*Mandy Sullivan of East Stroudsburg, Pa. is 12 years old and will be visiting her gynecologist for the first time this summer. Her mother, *Judy, decided to make an appointment for her when her periods were lasting more than a week.

"I have spoken at length with Mandy in trying to prepare her for her first visit," Judy Sullivan says. With the help of Mandy's pediatrician, Judy found what she hopes to be a suitable and friendly gynecologist. "I have been told that this doctor is very gentle," she says. Although Mandy will not have her first internal exam at this time, it is important to prepare teens before their first gynecological visit.

Carolyn Henderson, a mom from Alberta, Canada, would agree that preparing your daughter would greatly relieve the anxiety that accompanies the first gynecological exam. She vividly remembers her first visit at 14; the experience wasn't a positive one. "I felt so invaded," Henderson says. "I was terrified. I don't recall him (physician) being gentle at all. He didn't warn me about the speculum and didn't explain what he was doing."

According to Dr. Charles Farris from the Ochsner Clinic in New Orleans, La., "Pain and embarrassment are what your daughter will probably be most worried about. That is the reason for the introductory talk – to relieve them of their fears. They do not know what's going to happen."

When Should My Daughter Have Her First Exam?
The American College of Gynecology (ACOG) recommends that young women between the ages of 13 and 15 have their first gynecological visit. This first visit doesn't necessarily constitute an internal exam. Usually the internal exam and pap smear aren't required unless the young woman is sexually active. However, by 16 years of age, the ACOG recommends that young women have an internal exam and pap smear.

What Should My Daughter Expect at Her First Visit?
First and foremost, your gynecologist should have a discussion time and answer any questions your daughter may have. Unless your daughter requests you be in the examination room with her, it is probably best to wait outside. This will give your daughter the opportunity to openly discuss personal issues like her periods, breast discomfort and other issues that she may feel uncomfortable or too embarrassed to discuss with you.

Dr. Farris stresses the importance of educating young women about their gynecological health early on. "Preventive gynecology – both now and long term – is very important and is not being done today with teenagers," he says. "What they learn as teens affects them later in life. You must educate them early and instill these values."

The gynecologist will probably ask your daughter if she is sexually active and discuss the issue of birth control, condoms and "safe sex." If you are concerned about how the gynecologist will address this, you should find out how the doctor will be discussing this issue with your daughter. This also provides an excellent opportunity for you and your daughter to discuss the issue of sex and your own family's moral standards.

After the discussion phase is over, the gynecologist will perform a general exam. The gynecologist will also check the thyroid for unusual growth or lumps and listen to the lungs. A breast exam will also be done if your daughter is developed.

When your daughter is scheduled for an internal exam or pap smear, it is important to tell her what to expect from the actual procedure. She will have a sheet or gown over her, and the gynecologist will have her lie down with her feet placed in stirrups for the examination. It will feel awkward, but assure her that she is not the only woman to feel this way, and the examination is necessary to screen for many medical problems like cervical cancer or precancerous changes of the cervix, as well as ovarian tumors or sexually transmitted diseases.

"It is so important that the gynecologist make the teen feel comfortable about the pelvic exam by providing visual information through the use of models and taking her through the exam step by step before the exam is started," says Dr. Jean Hundley from the Mercy Medical Center in Baltimore, Md.

Many teens will be very apprehensive about this exam, as they have heard their friends or peers talk about how painful it is. Reassure her that the exam should not be painful, but she will experience some brief discomfort. "The teen should be made to feel that she is in control, so that if the exam becomes too uncomfortable, she can ask her gynecologist to stop," Dr. Hundley says.

What Can I Do to Ease My Daughter's Anxiety?
*Susan Miller's daughter, *Amber, will be visiting the gynecologist for the first time soon. The Wheaton, Md. teen has had numerous medical problems throughout her young life and was not looking forward to another doctor's visit, let alone one to a gynecologist. Her fears, however, were eased by going in the exam room when her mother had her yearly exam done. Now Amber knows what to expect. Susan will also support her daughter by staying by her side while she is in the exam room.

Some teens, however, may not want their moms there. Although it may be hard to let go, it is a healthy way to establish a relationship with her gynecologist. "If in the future the teen needs information from a health care provider, she will feel comfortable picking up the phone and calling her gynecologist to get the most accurate answers that are nonjudgmental with well-informed medical guidance," Dr. Hundley says.

The first gynecological exam can be a "rite of passage" into womanhood for your daughter and a good time for the two of you to connect. Now that you've both "been there and done that," you can share your experiences with each other. Make a day of it; offer to take her shopping and out to lunch. After all, women of all ages can bond over new shoes and a hot fudge brownie sundae.

Want to see more?

• Healthy Teens: Mission Possible
• What Mothers and Daughters Should Know About Birth Control
• Best Face Forward: Coping with Teenage Acne
• Talk about it!