by Sarah Mirk
Research also shows that the teen brain works better if a person can start the school day at 10 a.m. or later. So if yours starts super early and you’re going to bed super late, you might find yourself falling asleep in class. If so, adjust the time you go to bed so you get at least a full eight hours of sleep every night.
Cycles usually take years to become regular. Usually, when people first get their period, they might miss their period every once in a while or the time between periods may vary. Lots of things—stress, diet, exercise, and anything else that can throw hormones out of whack—affects how much you bleed, how long you bleed, and even if you bleed.
Not everyone with a uterus gets a period. About 3 percent of people with ovaries don’t start getting a period when they go through puberty. That’s called amenorrhea. If someone starts having a period and then it stops for six months or longer, that’s called secondary amenorrhea. Extreme exercising, disordered eating, endocrine problems, or chronic illnesses such as diabetes, Crohn’s disease, or ovarian cysts can cause amenorrhea. See your doctor if you experience any of these conditions.
When they are adults, some transgender and nonbinary people take the hormone testosterone or have a hysterectomy surgery to remove the uterus. These steps end the menstrual cycle permanently. For everyone with a uterus, the menstrual cycle eventually ends with age. Typically, between the ages of forty-eight to fifty-five, people go through menopause. The ovaries start producing less of the hormones estrogen and progesterone, and the menstrual cycle ceases.
The menstrual cycle follows a pattern. At the beginning of the cycle, the pituitary gland in the brain releases hormones that cause an egg in the ovaries to mature and release. The egg moves through the fallopian tubes to the uterus. As the egg is maturing and making its way down the fallopian tubes, the uterus prepares for its arrival. This part of the cycle is ovulation. The uterus builds up its interior lining—the endometrium—to give the egg a cozy, nourishing place to land. If sperm fertilizes the egg, the egg will attach to the uterine lining and start to grow. This is the very beginning of pregnancy.
If sperm is not around to fertilize the egg, it remains unfertilized. Then the uterus sheds its extra-thick lining. That lining flows out of the uterus through the cervix (at the top of the vaginal canal) and then through the vagina and out of the body. The flow lasts two to seven days. Getting your period is a sure sign you are not pregnant. Periods start in puberty about two to three years after the breasts start growing. The average age for starting a period is twelve or thirteen. People feel all sorts of ways about getting their period. Some people are excited to be getting older. Other people are scared, confused, and surprised. There’s no right way to react.
Is That . . . Blood?!?
Menstrual flow is often described as blood because it’s a reddish-brown fluid. But it’s actually only about 35 percent blood. The rest of the fluid is uterine lining, which often has little clumps of cells and blobs of mucus in it.
The amount of fluid that comes out of the body during a period varies for everyone and often fluctuates every month. While it might seem like a lot of fluid, periods usually have less fluid than 1/2 cup (118 mL) of water. An average light flow would be just 1 tablespoon (15 mL) of fluid over the course of the week. A heavy flow is about 6 tablespoons (90 mL). Some people have periods that are really light, never getting much fluid and just spotting of red and brown discharge. Other people have extremely heavy periods, soaking more than one pad or tampon an hour. Both of these conditions can be an indication of something unhealthy going on in your body, so talk with a doctor about this.
Period Problems
You’re watching a corny movie on TV, but you can’t stop yourself from tearing up. And your lower belly hurts. When your dad asks what’s wrong, you snap at him.
Moodiness, cramps, and crying spells are all symptoms of premenstrual syndrome, better known as PMS. In the days before each period, at least 75 percent of menstruators experience PMS. The menstrual cycle causes fluctuations in brain chemistry and hormones that create a range of symptoms such as cramps, mood swings, feeling sensitive or depressed, and breast sensitivity. Other symptoms include headaches, acne flare-ups, constipation, fatigue, joint pain, bloating, and joint pain.
Dealing with PMS
Many people take over-the-counter medications to help with PMS. You can also try these natural remedies:
Use heat to reduce cramps. Taking a hot bath or putting a heating pad or hot water bottle on your lower belly can ease muscle pain and cramping.
Exercise. Physical activity, even a short walk, helps fight mood swings and fatigue.
Take calcium. Research shows that menstruating people who take two calcium supplements a day have less period-related depression and fatigue.
Eat ginger. Studies show that consuming ginger reduces nausea, headaches, and muscle pains caused by PMS. Try ginger tea or add grated fresh ginger to your favorite stir-fry
Some people have cramps that are so painful, they’re debilitating. Periods should not leave you regularly bedridden. If it’s hard to go about your regular life when you have your period—the pain is so bad that it’s tough to get out of bed, go to school, focus in class, and play sports—see your doctor. Two common conditions that cause terrible menstrual cramps are cysts and endometriosis. Endometriosis is a painful disorder in which tissue that normally lines the inside of your uterus—the endometrium—grows outside your uterus. Ovarian or uterine cysts are growths that can cause pelvic pain and pain while peeing or pooping. Both can be treated, so talk to a doctor.
Hormonal birth control methods such as the Pill, intrauterine devices (IUDs), and vaginal rings often help ease the symptoms of PMS. They reduce cramps, prevent menstrual-related migraine headaches, help control endometriosis and uterine cysts, and improve acne. Actually, 33 percent of teens get a prescription from their doctor to take the Pill to manage their period and its side effects.
You’re in charge of your body. Keep track of what’s going on with your hormonal changes and your genitalia. Get to know what’s normal for you so you can be the best expert about how to take care of and advocate for you.
Questions to Think About
I feel as if I missed something. I’m thirteen and I haven’t gotten my period or had my breasts get bigger or gotten much taller at all. All my friends talk about having to shave their armpits and buy tampons, and I nod along as if I know what they’re talking about. Is there something wrong with me?
If you haven’t started puberty by the time you’re thirteen or fourteen, you might be among the 3 percent of Americans who experience delayed puberty. About 90 percent of the time when puberty is delayed, doctors will take a “wait and watch” approach, and puberty will eventually start up naturally.
Delayed puberty can be caused by chronic illnesses such as diabetes or celiac disease. Bodies also naturally delay puberty if they don’t have enough body fat, which is often seen in people who are anorexic. Check with a doctor if you think your puberty is delayed. They can do a blood test to see if something is causing the delay or if you’re just naturally developing a bit later.
I’m in seventh grade, and I think I must be the only girl in school who doesn’t shave her legs. Some kids call me “mountain woman” and a lesbian. I know I could shave, but it just seems, like, not right to me. I’ve tried it before, and it doesn’t feel good. Do all girls shave their legs? If I don’t, does it mean I’m a lesbian?
Nope and nope. Women of all sexual orientations decide to remove their leg hair, armpit hair, pubic hair, and facial hair . . . or not! People who call you names or make assumptions about your sexual identity because you don’t shave your legs are being ignorant and unkind. The only reason to shave your legs is if you think it looks good and feels good. No one has the right to shame and harass you into making you treat your body in a way you don’t want to. Do what feels right to you.
Chapter Five
Know Your Germs
People often
get awkward when talking about sex and bodies, and that can keep them—especially young people!—from speaking up and seeking help when their reproductive and sexual organs don’t feel right. Knowledge is power. You’re the expert on what feels right with your body. If you’re experiencing pain, burning, or any other unusual or uncomfortable physical feelings, that’s a red flag to talk to a doctor. Here are some common things to watch out for:
Keep It Clean
Did you know your genitalia is home to a lot of bacteria? That’s a good thing! Our bodies are home to millions of helpful bacteria that keep us working well. Every part of the body—your mouth, stomach, intestines, and genitalia—have bacteria. So just as with any other part of your body, keep your private bits clean. Genitals do a great job of self-cleaning, so don’t douse them in soap. It will kill off the good bacteria that occur naturally. Instead, clean your genitalia just with warm water.
If you have a vulva, never use a douche. A douche is water or a chemical squirted into the vagina. Companies sell douches by marketing the false idea that vaginas are smelly and dirty and need to be cleaned. Actually, the opposite is true. Douches wipe out a vulva’s natural, healthy bacteria, leaving it vulnerable to unhealthy, foreign bacteria. That can cause infections. So douches are a dangerous scam.
If you have a penis that’s uncircumcised, the foreskin can get inflamed or infected. If your penis hurts or it stings when you pee, it may be infected. To prevent that, clean underneath the foreskin with warm water when you take a shower. Without regular cleaning, smegma, a whitish-yellow substance, can build up under the foreskin. Smegma can look like pus, but it’s dead skin cells, oils, and other fluids that build up.
UTI OMG
One of the most common and painful problems for people of all genders are urinary tract infections (UTIs). A UTI occurs when bacteria that aren’t normally in the bladder get inside the urethra and begin to multiply in the bladder. Bodies are designed to keep out invading bacteria. But sometimes bacteria get inside anyway.
Signs of urinary tract infections are a semi-constant tickling urge to pee, pain while peeing, peeing often in small amounts, and cloudy urine that smells bad. If you have any of these symptoms, see a doctor. If left untreated, UTIs can spread from a minor annoyance to a full-blown kidney infection. Antibiotics or natural remedies can treat UTIs. See your doctor for advice and treatment ASAP if you suspect you have a UTI.
People with vulvas are at a higher risk for UTIs because the urethra is close to the vaginal opening. Sometimes sexual activity can bring bacteria from the vagina into the urinary opening, causing a urinary tract infection. Peeing after sex reduces the risk of UTIs, so doctors will often recommend that people with vulvas go to the bathroom within fifteen minutes of vaginal intercourse.
The Yeast of Your Problems
Yeast infections are another common condition that happens to 75 percent of people with vulvas. They’re not fun. A yeast infection comes with vaginal itching, swelling around the vagina, soreness, and pain during vaginal sex.
A healthy vagina contains bacteria and some yeast cells. But when the balance of bacteria and yeast changes, the yeast cells can multiply. Anything that helps bacteria grow out of control can cause yeast infections. To reduce the risk of yeast infections, do the following:
Towel off really well after showering. Completely dry your groin.
Don’t use scented tampons or pads.
Wear breathable cotton underwear (and pants, tights, and leggings that aren’t too tight!).
Change your tampons or menstrual pad at least every four hours.
If you think you might have a yeast infection, see your doctor for a diagnosis and treatment. Over-the-counter medications, available to people of all ages, will usually do the trick.
Kissing Problems
If you want to kiss someone, be aware of two kissing-related diseases. The first is oral herpes, a.k.a. cold sores. Herpes lives in the bloodstream of half of all Americans. Many people with this virus never have any symptoms. Most people (90 percent!) who have the oral herpes virus don’t even know it. For other people, the virus will cause sores around the mouth. Some people get sores every few months, usually when they’re stressed out, sick, tired, or about to get their period. The sores are clusters of little blisters that scab over. Cold sores go away on their own after about a week.
Cold sores hurt! And they’re contagious. Herpes is spread by direct skin-to-skin contact between a cold sore and someone else’s mouth or genitalia. You can’t get herpes from sharing silverware, cups, or pillows with someone who has a cold sore. If you have oral herpes, see your doctor for a prescription antiviral medication that clears up cold sores quickly and reduces the frequency of outbreaks. Over-the-counter and prescription creams help cold sores heal faster. Long story short: If you have a cold sore, don’t kiss anyone on the mouth or put your mouth on their genitals.
The other disease to know about is mononucleosis, or mono. Mono is a virus that is transmitted through saliva. You can get it through kissing but also through saliva droplets in the air from sneezing or coughing. You can also get it from sharing drinks or utensils with someone who has mono. If you have mono, you’ll likely have a fever, a sore throat, and fatigue. If you have these symptoms, see a doctor. The clinic can test to see if you have mono and tell you how to deal with it. If you have mono, cover your coughs and sneezes and don’t kiss anyone until the virus has gone away. There’s no quick cure for mononucleosis. You have to wait, rest, and take care of yourself (often for weeks) while the body fights the infection.
Sexually Transmitted Infections (STIs)
STIs are infections that spread through sexual contact—any combination of contact between a mouth, vulva, penis, or anus. Before you are sexually intimate with another person, talk about your sexual histories and the risk of STIs. The best ways to prevent STIs are
not having sex at all,
using condoms during sex, and
having sex that doesn’t involve genital-to-genital or mouth-to-genital contact.
To prevent the spread of STIs, it’s absolutely essential to know whether you have any! A lot of STIs have few or no symptoms but are still contagious, so get tested! If you’re sexually active, get tested for STIs at least once a year. If you have several partners, get tested more often. Any doctor’s office can test for STIs, and many cities in the United States have public health clinics that will test for free or at low cost. Because they’re part of your medical record, all STI tests are always 100 percent confidential. It is against the law for a doctor or any other medical staff to share the results with your family, employer, or the public.
Many people don’t get tested for STIs because they’re embarrassed. But STIs are very common. Half of sexually active people in the United States will have an STI by the age of twenty-five. These are the six most common STIs in the United States:
Human Papillomavirus (HPV)
HPV is the most common STI. Researchers estimate that at least 80 percent of sexually active Americans will have an HPV infection during their lifetime. Most of the forty known strains of HPV have no symptoms. The body gets rid of them without your ever knowing about it. Some strains of HPV cause genital warts, and others cause infections in the mouth and throat. The most dangerous strains cause a variety of cancers, including cancers of the cervix, vulva, vagina, penis, or anus. HPV vaccines protect against HPV strains that cause cervical cancer and genital warts. The Centers for Disease Control and Prevention recommends young women aged eleven to twenty-six and young men aged eleven to twenty-one get vaccinated.
Chlamydia
Chlamydia is the most commonly reported STI. Bacteria causes this infection, which is treated with antibiotics. Most people have no symptoms. Some people notice an unusual discharge from the vagina or penis or pain or burning when they pee. You’re contagious even if you don’t have symptoms. In 2015 rates of chlamydia, gonorrhea, and syphilis reached a record high. Researchers aren’t sure why, but they think it
could be because fewer people are using condoms during vaginal and anal sex. If left untreated, chlamydia can lead to pelvic inflammation in women and difficulty getting pregnant.
Gonorrhea
Gonorrhea, also known as the clap, has similar symptoms to chlamydia. Most people have none. Some people experience unusual discharge and pain or burning when they pee. A doctor will prescribe antibiotics if you have this STI. If left untreated, gonorrhea can lead to long-term pain and a host of fertility problems.
Syphilis
At first, the main symptom of syphilis is a sore at the original site of infection. Then it turns into a rash, followed by more sores on the mouth, vulva, or anus. Left untreated, syphilis causes organ, nerve, and brain damage. In extreme cases, it can also cause death. Be sure to see a doctor if you suspect you have this STI. It can be treated with antibiotics.
Genital Herpes
Genital herpes is a strain of the herpes virus that causes sores on the penis, vulva, or anus. It can be spread by any genital-to-genital or mouth-to-genital contact if one of the sexual partners has a herpes sore. Genital herpes outbreaks can be suppressed by one of several antibiotics. Studies have shown that antibiotics can also reduce the number of outbreaks by at least 75 percent if the medication is taken regularly. Be sure to check with a doctor if you think you have genital herpes. And remember that if you have oral herpes, you do not automatically have genital herpes and vice versa.
