The First Gynecology Visit
I’m a gynecologist who loves her job, but if someone came in for their first gynecological visit and said they were excited to see me, I’d be worried. No one enjoys a visit to the doctor! Even so, many girls and even women are anxious and scared about going to see a gynecologist for the first time, and that may have to do with notions about strange metal instruments and awkward positions or the stories from the older women in their lives. In my case, as for many of us in the (early) middle-aged generation, it was right before going off to college.
The Gynecologist’s First Gynecological Visit
The nurse told me to take everything off and put on the paper gown, then sit on the table and wait. I sat there waiting and waiting, while my anxiety was growing and growing! When the doctor finally arrived and gruffly introduced himself, I had difficulty focusing on his face because his shirt was unbuttoned to show off rows and rows of gold chains and massive amounts of chest hair. I recall there wasn’t much discussion before getting down to business: my first pelvic exam and Pap smear.
Afterward, I gingerly walked back to the waiting room, and smiled meekly at my Mom and thought, what was that all about? Now I’m the one greeting nervous girls and moms, and it’s such a privilege to provide my patients and their families with an exceptional experience for their first visit to the gynecologist. I know that if it goes well and they are able to let go of some of their fears about discussing and even looking at “yucky, gross private parts stuff”, they are one step closer to being able to take care of themselves and be as healthy and happy as possible.
First Visit to The Gynecologist
Since I was headed to college, thankfully, a lot has changed for young women embarking upon their first reproductive health visit. Most importantly, it is recommended that girls see a provider to address their gynecologic well-being well before they go to college or plan to become sexually active. The ACOG, or the American College of Obstetricians and Gynecologists, recommends girls see a gynecologist (or another qualified provider) for their first visit between the ages of 13 and 15 years old, sooner if there are any concerns or problems. An accurate assessment of pubertal development and even menstrual problems also can be difficult for girls and their parents, especially if mom had heavy, painful, or irregular periods herself and views that as the norm. Identifying pubertal or menstrual problems early on can prevent them from becoming serious issues in the future.
In addition to a shift in the timing of the first gynecological visit, there is now hardly any need at all for a pelvic exam using a speculum for an adolescent girl. There is no need for a Pap smear for anyone under the age of 21, and testing for infections, including sexually transmitted diseases, can be accomplished with urine testing or self-collection of vaginal swabs.
For girls coming to see me, an examination happens after we have had ample time to talk in my office and they become more comfortable and relaxed. After moving to an exam room, I do a focused physical examination that may involve a breast exam and visualization of the vulva, but I almost never need to use a speculum. A tool that I almost always use, however, is a hand-held mirror for what I call the “anatomy tour”. It can feel seriously embarrassing, but learning the detailed ins and outs of your vulva and what exactly to call the various parts is critical to feeling like you can manage any problems that might come up.
The Goal of The First Gynecological Visit
The goal of the first gynecological visit is to start to establish a relationship and making sure the real questions you have are getting answered. While there are pediatricians who are comfortable with gynecologic topics, it can be especially awkward to discuss extremely private matters with an adult that has known them since childhood. Parents always want their children to feel comfortable coming to them with any problems or concerns, but in reality, the topic of puberty can be so embarrassing to discuss (for both sides) that the conversations are often avoided.
The first gynecological visit is an opportunity to make these issues less “icky”, and allow some time and space to get the communication going. It’s also a chance for parents to ask questions and get guidance and support. Graduating to see a gynecologist is a major step for every girl, as she transitions into womanhood, and begins to take responsibility for her body, health and choices.
If you have been looking for a Pediatric Gynecologist, I encourage you to give my office a call and then, congratulations are in order for getting the first gynecologic visit scheduled, and I am looking forward to seeing you soon!
7900 Fannin Street #3000,
Houston, TX 77054
5757 Woodway Suite 101
Houston, TX 77057
2950 Cullen Pkwy Suite 201
Pearland, Texas 77584
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