HELP! 12 yo, first appt w/gyn questions

[midnitelpn]

my 12 yo has been having heavy periods & horrible mood swings since starting last year. they are regular, but heavy & lasting 7-10 days. her dr. wants her seen by gyn. she mentioned that they may not do an internal, but may rx. something like birth control to help regulate her periods. of course she said it would be up to the gyn md, as to what course of tx. etc., that they would take.....I am wondering what types of advice that you all could give to me. How i can prepare her for an internal, if thats what is needed. I also have some concerns about not having a internal & meds being rx.d w/o one (i'm fearful of masking something wrong & tx.ing just the sx.) what types of meds do you see rx.d most frequently, and what type of effects do they have on someone so young? what age would you recommend for tampon use? she is very active in sports & has a big problem w/using pads (she has to use very thick ones d/t flow etc), being embarrassed & having to change so frequently. is she too young? she is asking & talks w/me alot (for now, we'll see in a couple more yrs! lol) how graphic should i get w/ my explanations? she is a "young" 12 yo by todays standards.

[Jolie, BSN]

Does you daughter have a preference for a female vs male practitioner?

Can you contact the OB/GYN office to explain the situation and possibly schedule an "information only" visit with the office nurse, NP or CNM prior to the appointment? Perhaps having an opportunity to see the exam room, exam table, speculum and other items beforehand would be helpful. They may also have reading material intended for her age group.

Best of luck! I know this isn't easy.

[morte, LPN, LVN]

if you live in/near a large enough city....could you possible find a practitioner who specializes in adolescents????

[Elvish, BSN, DNP, RN, NP]

All the above advice is really great. The only thing I could add to it would be to allow some time for your daughter to be alone to ask any questions of the doc/NP/NM if she wants. She may not want to, but it is still a good idea to offer.

[daisydoll]

I started using tampons when I was 12 and have never used pads since! I can't imagine going back to pads, I always felt so gross when I used them. She is not too young to start using tampons.

[jadu1106]

do you have a planned parenthood near your vicinity?

here in my metro area, i personally know a np that works at pp and she mentioned to me that patients come in for info and bc pills, and the pap is not required. this is just what she mentioned, so maybe if you call the pp in your area they can give you more accurate info.

i know all too well how it is for the 1st pap, if your daughter gets one. i personally only prefer female ob/gyn's.

i think the above poster jolie gave some excellent advice.

i wish you all the best.

jadu1106 :heartbeat

[nursejohio, ASN, RN]

what age would you recommend for tampon use? she is very active in sports & has a big problem w/using pads (she has to use very thick ones d/t flow etc), being embarrassed & having to change so frequently. .

I've got nothing for you as far as the rest of your post, but I can weigh in on the tampon thing. If she's old enough to have periods, and having issues with pads, please please please help her figure them out! Nothing is quite as embarassing to a 13 year old than changing pads between every class and still leaking everywhere! Lemme tell ya, it was a rough few years.

And, cause I absolutely hemorrhage (at least it feels that way sometimes) I still have to change my tampon a million times a day. After a couple days of rough cotton sliding again one of the more sensitive areas a woman's got YOUCH! I gotta plug my very favorite invention in the whole wide world. http://www.softcup.com/ It's silicone (great for us latex sensitive folks) and contains instead of absorbing. The thing I love most about them is that even when I wore tampons I'd ALWAYS have to wear a pad for the leaks, and it's not an issue with these. They're approved to be worn for 12 hours each, but I usually stretch that out to 24. The coolest thing is that every time I get a potty break, I can kinda kegel/valsalva and that empties the cup out without ever having to touch it. It was a little bit of a learning curve figuring out how to use them, but soooo worth it. I'd give anything to have had these when I was in school!

[lindarn]

I started using tampons when I was 12 and have never used pads since! I can't imagine going back to pads, I always felt so gross when I used them. She is not too young to start using tampons.

When I was still getting periods, I would use a tampon, and a backup pad for extra coverage. It came in really handy when I was working 12 hour shifts, and FINALLY GET THE CHANCE TO USE THE RESTROOM. If my tampon was soaked, I would just take out the tampon, and I still had the pad on for protection.

I actually came up with this idea, when I would finally get to the bathroom, and I would realize that I forgot to grab another tampon out of my purse in the breakroom, I did not have to stop what I was doing, and run to get another tampon. When I did that inevitably, someone would jump in the bathroom while it was vacant, and then I would have to wait. Or I would get sidetracked, and not get to the bathroom for another two hours! Just another opinion and experience!

Lindarn, RN, BSN, CCRN

Spokane, Washington

[APBT mom, LPN, RN]

Most GYN's will not perform a pap on a child that young if she is not sexually active. The only time that one would be performed is if they were concerned about something else. When I was 12/13 mine were awful. Heavy the entire time and lasting about 10-14 days. MD put me on birth control just for that reason. I didn't have a pap but she gave me a script for a abdominal u/s to make sure that everything was OK. Maybe you could voice your concern about your daughter being prescribed something without an exam and see if an u/s could be an option.

As for tampons, if she feels comfortable using them then it shouldn't be a problem but if her flow is heavy she may still have to have frequent changes and wear a panty liner incase of leaking. But being on birth control after a few months should help with her flow decreasing.

[Penny8611]

I was put on birth control pills for the same reason, and my mother had an absolute COW. And I was 19 years old!

Best of luck...with such a caring mama she'll be fine!

[Batman24]

My guess is they won't do an internal on her at such a young age unless they fear something is wrong internally. Unless they feel it is absolutely imperative I wouldn't press for one either. They can and do prescribe BC without one as needed in cases such as this.

Some of us are just very heavy bleeders. I am and many in my family are as well. I've been like this since I am a little girl as well. If she wants to start using tampons I would teach her and see how she does. A pad is probably a good idea in the beginning in case she leaks. I also use wipes to clean up as I bleed so much and that might help her feel a little fresher during this time as well.

If they fear a problem I would get her a same sex doctor if that would make her more comfortable. You acting as chaperone might also make her feel more comfortable and I'm sure she would need the additional support but I really hope a pelvic isn't needed. It's a lot for a little girl to handle. Good luck.

[psalm, RN]

My first internal was at the age of 14, after 2 years of painful, painful, nauseating periods. They weren't particularly heavy, but the pain was deadening. This was before the use of ultrasounds. Turns out years later I find out I had endometriosis...

I would caution use of tampons, due to infectionand toxic shock, if she is flowing so badly.

I also know a relative who has a granddaughter who had ovarian cancer at the age of 14. Not to scare you, but I would want all the tests possible to see what is going on inside. U/S, CT, whatever...prepare her gently about what goes on in tests and maybe some anatomy pics will help her "see inside" what the doc will be looking at.