Adolescent Health

The American College of Obstetricians and Gynecologists 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.

If you're a parent, jump to Adolescent Health For Parents.

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.

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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.

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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

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For Parents

Supporting your adolescent - advice for parents

The following tips provide some general advice for the overall well being of your growing child/children. While not specific to OB/GYN related care; these straightforward steps can help to promote open communication, support and love with your adolescent(s).

1. Answer questions openly and honestly.
2. Start talking about puberty, menstruation and your philosophy about sex and contraception.
3. Be practical about how to handle situations like school and periods, breast development and your child’s appearance.
4. Be a positive role model and practice what you preach. Do not engage in any illegal, unhealthy, or dangerous drug use practices.
5. Be tolerant of a child's individuality. Accept a child for her/his talents and personality. Encourage individual expression and creativity.
6. Model and encourage good health practices: serve balanced and nutritious meals at regular times. Set aside time for fun family activities.
7. Provide love, support and encouragement to the child/children in your life. Let them know that they should come to a parent to discuss feelings of being bullied or abused.
8. Help your child deal with peer pressure. Practice ways for her/him to refuse drugs in ways that fit your child's personality.
9. Be sure children have easy access to a wide range of appealing, drug-free, alternative activities as well as safe, monitored areas where they can gather; work with others in your community -- clubs, schools, churches, and neighborhood groups -- to sponsor and promote safe, healthy activities.
10. Discuss the media’s acceptance and use of marijuana and drug images that your child may see in movies and on TV, and hear on CD's and the radio. Ask their thoughts on these messages. Do they understand their purpose? Do they recognize that these messages do not reveal the harmful effects of these products?
11. Be aware of the connection between marijuana and other risky behaviors. Car crashes, sexually transmitted infections, HIV/AIDS, and injuries all have been linked to marijuana use.
12. Help children and adolescents learn the health, safety, and legal consequences of using marijuana and other drugs. Be sure they understand that marijuana can be as dangerous as other illegal drugs.
13. Help your children and adolescents learn and understand the health, safety and legal consequences of alcohol.
14.  Help your children and adolescents understand the risks of smoking.
15. Help your adolescents understand the risks of sex and the incidence of pregnancy, sexually transmitted diseases (STIs) and AIDs.

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When to seek help for your child:

• Marked decline in school performance
• Inability to cope with problems and daily activities
• Marked changes in sleeping and/or eating habits
• Extreme difficulties in concentrating that get in the way of activities at school or home
• Sexual acting out
• Depression shown by sustained, prolonged negative mood and attitude, that often is accompanied by poor appetite, difficulty sleeping or thoughts of death
• Severe mood swings
• Strong worries or anxieties that get in the way of daily life
• Repeated use of alcohol and/or drugs
• Intense fear of becoming obese with no relationship to actual body weight; excessive dieting, throwing up or using laxatives to loose weight
• Persistent nightmares
• Threats of self-harm or harm to others
• Self-injury or self destructive behavior
• Frequent outbursts of anger, aggression
• Repeated threats to run away
• Aggressive or non-aggressive consistent violation of rights of others; opposition to authority, truancy, thefts, or vandalism
• Strange thoughts, beliefs, feelings, or unusual behaviors

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