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Caitlin Whyte: The first trip to see an OB GYN can be a daunting experience. I mean, I'm a grown woman who's still gets a little anxious and I know what the process is going to be. So how can you prep a teenager for their first OB GYN appointment here to give us some tips is Dr. Laura Kota a Gynecologist at McLaren Health. This is McLaren's in Good Health. The podcast from McLaren. I'm Caitlin Whyte. So Dr. Kota, Should parents plan to take their daughters for their first OB GYN appointment as teenagers or is that something that can wait until they're older?

Dr. Kota: So a lot of girls struggle with some problems with their periods that going to a gynecologist can be helpful to be seen and that doesn't necessarily mean they would have to have a pelvic exam or invasive testing. But gynecologists can do a lot to help with periods if teenagers are struggling.

Host: So describe their first visit, I guess. Does it change depending on what they're coming in for? What does it entail?

Dr. Kota: Correct. So a lot of times if girls are not sexually active yet, we will do a very minimal exam. Like listening to their heart and lungs and looking vaginally or at the pelvic area if they have specific concerns. But if there's concerns that we can address without making them feel uncomfortable about having their privacy invaded, then that's what we try to do. And then if a girl is sexually active, we would like to do STD testing and screening, and it's not recommended to start pap smears for cervical cancer screening until age 21.

Host: Let's say I'm the teenager in this scenario. What if there's stuff I want to bring up, but I don't really want my mom or dad to be in there listening? Am I allowed to ask them to leave the room?

Dr. Kota: So actually, it is part of a routine protocol to give the teenager time alone once they feel comfortable with the physician and want to speak alone. Because some girls come in and they're uncomfortable and they want their mom there, but then they're always given an opportunity to ask any questions without a parent present. And it's at that time that I try to establish that this is their doctor visit and I'm here to answer their concerns and to protect their privacy. As long as it's not hurting anyone else or themselves.

Host: How should a parent prepare their teen for their first visit? Are there conversations that should be happening even before going to the doctor's office?

Dr. Kota: So they probably should discuss with them that this type of doctor is different than their pediatrician or family doctor. And that there is the potential, if there's specific concerns about vaginal discharge or sores in the vaginal area, that they would have to get undressed from the waist down and the doctor will take a look in that area. The other part of it is that we focus a lot on whether or not patients are sexually active. And so that question will come up and if the teen is uncomfortable talking about sexual activity, then that's definitely something they should be prepared for.

Host: So after the first visit, how often should your teen go to the OB GYN? Assuming that there's nothing concerning.

Dr. Kota: That is controversial. And so if a teen is sexually active, they probably should be seen yearly for STD screening and if the teen is not sexually active, not having problems with their periods or any concerns in the pelvic area, they could wait until they were sexually active or age 21.

Host: What would you say to teenage girls who may be listening to this episode and just have general concerns? Maybe they're a little anxious about their first visit.

Dr. Kota: I would ask them to come prepared with questions about the changes that they are experiencing with puberty and to start thinking about their own female health, separate from being tied to a kid that is under the guidance of their parents because this is their first time to become their decision maker about their own health. And so they will get opportunities to make decisions about whether or not they want to start on birth control or whether or not they are interested in vaccine for HPV and discussing ways in which to stay safe and avoid situations that could put them at risk. Like being in an unsafe situation with a boy they're not familiar with or becoming intoxicated and maybe making some bad decisions under the influence.

Host: And on the other side of that, what advice would you give to parents listening?

Dr. Kota: That they should also be prepared for some autonomy for their teenagers, to make some decisions, and that we cannot force children to start a birth control option that makes a parent feel comfortable. And so that is a common scenario where the teen is feeling rebellious and the parent wants to force them to get an implantable birth control that they can trust, will protect them against pregnancy. And so we navigate that together because it's a discussion between parent, teen and provider and then eventually a discussion between provider and teen without the parent present.

Host: Great. Anything else you want to add? Just for people navigating this situation.

Dr. Kota: That having a teen come into the gynecologist should not be threatening and it should be looked at as a way to initiate their female health in a way that's nonthreatening and is a safe environment to discuss issues that sometimes are uncomfortable.

Host: Absolutely. Well thank you so much for your time, Dr. Kota. This is definitely super important information that I'm sure will help a lot of people out. That was Dr. Laura Kota, a gynecologist at McLaren Health. To learn more about Dr. Kota or submit a question, visit mclaren.org/kota, that's K O. T. A. If you enjoyed this podcast, find more like it in our podcast library and be sure to give us a like and to follow if you do. This is McLaren's in Good Health, the podcast from McLaren. I'm Caitlin Whyte. Thanks for being with us.