Her First Ob-Gyn Visit
Posted 6/22/2018 by UHBlog
You may not be thinking about your young daughter’s reproductive health, but her doctor is. Ask us which exams and discussions are appropriate at different times in your child’s development.
When you first cradle your newborn daughter, you’re likely more focused on breastfeeding or swaddling than you are on adolescent concerns such as menstruation, sexually transmitted infections or birth control. But, believe it or not, her first gynecological exam occurs shortly after birth.
“From age zero, we look at genitalia to make sure everything looks good,” says pediatrician Rina Lazebnik, MD. “Then at every well-care visit, we also look at genitalia. Gynecology should be part of every yearly visit.”
Dr. Lazebnik, who specializes in adolescent medicine, answers common questions about gynecological care for girls.
Do I need to find a gynecologist for my middle-schooler or can her pediatrician manage her gynecological care?
Adolescent medicine specialists and pediatricians are trained in adolescent gynecological medicine, says Dr. Lazebnik, who recommends children switch from a pediatrician to an adolescent medicine specialist, if one is available, upon reaching puberty.
“If everything is okay, there is no need for a gynecologist because there is no pap at this age,” she says. However, if a gynecological condition warrants surgery or a teenage girl is pregnant, the doctor will refer the girl to the proper specialist.
What is involved in a younger teenager’s gynecological care?
In addition to a visual exam of her genitalia, the doctor will ask your daughter about her period beginning at about age 11: Has she begun menstruating? Are her cycles regular? Are they painful? If she hasn’t received the HPV vaccine, which prevents the development of some cancers and warts caused by the sexually transmitted human papilloma virus, the doctor will encourage vaccination.
Do exams change as she moves through adolescence?
If she hasn’t begun menstruating by age 15 or 16 – and there isn’t a family history of late menarche – evaluation may be necessary. If she is sexually active, her doctor will also talk to her about birth control and sexually transmitted infections.
What is my role as a parent?
Make sure your daughter has a yearly check-up with an adolescent medicine specialist or pediatrician who, in addition to addressing gynecological concerns, will monitor her vital signs, treat other physical conditions and talk to her about anxiety, depression, school issues, dating and other areas of her life. Dr. Lazebnik says it’s important for doctors and parents to have an open dialogue, so parents feel comfortable talking to their daughters about the physical and emotional changes they will be experiencing.
“We talk about puberty and menses because a lot of the moms never had ‘the talk,’” she says.
Dr. Lazebnik says discussions with parents cover a broad range of topics, such as using pads and tampons at school, managing menstrual pain, shaving, feelings and familial expectations around dating and drugs.
When should my daughter see a gynecologist?
When she turns 21. She will have a pelvic exam that includes a pap smear, which checks for abnormal cell changes that could signal cervical cancer. For most women, pap smears are performed every three to five years (although annual exams are still recommended). Women with abnormal cells may require more frequent pap tests.
Rina Lazebnik, MD is a pediatrician and division chief of General Pediatrics and Adolescent Medicine at University Hospitals Rainbow Babies & Children’s Hospital and University Hospitals Cleveland Medical Center. You can request an appointment with Dr. Lazebnik or any other doctor online.