Amanda Wilde: Young women considering their first gynecological appointment. Have lots of questions today. We'll walk through the process together with Dr. Grace Bay who practices obstetrics and gynecology at Skagit Regional Health. This is be Well with Skagit Regional Health. I'm Amanda Wilde, Dr. Bay. Thanks for joining us.

Dr. Grace Bay: Yeah, thanks for having me.

Amanda Wilde: Girls are developing, and I mean, reaching puberty earlier and earlier it seems. So at what age is it recommended for young women to have their first gynecology appointment?

Dr. Grace Bay: It's recommended that the first visit with an ob gyn to be between 13 and 15 years old. However, with that being considered exactly what you're saying, we are seeing women, young girls hitting puberty earlier. So after the start of first menses, I think is a good time to establish. It helps to ensure there's a lot of information out there, and this helps to ensure that patients and parents or guardians have the right information.

Amanda Wilde: So we should really not base it on age as much as first menstrual period. And then a big question that we all wanna know what to expect at that first appointment. Can you walk us through?

Dr. Grace Bay: Yeah, I feel like this is where mostly anxiety comes from because anytime somebody thinks about going to the gynecologist, they expect a pelvic exam. And in the vast majority of cases, your first visit is not going to involve a pelvic exam. The first visits primarily just a conversation between the patient and the provider where you can find out what to expect, what's going to happen at future visits, and getting information about how to stay healthy.

You can ask questions about your body Growing up, sex. Your provider will typically ask a lot of questions about you and your family. These questions may seem personal, such as questions about your period or sexual activities, but this information's important for the provider so that they know how to best care for you. So first visit you can expect a discussion, and then typically a general examination. So head to toe, heart, lungs, pushing on the belly, but not a pelvic examination unless you're having a specific concern.

Amanda Wilde: Now, why is it important for teens to establish OB G Y N care at this age?

Dr. Grace Bay: It's important because there's a lot of changes going on in teens lives at that time. And again, with there being so much information out there right now, it's hard to know which information is accurate. So having that one-on-one visit with a healthcare provider ensures that you're getting the most accurate information.

Amanda Wilde: And who else should be present at that visit? if the child is minor, should the parent be present?

Dr. Grace Bay: So for that visit, I do typically recommend that either a friend or a family member comes with the patient. However, with that being said, at some point during the appointment, the provider will ask that your support person step out so that the more personal questions can be asked and that patients feel more comfortable with providing that information. That information's going to be kept confidential. The only time when this information would be shared is if there were a direct concern for the patient's wellbeing.

Amanda Wilde: So if you're a minor going with the parent and the parent steps out, whatever is talked about in that room remains totally confidential and doesn't go to the parent or outside of the room?

Dr. Grace Bay: Yes. Does not leave the room.

Amanda Wilde: Now, what are some common questions you get asked by teens at their first visit?

Dr. Grace Bay: The main thing, typically there at the start, there's not many questions, but I like to go over things that are good to talk about with your gynecologist. and those topics are cramps, problems with periods, acne, weight, sex, sexuality, gender identity, birth control options, contraception, sexually transmitted infections alcohol, drugs, smoking, emotional ups and downs, are just some of the things. And usually once that realm is kind of opened of things that can be discussed, the questions typically flow pretty freely.

Amanda Wilde: So now parents are present for part of the appointment and a young person might not know exactly how to feel calm and confident. So how can parents and guardians prepare their teens for the first appointment? How can they help with any nerves?

Dr. Grace Bay: I think the biggest thing to that helps with this is just letting their child know that unless there is a specific concern, that invasive pelvic examination will not be performed, and that if there is going to be a pelvic examination, If it's something that's recommended but they don't feel comfortable having done, they do not have to have it done at that time. And during the exam they will have either another clinic worker in the room with the provider, and they can also have their support person with them in the room. That if they are uncomfortable with the examination again, does not have to be performed at that time. Can be performed later on or just deferred.

Amanda Wilde: And once teens have had that first visit, what can they do to be proactive about gynecological care?

Dr. Grace Bay: After that first visit, I think it's important to once a year, just do a general check-in to see how everything's going. It's also important to know that even if at your first visit you're not sexually active, if later on you become sexually active, and you want a screening test done, most of that testing is actually done through urine test. And once you've established care, you don't actually need a formal appointment. You can stop in for a nurse visit to leave that urine sample for that sexually transmitted infection testing, pregnancy testing, anything along those lines.

Amanda Wilde: So you really try to make sure all these services are accessible.

Dr. Grace Bay: Yes, keeping things easily accessible.

Amanda Wilde: Dr. Bay, thank you so much for addressing the mixed feelings and the questions and anxieties that we've talked about so that as parents and teenagers, we can confidently approach this stage of life. It's really very helpful.

Dr. Grace Bay: Oh yeah, you're welcome. Just hoping to make it more accessible to people and make people feel more comfortable with coming in to their first gynecology appointment because it is so important to establish that care.

Amanda Wilde: Yeah, and it's great that you've taken some of the mystery away and it's something now, like I said, we can approach confidently and feel that we're in control. And as a patient that really matters.

Dr. Grace Bay: Yeah.

Amanda Wilde: We've been talking about women's health and teen health with OB GYN Grace Bay. To learn more, visit skagitregionalhealth.org. Thanks for listening to Be Well, the podcast from Skagit Regional Health, And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. I'm Amanda Wilde, and we'll talk again next time.