Dr. Patricia Zylman, an OB/GYN with Hibiscus Women’s Care of Brevard, explores developmental issues and gynecologic care for teenage girls

“Truth be told, teenage girls find themselves stuck somewhere between their pediatrician and their primary care/gynecologic physician. These years are considered a time in which teenage girls branch out from seeing only their pediatrician into gynecologic care,” explains Patricia Zylman, M.D., an OB/GYN with Hibiscus Women’s Care of Brevard. “Therefore, I believe it’s important to review some basic truths about teenagers … and how to survive living with them!”

The American College of OB/GYN (ACOG) recommends an early visit for teenage girls with a gynecologist. The recommendation is for teenagers to visit a gynecologist initially between the ages of 13-15. These visits will serve to establish rapport between the gynecologist and the teenager. The first pap smear is not recommended until age 21, so prior visits are for consultations, STD screening, well care, birth control options and problem visits.

“The goal is to afford your teen the opportunity to discuss personal issues with their doctor, ranging from school performance and eating disorders to sexual activity and abuse,” says Dr. Zylman. “In the case that a teenager’s pediatrician is uncomfortable with dealing with any of these issues, a visit to a gynecologist is in order.”

COMING INTO THEIR OWN

Dr. Zylman takes a look at the myriad of developmental issues teenage girls must deal with:

• Sexual development. Breast budding (thelarche), which is usually the first visible sign of female development, occurs on average at age 10 in the U.S. (range is from ages 8-13). Menstrual cycles occur on average between ages 11-13 with regular ovulation established by 20 cycles later. Teenagers also deal with growth changes, both in height and weight, and are quick to compare themselves to others in that regard.
• Intellectual development. In the earlier years (ages 10-14), teenagers enjoy learning in small groups. They are moving from concrete to abstract thinking. They have strong emotions and are influenced by friends. Older teens move toward expanding logic and reasoning abilities. Not only are they better able to understand others’ point of view and consider the future, but they are better able to argue … usually with their parents!
• Emotional development. Most parents are aware of their teenager’s avoidance of physical affection. Much has been made of this on TV and in the movies. They prefer to be with their friends rather than family (especially parents). Teenagers tend to be moody with “roller-coaster” emotions and are easily offended. These years are marked by tension and conflict as the teenager separates from her parents. It is helpful for parents to keep this in mind as they attempt to respond, and not react to their daughter’s behavior.
• Social development. A social life is the most important aspect in a teenage girl’s mind. The younger teen is most interested in being the “same” and accepted by her peers. Relationships are complex and marked by large shifts in social circles. Cliques and popularity are the rule. Older teenage girls (ages 15-19) are still heavily influenced by friends and will seek out advice from friends before their parents. Trust and loyalty become important components of friendships. Friendships and romance become more important than cliques now, and most report being happiest when with friends. They like attending parties and social gatherings in general.

ADVICE FOR PARENTS OF TEENS

“Both from personal experience as well as experience in my profession, I have a few bits of advice,” says Dr. Zylman. “Parents need to be aware of their teenager’s activities.” The doctor explains that the goal is to discuss risk-taking behavior and its inherent consequences, rather than simply police all behavior.

“Don’t be too nervous to give your teens the ‘sex talk,’” she continues, adding that the more open parents are with their teens, the more likely their teens will turn to their parents with issues, instead of turning to their friends.

“Remember that all of these changes your teen is going through are difficult on them. Being a teenager is a difficult time,” she says. Studies show that relationships improve in emerging adulthood (roughly ages 19-22).

Finally, Dr. Zylman says parents should “also remember that research shows that teenagers who have authoritative parents (parents who combine control with warmth) take part in risk behavior to a lesser extent than adolescents with parents of other styles.”

For more information on gynecologic care and parenting, visit the American College of OB/GYN’s website at ACOG.org and/or visit ParentFurther.com.

Dr. Zylman offers full-service gynecology care for all ages at Hibiscus Women’s Care of Brevard. Check her out on Facebook, visit her website at HibiscusWomensCareOf-Brevard.com or call the office at (321) 473-4647 for more personal assistance.