Our healthcare practitioners may discuss normal puberty development, review menstrual cycle problems, educate about vaccines, and review healthy eating and exercise. In addition, our healthcare professional can provide information on pregnancy and sexually transmitted infection prevention and assess for use of tobacco, alcohol, or drugs. Most girls do not need a pelvic examination at this time. The current recommendation for a first pelvic examination and Pap smear is age 21.
Adolescent women should have their first visit with a gynecologist between the ages of 13 and 15. This visit is intended to promote health, to educate, and to assist in the prevention of health problems common to teenagers. This visit is important for providing an adolescent woman with the opportunity to ask questions and to make sure her reproductive system is functioning properly. It’s also a good time to assess for adolescent risk-taking behaviors, such as experimentation with sexual activity, tobacco use, and drug or alcohol use. In addition, the healthcare practitioner can review the health detriments of each. A parent or guardian should accompany minors.
Topics of discussion and testing can include the following:
- Birth Control
- Human Papillomavirus (HPV)
- Premenstrual Syndrome (PMS)
- Sexually Transmitted Infections (STI)
The menstrual cycle is a normal part of life, but it can be a problem in some cases. Periods that are too close together, too prolonged, or too heavy can result in anemia or low iron levels. Menses can also be extremely painful and associated with severe nausea, vomiting, or headaches. If a teen is missing school, sports, or activities because of her period, she should be seen by her healthcare practitioner to address these issues.
Our providers are prepared to answer any questions related to STI and pregnancy prevention, including talking about abstaining from sex, using condoms, and providing contraception. STIs are transmitted through sexual contact. Because most STIs have no symptoms, knowing if you have been infected can be difficult. Periodic testing is recommended for people with multiple sexual partners, even if they are having protected sex and using condoms. Ask your partner if he or she has or has ever had an STI. We offer safe and confidential STI testing and treatment.
Most STIs can be treated effectively if you are diagnosed with one. Many, however, cannot be cured. Antibiotics are prescribed for gonorrhea, chlamydia, and syphilis, and patients usually respond well. There is no cure for genital herpes, but outbreaks can be shortened with antiviral medications. Similarly, there is no cure for HIV, but medication can be used to control spread of the virus. Hepatitis B and C may be cured with medical treatment.
Your Changing Body
The teenage years are also called adolescence. During this time, the teenager will see the greatest amount of growth in height and weight. Adolescence is a time for growth spurts and puberty changes. There is a great amount of variation in the rate of changes that may occur. Some adolescents may experience these signs of maturity sooner or later than others. Remember that these changes happen at different times for everyone. Being smaller or bigger than other girls is normal because each child experiences puberty at her own time. Sexual and other physical maturation that occurs during puberty results from hormonal changes.
Girls experience puberty as a sequence of events, but their pubertal changes usually begin before boys of the same age. Each girl is different and may progress through these changes differently.
The following is a brief overview of the changes that occur:
- The initial puberty change is the development of breast buds, in which a small mound is formed by the elevation of the breast and papilla (nipple). The areola (the circle of different colored skin around the nipple) increases in size at this time.
- Adolescent girls will also experience menstruation. This begins when the body starts producing more hormones to prepare for reproduction.
- There may be an increase in hair growth, not only in the pubic area, but also under the arms and on the legs. Many women may decide to shave this hair.
- The female’s body shape will also begin to change. There may be an increase not only in height and weight, but the hips may get wider as well. There may also be an increase in fat in the buttocks, legs, and stomach. These changes are normal and may occur during puberty.
- Her body size will increase, with the feet, arms, legs, and hands beginning to grow in advance of the body. This may cause the adolescent girl to experience a time of feeling clumsy.
- As the hormones of puberty increase, adolescents may experience an increase in oily skin and sweating. This is a normal part of growing. It is important to wash daily, including the face. Acne may develop.
Human papilloma virus (HPV) is a virus that may cause cervical cancer and genital warts. Persistent infection with certain types of HPV can lead to cervical cancer. In our practice, we offer Gardasil® vaccination to prevent infection with several types of HPV known to cause cervical cancer and genital warts. HPV vaccination has become a routine recommendation for adolescent preventive care.
Gardasil® is given by injection and requires three doses; the first injection is followed by a second and third dose two and six months later. If you miss a dose, talk to your healthcare practitioner about how many more doses you need.