Teen/preteen girls- gynecologist?

[doulatara]

I feel a bit embarrassed to say that I don't know when it is appropriate for a first visit to a gynecologist. I saw my primary care physician and didn't see a real gynecologist until I was on my own, but my mom was never very on top of our medical care.

Is it after the first period? When a girl is thinking about becoming sexually active? Or just when she feels ready?

I know there are midwives in my area who also do well woman care...would it be appropriate to take a preteen/young teen to a midwife instead of a gynecologist? Or will a family doc suffice?

Help me out here. Thanks!

[MCatLvrMom2A&X]

I have no intention of taking dd to a gyno. unless she has an issue that would need one.

I didnt see a Dr. for a gyno exam until a week before I got married at 22 and only then so that I could get the depo shot.

[Phantaja]

I've always understood that a girl should first see a gynecologist when she first starts habing sex, when she turns 18, or if something abnormal is happening with her reproductive system (extremely painful periods, odd vaginal discharge, unexplained low belly pain, etc) whichever comes first.

[just_lily]

I too have always heard the rule of thumb of 18, when sexually active, or if there is an issue.... whichever comes first.

But I wouldn't necessarily think that it needs to be a gynecologist per se, unless there is an issue. I am in Canada and family doctors handle most things unless there is a reason a referral to a specialist is needed. They definitely do pelvics, PAPs, and birth control which is all most young girls will need (again... unless there is an issue).

I actually went to a Sexual Health Clinic the first time I needed BCPs, and they did my exams as well. So that is also an option if there is one in your area.

[eclipse]

I don't think there's any need for an internal exam in a non-sexually active girl, in absence of any specific concerns.

[One_Girl]

You start seeing them when you first become sexually active. A family practitioner can do the same tests in the office. I used to see our nurse practitioner for my check-ups because my FP was a guy. My friend had periods that only came every six months and that kind of thing did require a gynecologist.

[Bellabaz]

Diddo here for 18, sex or issues. But again I don't think it needs to be a gyno. A midwife is fine or family doc. I didn't have a vag exam until I was 22 or 23. I went to a gyno. I should have started earlier but I didn't know too much about that stuff and no one to really ask. Plus my first college roomy went right before college when she turned 18 and scared me a bit with her story of it. Live and learn I guess.

[MAMom]

Originally Posted by doulatara

I know there are midwives in my area who also do well woman care...would it be appropriate to take a preteen/young teen to a midwife instead of a gynecologist? Or will a family doc suffice?

Help me out here. Thanks!

Yes, absolutely! I think it's a wonderful age to introduce women to all of the advantages of midwifery care.

[harrietsmama]

I would recommend a visit with a midwife, she can start a relationship with her, no exam needed, just a consult to say when you are ready, here is what we will do, this is what I will use, etc.

[rose123]

Yes. That's embarrassing.I don't think think there is need to go to gynaecologist for the first period issue. That's quite natural and you can consult at your family or that lady you mentioned.

[karanyavel]

Originally Posted by doulatara

I know there are midwives in my area who also do well woman care...would it be appropriate to take a preteen/young teen to a midwife instead of a gynecologist? Or will a family doc suffice?

I would definitely go with a midwife when it comes up (e.g., your DD is thinking about becoming sexually active). Either that or Planned Parenthood (I've had nothing but wonderful experiences at PP).

--K

[Ruthla]

My daughters still go to the pediatrician for their checkups, and both are well into puberty. I don't think there's any need for pelvic exams until a girl/woman is sexually active, or if she's considering sexual activity (say, to get birth control prior to having sex the first time.) I'm really not sure about the recomendations for young women (say, 18-25 or so) who are not sexually active. It didn't apply to me, but it may apply to one or both of my daughters.

I switched to my mom's doctor (who at the time did GYN care as well as regular checkups) after I became sexually active at age 16. The way insurance is currently set up, I need to see my PCP for everything but GYN care and then the GYN for the pelvic exam. I assume that a sexually active teenager would need to see the pediatrician and the GYN on two separate visits.

It would be nice if all 4 of us could see the same Family PRactice dr, but that's not the way they do things here. I need to see an "internal medicine doctor" and they need to see a pediatrician.

[Sarai18]

Originally Posted by Ruthla

I assume that a sexually active teenager would need to see the pediatrician and the GYN on two separate visits.

My two older girls had their first pelvic exams and got BC from the nurse practitioner at the pediatrician's office when they became sexually active - I'm thankful they could see someone they already knew!

[Storm Bride]

Originally Posted by just_lily

But I wouldn't necessarily think that it needs to be a gynecologist per se, unless there is an issue. I am in Canada and family doctors handle most things unless there is a reason a referral to a specialist is needed.

Ditto.
I've seen an OB/GYN for some of my prenatal "care" (not with my first, but I had to see a consulting OB after my first c-section). That's the only reason I've ever seen one. Most people I know have never seen one, except for the OB part of their specialty.

[mamabeca]

My FP does kids, adults, teens, pelvics, breast exams, everything. We could all go to see him, and we all like him a lot. I, personally, love seeing a mw when I can, though!

[philomom]

I sent my daughter at 16. She had a list of questions for the doc.... some of which, she did not want to ask me. She got on birth control pills even though she is not yet sexually active. Her friends convinced her it makes periods lighter and easier to deal with. I'm cool. That's her business.

BTW, I also went at 16 because I did want to be sexually active and was wanting to be on the pill. My mom was all squirmy about the whole thing but she didn't try to stop me.

[chiromamma]

I know this goes against all we've been taught but I see no reason for internal exams (GYN, midwife, GP) unless there is an issue or risk of having been exposed to an STD.
I didn't have a single one during any of my pregnancies and don't intend to subject my daughter to them just because she reaches an arbitrary age or becomes sexually active.
Sexual activity does not equal STD exposure.
DD's been educated about her body, the risks of hormonal birth control, condoms, etc. She knows she can come to me when she feels ready to have sex so we can buy condoms.
Dr. Mendelson, best known for his book How to raise a Healthy Child In Spite of Your Doctor, also wrote a great book called, Male Practice about the generally abusive and manipulative nature of women's health care.
It is an old book but unfortunately, things have not changed much. In most cases, they've gotten worse.

[Chicky2]

I will not take any of my girls until they are ready to be sexually active, and at that point, we will visit my midwife. I feel the whole experience is so much more gentle and understanding with a midwife. A midwife will be "with woman", physically, emotionally, etc., and I really believe in the whole philosophy. If she ever felt a gyno were necessary, I would wholeheartedly trust her advice. I also had the bestest midwife in the world, though, so I may be a bit biased.

[phathui5]

chiromamma, do you do Pap smears?

[Oubliette8]

Originally Posted by phathui5

chiromamma, do you do Pap smears?

I know that wasn't aimed at me, but I do not. I posted a bit about why I don't over on this thread- http://www.mothering.com/discussions...847&highlight=

False positives are pretty common in young women due to natural changes as their bodies mature. Other countries don't even start screening until 25. And cervical cancer is pretty strongly linked to an STD, which means its not indicated for virgins. There is also no reason to require a pap smear to obtain birth control (the two have very little to do with each other)

If I had a daughter, and SHE wanted care, I'd bring her. But I wouldn't otherwise encourage her to see a gyn or get screened. We'd discuss the risks and benefits and she could decide. I think genital health is a really personal thing. A teenager is old enough to make their own choices. I know I would have been mortified if my parent had ever forced me to have a genital exam. I guess forced might be a hard word, I mean, if my parents had said "we made you an appt with the gyn" I wouldn't have felt I had any choice in the matter or the ability to say no. My mother DID make an appointment for my younger siblings, and I know they were very unhappy with the situation. I guess, I think being open about risks and benefits and allowing them their own choice in the matter is the best option.