When puberty hits, Girls will need more guidance in the confusing phase to adulthood.

Nothing can be as special as the bond between a mother and her daughter. When puberty hits, this special bond is more important than ever. This time of in-between is a crucial period for tween girls as they begin to see changes in their body. They need more guidance in navigating the confusing phase to adulthood.

Aside from educating your daughter about the basics of sex and reproductive health, you should take her to a gynecologist who can provide more insights on her changing body, an expert from a top hospital in the Philippines Makati Medical Center (MakatiMed) says.

“We recommend moms to take their daughters aged 13 to 15 for a gyne check-up at the onset of their first menstruation or menarche,” Ma. Cristina Maledeo-Miravalles, MD, Department of Obstetrics & Gynecology, says. “This is more of a talking session for the daughter to ask questions about her current and future menstrual concerns.”

The gynecologist in return will get the medical and menstrual history. A simple inspection of the breast and external pelvic organ to establish baseline physical findings may be included in the visit.

“No pap smear, no intrusive poking of a speculum nor transrectal ultrasound will be done. These are unnecessary, medically inappropriate and will only traumatize the young girl,” Dr. Miravalles explains.

Such visit may also be recommended if it was not done earlier if you suspect that she has become sexually active. If she has not had her first menstruation at age 15, a check-up is necessary. Other reasons for a visit would be prolonged or heavy menstruation. It is usual for young girls to have long intervals between menstruation. Such is the manifestation of the immaturity of hypothalamus, pituitary and the ovarian functions at this period. The hypothalamus and pituitary glands are the brain sources of the hormones that wake up the ovaries to grow female hormone producing follicles. Highly irregular menstrual cycles occurring two years after menarche warrants a gyne visit.

Dr. Miravalles encourages moms to pull their daughters aside for a pep talk before the visit. “You can make the appointment easier for her by establishing the importance of this meeting, that this is one of the many steps in taking care of her health,” she explains. Below are some pointers Dr. Miravalles hopes moms can tackle with their daughters ahead of the visit.

Set her expectations. Provide a sense of familiarity about the visit by explaining what exactly a gynecologist does so she would know what to anticipate. Make sure to prepare her for a series of new tests. An external genital exam, breast exam, thyroid observations and a check for abnormal hair patterns are among the checks the gynecologist will do aside from the basic ones your daughter gets from the family doctor or pediatrician.

Tell your daughter to monitor her period. Dr. Miravalles says that the best time to visit the gynecologist is when your daughter is not on her period or during mid-cycle, which is one to two weeks after the period has started. Your daughter needs to note when her period started and its length as these are the basic information the gynecologist will ask during the visit. She should also observe how her period is giving her pain or cramps.

Write down her concerns. Like most young people, your daughter might have a gazillion questions about her reproductive system. Encourage her to write down her concerns and other questions about her body. Her first gyne visit is a great time for her to beef up her knowledge on reproductive health to serve as her baseline on what’s normal and not.

Aside from these pointers, moms should discourage their daughter from shaving or waxing their genital area as this might irritate the delicate labia. “You’re also advised to step out of the room after the intro, so your daughter will be more comfortable in sharing sensitive information with the gynecologist. Don’t worry, you’ll be informed if anything major comes out, and will be called in if needed,” she adds.

For more information, please contact MakatiMed On-Call at (+632) 888-8999, email mmc@makatimed.net.ph or visit www.makatimed.net.ph.