For many teenage girls, just thinking about your first gynecology appointment is nerve-wracking. It feels like a new type of doctor's appointment — one with many unknowns about what may or may not happen during the visit.

For moms of teenagers, there are questions, too. When exactly is it time to schedule your daughter's first appointment with a gynecologist?

"Moms will often ask me, 'My daughter just started her period, should she come in?' " says Dr. Waverly Peakes, a gynecologist at Houston Methodist. "And the answer usually is no, they don't need to come in yet. Most of the time, my recommendation for the first gynecology visit is right before going off to college."

Whether you're a teen or the parent of one, here's what Dr. Peakes wants you to know about seeing a gynecologist for the first time.

Plan to see a gynecologist before heading off to college

As Dr. Peakes explains it, when a young woman is about 18 years old and just heading off to college is the perfect time for her to see a gynecologist.

Here's why:

"This is when she may be moving out of the home and mom isn't necessarily in charge of her care anymore, so it's a great time for a gynecologist to start establishing a relationship with her," says Dr. Peakes.

And, ladies, don't panic just yet. This initial appointment is truly a time to meet your gynecologist and discuss a variety of gynecological topics. You won't get your first pap smear until you're at least 21. You likely won't even need a pelvic exam at this point.

Here's what to expect at a gynecologist for the first time

"I always start a visit by telling teens that we don't do a pelvic exam unless we really feel like it needs to be done — which is fairly rare," says Dr. Peakes. "More often than not, this first appointment is more of a get-to-know-each-other visit than an actual exam."

Upon learning this, many young girls are able to relax, says Dr. Peakes, using the appointment as an opportunity to learn about and discuss their gynecologic and sexual health.

When seeing a gynecologist for the first time as a teen, you and your doctor will discuss:

• Your medical history
• What age you started your period
• What your periods are like
• Whether you're sexually active
  
  

"It's also a good time for me to answer questions about how to handle health issues that arise when you go away to college," adds Dr. Peakes. "For instance, what to do if you think you have a bladder infection or yeast infection. It's also a time for young women to ask me any questions they might have about puberty, feminine hygiene, sexual health or any other gynecologic concerns they might have."

Lastly, if you haven't already been vaccinated against the human papillomavirus (HPV), your gynecologist will begin that discussion. HPV vaccination helps protect you from developing certain cancers later in life.

"After this initial appointment, most young women don't need to see a gynecologist again until they're 21 and it's time for the first pelvic exam and pap smear," says Dr. Peakes.

5 reasons you may need to see a gynecologist earlier than that

While Dr. Peakes recommends first seeing a gynecologist before heading off to college, here are five reasons a teen might need to make an appointment sooner:

1. You're having irregular periods

As a young woman, adjusting to the month in, month out reality of having a period will take some time. But you shouldn't have to adjust to periods that are unusually uncomfortable or irregular.

When it comes to irregular, we mean:

• Heavy bleeding
• Very painful cramps
• Periods that last longer than 7 days
• Periods that occur more frequently than every 20 days
  
  

"If a teen's period is particularly horrible, her pediatrician may refer her to a gynecologist for an evaluation," says Dr. Peakes. "For instance, with heavy bleeding there can be some serious bleeding disorders that, although rare, need to be ruled out."

And if heavier-than-usual bleeding isn't due to something more concerning, a gynecologist can recommend lifestyle changes or sometimes prescribe medications that help make periods more regular.

2. You haven't had your period yet

Most teens begin their period between 12 and 14, but not always.

"If you're 17 and experiencing other signs of puberty, like breast growth, but you've not yet had your period, it's time to see a gynecologist," says Dr. Peakes. "There could be a variety reasons for this, ranging from hormone imbalance to uterine disorders, and each need to be considered and ruled out."

3. You're getting recurrent bladder or yeast infections

A pediatrician can manage the one-off case of a bladder or yeast infection, but if a teen is getting infections frequently or recurrently, Dr. Peakes says it's time to check in with a gynecologist.

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4. You have severe acne

Although not typically considered a first-line treatment option for acne, the hormones in birth control can help control acne. A teen's dermatologist may recommend it if you have severe acne that's not responding to other acne remedies.

"When we see a teen for acne, this is typically just a visit where we check the skin to confirm that she would indeed benefit from birth control before prescribing it," says Dr. Peakes.

Similarly, if a dermatologist recommends isotretinoin, an acne medication more commonly known as Accutane, you're required to see a gynecologist to be prescribed birth control.

5. You're experiencing pelvic pain

When it comes to pelvic pain, Dr. Peakes says that, in most cases, young women are referred to a gynecologist after a trip to the ER for the pain.

"Often times, the pelvic pain starts and you rush to the ER thinking that it's an appendix issue or something else worrisome," says Dr. Peakes. "If that's ruled out, an ER doctor typically refers you to a gynecologist for a pelvic evaluation. In a case like this, the pelvic pain is often due to an ovarian cyst. We can determine the right treatment plan from there."