Pre-teen girls should have a wellness exam before puberty starts.

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Before the onset of puberty, all pre-teen girls should have a "well-girl exam," according to the Adolescent Wellness and Reproductive Education Foundation. This visit is an opportunity to discuss your questions and concerns with your health care professional. It is also a time for you to gather printed material on a variety of health issues, including your menstrual cycle, contraception and STDs. An internal (pelvic) examination is not a part of this visit.

By around age 16, you should have your first internal examination. You will probably be asked to undress. If you are, don't worry; you will be given a disposable robe or cover-up to wear and only those parts of your body being examined will be exposed. Some young women prefer to have their mothers or another person with whom they feel comfortable accompany them on the first few visits. You can decide whether that person comes into the exam room or not.

During an internal examination, the health care professional will examine your pelvic area internally and externally to feel for the presence of anything abnormal.

You may need a Pap smear as part of your annual pelvic exam. The American Cancer Society (ACS) recommends having this test within three years of becoming sexually active, or by age 21. You should have a Pap test every year if your health care professional uses a regular Pap test or every two years if the newer liquid-based Pap test is used, according to the ACS. Be sure to ask, if you're not sure.

A Pap test examines the cervix for the presence of any abnormal cells that could be precursors of cancer, or cancer itself. You should have a Pap test each year until you've had three normal screenings in a row, according to the U.S. Preventive Services Task Force. Then, you can have them less often — once every three years.

Here's how a regular Pap test is done:

In an examination room, a health care professional will insert a small plastic instrument called a speculum into your vagina and lightly swab cells from your cervix. The cell sample will be placed on a slide and sent to a laboratory where it will be examined under a microscope for abnormalities in the cell structure. Abnormalities could be signs of cervical cancer or viral infections such as herpes simplex.

Your annual visit will also include a breast exam. Your health care professional will examine both of your breasts for lumps and other abnormalities such as redness, pain or discharge. He or she will do this both by sight and by touch. You may feel embarrassed during this exam. Try to keep in mind, however, these types of examinations are critical for your health and are part of learning to take good care of yourself as you grow older.

Remember: the discussions you have with all of your health care professionals are confidential. Some of the topics you might discuss with your health care provider would include contraception, sexual activity or sexual problems, preventing and screening for sexually transmitted diseases (STDs), menstrual problems, pregnancy and general women's health issues.

If you are sexually active, you should also be screened for chlamydia infection (through a urine test) annually.