Posted: Oct 25, 2013 8:00 AM
 
The pediatrician has been your trusted source for anything and everything related to your young child — ever since that first well-baby visit. Now that your daughter is heading into puberty, does she need to start visiting the gynecologist? How do you know when the pediatrician isn’t enough anymore?

In years past, a teen girl would schedule her first visit to a gynecologist when she became sexually active. But with so many young girls starting their periods early — sometimes as early as 9 or 10 years old — are there other reasons for your daughter to visit the OB/GYN?

When is she ready?

As our daughters are all different, the answer to this question is not the same for everyone. "The answer to this question is very specific to each girl's emotional and physical development," says Pandora MacLean-Hoover, LCSW. "There is, therefore, no 'one answer fits all.'" While your daughter may be very open and eager to discuss her developing body and topics relating to sexual health, another girl her age may be sensitive and embarrassed. "In almost 15 years, I have seen and heard way too many moms say, 'She has her period and she likes boys, so I am making an appointment to get her on the pill. The last thing we want is her getting pregnant,'" she adds. Helping your daughter learn to care for her own health and take responsibility for her body may not work as well when you are making such big decisions for her (such as birth control).

Helping your daughter learn to care for her own health and take responsibility for her body may not work as well when you are making such big decisions for her (such as birth control).

Elaine Taylor-Klaus, CPCC, ACC, has a background in reproductive health. "Look realistically at your child's age developmentally — is she mature for her age? Is she dating and 'into' her sexuality, or is it still a long way off?" There is a wide range of differences between teens of the same age. Taylor-Klaus currently works with kids who have special needs, such as ADHD. "Sometimes this is an area of advanced maturity [special needs], and sometimes they are well behind their same-age peers. So I think this decision is about promoting a healthy confidence in your daughter's sexuality — and taking the lead from her," she adds.

Gynecologist or pediatrician?

Of course your daughter's pediatrician will still be her primary source of medical care during her teens — but there are some issues that make sense to discuss with a gynecologist. Dana Kamins-Jacobs is a certified nurse midwife and advanced registered nurse practitioner with 17 years of experience in working with gynecology for adolescents and teens. "Generally, teenagers come to see a gynecologist — often accompanied by their mother or other trusted female — for some of the following reasons.":

  • Dysmenorrhea (painful menses, cramps) 
  • Irregular menses
  • Birth control (sexually active or not) — especially if going away to college for the first time
  • Sexually transmitted disease (STD) testing if sexually active

"If none of these issues are of concern to a teen, there is no real value to a gynecology appointment other than teaching," she adds. "In fact, an exam is not even necessary particularly for the teens who have never been sexually active."

What about a pap?

Current guidelines suggest that pap smears aren't necessary until three years after the first sexual experience, regardless of how many times, or 21 years old, whichever comes first.

One of the main reasons some mothers consider taking their daughter to the gynecologist is so she can have a pap smear. While there is no one specific age recommended for a first pap, there are some guidelines that moms may not be aware of. "Current guidelines suggest that pap smears aren't necessary until three years after the first sexual experience, regardless of how many times, or 21 years old, whichever comes first," adds Kamins-Jacobs. "You can have STD testing without a pap smear if you haven't met the above criteria."

The bottom Line^ There is no one-fits-all answer as to when your daughter should have her first gynecologist appointment. Talk openly to her about her changing body and other issues related to puberty, so that when she is ready to visit the gynecologist, she can ask her own questions and become educated about her body.

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