Breaking the ice

The teenage years are full of firsts: first driver’s license, first job, first date—to name a few. And many teens look forward to these rites of passage with happy anticipation. 
Your daughter’s first visit with a gynecologist? Probably not so much.



“Most patients tend to be nervous for their first gynecological visit because they don’t know what to expect,” says Allison Fralick, DO, gynecologist with Kettering Health Network. “Scheduling the first gynecological exam as a ‘getting to know you’ visit is a great idea. It can often be difficult to discuss personal issues and concerns with a new provider. Therefore, being seen to establish care and discuss expectations for future visits can be a great way to relieve some of the anxiety that comes along with the first visit with a gynecologist.”

When to schedule, and with whom

The American College of Obstetricians and Gynecologists recommends young women have their first gynecological visit between the ages of 13 and 15, but Dr. Fralick says this can vary depending on the patient’s needs.

“Routine pelvic exams and Pap smears are not recommended until age 21, so a patient may not have any questions or concerns that require an earlier visit,” she explains. “Common reasons young women are seen before age 21 include the desire to establish care, questions regarding reproductive health and what to expect at future visits, screening for infections, abnormal menstrual cycles, and desire for contraception.”

Dr. Fralick says the visit can be scheduled with a gynecologist, gynecological certified nurse practitioner, or primary care provider. “Any of [them] are great for a first gynecological visit depending on the comfort level and the needs of the patient. If the patient has problems or concerns that can’t be addressed by a primary care provider or nurse practitioner, then patients are often referred to a gynecologist.”

What to expect

“I normally begin all my first visits with a discussion with the patient on what to expect and what we intend to cover that day,” Dr. Fralick says. Topics frequently discussed include routine health maintenance; medical, surgical, and family history; menstrual history (patient’s age when menstruation began, how often it occurs, how long it lasts); contraception; sexually transmitted infections; and sexual activity.

The physical exam will include listening to the patient’s heart and lungs, and examining her thyroid, abdomen, and extremities. “Pelvic exams are not typically performed at the first visit unless there is a specific problem or concern from the patient that necessitates the exam,” Dr. Fralick explains. After the first visit, annual visits are recommended unless sooner follow up is needed.

Parents can be present for the visit if it makes the patient feel more comfortable. “Some patients desire parents to be present and others prefer to be seen alone,” Dr. Fralick says, adding that parents should expect the provider will ask the patient at some point in the visit if she would like them to step out of the room. “This is often done routinely to make sure the patient feels comfortable addressing any personal concerns or questions they may have.”

Dr. Fralick says that parents can help prepare patients for their first visit by discussing ahead of time what to expect. “Often the idea of having a pelvic exam performed is the most stressful and anxiety-provoking aspect of the first gynecological visit,” she says. “Informing patients of what to expect beforehand can help them prepare and often feel less nervous.”


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