The first appointment with a gynecologist is a moment of transition, in which the girl passes from childhood to early adolescence. The initial contact with this medical specialty is usually surrounded by anxiety and questions, both on the part of the mother and the daughter. Therefore, it is important that it occurs as naturally as possible and that the relationship between doctor and patient gradually strengthens.
According to gynecologist Cláudia Barbosa Salomão, member of the Specialized Committee on Childhood and Adolescent Gynecology of the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo), the ideal is for the first treatment to be carried out around 10 years of age. It is at this stage, according to the World Health Organization (WHO), that adolescence begins.
Although, normally, the first menstruation has not yet occurred, the characteristics of puberty are beginning to appear, such as breast buds and pubic hair. “At this age, the girl has fewer expectations regarding the appointment and a lower level of embarrassment than later, which allows for more spontaneous and relaxed contact and, of course, the creation of a bond sooner,” says Salomão.
It is recommended that the gynecologist monitor the physical and emotional changes caused by hormonal changes from the beginning. This way, it is possible to prepare the girl for what is to come, allowing her to feel safer in the face of menstruation, cramps and all the changes in her body.
But it is important that the child never goes to a gynecological appointment against their will. Those responsible must explain the reason for the consultation and the importance of getting to know this professional. The choice of doctor also deserves attention. “Preferably, he should have some experience in dealing with teenagers, which makes him able to create a welcoming environment. The girl needs to feel protected and have confidence in the person who will accompany her from now on”, says gynecologist and obstetrician Renata Bonaccorso Lamego, from Hospital Israelita Albert Einstein. “They come eager to know what this contact will be like and how they will be examined.”
During the first consultations, the mother can come in to accompany her daughter. From the age of 12, they can be alone if they wish, as this is a right guaranteed by the Child and Adolescent Statute (ECA). “Some patients prefer to feel more comfortable talking to the specialist and clarifying their doubts”, says Salomão, who is also president of the Department of Childhood and Adolescent Gynecology at the Sociedade Mineira de Pediatria.
What is the first consultation like?
At the first meeting with a gynecologist, the patient is examined to see if her physical development is occurring normally and if she presents any anatomical changes. She can also receive requests for tests, such as blood counts and cholesterol levels. The doctor can also investigate your hormonal levels and order a pelvic ultrasound to analyze the ovaries and uterus.
It’s also a good time to check that your vaccines are up to date, especially immunization against HPV (human papillomavirus). This is the main way to protect yourself against this virus, which can cause cervical cancer. The vaccine is available on the public network for girls and boys aged 9 to 14, but can be taken by older people on the private network.
General questions about anatomy, hygiene and intimate care can be answered by the doctor. “In the first consultation, we usually discuss basic topics, such as the difference between normal vaginal secretion and discharge, and answer any questions. Topics such as sexuality, contraception and prevention of sexually transmitted infections are also very important in conversations between doctor and patient, but they can come into play during this first contact or later on”, explains Lamego, who also works as a sexologist.
The doctor must keep confidential what was discussed in the office, unless the case puts the health and physical integrity of the patient or other people at risk. Exams considered invasive, especially touch tests and Pap smears, are not usually part of the itinerary for this first meeting. But the fact that it is a slightly more basic query does not make it any less important.
This content was originally published in First appointment with a gynecologist: when and how should it happen? on the CNN Brasil website.
Source: CNN Brasil

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