Reproductive Health In Adolescent Women

By Natalya Danilyants, MD

The Center for Innovative GYN Care

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Reproductive Health In Adolescent Women

The provision of health guidance, screening, and preventive health care services is essential component of reproductive health care for adolescents. The first visit to a gynecologist should take place around ages 13-15 years or before the adolescent becomes sexually active. This visit usually does not include a pelvic examination or a Pap test. It gives an adolescent a chance to learn about cervical cancer screening and recommended timing for this care, as well as the need for sexually transmitted disease (STD) testing.
The American Cancer Society (ASC) recommends annual cervical cancer screening beginning three
years after the onset of vaginal intercourse or no later than age 21 years. Adolescent females have a higher prevalence of abnormal Pap test results when compared with adult females, although the severity of lesion tends to be lower in adolescents. The adolescent as well as her parents can learn about the benefits of HPV vaccine that can be administered at the first visit.
According to a recent survey, nearly half of female high-school students have had sexual intercourse. One study found that only 51% of mothers were aware of their daughters sexual activity. Adolescents have especially high rate of STDs due to the high-risk sexual behavior as they respond to their physical and emotional changes and strive for peer approval. Some adolescents may not possess the foresight to recognize and understand the potential consequences of their risky behaviors. The lack of foresight is often compounded by the use of alcohol or drugs or both. Counseling about what constitutes responsible and consensual sexual behavior as an integral part of the first visit.
Discussion regarding such topics as adolescent development, normal menses, healthy eating habits, immunizations and injury prevention are an important part of the first visit. Conversation regarding normal pubertal development and menstruation can be reassuring both to parents and patients. It is also essential to screen for eating disorders and other weight issues, blood pressure problems, anxiety, depression, and physical or emotional abuse.
The first visit provides education about important health issues. It also gives the adolescent opportunity to establish relationship with her gynecologist and initiate entry into health care system should she have a specific health care need in the future.