerns. The “21 Reasons to See a Gynecologist Before You Turn 21” resource is a good starting point for ideas. Encourage them to make a list on their phone. It’s hard to remember things in the moment at an appointment.
How to find a provider
If you have an ob-gyn provider that you like, you can see if they are taking new adolescent patients. There are also gynecologists who specialize in adolescent medicine. Ask your pediatrician’s office for a recommendation or explore the available clinics at your local children’s hospital.