When should a female start seeing a gynecologist?

With several choices in health care providers and specialties, determining who to see and when can be confusing. As an OB-GYN provider, one of the most common questions I hear from patients is, “What are the differences between the services offered by a gynecology provider versus a family medicine provider?” The second most common is, “When should my daughter start seeing a gynecology provider versus her pediatrician or family medicine provider?” Both of these are excellent questions. However, the answers are not as straightforward as one might hope.

Gynecology or Family Medicine?

Both departments can complete preventive health exams for women. Both departments can screen for health disease. So, when do you see a gynecology provider and when should you see a family medicine provider?

Family Medicine is best suited if:    

• You have a chronic medical condition that requires medication or regular lab work. Examples would be diabetes, high blood pressure or cholesterol and chronic pain.
• You have an acute condition that might require antibiotics. Examples include ear infections, strep throat, cellulitis or upper respiratory symptoms.
• You have any new onset of pain or recent injury.

Gynecology is best suited if:

• You have any questions or concerns regarding the female reproductive system. This includes breasts, uterus, ovaries and vulva. It can also include some urological or gastrointestinal symptoms.
• You have any menstrual, pregnancy, fertility or contraception questions or issues.
• You have any sexual health concerns. Examples include libido, pain or abuse.
• You are seeking a preventive health exam and age-appropriate screenings.

There is some overlap in services provided by Family Medicine and Gynecology. Examples can include birth control, thyroid disorder and mood changes. In these cases, it’s best to start with whomever you feel most comfortable with, and then that provider can guide you further if they cannot fully address your concerns.

At what age should a female see a gynecology provider?

Between the ages of 11 and 18, a female could potentially see a pediatrician, a family practice provider and/or a gynecology provider. The majority of health care needs can be addressed by family medicine or pediatric providers. However, there are instances when it would be appropriate to have a younger patient see a gynecology provider, such as:

• Delayed puberty (no breast tissue changes before age 14) or delayed menarche (no menstrual cycles prior to age 16)
• Painful menstrual cycles, especially if missing school or activities due to symptoms
• Unable to wear a tampon
• Any sexual health concerns or contraceptive needs

When to begin Pap smears

It’s important to understand Pap smear screening recommendations have changed numerous times over the last decade. As a result, many mothers remain uncertain as to when their daughter should begin this screening. The current recommendation is to begin Pap smear screenings at the age of 21, regardless of sexual activity or birth control needs.

There are times when a pelvic exam (evaluation of the genitalia) might be warranted, but this is not for Pap smear screening purposes. Additionally, the human papillomavirus (HPV) vaccination is recommended during the teenage years to help prevent cervical cancer in the future. Your health care provider can give you more information regarding HPV vaccination at your appointment.