Teen/preteen girls- gynecologist? - Page 2

[ErinYay]

Originally Posted by Oubliette8

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)

You kind of contradicted yourself- almost 50% of 20-25 year old women who are sexually active have HPV. I personally had a very fast-developing cancer-causing strain that went from a perfectly good pap to a cold cone biopsy in 6 months where CIN-3 cells (precancerous cells that are the last stop before full cancer) at 25.

Paps for women who are sexually active *are* needed regularly to ensure the US doesn't end up with a huge mortality rate for cervical cancer. Brazil, for example, has a low pap smear rate and a high death rate due of cervical cancer. Compelling women to get a pap in exchange for birth control is one of those "greater good" kind of things, and an individual good if you're one of the unlucky ones who has cancerous HPV.

[justKate]

Originally Posted by 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!

Well I'm one of the lucky ones that got to see lots of a GYN and have surgery with one before becoming sexually active. Just after turning 14 I had a cyst rupture on an ovary--this was ~'94, so no laproscopic surgery for me--major abdominal instead. Lots of exams, lots of pain. Missed 3 weeks of school. Put on BC pills thereafter to help with periods. Not sexually active for more than a year after that, FWIW.

So with that experience in mind, I would not take my DD to the GYN until she either asked to go or it was apparent that she was sexually active. I think (and this is just me) that check ups are a part of being an adult, so if you're going to be sexually active, you have to be responsible and get check ups. I think a midwife is a great idea--I've seen a lot of different care providers and have always found that midwives are more respectful and don't hurt me. They (IME) don't leave you in a paper gown in the freezing exam room with nothing to read for an hour, either.

I'm not big on well baby visits and decline paps/procedures during pregnancy, but I think an annual exam for a sexually active teen is appropriate. OP, it looks like your DD is ~12ish? I don't think it's too young to have a basic conversation about it, but no need to take her yet!

[Oubliette8]

Originally Posted by ErinYay

You kind of contradicted yourself- almost 50% of 20-25 year old women who are sexually active have HPV. I personally had a very fast-developing cancer-causing strain that went from a perfectly good pap to a cold cone biopsy in 6 months where CIN-3 cells (precancerous cells that are the last stop before full cancer) at 25.

Paps for women who are sexually active *are* needed regularly to ensure the US doesn't end up with a huge mortality rate for cervical cancer. Brazil, for example, has a low pap smear rate and a high death rate due of cervical cancer. Compelling women to get a pap in exchange for birth control is one of those "greater good" kind of things, and an individual good if you're one of the unlucky ones who has cancerous HPV.

I'm sorry you had to experience that. I hope you are feeling better now.

Yes, being sexually active is a reason to think about getting screened. What I meant was, birth control and cervical cancer screening should not be linked because health wise, they do not immediately effect each other. A pap smear is not a screening test that rules out contra-indications for taking BC. A pap smear is a screen for cancerous changes of the cervix. It has nothing to do with your suitability for taking contraceptives. Might it be a good idea to have a pap smear if you are sexually active with a non-virgin partner? Yes, its something you should consider.

However, greater good or not, I do not think requiring cancer screening of every woman who wants birth control is the way to go. Its paternalistic. Women are perfectly capable of examining the facts, considering their risk factors and making their own decisions. Also, not all women on birth control are sexually active. Many women take it for other reasons, like heavy menstrual bleeding, irregular periods, etc.

I am also aware that a large percentage of sexually active people have HPV. However, most strains of HPV are fairly harmless. Only a very small few cause cancer, and not everyone who gets those strains will develop cancer either. According to the CDC, most healthy people clear HPV from their bodies all on their own without any special treatment.

[mclisa]

Girls don't need pap smears in their teens (for the most part), so she has time to wait. She might have need for birth control and hopefully she feels comfortable letting you know that. Then you can discuss from there.

[chiromamma]

Originally Posted by phathui5

chiromamma, do you do Pap smears?

I do not have routine paps. I reluctantly succumb to them every 5 years or so as part of a physical for my life insurance policy.
I was diagnosed with cervical cancer linked to HPV in my 20's.
I gave the gyns their shot at "curing" it, only to have it become more invasive. After that I took full responsibility for my reproductive health and healed it on my own with Network chiropractic and lifestyle changes.
Despite dire warnings, and horrible prognoses, I have given birth at home to 3 children and remain extraordinarily healthy.
I am adamantly opposed to gardasil.

[angelpie545]

I'm wouldn't take a teen to the GYN unless she was sexually active. I don't think there's much need, and GYN visits can be traumatic and embarrassing tfor young girls. IMO, it's much better to have a gentle mother/daughter talk about sexuality and what the OB/GYN role is. Where available, I'd much rather take my daughter to a midwife for well-woman care. They tend to be more gentle and are able to take more time to talk to their patients.