By: Kathy Hubbard
Last week’s article about choosing between a family medicine or an internal medicine provider spurred a question from a reader. She wrote, “My daughter is going through puberty. Should she still see her pediatrician, or should I take her to a gynecologist?”
Not surprisingly, there are no easy answers. There are benefits to staying with the pediatrician and advantages to seeing a gynecologist or family nurse practitioner who specializes in women’s health. It basically comes down to what you prefer and, of course, what your daughter wants to do.
The American College of Obstetricians and Gynecologists (ACOG) recommends that “girls first see a gynecologist when they’re between the ages of 13 and 15. Most girls will not need a pelvic exam during this first visit, though. Many gynecologists will just do a regular health exam and talk to a girl about her development.”
“This is a great way for your daughter to develop a relationship with her gynecologist so that she is comfortable sharing personal information in the future,” they say.
Although most pediatricians will see patients up to the age of 21, some will actually see their patients through college. However, between the ages of 18 and 21, most patients change to either a family or internal medicine provider.
Nemours Kids Health (Kidshealth.org) is a website that provides information to help families make the best healthcare decisions. On this subject, they say, “Pediatricians are trained to treat teens, so it’s perfectly fine to continue to see yours as long as you feel comfortable. But some people find it harder to connect with their childhood doctors as they get older.”
Take this into consideration. If you’re seeing the same pediatrician that you did when your child was born, your child was a patient multiple times up to the age of two and then at least once a year after that for wellness or sickness visits. That means that the doctor has a good knowledge of the child’s health history.
“Since their focus is on children, they may be better at talking to kids on their level and to parents about delicate, personal issues with sensitivity and understanding,” WebMD says.
There’s a clinic in Ohio called P&S that has ob/gyn, pediatric, and internal medicine providers. They say that you should take your daughter to a pediatrician when she has “a chronic medical condition like diabetes, high blood pressure, or chronic pain that requires medication or regular lab work; an acute condition that may need antibiotics, like ear infections, strep throat, or upper respiratory symptoms; or a new pain or recent injury.
They also say that if the girl has questions or concerns about her reproductive system, which includes her breasts, uterus, ovaries, and vulva, she should see a gynecologist. Sometimes, issues with the reproductive system can cause urological or gastrointestinal symptoms, so add that to the list.
“During late childhood and adolescence (11 to 18 years old), a girl could see a pediatrician or gynecology provider,” P&S says. “Many of her health care needs can be addressed by her pediatric provider. In some instances, it would be appropriate for her to see a gynecology provider. These include delayed puberty (no breast tissue changes before 14); delayed menarche (no menstrual cycles before 16); menstrual cycles that are painful and cause her to miss school or activities; unable to use a tampon; sexual health concerns; and contraceptive needs.”
I guess the simple answer for my reader is to sit down and talk it over with the child. Determine if she would feel more comfortable talking to a doctor who specializes in women’s health or one who’s known her all her life. And think about this: with the changes her body is going through, she may feel she’s growing up and is too old to go to a practice where children’s toys are scattered about.
Regardless of how that discussion plays out, please be sure to talk to both your daughters and sons about human papillomavirus (HPV) and how important it is for both of them to get their vaccines. And don’t put off having a discussion about sex, contraception, and how to avoid abuse.
Kathy Hubbard is a member of the Bonner General Health Foundation Advisory Council. She can be reached at email@example.com. If there’s a topic you’d like me to tackle, please send me an email. This article was written for publication in the Bonner County Daily Bee on January 10, 2024.