Dr. Judith Reichman 'Today' show contributor • Profile • E-mail

Q: I’m 15 years old and I’ve been dating, but I don’t have a serious boyfriend. My mom says I should see a gynecologist or nurse practitioner. Is she right?

A: When moms (and dads) hear that their daughters are interacting with boys, it’s natural that they become concerned. However, their concern is also shared by major medical associations, including the American College of Obstetricians and Gynecologists. They believe that young women should have their first visit with a gynecologist or nurse practitioner between the ages of 13 and 15 just to talk, if nothing else.

Your doctor will assess if your body has developed as it should for your age group. (By now you should have complete breast development and pubic hair, be close to your final height, and most likely have started your period). If you haven’t started or completed your transition into puberty, your doctor will help you determine if you’re too thin, or if your dieting or exercise regimen have prevented you from getting the proper nutrition and having the necessary body fat for development. It’s also important to look at your family history. If your mom or older sister got their periods after the age of 15, then you may copy their later development.

Delayed onset of your first period may prompt your doctor to do a blood test to assess your hormones, thyroid function, and protein and iron levels. If you’ve never had a period and secondary sex characteristics have not been “on course,” your doctor may suggest that you get a special blood test to check for chromosome irregularities.

I’m assuming, however, that you now have your periods. Are they heavy, crampy, or irregular? Are you missing school because of them? This is your chance to complain and get help with your monthly blood flow, especially if it’s excessive or painful. It’s not unusual for periods to be irregular for the first year or two. But your doctor may feel that in your case (especially if you have gained a lot of weight since puberty or have severe acne) that the irregularity is due to a glandular condition called polycystic ovarian syndrome (PCOS). Treatments may be warranted in order to prevent future health problems.

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Next, of course, is the issue of your present or future need for contraception. Twenty-two percent of 15-year-olds are sexually active. If teen girls don’t use contraception, or don’t use it correctly, they run a huge risk of either becoming pregnant or contracting a sexually transmitted disease. If you think you’re going to have sex (or have), talk to your doctor or nurse practitioner about contraceptive options. (This doesn’t mean that I’m encouraging you to become sexually active at your age.) If you’ve not been sexually active and have no major menstrual problems, you don’t need a pelvic exam, even if you’re asking for birth control “just in case.”

You should also stock up on condoms if you plan to be sexually active. But know that the less sexual experience a guy has, the greater the chance that the condom will tear, break, or slip off. So relying solely on condoms could result in a pregnancy. As you may have heard, Plan B is now available over-the-counter for young women over the age of 18. Unfortunately, that precludes you, but once you have a doctor’s appointment, ask for a standing prescription for this drug if you think there is a potential that you will need it in the near or not-too-distant future. If you don’t want to take any chances, you might discuss the possibility of starting a low-dose birth control pill

Finally, there’s the issue of sexually transmitted diseases. I know most teens are bombarded with health lectures about all you want (and don’t want) to know about STDs. Unfortunately, STDs, especially the human papillomavirus (HPV), are horrendously prevalent. Now’s the time to start the vaccination process to protect yourself from the four types of HPVs that cause 70 percent of cervical cancers and most venereal warts. This vaccine is given in a series of three shots over a six-month period.

But remember, there’s a lot more out there — roughly 26 other types of genital HPVs,  in addition to gonorrhea, chlamydia, HIV, and even syphilis. Although your boyfriend may seem great, he could have caught a disease in the past. (Remember, every time a person has sex with another person, they’re having sex with all the individuals that person has slept with, and all their partners, and so on …)

So make that first appointment, regardless of whether or not you have menstrual problems or are sexually active. If you wish to keep your visit information, tests and care private (unless, of course, you have a life-threatening problem), you should request this at the beginning of your visit.

Dr. Reichman’s Bottom Line: Even if you’re not sexually active, I, and most concerned physicians, encourage you to have your first ob-gyn doctor or nurse practitioner visit by 16, at least to talk.

Dr. Judith Reichman, the “Today” show's medical contributor on women's health, has practiced obstetrics and gynecology for more than 20 years. You will find many answers to your questions in her latest book, "Slow Your Clock Down: The Complete Guide to a Healthy, Younger You," which is now available in paperback. It is published by William Morrow, a division of HarperCollins.

PLEASE NOTE: The information in this column should not be construed as providing specific medical advice, but rather to offer readers information to better understand their lives and health. It is not intended to provide an alternative to professional treatment or to replace the services of a physician.

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