| Gynecological exams are not necessary as soon as a young woman starts having her period. We now recommend that young women start having pelvic exams with Pap tests within three years of starting vaginal intercourse. If a young woman has not had first vaginal intercourse by age 21, then she should have a pelvic exam when she becomes 21 — even though she has not had vaginal intercourse. Of course, gynecologic visits are a very good idea if sexual or reproductive health concerns or problems arise earlier than within three years of starting vaginal intercourse or age 21.
Young women should be counseled about their birth control options before they become sexually active. They may want to consider taking regular, ongoing, highly effective hormonal prescription methods before beginning vaginal intercourse because of the health benefits of some methods. After they have been used for a few months, combined hormone methods such as the pill and the patch offer health benefits, including lighter periods, less bleeding during periods, less pain with periods, more regular periods, and reduced acne. Combined hormone methods also offer advanced protection against pregnancy as a woman reaches the point in her life when she decides to have vaginal intercourse.
When it comes to sexual and reproductive health, young women are often more comfortable with health care providers who are not also their parent's providers. Even young women who talk with their parents about sex and sexuality may be more trusting and confident with their own providers. Ask your daughter whether she wants her own personal clinician — a clinician different from her pediatrician, your family-medicine doctor or nurse practitioner, or your gynecologist — to take care of her now that she is older. Respect whatever decision she makes, and help her to find a caring provider if she chooses to change providers. Regardless of the provider they choose, young people should be encouraged to have their visits in private — by themselves. They should also be given every assurance that their confidences will be respected.
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