Pediatric and Adolescent Gynecology

There’s no “right age.” Anyone of any age with a gynecological problem or concern can and should see a gynecologist. But, according to the American College of Obstetricians and Gynecologists, a good time for a first visit would be when you’re between the ages of 13 and 15.

Depending on your age and your concerns, your first visit may just involve a talk with your doctor. Your doctor will ask about your health, family history, and medical history and answer any questions you have. You’ll also learn how often you should have future exams.

It’s very normal to be nervous or embarrassed. A visit with a gynecologist can include talking about topics that feel uncomfortable. For example, you may be asked what your periods are like or if you are having sex with anyone. It is important to know that, although these conversations might feel personal, having them honestly with your doctor is important to keep you healthy.  

Sometimes an examination is recommended, which might include parts of your body that you may be accustomed to keeping private. We hope that it helps you to know that we see thousands of patients every year and have heard and seen everything related to gynecology. Our goal is to make sure all of your body is healthy and we are here to care for you with kindness and compassion.

Many young people do not need an internal exam, also called a pelvic exam. Instead, your doctor may do a general physical exam as well as an external genital exam to check for normal development. However, sometimes a pelvic exam is recommended, for example, if you have unusual pain or bleeding. A parent or guardian can be present for any examinations needed if you choose.  

In some cases, a pelvic (transabdominal) ultrasound can also be used for an examination. The technician will spread a clear, gel-like liquid on your belly and place a scanning instrument on your skin that uses sound waves to take “pictures” of your internal organs. You may feel a little pressure as the technician moves the scanner around.

This tends to be the part of the visit that concerns young patients the most. And even though you probably won’t need one for a while, it’s good to know what happens during this type of exam.

During a pelvic exam, the doctor starts by examining the vulva, the outside parts of your genitals. Next, an instrument called a speculum is placed in your vagina. The speculum opens the walls of the vagina and keeps them open during the exam. Once the speculum is placed, the doctor will be able to examine the walls of your vagina as well as your cervix.

If you need a Pap test, which tests for abnormal cells and is usually done when you’re around 21 years old, the doctor will use a tiny brush to collect a few cells from the cervix, which will be sent to a lab for examination.

Another part of a pelvic exam is a quick check of your internal organs. To do this the doctor gently places one or two gloved, lubricated fingers into your vagina up to your cervix while pressing down on your abdomen.

To help make the exam more comfortable for younger patients, our doctors use smaller instruments and different techniques than are used for adults. Your doctor will also take as much time as you need to feel at ease.

You may receive care or treatment for any medical issues you have. These may include prescription medicines that you take by mouth or topical medicines that you apply to your body.

You may also receive a vaccine to help prevent HPV (Human Papillomavirus). This is a very common virus that can lead to certain types of cancer later in life. Getting the proper dose of the HPV vaccine for your age can protect you from developing the cancers that HPV can cause.

If you are having sex, you may also have tests done for certain sexually transmitted infections (STIs).

Yes, and in fact, we encourage a portion of your visit to be private. We understand and respect that you may want to discuss things with your doctor that you don’t want a parent to know about.  

Even if a parent comes to your visit and is part of the initial conversation, you will be given the time to have a confidential discussion with your doctor. The doctor will ask your parent to wait outside.

You can discuss pretty much anything concerning your reproductive health, which can include your emotional health too. You can discuss cramps or problems with your period, sex, birth control, mood changes, hormonal issues, sexually transmitted infections, weight loss or gain, gender identity, changes to your body and skin, and more.

What’s really important to remember is that your visit with us is intended to make you feel cared for and to relieve any embarrassment or nervousness you may have.

Additional resources you may find helpful include:

• The Care and Keeping of Your: The Body Book for Younger Girls (American Girl Library)
• Celebrate Your Body (And Its Changes, Too!): The Ultimate Puberty Book for Girls, by Sonia Renee Taylor
• Our Bodies, Ourselves  (Boston Women’s Health Collective)

Foul-smelling and/or thick or discolored fluid or material that comes from the vagina. Normal vaginal discharge is typically a thin, liquid-like substance that’s clear or milky with a mild odor or no odor.

The end of the uterus can be seen during an internal examination of the vagina.

Another term for periods.

A sac containing fluid that develops in the ovary. Most cysts don’t cause any problems and go away on their own, while others require treatment.

A test in which cells are collected from the cervix and examined under a microscope.

An examination of the reproductive organs.

An instrument doctors use to hold open the walls of the vagina during an examination.

These are infections that are spread from one person to another through sexual contact.

A tube-like structure in the body that leads from the uterus to the vulva.

The portion of your genitals outside of your body.