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Women's Health Blog

Caring For Our Bodies: For the Young Women in Your Life

I often get questions about when young women should start coming in for gynecologic care. I love this question because it means someone is thinking ahead.

I recommend a first OB/GYN visit anytime in the early teen years. Our governing body, American College of Obstetricians and Gynecologists, recommends establishing care with a women's health provider between the ages of 13-15. Though it may seem intimidating, this visit is intended to be a "getting to know each other" visit and an opportunity to talk about confidentiality, wellness, normal menstrual cycle, and to outline future gynecologic care. 

I go through family and personal medical history to find any red-flags such as history of blood clots, cancers, and bleeding disorders. We screen for depression and eating disorders. I talk about safe sex and contraception. I stress the importance of communication with trusted adults and also with one's romantic partner (if there is one.)  I am careful to support each young woman, and I talk about sexuality and sex while trying to make her feel empowered and have self-confidence. We review the menstrual cycle, normal physiology and assess individual needs. And, we talk about how to stay healthy.

One of the things I want to promote is that an OB/GYN can be another trusted adult who will care about your child. We try to be nonjudgmental, and we encourage our patients to talk to their parents. I know some parents fear that once their daughter enters the realm of OB/GYN, that she will be encouraged to have sex and that all innocence will be lost. This is not the case. There are laws in Delaware to protect her confidentiality, even from her parents (i.e. testing for sexually transmitted infections, pregnancy testing, or contraception.) But, we really try to encourage responsible behavior, self-respect and self-esteem. Statistics show that one-third of high schoolers are sexually active, and it is important to arm our young women with real knowledge and access to information and care. 

She does not necessarily need to have an invasive exam until she is 21 years old. Personally, I work hard to keep the visits comfortable and limited to talking. I will do a pelvic exam if the conversation reveals a concern, but a pap test is not done until age 21. I instruct my patients to do self-collections in the office for some of the sexually transmitted infections. Usually, my patients are relieved and leave with a smile and new knowledge. This non-scary experience helps them come back regularly for follow-up care.

Many young women see their primary care provider or pediatrician for all of their needs. This is usually perfectly great. For some young women, it  may be helpful to establish care with an OB/GYN if they want to talk about the more "uncomfortable" private concerns with someone different. 

Here are a few examples of when I would recommend a gynecology consult:

  • You are 15 years old and have not had a period.
  • Your periods were regular each month and then they stopped being regular.
  • Your period comes more often than every 21 days or less often than every 45 days.
  • Your periods come 90 days or more apart.
  • Your periods last more than 7 days.
  • Your periods are so heavy that you have to change pads or tampons more than every 1-2 hours.
  • You have bad cramps that keep you from doing your regular activities and pain medicines don’t help.
  • You cannot get a tampon into the vagina.
  • You have an abnormal vaginal discharge (other than a clear-white) or a bad odor.
  • You have a discharge from your breasts or a new breast lump.
  • You are sexually active.
  • You think you may be pregnant. 

At Beebe Women’s Healthcare – Plantations, we welcome all questions and concerns and we look forward to your visit!

Contact Beebe Women’s Healthcare – Plantations and Dr. Caswell-Monack at (302) 480-1919.

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Angela Caswell-Monack, DO

Dr. Angela Caswell-Monack is Board Certified in Obstetrics/Gynecology and is a member of the Beebe Medical Staff. She sees patients at Beebe Women's Healthcare - Plantations.