So, this is a great time to talk about vaginal infections that are NOT sexually transmitted. Because, yes, you can have discharge and an infection that occurs without sex. In fact the two most common types of vaginitis (medical speak for vaginal infections) are NOT sexually transmitted. Here is a simple way to tell them apart:
If you like this infographic, you can click on it and download a copy!
Ahh, periods. Half of us humans have them, and yet there is so much mystery! For basics on exactly what is a period and why females have them go HERE. Now, onto the question.
So, irregular periods. In general, periods come once a month, but a common mistake that a lot of young women make is that they think that once a month means every month on the same day. That actually is not true at all. Period cycles occur based on when you ovulate (or release an egg each month). When young teens start getting periods, they can be all over the place. After about a year or so, periods settle into a usual pattern of about every 28 – 35 days. You can use a period tracker to guess when your next period is coming or just mark on a calendar. After a few months of counting out the days, you will see what your personal cycle is. If you’ve done this and you are having periods all over the place, some teens always have irregular periods – but your doctor will consider other things before deciding that’s what is going on with you.
For instance, if you are overweight and notice some hair growth in places you wouldn’t expect (like the mustache area or your chest), you may have something called polycystic ovary syndrome, or more commonly PCOS. This is a disorder where your metabolism is affected and in some young women, can lead to early diabetes. This is something your doctor can look for. The underlying metabolic problem needs to be treated for your periods to get back to normal.
Now if you once were regular but now are not, there are a few things that can be the reason:
What is Athlete’s Triad? This is when female athletes have a trio of unhealthy problems: 1) disordered eating – or a full-blown eating disorder 2) osteoporosis (thin, weak bones) and 3)amenorrhea (no periods). Your periods and your bone strength are related. Losing your periods due to extreme thinness or low body fat is a sign that your estrogen levels have dropped. And you need estrogen to build up those bones. So, low estrogen = weak bones (often this is made worse by low calcium that can be caused by teens who avoid dairy like the plague to cut calories).
These are just a few examples of what might be going on.
So, what to do?
You see there are many reasons periods can become irregular, and each young woman is different. Which is why I always say, you’ve got to see your doctor to get checked out. She knows your medical situation better than anyone, and you know your body better than anyone, so the two of you are a great team to work to get to the bottom of it. Depending on what she finds, treatments may vary. Sometimes birth control pills are used to regulate hormone cycles but that won’t help if there is a treatable reason for your irregular periods. They are only used for regulating periods if everything else has been ruled out.
Hope this helps, but again, seeing your doctor is important. No internet source can replace a live in the flesh doctor!
"I had sex with a guy I am currently involved with yesterday afternoon. I have been on birth control for about a year now and I just started at new pack of pills ( 6th day of active pills). When he came, he pulled out but as he pulled out, the condom broke and sperm went over his leg and my bed, and some , I am pretty sure, got on my vagina. I am not exactly positive if it was his sperm or my fluids from me. Am I at risk for getting pregnant, and should I go get Plan B?"
Thank you for your question – it seems to me that your question has two parts – one is about how well birth control pills work, and the other is about Plan B. I have a lot of information about Plan B HERE. And I have talked about missed pills HERE. But your question reminds me that I am long overdue for a good summary of how birth control pills work, how well they prevent pregnancy, why you still need to use condoms, other things birth control pills can be used for other than pregnancy prevention, and more.
So, let’s get started.
What exactly are birth control pills and how do they work?
Birth control pills usually contain a combination of two hormones – progesterone and estrogen. These work together to prevent pregnancy by preventing ovulation (the release of the egg) each month, by making the lining of the uterus thinner to prevent implantation, and in other ways. Some pills contain only progesterone, but most have both.
Are there different kinds?
There are a lot of different types of pills, each with slightly different hormone amounts and ratios. Some pills have the same combination of estrogen and progesterone each day, and others change the amounts of estrogen / progesterone week to week. No one pill is better than another, though each woman may have different experiences with different pills (meaning that if one doesn’t agree with you another formulation might be a better fit for you.) Most pills come in monthly packs, where you take 21 days of active pills, and then 7 days of placebo (sugar pills) – during those 7 days, you get your period. There are some brands which you can take active pills for 84 days and then a week with no pills so you get a period every 3 months – you need to check with your Dr about how to do that exactly. Don’t try it on your own!
How well do they work?
The average Pill failure rate is about 10% per year. Meaning that over a year, 1 in 10 users may get pregnant. This is almost always because of missed pills or not taking the pill perfectly. If used perfectly, the failure rate is very, very low. If remembering to take a pill every day isn’t for you, then you might want to consider another birth control option – there are a lot out there!
How do I start the pill?
First you will take a pregnancy test – if it is negative, and after your Doctor or nurse prescribes the Pill for you, you can start it one of two ways:
What do I do if I missed a pill?
Missed pills are the reason for pregnancy occurrence in women taking the Pill, almost always. What to do:
What about if you took an extra pill by accident?
Not a problem – just keep taking the pills in the rest of the pack one a day – you will finish the pack a day earlier, but that is OK. If you aren’t sure what to do, call your Dr or nurse! There are other situations where they may make other recommendations. And when in doubt, use a backup!
Always, for STD prevention. The only exception? Both partners are tested at the same time and all STD screens come back negative. And you both are monogamous.
Most women have very few side effects, especially now that hormone doses in pills are lower than in the past. The first few months you might have some breast tenderness, a bit of bloating and maybe nausea (taking the Pill at bedtime can help with that). You may have read that Pill cause blood clots – they can. But actually the risk of blood clots with pregnancy is HIGHER than on the Pill. If you have family members who have had blood clots, you will want to mention that to your Dr when you go in to ask about birth control. What do they NOT cause? AKA side effect urban legends: They do not cause weight gain, birth defects, or infertility.
Other things birth control pills are used for.
Some young women can benefit from birth control pills for reasons not related to preventing pregnancy. The Pill can make you periods lighter so you lose less blood (and iron!) each month. It also can decrease cramps and PMS. And, acne – they can lessen acne. And if you get migraines related to your periods, there are some pills that might be able to help with those too (though this is something you should discuss specifically with your Dr).
So, back to your question, you are wise to use both the Pill and condoms for the reasons we talked about above. You have double protection, and STD protection and it sounds like you are very serious about taking the Pill properly and every day. This is the perfect way to use the Pill to prevent pregnancy. In a scenario like this, it is very unlikely that pregnancy can occur (again, if every single day the Pill was taken properly). For information about Plan B specifically, read more HERE. You might be interested to know that for women on the Pill who have an issue where they think they might have an accidental fertilization, there is a way that regular birth control pills can be used in an emergency (like a Plan B) – for that situation, I always encourage teens to call their Dr for more information so that they know what to do in advance of needing to do it.
I hope this helps clear up some questions. Remember, Real Talk with Dr Offutt answers questions for everyone – we are not a replacement for asking your own regular Dr or NP for medical guidance and we cannot respond ot urgent medical situations. What we are all about is sharing as much useful medical information with teens like you out there in the e-world, and your questions help us know what worries teens about their health.
“I'm sixteen, and i've been dating my boyfriend for over a year. we have been thinking about having sex, because we are happy with our relationship, we trust each other, we tell each other everything, and are very clear in our communication. we only want to have sex safely, and we have condoms, but we want another layer of protection. However, my parents don't want me to have sex in high school, regardless of how healthy our relationship is. i don't feel pressured to have sex at all and will do it on my own terms. I also don't want to sneak around my parents' back for birth control pills. what should i do?”
Thank you for your question. Let me start by saying that you are thinking about all the right things and I am happy that you are in a healthy romantic relationship. It is very important that you and your boyfriend have open and honest communication about all sorts of things including about how each of you feel about sex. Now onto your question(s).
You are right that if you and your boyfriend do decide to have sex, that a form of birth control is needed in addition to condoms. Condoms are really important to prevent sexual infections (which are very common and do not only affect “those kind of people”!). But failure rates of condoms used by themselves as birth control in teens range from 5-20%. That means pregnancy will occur in up to 1 in 5 times that teens have penis-vaginal sexual intercourse with condoms alone for birth control. A whole bunch of things contribute to that including breakage and putting it on incorrectly. I have more information on condoms here and here. This is exactly why it is good you are thinking already about a backup method in advance of starting to have intercourse.
It sounds like you have a good relationship with your parents, and take their advice and guidance to heart. That is great. Parents are a very important resource for questions about sex and other health issues. But you are right, teens sometimes make decisions that are at odds with what their parents want for them. Having a discussion with your parent(s) about why they feel the way they do about you not having sex in high school is a good place to start. If you feel like you can ask them, too, about birth control, that is great. Another option if that isn’t going to work is to tell them you’d like to make an appointment to see your Doctor to ask questions. Each state has different laws around confidentiality and sexual health care for teens, meaning that you can get care in some states without parental consent. You can ask your doctor about that when you see her. Planned Parenthood is another great resource for teen reproductive health care. You can find a clinic near you, as well as explore different types of birth control on their website here.
Now I know that would all fall under “sneaking around” about birth control, which you said you do not want to do. The deal is this, though. Although in an ideal world, we can all have these conversations with our parents, and all see eye to eye on certain issues (sex), that is not always the case. Adolescence is a time when you are taking more control of your life and transitioning into adulthood. Taking control of your health is an important part of that. So what I never want to see is two teens deciding they are both ready for sex (but not a baby!) in their relationship, but skipping the necessary birth control because they don’t want to feel like they are sneaking around about it. That is not going to end well.
I hope this helps. I know you asked a question that a lot of other teens have as well, so I am glad to have the chance to answer it!
Today we talk about IUD, which is the abbreviation for a type of birth control method called an Intrauterine Device. IUD’s are a great birth control option for a lot of young women. Let’s take a few minutes to understand how they work and what to expect if you decide an IUD is right for you.
What is an IUD?
An IUD is a tiny t-shaped device that sits inside of the uterus to prevent pregnancy. Where exactly is the uterus? Remember this picture? You can see where the uterus is here. It is at the top of the vagina, and behind your bladder and in front of the rectum
How does the IUD work?
IUDs are made of different things that prevent pregnancy in different ways. They can be made from copper, and these act to prevent sperm from reaching the egg. Other IUDs are made with hormones that thicken the mucus that covers the cervix so that the sperm cannot get through to meet the egg, and then also prevent the lining of the uterus from building up which is needed for pregnancy.
How long does the IUD last?
It depends which one you get. The copper IUD lasts up to 10 years, and the hormonal ones last between 3 and 5 years.
How does the IUD get put in?
Your doctor or nurse can insert the IUD with a tiny “straw-like” inserter that has the IUD in it. They put that through the normal opening in your cervix, and then when it is in the uterus, they release the IUD and it opens into the T-shape. The IUD has little threads or strings on the end which come through the cervix and hang out in your vagina. You can’t feel them, and usually your partner doesn’t either.
Does it hurt?
Many teens get some cramping when it is inserted, but once it is in place, you don’t feel anything.
Are there side effects?
Again, it depends of the type of IUD you choose – but side effects aren’t a big issue:
How well does it work?
IUDs are very, very effective methods of birth control. More than 99% of women do not get pregnant when they use the IUD. One big reason is that you don’t have to remember it! It is always there until you decide to take it out.
How does it come out? And then what happens?
Your Doctor or Nurse can remove the IUD whenever it is time to change it or if you decide you want it removed. They will gently pull on the strings hanging into the vagina to slowly remove it back through the cervix. You can get pregnant right away after removing the IUD.
Anything else I should know?
The IUD does not protect against STDs. You still need a condom to help prevent infections. The IUD also does not damage your chances of getting pregnant later in life when you are ready to have a family. Very, very rarely the IUD can come out with your period (this is something I have read about but haven’t seen). So if you see the IUD in your pad or in your underwear, you will need to get a new one or use some other birth control.
For more on birth control options for teens see: http://stayteen.org/sex-ed/birth-control-explorer
I know - it's PROM SEASON! You've got the dress / reserved the tux. Maybe you have a date, maybe you're going with friends. You're figuring out all the plans for stuff that doesn't happen at the dance itself. Perhaps one of those things is SEX. I have heard from many a teen that they thing Prom = Sex. But I am going to tell you right now, Prom Night does NOT equal "GettinItOn", as they say. That means, sex is not a mandatory piece of a great prom night. BUT, you should think about what you are going to do about sex in advance of being faced with a Situation that night. And if you think you there is even a tiny chance that you might have sex that night, be prepared.
Let's start with some stuff about birth control?....
Actually not really such a fun fact - but I caught your attention. Can you believe in a health survey done by the Centers for Disease Control, that (in general, not at prom.....) MORE THAN A THIRD OF HIGH SCHOOL STUDENTS WHO HAD SEX DID NOT USE A CONDOM!!! Do NOT be one of those people. Birth control helps prevent pregnancy, but not all methods minimize (notice I don't say totally prevent) the risk of sexually transmitted infections.
BIG THING TO REMEMBER:
ANOTHER BIG THING TO REMEMBER:
So, what are different methods out there for birth control? Here is a summary for you... birth control methods can be grouped by the way they work:
You can see there are a lot of options. Notice that "pulling out" is not listed as birth control. That's because it isn't.
So, how do you know what is right for you? I think this tool from the Association of Reproductive Health Professionals (ARHP) is really helpful and helps sort through the different methods to help you make a choice that is good for you.
ARHP - Birth Control Tool
This is an important discussion to have with your doctor or nurse. You need to talk with your doctor or other health professional if you are planning to have sex to make sure that you are prepared. Remember, no matter what method you choose, you must use a condom - male or female - to minimize the risk of sexually transmitted infections. Nothing makes your risk for pregnancy ZERO except for no sex at all.
"I have had sex with a pillow and I have not started my period am I going to get pregnant. I do not have a boyfriend and not had any contact with a penis. Do the eggs only work when a penis is put in them? But the most important question is am I going to be pregnant even though I have not started my period"
This is one of the most common questions that I get. The specific answer to whether or not you can get pregnant after masturbating with a pillow (or a towel, or something else like that) is no. And HERE is where you can read more about that. The short answer is that orgasms are not what make you pregnant. Having a sperm meet an egg is what does make you pregnant – that means you can get pregnant without an orgasm.
But let’s step back and talk about exactly how pregnancy happens. Sex Ed in school and elsewhere has gotten so restricted or incomplete, that I see more and more young people who really do not understand how pregnancy happens. Or even how sex happens. Which brings me to another reminder: Porn is not a good place to try to figure out how sex works. HERE is why.
So, pregnancy. The short explanation is when sperm meets an egg, the egg is fertilized by the sperm, and becomes a zygote. There is a long process from fertilization to zygote to embryo to becoming a baby, and this process takes 9 months. I am going to go into more details for you to help you understand. (One note – when I am talking about “female” and “male”, I am referring to the biological or birth physical sex of a person. If a person is transgender, their reproductive tract will function the way their “birth sex” reproductive system would, unless surgery or hormones have changed that as part of their transitioning.)
Here is a picture of the female reproductive tract:
Now, each female is born with eggs already in the ovaries. With puberty, eggs start to mature and one is released from one of the ovaries every month (more or less). The egg will travel along the Fallopian tubes which go right into the uterus. The uterus gets itself ready to support pregnancy by building up a thick lining. If the egg is fertilized by a sperm swimming upstream from the vagina into the uterus or even the tubes, it becomes a zygote and starts to divide into more and more cells. These cells may “implant” into the uterine lining where it may start the long process of developing from a cluster of cells to an embryo to a baby.
The next picture shows the path (the pink dots) that the egg travels. If it doesn’t get fertilized, it just keeps on going right out the vagina. The egg is too tiny to see without a microscope.
Next up, guys. Here is a picture of the male’s reproductive tract:
Sperm are made in the testes which sit in your scrotum (aka: “balls” or “nuts”). They leave the testes to go to the epididymis where they hang out (are stored) and mature. When they are ready, they leave the epididymis to meet up with seminal fluid which is made by the seminal vesicles. This sperm plus seminal fluid is what we call semen. Semen then goes into the urethra (which is the same tube that carries urine from the bladder out of your body too) when you ejaculate (or “cum). Confused? Maybe a picture will help.
This picture shows the path that sperm travel (blue dots):
Now, each ejaculation releases a couple hundred million sperm. Yes, you read that right: HUNDREDS OF MILLIONS OF SPERM! If male ejaculates or cums (or even pre-cums) in or near the vagina of a female, without protection, all those millions and millions of sperm start swimming upstream up the vagina, into the uterus in search of that egg.
Only one sperm wins.
And it takes only one sperm to fertilize the egg. This picture might make no sense, and it does have a lot of big medical words, but look at it this way. There is a super zoom-in of the egg on the right upper side and there are a lot of little green sperm, each showing exactly how they enter the egg to fertilize it. Only one gets in - once one is in, the egg won't let any more in. (how cool is the body?! - you can see why I love medicine).
Months and months later:
Notice, no where in there did I talk about orgasm being required for pregnancy. That means females can get pregnant without having an orgasm. And males can release sperm and ejaculate without a full orgasm as well.
Two take home points:
I have to say, I am surprised at the number of times I get this question in some form. The first time I got the question, I answered it HERE. But I get more hits on that post and lots of new questions just like it, so I have been trying to figure out really what information is missing that is causing young women to worry so much.
These are just a few examples of questions I've gotten:
So, I’ve been thinking and thinking about what these questions are really getting at, and I think I figured it out.
I think that some teens believe that when you have an orgasm (or cum) that is how you get pregnant. That is NOT TRUE!
I want to make you understand this for 3 reasons:
Now I hope that settles some worries out there. If there is another hidden question that I missed, put it in the comments below (just put your name as anonymous) so I can tackle that one too.
"I can’t find any blogs to talk about teen with breast lumps.... i want to self exam but my breasts are too sensitive and it hurts to press down. I’m desperate."
First of all I am glad you asked this question since many teen girls have painful breast lumps and that makes them panic. Answering your question will help those other young women stop worrying too! I want you not to panic. Every time there is something not right with breasts, most females cannot help but worry about breast cancer. And even though breast cancer is a pretty common cancer, it is VERY RARE in teen females.
What else could those sensitive lumps be?
The most common cause of breast lumps in teens are what are called fibrocystic changes or fibroadenomas. These affect many menstruating females. These are not cancer. They are not pre-cancer. The breast tissue is made up of fatty tissue, milk glands and ducts, and fibrous tissue. It has lumps in it that may be caused by some hormone imbalance between estrogen and progesterone (2 female sex hormones).
What are the common symptoms?
There are other things that can cause tender breast lumps in teens such as cysts (also not cancer) or old bruises. Breast tenderness and swelling is really common before your period starts and it goes away shortly after you start bleeding.
Other things that can cause really sensitive breasts?
When to see your doctor? Whenever you’re worried! That’s what they are there for and they know your health better than anyone on the internet! If there are a lot of people in your family who have had breast cancer, that is another reason to go see your doctor.
I hope this helps,
"I'm a seventeen-year-old girl and whenever I masturbate when I orgasm I get a small sharp pain in my lower right side sort of by my hip area. Is this normal or something I need to discuss with my doctor or go to a gynecologist for?"
A lot happens during the female orgasm and a bunch of different sensations occur. The sensations experienced during orgasm have been described as flooding, flushing, spurting, throbbing, and spasms, just to name a few. What is actually happening when the orgasm occurs involves a lot of muscles and nerves. The uterus or womb contracts, in a rhythmic movement that is felt deep inside. The vagina itself has its own rhythmic contractions or throbbing that is felt in the outer section. There are muscles that make up what is called the pelvic floor that also contract – these muscles wrap around the vagina, the urethra (tube where your urine comes out) and rectum (where your bowel movements come out) and hold up your internal organs. That’s not all – your rectum actually contracts too.
As you can imagine you can feel all sorts of intense sensations deep inside as well as closer to the outside when you orgasm. Why there is a small sharp pain in one specific area is hard to say. It might be part of the whole contraction of the orgasm. I guess one thing that would make me suggest seeing your doctor is if you have had vaginal intercourse and there could be a chance of a sexual infection. Some sexual infections can travel upward into the reproductive tract and cause scarring and inflammation of the tubes. I always recommend that sexually active young people get tested for STDs at least once a year just in case!
One more thing, I have heard from teens that they wish that someone told them that masturbation was normal and a healthy way to deal with sexual feelings earlier. Like in Middle School.
So, here I am telling you – IT IS NORMAL!
There is nothing bad that can happen to you if you masturbate, and you cannot get pregnant or get STDs if you masturbate by yourself. As long as it doesn’t interfere with school or work or other important activities, you’re fine! No guilt!
Hope this helps – when in doubt you should feel comfortable going to your doctor with your questions since she knows your health situation best!