When girls should begin pelvic exams

At what age should a teenage girl have her first Pap smear and gynecologic exam?

Pelvic exams and Pap smears are not necessary in healthy adolescent girls who are not sexually active and who do not have gynecologic symptoms or other concerns. The recommended age for young women who have not previously needed a Pap smear to begin having the test is 21. Primary care providers, such as those in family medicine or internal medicine, can perform that exam, or a gynecologist can perform the exam.

The purpose of a Pap smear — a procedure that collects cells from the cervix — is to check for changes in those cells that could be a sign of cancer and look for the presence of high-risk types of HPV that are known to cause cervical cancer.

HPV is the most common sexually transmitted infection in the U.S. Although most cases of HPV do not cause symptoms or lead to problems, certain strains of the sexually transmitted HPV are considered high risk, and can lead to cancer and potentially be deadly if left un- treated.

If a teen is not sexually active, in most cases there is no need for a Pap smear because the risk of cervical cancer is low, and there is no risk of HPV or other sexually transmitted infections. Once a teen begins having sex, a Pap smear may be appropriate. But even in many of those situ- ations, Pap testing still may not need to begin until 21.