Development of Female Sexuality
During puberty, a girl undergoes several physical changes leading to sexual maturation. Release of gonadotropin-releasing hormone by the brain stimulates other hormones, which trigger the production of estrogen and the development of eggs. Hair begins to grow on the legs, under the arm, and in the pubic area. Girls start to develop curvier bodies, with the growth of breasts and wider hips. Puberty also signals the start of a major growth spurt that can last for two to three years. The first menstrual period usually begins about two years after the development of breast buds.
Age at the onset of puberty varies. Some develop early while other children are "late bloomers." On average, the start of puberty in American girls is around 8 to 13.
Timing the First GYN Visit
An important part of preventive health care for women is regular visits to the gynecologist. Most adolescents and teens probably don't think they need a gynecologist. However, the North American Society for Pediatric and Adolescent Gynecology recommends girls schedule their first GYN visit sometime between 13 and 15.
The initial GYN visit is important to establish doctor/patient rapport and help a girl become comfortable with the healthcare setting. A doctor or nurse can use the time to educate the patient about puberty and expected changes in the body. It's also a time to educate girls about the importance of sexual health, birth control (if the girl is sexually active or anticipating becoming sexually active), and prevention of sexually transmitted diseases. A pelvic examination is not necessary at the first GYN visit unless the girl is sexually active or experiencing symptoms that warrant attention (such as unusual discharge or very painful periods). Girls who are healthy and not sexually active generally don't need to have a pelvic exam until about 18. After the first exam, doctors recommend annual follow-ups for continued preventive heath services.
If you have any questions or concerns about your daughter's need for a gynecologist, talk with your family health care provider.
For general information:
American College of Obstetricians and Gynecologists, public website: www.medem.com