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Dr. Mary Jo Podgurski is the founder and director of the Washington Health System Teen Outreach. She responds to 6–8 questions from young people daily and has written 'Ask Mary Jo' since 2005.

Q.I’m going for my first gyne exam next week. I’m nervous. It took me a solid year to talk my mom into taking me. What’s wrong with grownups? They always think the worst. I have horrible pain every month with my period, and my mom still didn’t want me to go see a doctor because she said I’d get birth control and then have sex! Can you please tell clueless adults people my age can have sex any time? I know a lot of kids who don’t wait for a doctor visit or for birth control before they hook up. I’m not having sex, and getting the pill or something else to make one week of every month more bearable isn’t going to make me start. Also, can you tell me what will happen at the doctor visit? I’d like to be ready. Thanks a lot for listening to me.

15-year-old

Mary Jo’s response: I really enjoy your texts! You’re a well-informed, bright young person. Listening to you is a pleasure, and talking with you is a joy.

I’ll respond to your request to teach adults first, then describe what will probably happen at your gyne visit. I agree, it helps to be ready for new experiences.

Your mom isn’t alone. Many adults fear adolescent behavior. Worrying is part of parenting. Your mom held you as a newborn and vowed to protect you. Now, you’re on your way to adulthood, and protecting you grows harder every day. Stories about unplanned pregnancies, drug and alcohol use, talking with strangers online, and sexually transmitted infections can crowd a parent’s mind.

Think of it from your mom’s perspective. She’s always considering the pros and cons of her decisions, thinking of how to protect you. Fear is one of the biggest challenges to adult/teen relationships. In this case, her fear blinded your need for health care. Sadly, as you said, many grownups do judge young people. I spend my days with teens; I can state with total honesty they are amazing individuals who deserve to be viewed without stereotypes.

I agree with you about sexually involved teens. Most young people don’t wait to see a gynecologist or health-care provider before getting involved sexually. Sadly, too few consider consequences. I wish adults would listen to hear when their young people ask for support. Your behavior is not the behavior of any other teen. You’re unique.

Taking care of a health problem like the one you describe is important. Your health-care provider can assess your needs. Medication to make you more comfortable is not going to make you get involved sexually. It’s about trust. Talk with your mom. It seems you’ve communicated well enough – even after a year – to get an appointment. Keep up the communication.

Let’s prepare you for your first visit with a gynecologist (gyne). A gynecologist is a doctor who specializes in women’s health. ACOG (American College of Obstetricians and Gynecologists) recommends a girl have her first gyne appointment between the ages of 13 and 15.

Feeling nervous before the first visit is totally normal. Here’s what will probably happen:

  • Your gynecologist will ask you questions. Some of them may be personal. It’s OK to clarify confidentiality before your conversation. Who will be told your answers? In my opinion, you should not be accompanied by a parent during the visit. This time is for you and your doctor. If, however, you feel safer with your mom there, you have the option of asking her to stay with you.
  • You should bring information about your periods – how long they last, how regular they are, how you feel when they occur.
  • You may be asked questions about your sexual experiences. Please be honest.
  • Your doctor should respect your gender and sexual identity.
  • You may have a general physical exam. Typically, this includes your blood pressure, your weight, your height and an overall assessment of your health. You’ll be asked to remove your clothes and wear a paper gown. You’ll then wait for the doctor or nurse practitioner or physician’s assistant on an examining table. The gown is weird, and the room is usually cold, but you’ll survive.
  • You may have an external genital exam. A person’s genitals are the parts connected with your sex – the vulva (the part between your legs) and abdomen will be examined. Your doctor may also check your breasts. I know this may feel embarrassing; try to remember your body belongs to you and is wonderfully made. It’s OK when a gynecologist looks at body parts that may be thought of as private.
  • It isn’t always necessary to have an internal genital (or pelvic) exam. This is a physical assessment of body parts like your cervix – the uterine opening – and your vagina. If the doctor thinks you need this type of exam, please don’t be afraid to ask questions. Your doctor will explain what’s going to happen first. Write down your questions before the appointment, just in case you are nervous.
  • I found an excellent online resource from ACOG that includes pictures and details about an internal pelvic exam. You probably won’t need this type of exam on your first visit, but it is possible. Check out https://www.acog.org/Patients/FAQs/Your-First-Gynecologic-Visit-Especially-for-Teens for this information.

I hope your visit goes well and your discomfort eases. Let’s keep in touch. I’m creating a team within our peer education group to provide support for these kinds of new life experiences. You’d be a great asset to the program! Good luck.

Have a question? Send it to Dr. Mary Jo Podgurski’s email at podmj@healthyteens.com.

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