GYN exam for a female under the age of 21 should be scheduled if she is sexually active, is considering become sexually active in the near future, or if she is having menstrual irregularities for which she would like to seek treatment. Otherwise, she can wait until age 21 at which time her first Pap smear will be due. It is not uncommon for sexually active females under the age of 21 to be exposed to the Human Papilloma Virus (HPV) which can lead to precancerous genital lesions. When providers find abnormalities on Pap tests, we want to treat them. However, studies have shown that the majority of these lesions in patients under the age 21 will regress on their own without any residual effects. Treating those lesions as soon as they are discovered can result in surgical procedures at a very young reproductive age that could potentially weaken the cervix for future pregnancies. Hence, the recommended age of 21 for initial Pap smears.

If your daughter is sexually active prior to the age of 21, she should have a GYN exam to be screened for sexually transmitted infections, to have a discussion on safe sex and for contraception options if not planning immediate pregnancy. Treatments for painful or heavy menses may also be reviewed. The exam itself may be performed by her pediatrician or in an OBGYN office. Your daughter should be current with her Gardasil vaccinations (HPV vaccine) prior to leaving for college as well.

With Regards,
Sara Giselle
Associate Managing Editor
Journal of Critical Care Obsestrics & Gynocology