Adolescent Health

The American College of Obstetricians and recommends that adolescent girls have a reproductive health visit between the ages of 13 and 15. This allows the opportunity for them to begin to know their health care provider and build a strong, trusting relationship. These early visits focus on information and prevention.

What happens at the first visit?

Your provider will meet with you and your parent(s), if accompanying you, and then will have a private talk with you. For a well visit, most of the time will be spending talking.

Your provider will:

• Ask a lot of personal questions about you and your family so that they know how best to care for you.
• Learn about you and the questions or problems you may have. Many young women share the same health concerns, most of which are a normal part of growing up.
• Discuss normal development, and normal menstrual periods so that you know when you may have a problem with your period.
• Talk to you about safety, including abstinence, use of contraceptives, avoiding smoking, alcohol, and drugs, as well as how to avoid dating violence. The leading causes of death of women this age include accidents, cancer, suicide, homicide, heart disease, genetic abnormalities, chronic lower respiratory disease, influenza (flu) and pneumonia. Your provider will screen you for risks associated with these conditions.
• Perform an examination similar to what you have had with your pediatrician or family practitioner. This helps your provider understand your development in puberty. A medical assistant or nurse will be present. You may also ask to have your mother with you.

Most healthy teens will not need a pelvic exam. For problem visits, your provider will use ultrasound and urine tests as a first line for evaluation, and perform a vaginal exam only when absolutely necessary.

Your provider can answer questions about cramps and problems with your menstrual period, tampon use, headaches with your period, vaginal infections, acne, weight, sex and sexuality, birth control, sexually transmitted infections, alcohol, drugs, smoking, as well as emotional ups and downs.

At your first visit and other visits, your physician will:

Order Lab Tests:

• If you are sexually active, you will be screened for Chlamydia, gonorrhea and HIV

Based on both your medical and family histories, if you are considered at high risk for certain health conditions the following tests may be recommended:

• Genetic testing for hereditary breast, ovarian, colon and melanoma cancers
• Glucose testing for risks of diabetes
• Tuberculosis skin testing

Administer or recommend you see your family practitioner for the following vaccinations:

• Influenza (flu)
• Varicella (chicken pox) if not previously vaccinated and there is no history of being exposed
• Diptheria, Tetanus and Pertussis (Tdap or Td) booster (if Tdap booster has not been administered as required for entry into grade 7)
• Hepatitis B series for those not immunized previously
• HPV (human papilloma virus) series for those under age 26 who have not been immunized previously
• Measles, Mumps and Rubella booster
• Meningocccal before entry into high school and for those not immunized previously

Refer you to a genetic counselor if you are at risk for an inherited condition, if you are pregnant, considering pregnancy or have a strong family history or risk for a hereditary cancer.

Problems your gynecology provider should know about

You may be embarrassed to call your provider or ask questions. Here are some important issues on which you should always call. Don’t hesitate to ask to be seen when:

• You are aged 15 years and have not had a menstrual period
• Your periods were regular, occurring monthly and then they became irregular
• Your periods occur more often than every 21 days, or less often than every 45 days
• Your periods occur 90 days apart (even if only for one cycle)
• Your periods last more than 7 days
• Your periods require frequent pad or tampon changes (soaking more than 1 pad or tampon every 1–2 hours)
• You have pain in your vagina or lower abdomen
• You have unusual discharge coming from your vagina
• You have itching in your vagina or on your labia and vulvar area
• You notice a growth or sore on your labia or vulva area
• You notice a lump on your breast that is only on one side
• You have been involved in a sexual assault, or have been physically abused