Dr. Christina Green is an obstetrician/gynecologist at St. Elizabeth Physicians. She sees patients at Women’s Health – Crittenden and Women’s Health – Edgewood.
Why is it important for teenage girls to see a gynecologist?
Seeing a gynecologist each year helps teenagers learn about and protect their reproductive health. It’s an opportunity to build trust with a gynecologist and discuss sensitive issues. Girls can learn a lot about their bodies on the internet and from their peers, but one-on-one communication with a doctor is invaluable. Girls should see a gynecologist for the first time between the ages of 13 and 15.
How do you help younger teens feel comfortable during their first visit?
If a patient is under 21, I tell them right away that their first visit likely won’t include a pelvic exam. That information always puts them at ease! Pelvic exams are not necessary before 21 unless you are having menstrual cycle issues such as heavy bleeding or are worried about an infection.
I take an informal approach with younger patients. We will chat a little bit about school and extracurricular activities before I start asking any health-related questions. Also, if a patient wants their mom or another family member in the room, I welcome that. Some girls prefer to keep the conversation private between her and me.
What topics do you cover during the first appointment with a young teenager?
I ask questions to learn what they already know about their reproductive health. Questions might include “Do you know what a period is for?” and “What changes are you noticing in your body?” I also make time for them to ask questions about whatever is on their mind health-wise.
Even if the patient isn’t sexually active, I go over safe sex practices, cycle control medications and warning signs of an unhealthy relationship. It’s so important for them to know what is and isn’t OK in an intimate relationship. They may not need that information now, but someday they might. I stress that our conversation is confidential unless I have concerns about their safety.
How do you counsel patients and families about cervical cancer prevention?
I strongly encourage my patients to get the human papillomavirus (HPV) vaccine. HPV is a very common virus and is responsible for almost all cervical cancers. Any woman who has had sex, even with one partner, can be exposed to HPV. The vaccine is nearly 100% effective at preventing HPV types that cause cervical cancer and genital warts. Both males and females should get the series of HPV vaccines.
The number of doses of the HPV vaccine depends on your age. It’s two doses for people ages 9 to 14 and three for people ages 15-26. If you are between 27 and 46 and want the HPV vaccine, talk to your gynecologist.
How do gynecology appointments change during the later teen years?
As girls become older, topics of conversation broaden to include more specifics about sexual activity and cycle control medications. Occasionally, we touch on mental health concerns and eating disorders. I also do a screening to determine whether a patient is experiencing verbal, sexual or physical abuse.
We always talk about periods. Some girls with extremely heaving bleeding or infrequent periods aren’t aware that their experience is outside the norm. I make sure they know what a typical period is like so they can compare.
If obesity is a concern, I gently broach the subject and encourage them to lose weight. Being obese can cause a host of reproductive health issues, from irregular cycles to the risk of diabetes during pregnancy. These patients have their whole lives ahead of them, and I want them to be as healthy as possible. If they are open to a referral, I tell them about the St. Elizabeth Healthcare Weight Management and Bariatric Surgery Program, which offers many non-surgical approaches.
When should pap smears and pelvic exams begin?
The guideline for pap smears is to begin having them when you are 21, especially if you are sexually active. The purpose of a pap smear is to check for cervical cancer and other conditions in women. Some women are apprehensive about having a pap smear, and I admit, it’s not the most comfortable experience in the world! I try to put patients at ease by talking through each step and distracting them with small talk if necessary.
Women who are 21 or older and sexually active should have a pelvic exam. Otherwise, you can wait a bit —that’s something women and their gynecologists can decide together.
Is there anything else you want people to know?
Yes! If you are a female, see your gynecologist once a year. Your gynecologist can help you identify potential concerns and experience the best reproductive health possible.
To learn more about gynecological care at St. Elizabeth Physicians please visit www.stelizabeth.com/womenshealth or call a Women’s Health office located near you.
