Teenage girls may need two annual preventive health checkups

Most kids have a well-child medical check-up once a year. That's what the experts recommend for school-age children and teenagers. But one medical group suggests that teenage girls should have two annual preventive health visits: one a general checkup with a primary care doctor and a second "dedicated" reproductive health visit.

The idea is proposed in the July issue of the journal Obstetrics & Gynecology by an American College of Obstetricians and Gynecologists committee. The group recommends a girl have her first visit with an ob-gyn between the ages of 13 and 15. The visit should be primarily educational and a chance to establish a relationship with the doctor, according to the paper. Topics of discussion could include puberty, menstruation, healthy eating habits, sexually transmitted disease and pregnancy prevention, sexual orientation and gender identity. A pelvic exam would be performed only if warranted. The visit should include a discussion involving the teenager, a parent and the doctor about patient confidentiality.

Such a visit would "assist an adolescent in negotiating entry into the health care system when she has a specific reproductive health care need," the authors wrote. In a news release, Dr. Diane F. Merritt, chairwoman of American College of Obstetricians and Gynecologists' committee on adolescent health care, added: "Given the high pregnancy and STD rates among adolescent girls in the U.S. compared with other developed countries, we continue to encourage parents to bring their daughters to an ob-gyn for their first visit earlier rather than later."

The American College of Obstetricians and Gynecologists has a resource for teens and their parents called Tool Kit for Teen Care.

-- Shari Roan

Photo credit: Mark Boster  /  Los Angeles Times

Comments

[Joseph E]

Alternatively, girls can establish care with a Family Medicine doctor, who is trained in pediatrics, obstetrics and gynecology, and adult medicine. Then she can have her annual visit with the same doctor from childhood into adulthood. A good Family Medicine doctor can take care of a pregant woman, deliver her baby, see her children for illnesses and well child check-ups, and take care of her husband, her mother and her grandfather, too.

[Wolfbane]

Sorry, this data cannot be accepted

[GaryM]

Yet another way to boost income for doctors, HMOs, etc.
Hey, what about parents taking the responsibility for edumacating their kids about the risks/rewards (=none) about having sex, protected or otherwise. Oh, I guess that's so last century...

[Dana]

Women must be starting to tire of the "bikini medicine" that's practiced on us, so the ACOG feels they need to hook teenage girls early.

Would anyone take this seriously if it referred to anything but "women's dark parts?" Adolescents have lungs, stomachs, eyes, brains, and hearts. They should have their first routine visit with their pulmonologist, gastroenterologist, ophthalmologist, neurologist, and cardiologist before they turn 15. And of *course* teenage boys should see their urologist.

How ironic that this story is paired with the one about the ever-escalating cost of medicine in the USA. Could it be that we don't need to teach our children to see specialists for routine care?

[Liz T]

I agree with Dana. No teenage girl or woman should yield blindly to the pressure to have their privates poked and prodded by medical professionals at every "opportunity" anyway. Why doesn't anyone ever want us to get tested regularily for, say, a brain tumor? Oh no, it is always pap smears and worse. No thanks.

[AnnieL]

GaryM,

When you speak of young girls learning about sexual matters from their parents, please keep in mind that while some parents are qualified to do this, others are not. Some parents have weird religious views that teach girls sex is evil and they should be killed or otherwise if they don't do what daddy tells them. Some girls have been molested by their family members and have no reason to trust them. Others still have parents who would never even bother with telling them anything. So how do they get informed information?

[chick]

Dana: Boys have a very different set of organs that don't typically shed, give birth, or get bacterial imbalances.

There are a number of common conditions (like UTIs, yeast infections, etc.) that women develop (and that have nothing to do with sexual activity) due to the layout and function of their ladyparts, and from my experience and those of my friends, young women generally don't get a lot of education about these from their primary doctors & pediatricians.

Most medications for these problems are not available over the counter, and doctors appointments are necessary for diagnosis & treatment because there can be complications. But if an older teen or young woman hasn't had a gyn appointment before, she might be hesitant or embarrassed to seek out help if she thinks something might be wrong with the plumbing.

It's good for a girl to have a medical professional with whom they feel comfortable discussing their reproductive parts. This is a great idea, whether the dedicated visit is with a gyn specifically or with a primary doctor.

[Victoria Regan, MD]

I am a pediatrician and these topics are covered at a teenage girls annual visit with their pediatrician. I do reder them to an ob/gyn if they need further ebvaluation for gyn/reproductive issues but I feel trained and comfortable discussing these issues and prescribing birth control if warranted.

[Sophia Yen MD, MPH]

As a board-certified specialist in Adolescent Medicine, I suggest that instead, young women could get your check up AND your reproductive health addressed by the same person - either a board-certified specialist in Adolescent Medicine or a pediatrician. All pediatricians who have graduated in the past 5? years, are required to have at least 1 month training in adolescent medicine (which covers reproductive health).

The Society for Adolescent Health and Medicine (SAHM) has a listing of Adolescent Medicine providers.
http://www.adolescenthealth.org/source/FindHealthProfessional/

OR just make sure your ob/gyn that you go to is up to date on the latest pap smear recommendations (NOT until 21 years old UNLESS you are immunosuppressed or high risk) AND that IUDs are fine for adolescents.

AND they know about adolescents rights to confidentiality.