Gynecology

[OConfusedOne]

Okay, so there's this ongoing dispute between my mother and myself. I think that as a young woman of almost seventeen years, it is far past time for me to be going to a gynecologist and looking after my sexual health. My mother has had bad gynecology experiences and thinks I shouldn't go to one at all unless I want birth control, which I do not. Most of the time when I bring it up she asks me (quite cattily) who I intend to jump in the sack with and drops the conversation right there. I think it's rather naive to neglect a very important area of personal health over my mother's bad memories.

A few questions, then, I guess. Do any of you know of any "official" opinions on when is a good time to start gynecological appointments? And for the women: when did you start going and do you feel it was too early or too late or just right (haha, goldilocks)? I'm not trying to pry into personal matters, just trying to get a better sense of the general population and get this sorted out. Thanks in advance!

~Mollie~

[Flower]

Gee, I started going when I was 16. I think it's *extremely* important to go after that age. On one of my first appointments my pap smear turned out abnormal and I had to have minor surgery to remove some cancerous cells from my uterus. Imagine if I would have let it go for a few years!

I think it's important to stress to your mother that a gynelogical check up is as important as keeping your teeth healthy. It's not about birth control but your health. Whether you're having sex or not doesn't matter, especially if it means finding something early before it becomes a big problem.

[Thalia]

Well they have changed the recommendations. If you are not having sex, you can wait to start going until like 21 or something (I'll check on this). But if you are having sex you have to go.

Maybe your mother is having growing pains because this is a tangible sign of your womanhood and sexuality.

ETA- I haven't found back-up of the age 21 if no sex, but I have found sources that support when sex starts or 18 whatever is first.

also eta- I started going at 16 because I was having sex. It's just a good habit to get into. And it is very fast and not as terrible as one might imagine.

[Blue Plastic Straw]

The general medical consensus has been that you should start getting PAP tests at age 18 or when you start having sex, whichever comes first. If you feel strongly that you need to see a gynecologist, have a talk with your GP and perhaps s/he can help you discuss with your mom.

[spa_girl]

Well, I just scanned a few articles on the web after going to Ask Jeeves, and everything I read said you a young woman should start seeing a gynecologist when she becomes sexually active or when she turns 18, whichever comes first. I believe those were the rules when I was younger, too.

I started going when I was 16 because that was around the time I had become sexually active and I'm glad I went. I just told my parents that I thought I should go and that I wanted to start birth control (I had a very open relationship w/my parents). I didn't explicitly say I was sexually active, but I'm sure they got the picture.

If I can find a link from a good, reputable source, I'll post it. Most of the links I found were from Q&A teen/health sites, and they were all in accord, but the sources were not what I'd consider "official."

Edited to add:

Here we go...
http://www.ivillagehealth.com/experts/womens/qas/0,,242103_125000,00.html

[rabid_child]

My mother's gyno said 21 or sexually active, whichever comes first.
I hit 21 before sexually active, so I went at 21, but not to my mom's doctor. My GP advised going at 18 or sexually active, whichever comes first. I don't know where my doctor stands on the whole thing, but she never even asked if I was sexually active. I figured I was there so whats her policies matter?
My little sister just went for the first time at 19, but she's not sexually active, but she, like me, had goofy periods and got on birth control.

Thats the end of my report.

[Thalia]

OK, here are the official recommendations which just changed.
Cervical Cancer Screening: Testing Can Start Later and Occur Less Often Under New ACOG Recommendations


Washington, DC -- In its most comprehensive revision of Pap test and other cervical cancer screening recommendations in over a decade, The American College of Obstetricians and Gynecologists (ACOG) has issued a new, evidence-based practice bulletin, "Cervical Cytology Screening." ACOG notes that an increasing number of women will no longer need annual testing for cervical cancer and that screening can also begin later than previously recommended. However, annual pelvic examinations are still advised for women across a broad age range.

ACOG's new recommendations differ only slightly from recently revised recommendations of the American Cancer Society (ACS) and the US Preventive Services Task Force (USPSTF), but ACOG's new practice bulletin may have a bigger impact on the clinical practices of the nation's obstetrician-gynecologists.

"Many of these changes have come about not only because of the technological changes in cancer screening over the years, but also because scientists now have a better understanding of the development of cervical cancer," says ACOG's Vice President for Practice Activities, Stanley Zinberg, MD.

Among ACOG's new recommendations:

Changes in Screening Frequency

First screen -- Screening of cervical cytology (cervical cells) should begin by approximately 3 years after first sexual intercourse or by age 21, whichever comes first. (Previously, ACOG called for screening by the onset of sexual activity or by age 18, whichever occurred first.)

Women up to age 30 -- Women this age should undergo annual cervical cytology screening. (Previously, ACOG did not distinguish between age groups.) Women under age 30 have a higher likelihood than older women of acquiring high-risk types of HPV that cause premalignant cervical disease, which should be ruled out before extending the testing intervals.

Women age 30 and older -- There are two acceptable screening options for women in this age group, says ACOG. Under either option, women may not need annual screening:

Testing using cervical cytology alone. If a woman age 30 or older has negative results on three consecutive annual cervical cytology tests, then she may be rescreened with cervical cytology alone every 2-3 years.

The combined use of a cervical cytology test and an FDA-approved test for high-risk types of HPV - Under this option women receive both a cervical cytology test and a genetic test that looks for certain high-risk types of the human papillomavirus (HPV) known to cause cancer (HPV DNA test). Once women test negative on both tests they should be rescreened with the combined tests no more frequently than every 3 years. If only one of the tests is negative, however, more frequent screening will be necessary. (The combined testing is not appropriate for women under age 30, since they frequently test positive for HPV that will clear up on its own.)
Exceptions -- More frequent cervical screening may be required for higher-risk women who are infected with HIV, are immunosuppressed (such as those receiving kidney transplants), were exposed to DES in utero, or were previously diagnosed with cervical cancer.


Hysterectomy -- Women who have had a hysterectomy with removal of the cervix for benign reasons and with no history of abnormal or cancerous cell growth may discontinue routine cytology testing. Women who have had such a hysterectomy but who have a history of abnormal cell growth (classified as CIN 2 or 3) should be screened annually until they have three consecutive, negative vaginal cytology tests; then they can discontinue routine screening.

When to Discontinue Screening -- Physicians can determine on an individual basis when an older woman can stop having cervical cancer screening, based on such factors as her medical history and the physician's ability to monitor the patient in the future.
(Whereas ACS calls for cessation of testing in non-high-risk women at age 70, and the USPSTF by age 65, ACOG notes that due to limited studies of older women it is difficult to set an across-the-board upper age limit for cervical cancer screening.)


Annual Exams Continue -- Regardless of the frequency of cervical cancer screening, annual gynecologic examinations, including pelvic exams, are still recommended.
http://www.acog.org/from_home/publications/press_releases/nr07-31-03-1.cfm

[EquiPro]

Seems to me that you should start going now. I would highly recommend talking to friends and friends sisters and such and find a WOMAN OB/GYN. I know that I will be hounded for that opinion, but, to me, that is like someone being a mechanic but never having owned and driven a car.

My first visit was to Planned Parenthood, and they were really wonderful. You might try there first.

Good luck!

[Epinephrine]

i've always been told that girls should go as soon as they get their first period... i guess they lied then :p
i went when i was 14.

[freemouse]

at 27, I've never been there yet :p

[rabid_child]

Seems to me that you should start going now. I would highly recommend talking to friends and friends sisters and such and find a WOMAN OB/GYN. I know that I will be hounded for that opinion, but, to me, that is like someone being a mechanic but never having owned and driven a car.


I agree with you there. I don't think someone can really understand what I'm talking about if their bodies don't even have these parts.

[wild blackberry]

i started going when i was 17. i just go to my gp for it instead of an ob/gyn.

i know some people have mentioned planned parenthood, and i want to add that if your mom disapproves and you still feel very strongly about it, you can go there by yourself. they keep everything confidential, and contrary to popular belief, it's not just a place for birth control or abortions or whatever. it's for reproductive health in general, and it is very affordable, especially for students. several of my close friends always go there.

best wishes.

[oneness]

My Doc says when you start being sexually active you need to start having pap smears and pelvic exams.. cervical cancer is generally caused by a virus you can only get from sexual relations, so testing sooner then sexually relations is not generally needed, unless you are having issues..

you can always go to the GYN for a visit and not actually have tests, so he/she can answer your questions..

[kitgem]

I'm 26 and still have not been.

What if they found something and insisted I had surgery. I would refuse due to animal testing and ingredients. I would rather not know so I don't see the point in going.

Is my life more inportant that all the animals used in evil cancer reserch?

Kitgem

[Feliner]

find a WOMAN OB/GYN. I know that I will be hounded for that opinion, but, to me, that is like someone being a mechanic but never having owned and driven a car.

That is a pretty common opinion from what I've seen. I totally understand where you're coming from, but.. we don't expect a cancer specialist to have experienced cancer themselves to understand how to treat someone with cancer.. y'know? There are a lot of analogies like that one, so when you really think about it, the logic doesn't hold water. I do understand/respect personal preference, if somebody is more comfortable with a doctor because of their gender, age, race, etc.. that is their right. I for whatever strange reason find myself uncomfortable with the idea of a female ob/gyn. It does seem realistic to say "a woman would understand where I'm coming from, because she has one" but what if she hasn't had ovarian cysts herself, or doesn't suffer from menstrual cramps? Well, anyway..just thought I'd chime in with my 2 cents. In the end, go to someone you're comfortable with.

[Christy]

I started going at 16, but it was because I had a miscarriage and started hemorrhaging and was rushed to ER. My first exam was in ER, where the man doctor and several other nurses/doctors were in the room. Lovely.

I had a follow up appointment with a male doctor the next day, and then a few weeks later. The whole thing was traumatic. I went to the clinic after that to get examined and get birth control until I got out of college and got a job with health insurance.

All of that could have made me biased, but I also prefer a woman doctor.

[missleigh]

I have also been going since I was sixteen, when I became sexually active. I do think it is very important to get a pap every year. I will just say that the first few years that I went, I was going to the free clinic, and the experience was miserable. Rude doctors man- handling that speculum, and talking to me like I was teenage trash. At that time I thought that was just what that experience was supposed to be like, until I got insurance and went to a real doctor's office. She was kind, helpful, explained everything, it was not terrible at all.

[carnelian]

I started going when I was 16. I've had both male and female doctors and, like some of the others here, I much prefer a female doctor for these matters.

[spa_girl]

To all of you 20-somethings who haven't been -- I really wish you would consider making an appt. Not going is like playing russian roulette with your life. (and with your fertility -- if there is a chance you would ever want to conceive a child in the future) You've only got one you!

[spa_girl]

Seems to me that you should start going now. I would highly recommend talking to friends and friends sisters and such and find a WOMAN OB/GYN. I know that I will be hounded for that opinion, but, to me, that is like someone being a mechanic but never having owned and driven a car.


You know, I always felt the same exact way until recently. When I had my early miscarriage, my regular OB/GYN (female) was out of town so I had to see another doc from her practice and it was male ob/gyn. I REALLY liked him. I felt like he was MORE sympathetic than my female doc. I don't know why. But I felt very comfortable with him and he took all of my concerns very seriously and I walked away feeling very good about the experience (well, not the m/c, but you know what I mean).

Anyways, I felt like you for years but now I am actually considering making this male ob/gyn my regular one. Just thought I'd share.

[MsRuthieB]

I was always the opposite until 2 or so years ago. I was always seeing a male OB/GYN. Something about him just wasn't sitting right with me on the last couple of visits; call it a gut instinct. So, I switched to a female OB/GYN. 6 months later I saw him on the news. Apparantly he had almost 100 incidences of some type of sexual misconduct. He actually was indicted on 54 counts. Was on the board at several hospitals and was the head of something or other on one. Was a fertility specialist to boot. Anyhow, not saying they are all like this because they aren't. This is an extremely rare situation. I just don't trust the male ones anymore.

[Thalia]

To all of you 20-somethings who haven't been -- I really wish you would consider making an appt. Not going is like playing russian roulette with your life. (and with your fertility -- if there is a chance you would ever want to conceive a child in the future) You've only got one you!

I agree.

And Kitgem-I admire people who follow their values, but I'm really hoping you not only thought this through to the end? Are you just looking for a rationale not to go to the gyn? What is the goal of not going? are your actions going to produce that goal? Are you going to be consistent? For example will you never go to any doctors for anything and plan on not taking any pain relief if you get cancer? You might also want to consider not having children. Would you want to die a young mother from not wanting to ever see a doctor, leaving your children behind, grieving? Are you OK knowing that if you are never checked for STD's you could pass them on to others, causing people serious illness, pain, infertility, cancer or death? Some things to think about before committing to such a big decision.

I personally don't see how letting yourself die will help the animals more than if you stay alive and influence people to become vegan and to stop experimenting on animals. You're not going to the doctor or not taking a pill will not stop a single experiment. People who abuse animals would be happy to see you go. The world is easier for animal abusers when AR supporters martyr themselves instead of staying alive to fight for their cause.

Besides if they find something, they can't make you have sugery. There's something called informed consent.

[Marie]

I've never had a female gyn. The last one I had was funny... he was always fumbling around and dropping things. It was odd laughing when I was lying there on the table in that awkward way.

Now I need to find a new one. I choose them by location not by gender.. I hate getting lost.

[OConfusedOne]

Wow, thank you all for all your replies! I had heard most of those versions of the story - when you get your period, when your eightteen - though the 21 years old idea was a new one. I got my period when I was ten years old. Haha, imagine that scene, a 10-year-old walking into a gynecology clinic. Hah! As far as eighteen goes, as I said I matured sexually rather early so I think my reproductive organs are in about the same state as a late teen or early twenties woman. Planned Parenthood isn't really an option because I'm not sure we even have one, and I don't have my license quite yet. Sigh. I guess I feel like because of my strenuous exercise and frequent lack of a period, there's probably some stuff going on hormonally that merits looking after. Unfortunately, I can't tell my mother I'm not getting my period because she automatically associates that with an eating disorder. Hurgh!

I don't know if I would prefer a male or a female doc. I actually don't think I've ever been to a female doc, except for my eyes, but I'm so horribly afraid of one coming in and sharing all of her gory stories or something like that. I'm pretty comfortable with guys, actually. I'll go to whoever gets the best reccomendations, whether it's a man or a woman, and then take it from there based on my comfort, I suppose.

Anybody have any idea how to breach the subject (for the upteenth time, grr) in a way that will get my mother to get me an appointment?

~Mollie~

[missleigh]

Mollie, I want to commend you for being so seemingly well adjusted to the idea of taking care of this! Alot of women (your age and older) are not so open to going to the gyn for the first time. As far as talking your mom into making you an appointment, I have no clue. But, if you do happen to find a free clinic in your area (there probably is one) you can go without your parents help. Best of luck.