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SICK & WELL
HEALTH CARE
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PROMOTING
HEALTHY LIVING
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PREVENTING
DISEASE
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ABOUT US
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Just For Teens
Puberty
Puberty can be one of the roughest times in life. Sometimes it helps to remember that everyone goes through it and
some adults would gladly live through those years again! Your family and friends can help you through this time and
you can help yourself by knowing what to expect. Ask your friends, parents or a trusted older adult lots of questions.
Read books or websites. Talk to your parents. They’re probably as stressed out about your puberty as you are but
they love you and will support you and they were once there themselves! Most importantly, respect and accept your
body. Smoking, using drugs, drinking alcohol and having sex when you are not ready can be harmful. Eat properly
and get plenty of rest and exercise. The body and attitude you develop now will be yours for the rest of your life!
Puberty hits anywhere from age 8 to 18. Your body is producing more hormones and you begin to change on the
inside and the outside. For girls the main hormone causing these changes is estrogen. For boys the hormone is
testosterone. You may notice changes in your body or your feelings may change a lot. You may feel differently about
your family, friends or classmates. These changes, although they can be awkward, are completely natural.
Both boys and girls will gain weight and grow taller at around age 11. You’ll grow body hair and develop acne (“pimples”
or “zits”). Both boys and girls will develop deeper and stronger voices although the change in boys is often more noticeable.
The changes in estrogen and testosterone can cause mood swings and intense emotional reactions in both boys and girls.
Other emotional changes can include: feeling concerned about how your body looks and how other people’s bodies compare
to yours, feeling awkward or embarrassed, feeling sexual curiosity and attraction to other people (like crushes!) and wanting
more independence from your parents.
Puberty For Girls
When am I going to start my period?
Your period or “menstruation” may begin around age 13 (sometimes a few years younger, sometimes a few years older).
It mostly depends on your own body’s development, weight and hormones.
What is a period?
Your menstrual cycle (“period”) is the monthly discharge of blood and tissue from the uterus. The bloody discharge
comes through the vagina to exit the body and may last between two to seven days. It is normal to lose one-half to
a cup of blood and tissue each month. Menstrual cycles usually begin irregularly but will start happening around
every 28 days as you get older. You should always use pads or tampons to absorb the blood.
Menstruation is the bloody discharge caused when the uterus sheds built up tissue every month. Every menstrual
cycle the uterus begins to build up tissue and blood vessels to nourish the tissue. If an egg is fertilized by a sperm
cell following sex, the fertilized egg can become lodged in the uterus and starts to develop. This is pregnancy. If an
egg is not fertilized the uterus sheds the built up tissue, which causes some bleeding, to begin again for the next
month’s egg. Because your period starts 2-3 weeks after an egg is ready to be fertilized, girls can become pregnant
before ever having a first period! Menstruation is perfectly normal and lets you know that your reproductive system is
working.
What is PMS?
Hormones cause premenstrual syndrome (PMS). PMS can make you “moody” or have cramps. Some girls have it
worse than others. Some girls know when they are going to begin their period because they notice their PMS symptoms
in the days before their period starts.
How do I choose between pads or tampons?
Pads and tampons are the “feminine hygiene” products used to absorb the menstrual blood flow. Pads are worn on the
inside lining of the underwear and should be changed every four to five hours. Overnight pads should be changed every
eight hours. Using them longer can cause a bad smell. Tampons are absorbent cotton inserted into the vagina. They
should be changed every four hours. A very rare bacterial infection called TSS (Toxic Shock Syndrome) is associated
with leaving tampons in for more than four hours. The package insert that comes with tampons has more information on
TSS. Pads do not have the same risk of TSS.
You may want to try both to see what works best for you. Some use tampons during the day and pads at night because
of the TSS risk associated with leaving tampons in too long. Experiment to find what is right for you. Also, many girls
have extra pads or tampons around at home or at school so that they have them when needed. You can tuck them away
in a purse or backpack. Planning ahead can save you some future embarrassment!
When will I begin to develop breasts?
Girls will begin to grow larger breasts around age 11. Breast size and shape depends on what you are going to look like
as an adult. Sometimes one breast grows faster or is larger than the other. That is perfectly normal.
How will I know when I need a bra?
If you feel more self conscious without a bra than with one, get a bra. If you feel like you would be more self conscious
with a bra on, don’t wear one. If you go ahead and get one you’ll have it when you decide you need it. It is your body to
take care of so it should be your decision!
How do I choose a bra?
Bras come in all shapes, sizes, colors and materials. The most important two things to know is the bra size number and
letter. The number is the inches around your chest. The letter is the cup size your breasts are. The bra should be snug
around your chest but not too tight. The cup should be large enough that your breasts don’t pillow out around the edges
but small enough that the cup does not fold or raise up off your skin. Most girls start out with a “training” bra that does
look a lot like athletic bras. These kind provide general support based more on your chest size than cup size. The best
advice is to keep trying them on until you found something you like.
How do I know when I need to start using deodorant?
During puberty hormones are changing and so is your body chemistry. You will begin to sweat more which can lead to
smelly underarms and feet or oily faces and acne. Bacteria that live off of sweat can make your sweat smell bad,
especially as you begin to grow hair in your armpits. You may need to change your socks and shoes more often. You
may want to bathe or wash your face more often. Antiperspirant and deodorants are used under the arms.
Antiperspirant stops you from sweating as much. Deodorant stops the bacteria from making your sweat smell. Most
likely if you are developing acne, you need to think about deodorant too. They come in lots of different kinds: solid
powders, gels, roll-on liquids and many different smells. Choose the one that you think works or smells the best.
Puberty For Boys
How do I know when I’ve hit puberty?
Around age 12 boys begin seeing the physical changes of puberty. Their penises and scrotum (“balls”) grow larger and
are more sensitive to the touch. Then at around age 13-14 they’ll hit a growth spurt. They grow larger hands, feet and
ears while their shoulders will become broader and their muscles will become larger. They’ll begin having frequent
erections (the penis becomes erect or “hard”) and ejaculations – the release of semen through the penis. These are all
very normal changes that all boys go through during puberty.
How do I know when I need to start using deodorant?
During puberty hormones are changing and so is your body chemistry. You will begin to sweat more which can lead to
smelly underarms and feet or oily faces and acne. Bacteria that live off of sweat can make your sweat smell bad,
especially as you begin to grow hair in your armpits. You may need to change your socks and shoes more often.
You may want to bathe or wash your face more often. Antiperspirant and deodorants are used under the arms.
Antiperspirant stops you from sweating as much. Deodorant stops the bacteria from making your sweat smell. Most
likely if you are developing acne, you need to think about deodorant too. They come in lots of different kinds: solid
powders, gels, roll-on liquids and many different smells. Choose the one that you think works or smells the best.
Am I developing breasts?
Yes. Many boys have larger and more sensitive breasts for a short time. It is because of all the changes in your hormones.
It will go away. It is temporary.
When am I going to get facial hair?
You will begin to notice hair on your face, cheeks, chin, upper lip and sometimes throat. The amount and where it shows
up depends on what you are going to look like as an adult. It is generally the same color as the hair on your head. It may
grow quickly or very slowly. You may choose to shave it all off until it looks more full and less patchy. You may choose
to shave some and leave other parts for a moustache or beard. This is something you will likely change throughout your
adulthood so have fun with it.
Why do I get erections for no reason?
It can happen because you are thinking about something sexy or for no reason other than your hormones. It is perfectly
normal and will go away. It will stop happening as you get older.
What is a wet dream?
A wet dream or “nocturnal emissions” happen when a boy is sleeping. It doesn’t mean you were having a dream about
sex. It just happens.
Peer Pressure
Puberty is a time when you discover who you are, often by comparing yourself to others. It is also a time to discover who
you are not. Trying to make new friends or keep old ones can be a challenge when all of you are going through the same
physical and emotional changes. Knowing how you feel about yourself is the first big step in handling peer pressure. It’s
OK to choose your own limits, rather than going along with the limits of your friends – or those who are not your friends.
It is an important part of finding your identity and respecting yourself. Peer pressure can be difficult to fight but there are
some things you can do to ease the pressure and discover the real you.
What if someone is trying to pressure me into having sex?
If you have not decided that you want to have sex, if you have had sex before but want to find the right person before doing
it again or even if you have had sex with this same person but do not want to have sex again, you always have the right to
say “no”. Some girls think it's cool to date older guys. Older guys may be ready for sex when you're not. Remember it's
your choice, you decide. If the person does not take “no” for an answer it is rape. There are some things you can do to
avoid a situation where it would be more difficult to say “no”:
Don’t date just one person. The average age of people get married for the first time is in the mid to late 20’s. You have a
lot more people to meet before you make up your mind!
Hang out with different groups of people. New people have different ideas on life, dating, sex, family, drugs, etc. Find
friends who share your beliefs and what is important to you.
Invite people to hang out at your house while an adult is at home. (You don’t have to hang out with the adult, however. )
When you go on a date, go with other couples or go with friends and include your date.
Be ready to leave the situation. Call your parents, trusted adult or other friends to pick you up if you need to leave a date.
Carry money for a pay phone or a cell phone in case you want to call a taxi or other trusted adult to pick you up if you need to
leave the situation.
Think of what you would say in advance in case someone tries to pressure you. Practice saying “no” and mean “no” if that’s
how you feel.
Never feel obligated to “pay someone back” with sex for a gift or for paying for your date. You can refuse gifts, return them or
go stag on dates (you each pay your own way) to avoid feeling this way.
Finally, never feel like you need to have sex because you’ve had sex before – even with the same person. You always have a
right to say “no”.
What if someone is trying to pressure me into using drugs?
If you know that drugs are not for you, whether it is cigarettes, alcohol or marijuana, you always have the right to say “no”.
There are some things you can do to avoid a situation where it would be more difficult to say “no”:
Hang out with different groups of people. New people have different ideas on life, dating, sex, family, drugs, etc. Find friends
who share your beliefs and what is important to you.
Invite people to hang out at your house, letting them know that drugs are not accepted at your home.
Be ready to leave the situation. Call your parents, trusted adult or other friend to pick you up if you need to leave. Carry
money for a pay phone or a cell phone in case you want to call a taxi or other trusted adult to pick you up if you need to
leave the situation.
Think of what you would say in advance in case someone tries to pressure you. Practice saying “no” and mean “no” if
that’s how you feel.
Not Having Or Having Sex
Sex can be fun, but "fun" only lasts for a moment. Sex is a responsibility that can carry consequences that can last for
a lifetime such as a sexually transmitted infection (STI) or an unplanned pregnancy. How do you pan to protect yourself
from sexually transmitted infections or pregnancy? How will this change your mental health? Will this affect the friends
you have? Whatever your decision is, you are the one who will have to face yourself in the morning. Keep in mind that
there are always people around who love you who can help you with your decision. If you do not feel like you can talk
with your mom or dad, sometimes a trusted friend, school nurse or counselor is separate enough from your situation that
you could talk with them honestly and openly about your questions. Always know that if you do decide to have sex, you
can decide not to have sex any more until you feel you’re ready again.
What does “having sex” mean?
Having sex is something you do. Sex can be between a male and a female, between two females, between two males,
between more than two people, or by yourself (“masturbation”). Sex doesn’t just mean when a man’s penis enters a
woman’s vagina. There are other types of intimate actions such as manual, oral or anal sex. Many people confuse love
and sex. Love is an emotion that can include romantic feelings or sexual attraction but it is not the action of having sex.
Can I decide not to have sex?
Yes! Many teens assume everyone is “doing it” when in fact more than half of high school seniors graduate without every
having had sex. Having sex for the first time is a huge emotional event so there are some things you may want to ask
yourself before you get into the “heat of the moment”. How am I going to feel about myself after I have sex? How will I
feel about my partner afterwards? Am I doing this for the right reasons? Will I feel like I need to lie about having had sex?
Am I going to feel guilty? How do my parents feel about me having sex? What would the leaders of my faith say about it?
Remember, if you are not having sex you don’t have to worry about getting pregnant or getting a girl pregnant. You don’t
have to worry about contracting many of the STIs, some of which are NOT CURABLE. If your boyfriend/girlfriend and you
break up you don’t have to stress about him/her spreading rumors around school about you having sex. And if you don’t
have children, you have more time to hang out with friends and doing what teenagers do instead of having to take on the
responsibilities of being a young parent.
Can I decide that I want to have sex?
Yes. Deciding to have sexual intercourse with another person is a very personal and private matter. There are many
reasons teens give for choosing “yes”. Some are: they want to feel accepted, it feels good, it’s “cool”, it’s easier than
saying “no”, to feel close to their partner, they felt pressured, they’re in love, they want to experiment. Once you have
decided to have sex there are other decisions you’ll need to make:
Am I sure that no one is pushing me into having sex?
Does having sex go against my personal values or the values I was raised with?
If the relationship breaks up, will I be glad I had sex with this person?
Am I absolutely sure my partner is not infected with an STI?
Am I taking precautions to prevent STIs or pregnancy?
If I have a child, am I responsible enough to provide for its emotional and financial support?
What if I’m gay?
Sexual attraction usually begins during the teenage years. Sexual orientation is not the same thing as sexual activity.
Having sex doesn’t make you straight and not having sex doesn’t make you gay. Sexual orientation can be attraction to
members of the opposite or same sex. Gay or lesbian teens often have feelings of being different, not fitting in or rejection
and there are very few role models for gay or lesbian teenagers. These feelings of being alone can make sexual partnerships
seem more fragile. Safe sex may not be something a questioning teen would fight for if he or she thought it would ruin the
relationship, but that does not eliminate the risk. Some estimates suggest that one out of every five HIV+ men were infected
during the teenage years. Just remember that there are always people around who love you who can help you with your
decision. If you do not feel like you can talk with your mom or dad, sometimes a trusted friend, school nurse or counselor is
separate enough from your situation that you could talk with them honestly and openly about your questions. Remember
some decisions can impact the rest of your life.
Drugs, Alcohol and Sex
Using drugs or alcohol can make it hard to make decisions best for you and stick with them. If you make decisions
under the influence of drugs or alcohol it may be a decision that you’ll regret later. Your actions while under the influence
of drugs or alcohol are not excusable. They still have consequences and some of them can change the rest of your life.
Even worse, some people would use your altered condition to force you into doing things you normally would not want to
do. You may have to accept that you put yourself in a vulnerable position but you never “ask” to be sexually assaulted.
Even more dangerous than the influence of drugs and alcohol is the “date rape” drug, also called GHB or “roofies”. It is
usually mixed into a drink. If you fall asleep drunk or pass out at a party, it is possible that someone has slipped GHB
into your drink to have sex with you against your will. Try to have a friend watch out for you, or your drink if you decide to
drink. Most importantly, if you have been hurt sexually it is not your fault. You should not feel guilty or ashamed. Talk
with someone you can trust, like a friend or parent, or contact SAFE at 838-7233.
Drugs
Someone hurt me
Sexual assault or rape is when someone forces sexual activity on your body against your will. If it is a date or someone you
know it is considered date rape or acquaintance rape. It is a scary experience and it can make you feel guilty, angry, dirty
and responsible. If you live in an abusive household or if you are a survivor of rape, find help soon so that you can feel safe
and start to heal. Always remember that it was not your fault. You should not feel guilty or ashamed. Talk with someone
you can trust, like a friend or parent, or contact SAFE at 838-7233.
For more information on violence against teens, not just sexual assault, please visit
http://www.nlm.nih.gov/medlineplus/teenviolence.html
Sexually Transmitted Infections (“Venereal Disease”)
How can I best protect myself against STIs?
Abstinence is the best protection against STIs. If you choose to have sex, latex condoms give you the best level of
protection against STI. They keep your body from coming into contact with your boyfriend's or girlfriend's sex fluids.
Hormonal types of birth control such as “the pill” or depo provera protect against pregnancy, but not against STIs. If you
do have sex the best protection is to use both hormonal types of birth control and latex condoms to prevent pregnancy and
transmission of STIs.
Can I get an STI from a toilet?
It is possible, but not very likely, that you could catch public lice (“crabs”). Most STIs are only passed during sexual contact,
either by skin to skin contact or through body fluid exchange. Pubic lice, also called “crabs” can be passed through sexual
contact, sleeping in infected bedding, sharing infected clothing and possibly even through sitting on an infested toilet seat.
Lice cannot survive away from the human body for longer than 24 hours though so catching them from a toilet seat is unlikely.
Can I get HIV or another STI from getting a tattoo or through body piercing?
It is possible to catch the STIs that are passed through blood, such as HIV, Hepatitis B or Hepatitis C even though tattooing
and body piercing is not sexual activity. The instruments in the parlor used for piercing or tattooing must be sterilized or
disinfected between clients. Any instrument used to pierce or cut the skin should be used once and thrown away, or
thoroughly cleaned and sterilized before using them again. Ask the staff at the parlor about their equipment. They will show
you what precautions they use. Many places will open a brand new needle in front of you.
Can I get an STI from kissing?
It is possible, but not likely. If your partner’s genitals are infected, kissing mouth to mouth will not pass the disease. If
your partner's mouth has fever blisters or cold sores then the disease can be passed to your mouth while kissing.
Diseases like HIV or Hepatitis B and C are blood-borne. They can only be passed through kissing if blood is passed
during the kiss.
Can I get an STI from oral sex?
Yes. STIs are passed when there is skin to skin contact or body fluid exchange. It is important to use protection against
STIs during oral sex.
How do I know if my partner has an STI?
You may not know unless he or she tells you. One out of every four teenagers will get an STI during the teenage years.
Some people don’t ever have visible symptoms even if they do have an STI, so they might not even know if they have one.
The best protections from STIs are abstinence or latex or polyurethane condoms if you choose to have sex.
What happens if I get a STI?
Many STIs can be cured, like gonorrhea, chlamydia and syphilis. Other STIs, like herpes, genital warts or HIV cannot be
cured but there are treatments that make the symptoms less painful or frequent. It is important to get checked for an STI as
soon as you believe you have one. Some STIs can get a lot worse, spread to other internal organs, cause you to be very
very sick and can damage your reproductive organs too much to have children naturally.
Every year 15 million people are diagnosed with STIs and close to 4 million of them are teenagers. There are several reasons
why one quarter of all STIs diagnosed every year are in teenagers. Many teens are too embarrassed to buy condoms.
(If you are too embarrassed to buy condoms, how are you going to feel about putting a condom on! Are you sure you are
ready?) Teens say they felt pressured from their dates or friends. Many become sexually active under the use of alcohol
or other drugs, lose some respect for themselves and then take risks they wouldn’t have taken earlier. Teens have said that
they thought using birth control pills also protected against STIs (they don’t) or they didn’t think ahead of time. Some were
too embarrassed to ask questions.
No matter what STI you are diagnosed with, you may experience a whole bunch of different emotions. Many people won’t
tell anyone because they are embarrassed. If they are too embarrassed to see their healthcare provider, then that can be
dangerous. Sometimes partners feel betrayed or like victims. Keep in mind that STIs are very common. They do not make
you dirty or a bad person. The best way to keep from ever feeling this way is to protect your body. Don’t have sex until you
are ready and if you choose to have sex, be safe.
Preventing Pregnancy
How can I best protect myself against pregnancy?
Abstinence is the best protection against both STIs and pregnancy. If you choose to have sex, hormonal types of birth
control such as “the pill” or depo provera protect against pregnancy. Latex condoms protect against pregnancy because
they are barriers. They keep the sperm and egg from coming into contact. If you take one of the hormonal types of birth
control you still need to use condoms to protect yourself against transmission of STIs.
Birth Control for Pregnancy and STI Prevention
How do you use condoms?
There are several tips to remember when putting on a condom:
The penis should be erect (hard) and the condom should be put on before the penis touches your partner.
Check the date on the condom package to make sure it has not expired.
Don’t use your teeth, fingernails or anything sharp to open the condom packet. You could put a small hole in it.
Leave a small “reservoir tip” at the end of the condom when putting it on by pinching the end of the condom before
placing the condom on the head of the erect penis. This is where the semen will go when you ejaculate. It is also
important to squeeze the air out of the reservoir tip. Most condoms have a nipple-shaped end to remind you about
the reservoir tip.
Roll the condom down the erect penis. If the condom will not roll, it's on upside down. Do not turn it over. You may
have already gotten body fluids on the outside of the condom. Throw the old condom away and get a new one.
Unroll the condom until it covers most of the penis shaft. Squeeze out any air bubbles before insertion by running your
hand down the shaft of the penis.
When intercourse is complete, hold the condom securely at the base of the penis and withdraw before the penis goes
soft. Holding the condom on prevents it from slipping or spilling.
Throw the condom away after it's been used.
Never ever reuse a condom.
We used a condom so why do I burn and itch after sex? Do I have an STI?
Some people are allergic to latex. They will develop intense redness, swelling, itching or burning on the area that has
made contact with the latex. Some condoms are made from lambskin. These prevent pregnancy but are not protection
against some STIs such as HIV. There are also condoms are made of polyurethane so you do not have that reaction.
Polyurethane condoms also are not broken down by petroleum-based products like latex condoms are. The type of
materials condoms are made from are listed on the box. There are also people who are allergic to Nonoxenol-9, the
spermicide often used in condom lubrication. You can find non-lubricated condoms at most places where condoms are
sold. If you still have itching and burning a few hours after using a condom, you may want to be checked for an STI.
What is the “morning after pill?”
The “morning after pill,” also known as “Plan B” is actually two pills that must be taken within 72 hours of the risky
sexual encounter to prevent pregnancy. If a pregnancy has already been established, no harm is done to the developing
fetus. The Health Department will provide the “morning after pill” to individuals one time only.
If I come to the Health Department for birth control are you going to tell my parents?
No, at least not unless your life is in danger. North Carolina State Law requires that Wilkes County Health Department
provide services to minors upon their request without parental consent unless their lives are threatened. The services
will not be filed on your parents’ insurance and the cost of the services will be calculated on a sliding fee scale based
your income, not your parents’. We do encourage minors to discuss their health needs with their parents or guardians.
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