Adolescence is the process of growing up-referred as the “teenage years”. It is a period of life from puberty to adulthood (roughly ages 13-20) characterized by marked physiological changes, development of sexual feelings, efforts toward the construction of identity, and a progression from concrete to abstract thought. Adolescence is sometimes viewed as a transitional state, during which young people begin to separate themselves from their parents but still lack a clearly defined role in society. It is generally regarded as an emotionally intense and often stressful period.

Your Period

What is menstruation (a period)?

Menstruation is a woman’s monthly bleeding. When you menstruate, your body sheds the lining of the uterus. Menstrual blood flows from the uterus through the small opening in the cervix and passes out of the body through the vagina. Most periods vary; the menstrual flow may be light, moderate or heavy lasting 3 to 5 days. But, anywhere from 2 to 7 days is normal. It is important to track on a calendar when your period starts, ends, flow (light, moderate, or heavy), any cramping or passing clots. 

When does menstruation (period) begin?

On average, menarche (a young women’s first menstrual period) occurs between the ages of 12 and 14 years old. Menstruation is generally two years after breast budding (average age 10 to 12 years old), and, in most cases, not long after the onset of pubic hair (average age 12 years old) and underarm hair. Stress, various types of strenuous exercise and diet can affect the onset of menstruation and the regularity of the menstrual cycle.

The American Congress of Obstetricians and Gynecologists recommends that a young woman consult her health care provider if she has not started to menstruate by the age of 16, and/or if she has not begun to develop breast buds, pubic hair, or underarm hair by the age of 13 or 14.

How long is a menstrual cycle?

When periods (menstruations) come regularly, this is called the menstrual cycle. For menstruating women, an average menstrual cycle lasts 28 days. A cycle is counted from the first day of one period to the first day of the next period. The length of your cycle varies, particularly for the first one to two years after menarche. Cycles can range anywhere from 21 to 45 days in young teens. 

When should I call a doctor about my period?

  • You have not started menstruating by the age of 16, and/or not begun to develop breast buds, pubic hair, or underarm hair by the age of 13 or 14.
  • Your periods become very irregular after having had regular, monthly cycles.
  • You have severe pain with your periods
  • You suddenly get a fever and feel sick after using tampons
  • Heavy periods- you are bleeding more heavily than usual or changing a soaked pad every hour
  • Your period suddenly stops for more than 90 days

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Your Annual Gynecological Exam

Why is a yearly gynecology exam important?

A yearly gynecology exam is important for women of all ages. At an annual appointment, a physical exam is performed assessing your heart, lungs, breasts, abdomen and pelvic anatomy. It is also a perfect time to touch base on special individual needs of women in different age groups and/or with a family history of specific illnesses.

During the women's health exam, the physician or advanced practitioner (nurse practitioner, midwife, physicians assistant) will:

  • review your past medical history and surgeries, medications, concerns and medical problems you may be having.
  • assess your blood pressure, height, weight and body mass index
  • discuss the importance of pap smears, screenings for sexually transmitted diseases, self breast exams, mammograms, colonoscopy screenings, immunizations, heart health, bone health
  • discuss practicing good health habits such as eating a well balanced diet, incorporating exercise into your daily life style and being pro-active about your health care in years to come

What should I expect at the first gynecologic visit?

IT IS NORMAL TO BE NERVOUS ABOUT YOUR FIRST VISIT! The first visit may be just a talk between you and your doctor. Your doctor may ask a lot of questions about you and your family. Some of them may seem personal, such as questions about your menstrual period or sexual activities. You usually do not need a pelvic exam at the first visit unless you are having problems, such as abnormal bleeding or pain. If you are sexually active, you may have tests for certain sexually transmitted diseases (STDs). Depending on your age & increased risk of certain diseases your doctor will recommend certain vaccinations.

What vaccines do teenagers need?

  • Tetanus-diphtheria-pertussis (Tdap) booster (once between ages 11 years and 18 years for those who have never had a dose of tetanus-diptheria (Td) booster; those who have had a Td booster should get a dose of Tdap 5 years after they received Td)
  • Hepatitis B virus vaccine (one series for those who have not been vaccinated)
  • Mengiococcal vaccine (once between ages 11 years and 12 years; once at about age 15 years for those who have not been vaccinated)
  • Varicella (chickenpox) vaccine (once between ages 11 years and 12 years for those who have not had chickenpox or have not been vaccinated)
  • Measles-mumps-rubella vaccine ( once between ages 11 years and 12 years for those who did not receive the two-shot vaccine during childhood)
  • Human papillomavirus (HPV) vaccine (one series between ages 11 years and 12 years; one series between ages 13 years and 26 years for those who have not been vaccinated; it also can be given to girls 9 years or 10 years)

In addition to routine vaccines, special vaccines may be given to teenagers who are at an increased risk for certain diseases. Listed are some of these vaccines:

  • Influenza vaccine
  • Hepatitis A virus vaccine
  • Pneumococcal vaccine

Sexual Health

What is Safe Sex?

The only safe sex is no sex. Abstinence may be the only true form of safe sex, as all forms of sexual contact carry some risk. Abstinence is a personal decision to refrain from all sexual intercourse: vaginal, anal, or oral.

What is an STD?

It is possible to get a Sexual Transmitted Disease even without having intercourse through skin-to-skin contact. However, certain precautions and safe behaviors can minimize a person’s risk of contracting a sexually transmitted disease (STD) and preventing an unwanted pregnancy.

Some misconceptions about Safe Sex:

  • Kissing is thought to be a safe activity, but herpes and other diseases can be contracted by kissing
  • Condoms are commonly thought to protect against STDs. However, while it is true that condoms are useful in preventing certain diseases, such as herpes and gonorrhea, they may not fully protect against other diseases such as genital warts, syphilis or AIDS.

Guidelines for safer sex:

  • Limit your sexual activity to one partner who is having sex with only you. The more partners you or your partners have the higher your risk of getting an STD.
  • Think twice before beginning sexual relations with a new partner. First, discuss past partners, history of STDs, and drug use.
  • Always use a latex or polyurethane condom every time you have intercourse to decrease the chances of infection. Male and female condoms are available.
  • Have an appointment with your healthcare provider and screening for STDs as recommended.
  • Check your body frequently for signs of a sore, rash or discharge.
  • Get immunized-Vaccinations are available that will help prevent hepatitis B and human papillomavirus (HPV).

Additional Resources:

There are numerous helpful books that offer advice on talking to your kids about sex. Many are available in the public library and even online. We suggest the following titles:

  • It's Perfectly Normal by Robie H. Harris and Michael Emberley
  • Let's Talk About Sex: A Guide for Kids 9 to 12 and Their Parents by Planned Parenthood / Mar Monte
  • The "What's Happening To My Body?" Book For Boys by Lynda Madaras with Area Madaras
  • The Boy's Body Book: Everything You Need to Know for Growing Up You! by Kelli Dunham, RN
  • The Girl's Body Book: Everything You Need to Know for Growing Up You! by Kelli Dunham, RN