Abstinence is not having sex. A person who decides to practice abstinence has decided not to have sex.
How Does It Work?
If two people don't have sex, then sperm can't fertilize an egg and there's no possibility of a pregnancy. Some forms of birth control depend on barriers that prevent the sperm from reaching the egg (such as condoms or diaphragms). Others interfere with the menstrual cycle (as birth control pills do). With abstinence, no barriers or pills are necessary because the person is not having sex.
You don't have to be a virgin to practice abstinence. Sometimes people who have been having sex decide not to continue having sex. Even if a person has been having sex, he or she can still choose abstinence to prevent pregnancy and sexually transmitted diseases (STDs).
How Well Does It Work?
Abstinence is 100% effective in preventing pregnancy. Although many birth control methods can have high rates of success if used properly, they can fail occasionally. Practicing abstinence ensures that a girl will not become pregnant because there is no opportunity for sperm to fertilize an egg.
Protection Against STDs
Abstinence protects people against STDs. Some STDs spread through oral-genital sex, anal sex, or even intimate skin-to-skin contact without actual penetration (genital warts and herpes can be spread this way). So only avoiding all types of intimate genital contact can prevent STDs. Avoiding all types of intimate genital contact — including anal and oral sex — is complete abstinence.
Only complete and consistent abstinence can totally prevent pregnancy and protect against STDs. Because a person does not have any type of intimate sexual contact when he or she practices complete abstinence, there is no risk of passing on a sexually transmitted infection.
Consistent abstinence means that someone practices abstinence all the time. Having sex even once means that the person risks getting an infection.
Abstinence does not prevent AIDS and hepatitis B infections that come from nonsexual activities like using contaminated needles for doing drugs, tattooing, or taking steroids.
How Do You Do It?
Not having sex may seem easy because it's not doing anything. But peer pressure and things you see on TV and in the movies can make the decision to practice abstinence more difficult.
If it seems like everybody else is having sex, some people may feel they have to do it, too, just to be accepted. Don't let kidding or pressure from friends, a girlfriend, a boyfriend, or even the media push you into something that's not right for you. The truth is that most teens are not having sex.
A couple can still have a relationship without having sex. If you've made a decision not to have sex, it's an important personal choice and the people who care about you should respect that.
You may have questions about making this choice or about other methods of birth control. Your doctor or nurse — or an adult you trust, such as a parent, teacher, or counselor — can help provide some answers.
One of the toughest decisions that a lot of teens face is whether to have sex. If people decide to have sex, it means they must also take responsibility to protect themselves from unplanned pregnancy and sexually transmitted diseases (STDs).
In the United States, the teenage pregnancy rate is higher than in many other countries. Approximately 1 million teens become pregnant every year and most of them don't plan on becoming pregnant. In addition to preventing unplanned pregnancies, people who have sex must protect themselves from STDs. For those having sex, condoms must always be used every time to protect against STDs.
The most effective method of birth control is abstinence, which means no sexual intercourse. Abstinence is the only way that couples can be 100% sure they will not have to deal with pregnancy or STDs.
For couples who do choose to have sex, there are many effective birth control methods to choose from. Check the articles below to learn some important information about different methods of birth control. You may be surprised — some popular methods aren't as effective as people might think.
Chlamydia (pronounced: kluh-mid-ee-uh) is a sexually transmitted disease (STD) that is caused by bacteria called Chlamydia trachomatis. Although you may not have heard its name, chlamydia is one of the most common STDs. Because there often aren't any symptoms, though, lots of people can have chlamydia and not know it.
The bacteria can move from one person to another through sexual intercourse, and possibly through oral-genital contact. If someone touches bodily fluids that contain the bacteria and then touches his or her eye, a chlamydial eye infection is possible. Chlamydia also can be passed from a mother to her baby while the baby is being delivered. This can cause pneumonia and conjuntivitis, which can become very serious for the baby if it's not treated. You can't catch chlamydia from a towel, doorknob, or toilet seat.
How Does a Girl Know She Has It?
It can be difficult for a girl to know whether she has chlamydia because most girls don't have any symptoms. Chlamydia may cause an unusual vaginal discharge or pain during urination. Some girls with chlamydia also have pain in their lower abdomens, pain during sexual intercourse, or bleeding between menstrual periods. Sometimes a chlamydia infection can cause a mild fever, muscle aches, or headache.
How Does a Guy Know He Has It?
Like a girl, a guy can also have a difficult time telling whether he has chlamydia. Some guys may have a discharge from the tip of the penis (the urethra — where urine comes out), or experience itching or burning sensations around the penis. Rarely, the testicles may become swollen. Many times, a guy with chlamydia may have few or no symptoms, so he might not even know he has it.
When Do Symptoms Appear?
Someone who has contracted chlamydia may see symptoms a week later. In some people, the symptoms take up to 3 weeks to appear, and many people never develop any symptoms.
What Can Happen?
If left untreated in girls, chlamydia can cause an infection of the urethra (where urine comes out) and inflammation (swelling and soreness caused by the infection) of the cervix. It can also lead to pelvic inflammatory disease (PID), which is an infection of the uterus, ovaries, and/or fallopian tubes. PID can cause infertility and ectopic (tubal) pregnancies later in life.
If left untreated in guys, chlamydia can cause inflammation of the urethra and epididymis (the structure attached to the testicle that helps transport sperm).
How Is It Treated?
If you think you may have chlamydia or if you have had a partner who may have chlamydia, you need to see your family doctor, adolescent doctor, or gynecologist. Some local health clinics, such as Planned Parenthood, can also test and treat people for chlamydia.
The doctor will do an that may include swabbing the vagina or penis for secretions, which will then be analyzed. Sometimes doctors can diagnose chlamydia by testing a person's urine. Talk to your doctor about which test is best for you.
If you are diagnosed with chlamydia, the doctor will prescribe antibiotics, which should clear up the infection in 7 to 10 days. Anyone with whom you've had sex will also need to be tested and treated for chlamydia because that person may be infected but not have any symptoms. This includes any sexual partners in the last 2 months or your last sexual partner if it has been more than 2 months since your last sexual experience. It is very important that someone with a chlamydia infection abstain from having sex until they and their partner have been treated.
If a sexual partner has chlamydia, quick treatment will reduce his or her risk of complications and will lower your chances of being reinfected if you have sex with that partner again. (You can become infected with chlamydia again even after you have been treated because having chlamydia does not make you immune to it.)
It's better to prevent chlamydia than to treat it, and the only way to completely prevent the infection is to abstain from all types of sexual intercourse. If you do have sex, use a latex condom every time. This is the only birth control method that will help prevent chlamydia.
Sexually transmitted diseases (also known as STDs and once called venereal diseases or VD) are infectious diseases that spread from person to person through intimate contact. STDs can affect guys and girls of all ages and backgrounds who are having sex — it doesn't matter if they're rich or poor.
Unfortunately, STDs have become common among teens. Because teens are more at risk for getting some STDs, it's important to learn what you can do to protect yourself.
STDs are more than just an embarrassment. They're a serious health problem. If untreated, some STDs can cause permanent damage, such as infertility (the inability to have a baby) and even death (in the case of HIV/AIDS).
How STDs Spread
One reason STDs spread is because people think they need to have sexual intercourse to become infected. That's wrong. A person can get some STDs, like herpes or genital warts, through skin-to-skin contact with an infected area or sore. Another myth about STDs is that you can't get them if you have oral or anal sex. That's also wrong because the viruses or bacteria that cause STDs can enter the body through tiny cuts or tears in the mouth and anus, as well as the genitals.
STDs also spread easily because you can't tell whether someone has an infection. In fact, some people with STDs don't even know that they have them. These people are in danger of passing an infection on to their sex partners without even realizing it.
Some of the things that increase a person's chances of getting an STD are:
Sexual activity at a young age. The younger a person starts having sex, the greater his or her chances of becoming infected with an STD.
Lots of sex partners. People who have sexual contact — not just intercourse, but any form of intimate activity — with many different partners are more at risk than those who stay with the same partner.
Unprotected sex. Latex condoms are the only form of birth control that reduce your risk of getting an STD. Spermicides, diaphragms, and other birth control methods may help prevent pregnancy, but they don't protect a person against STDs.
Preventing and Treating STDs
As with many other diseases, prevention is key. It's much easier to prevent STDs than to treat them. The only way to completely prevent STDs is to abstain from all types of sexual contact. If someone is going to have sex, the best way to reduce the chance of getting an STD is by using a condom.
People who are considering having sex should get regular gynecological or male genital examinations. There are two reasons for this. First, these exams give doctors a chance to teach people about STDs and protecting themselves. And second, regular exams give doctors more opportunities to check for STDs while they're still in their earliest, most treatable stage.
In order for these exams and visits to the doctor to be helpful, people need to tell their doctors if they are thinking about having sex or if they have already started having sex. This is true for all types of sex — oral, vaginal, and anal.
Don't let embarrassment at the thought of having an STD keep you from seeking medical attention. Waiting to see a doctor may allow a disease to progress and cause more damage. If you think you may have an STD, or if you have had a partner who may have an STD, you should see a doctor right away.
If you don't have a doctor or prefer not to see your family doctor, you may be able to find a local clinic in your area where you can get an exam confidentially. Some national and local organizations operate STD hotlines staffed by trained specialists who can answer your questions and provide referrals. Calls to these hotlines are confidential. One hotline you can call for information is the National STD Hotline at 1-800-227-8922.
Not all infections in the genitals are caused by STDs. Sometimes people can get symptoms that seem very like those of STDs, even though they've never had sex. For girls, a yeast infection can easily be confused with an STD. Guys may worry about bumps on the penis that turn out to be pimples or irritated hair follicles. That's why it's important to see a doctor if you ever have questions about your sexual health.
For more information about the signs, symptoms, and treatments of some common STDs, click on the links below.
If you're a guy, you probably know the drill by now: The doctor snaps on a latex glove and tells you to turn your head and cough. You probably wonder, "Why do I have to do this?"
Your doctor is checking you for a condition called a hernia. There are several types of hernias, and they don't just happen to guys — everyone from your baby sister to your grandfather can develop them. But learning to prevent hernias isn't hard to do.
What Are Hernias?
A hernia (pronounced: hur-nee-uh) is an opening or weakness in the wall of a muscle, tissue, or membrane that normally holds an organ in place. If the opening or weakness is large enough, a portion of the organ may be able to poke through the hole. Imagine an inner tube poking through a hole in an old tire — that's what a hernia is like.
Hernias happen more frequently in certain parts of the body, like the abdomen, groin and upper thigh area, and belly button area. They also can happen in any place where you may have had an incision from surgery.
How Do People Get Hernias?
It might take a long time for a hernia to develop or it might develop suddenly. Hernias are caused by a combination of muscle weakness and strain, although the cause of the weakness and the type of strain may vary. Hernias are actually more common in babies and toddlers. And most teens who are diagnosed with a hernia actually have had a weakness of the muscles or other abdominal tissues from birth (called a congenital defect). In these cases, straining your muscles doesn't cause the hernia; it only makes the hernia more apparent (and painful!).
Here are some types of strain on the body that may induce hernias:
obesity or sudden weight gain
lifting heavy objects
diarrhea or constipation
persistent coughing or sneezing
pregnancy
These types of strain on their own probably won't give you a hernia. But when they team up with a weak muscle, a hernia is more likely to result.
Many hernias are discovered during routine physical exams. If you're a guy, you may have had a physical exam where your doctor gave you a testicular exam and checked your testicles for a hernia. By placing a finger at the top of your scrotum and asking you to cough, the doctor can feel if you have a hernia.
It's good for girls to know about hernias, too, because they can affect you, especially if you've been pregnant or are obese. A doctor can check for any possible hernias in girls by gently pressing on the organs or looking for possible signs during an examination.
Types of Hernias
Inguinal Hernias
Inguinal (pronounced: in-gwuh-nul) hernias are more likely to occur in guys than girls. More than 70% of all hernias that occur are inguinal hernias, which means that a part of the intestines protrudes through an opening in the lower part of the abdomen, near the groin, called the inguinal canal. In guys, the inguinal canal is a passageway between the abdomen and the scrotum through which a cord called the spermatic cord passes (the testicles hang from the spermatic cord). In girls, the inguinal canal is the passageway for a ligament that holds the uterus in place. Nearly all cases of inguinal hernias in teens are due to a congenital defect of the inguinal canal. Instead of closing tightly, the canal leaves a space for the intestines to slide into.
If you have an inguinal hernia, you might be able to see a bulge where your thigh and your groin meet. In guys, the protruding piece of intestine may enter the scrotum, which can cause swelling and pain. Other symptoms of an inguinal hernia might include pain when you cough, lift something heavy, or bend over. These types of hernias require surgery to repair; in fact, inguinal hernia operations are the most common type of surgery performed on kids and teens.
Umbilical Hernias
Umbilical hernias are common in newborns and infants younger than 6 months. They occur when part of the intestines bulge through the abdominal wall next to the belly button. In babies with umbilical hernias, parents may see bulging around the belly button area when the baby cries. Unlike other types of hernias, umbilical hernias may heal on their own, usually by the time a baby is 1 year old. If not, surgery can repair the hernia.
Epigastric Hernias
In an epigastric (pronounced: eh-pih-gas-trik) hernia, which is also called a ventral hernia, part of the intestines protrude through the abdominal muscles located between the belly button and the chest. It's mostly guys who have to worry about this type of hernia — about 75% of epigastric hernias occur in males. People with this type of hernia may notice a lump. Surgery is a common way to fix this problem.
Incisional Hernias
If you've had surgery in your abdominal area, you might experience this type of hernia. In incisional hernias, part of the intestines bulge through the abdomen around a surgical incision. In this case, surgery actually weakened the muscle tissue in the abdomen. This type of hernia requires another surgery to repair it.
Hiatal Hernias
This type of hernia occurs at the opening of the diaphragm where the esophagus (the pipe that food travels down) joins the stomach. If the muscle around the opening to the diaphragm becomes weak, the uppermost part of a person's stomach can bulge through the diaphragm. Hiatal (pronounced: high-a-tul) hernias are common, although small ones don't usually cause any symptoms. Unlike the other types of hernia, you won't be able to see a bulge on the outside of your body, but you might feel heartburn, indigestion, and chest pain. Hiatal hernias can be treated with medication and diet changes, but they do sometimes require surgery.
What Do Doctors Do?
If you notice a bulge or swelling in your groin, abdomen, scrotum, or thigh, you should talk to your doctor. Sometimes a hernia may also cause sharp or dull pain and the pain may worsen when you are standing.
With most types of hernias, including inguinal, umbilical, epigastric, and incisional, your doctor will be able to see and feel the bulge and diagnose you with a hernia.
Except for umbilical hernias in babies, hernias don't just go away on their own — you must talk to your doctor and receive treatment. Over time, your hernia may become larger and more painful, and in some cases of hiatal hernia, a piece of the intestine could become trapped (this is known as incarceration). In a true surgical emergency, the blood supply could be cut off to the incarcerated intestine (this is known as strangulation). This situation is painful and dangerous because it can cause infection and may cause the strangulated tissue to die, so it's important to call your doctor.
If you've had a hernia operation and you notice redness or discomfort around your incision (the area where the cut was made to perform the operation), be sure to let your doctor know. It could be a sign of infection that will require further treatment.
Can Hernias Be Prevented?
Here are a few tips for keeping hernias from hurting you:
Stay at a healthy weight for your height and body type. Talk to your doctor or a dietitian about a healthy eating and exercise program if you think you are overweight or obese.
Make fruits, veggies, and whole grains a "regular" part of your diet. Not only are these foods good for you, they're also packed with lots of fiber that will prevent constipation and straining.
Be careful when weight lifting or lifting heavy objects. Make sure you lift weights safely by never lifting anything that's too heavy. If you have to lift something that's heavy, bend from your knees, not at your waist, or don't lift it at all.
See your doctor when you're sick. If you have a persistent cough from a cold or you sneeze a lot because of allergies, see your doctor about cough or allergy medicines.
Quit smoking. Smoking can cause persistent coughing, and this can strain your abdominal muscles. The risk of getting hernias is just one more reason to kick the habit!
Can a girl get pregnant if she has sex during her period? – Jamie*
A lot of people think that if a girl has sex during her period, she can't get pregnant. But it is possible for a girl to get pregnant while she is bleeding. This can happen for a couple of reasons:
Not all vaginal bleeding is the result of a menstrual period. Sometimes a girl will have a small amount of vaginal bleeding at the time of ovulation — the time when she is most fertile. During ovulation, an egg is released from one of the ovaries and travels down a fallopian tube to the uterus. It's common for girls who are ovulating to have some vaginal bleeding that can be mistaken for a period.
Sometimes ovulation can occur before the bleeding from a girl's period has stopped, or it may occur within a few days after her period is over. Sperm can fertilize an egg for several days after ejaculation. So in both cases, having sex before the period is finished can result in pregnancy.
Having unprotected sex at any time is very risky. Along with the chance of becoming pregnant, there is also the risk of getting a sexually transmitted disease (STD), such as chlamydia, genital warts, or HIV. The only surefire way to prevent pregnancy and STDs is abstinence. If you do have sex, use a condom every time to protect against STDs. And talk to your doctor about additional forms of contraception.
Some girls worry that if they use tampons, they will no longer be virgins. The truth is, a virgin is someone who has never had sexual intercourse. Inserting a tampon is definitely not the same as having sex!
So why do girls ask this question so often? Girls who are virgins usually have a hymen, a very thin piece of skin-like tissue that stretches partly across the opening of the vagina. A lot of people mistakenly think that a girl is still a virgin if her hymen has not been broken. Most of the time a girl's hymen breaks after having sex for the first time.
But a girl's hymen can tear in ways that have nothing to do with having sex. For example, it is possible that inserting a tampon might tear the hymen (although that usually doesn't happen). So even if a tampon does break a girl's hymen, she is still a virgin until she has had sexual intercourse.
Menstruation (a period) is a major stage of puberty in girls; it's one of the many physical signs that a girl is turning into a woman. And like a lot of the other changes associated with puberty, menstruation can be confusing. Some girls can't wait to start their periods, whereas others may feel afraid or anxious. Many girls (and guys!) don't have a complete understanding of a woman's reproductive system or what actually happens during the menstrual cycle, making the process seem even more mysterious.
Puberty and Periods
When girls begin to go through puberty (usually starting between the ages of 8 and 13), their bodies and minds change in many ways. The hormones in their bodies stimulate new physical development, such as growth and breast development. About 2 to 2½ years after a girl's breasts begin to develop, she usually gets her first menstrual period.
About 6 months or so before getting her first period, a girl might notice an increased amount of clear vaginal discharge. This discharge is common. There's no need for a girl to worry about discharge unless it has a strong odor or causes itchiness.
The start of periods is known as menarche. Menarche doesn't happen until all the parts of a girl's reproductive system have matured and are working together.
Baby girls are born with ovaries, fallopian tubes, and a uterus. The two ovaries are oval-shaped and sit on either side of the uterus (womb) in the lowest part of the abdomen called the pelvis. They contain thousands of eggs, or ova. The two fallopian tubes are long and thin. Each fallopian tube stretches from an ovary to the uterus, a pear-shaped organ that sits in the middle of the pelvis. The muscles in a female's uterus are powerful and are able to expand to allow the uterus to accommodate a growing fetus and then help push the baby out during labor.
As a girl matures and enters puberty, the pituitary gland releases hormones that stimulate the ovaries to produce other hormones called estrogen and progesterone. These hormones have many effects on a girl's body, including physical maturation, growth, and emotions.
About once a month, a tiny egg leaves one of the ovaries — a process called ovulation — and travels down one of the fallopian tubes toward the uterus. In the days before ovulation, the hormone estrogen stimulates the uterus to build up its lining with extra blood and tissue, making the walls of the uterus thick and cushioned. This happens to prepare the uterus for pregnancy: If the egg is fertilized by a sperm cell, it travels to the uterus and attaches to the cushiony wall of the uterus, where it slowly develops into a baby.
If the egg isn't fertilized, though — which is the case during most of a woman's monthly cycles — it doesn't attach to the wall of the uterus. When this happens, the uterus sheds the extra tissue lining. The blood, tissue, and unfertilized egg leave the uterus, going through the vagina on the way out of the body. This is a menstrual period. This cycle happens almost every month for several more decades (except, of course, when a female is pregnant) until a woman reaches menopause and no longer releases eggs from her ovaries.
How Often Does a Girl Get Her Period?
Just as some girls begin puberty earlier or later than others, the same applies to periods. Some girls may start menstruating as early as age 10, but others may not get their first period until they are 15 years old.
The amount of time between a girl's periods is called her menstrual cycle (the cycle is counted from the start of one period to the start of the next). Some girls will find that their menstrual cycle lasts 28 days, whereas others might have a 24-day cycle, a 30-day cycle, or even longer. Following menarche, menstrual cycles last 21–45 days. After a couple of years, cycles shorten to an adult length of 21–34 days.
Irregular periods are common in girls who are just beginning to menstruate. It may take the body a while to sort out all the changes going on, so a girl may have a 28-day cycle for 2 months, then miss a month, for example. Usually, after a year or two, the menstrual cycle will become more regular. Some women continue to have irregular periods into adulthood, though.
As a girl gets older and her periods settle down — or she gets more used to her own unique cycle — she will probably find that she can predict when her period will come. In the meantime, it's a good idea to keep track of your menstrual cycle with a calendar.
How Long and How Much?
The amount of time that a girl has her period also can vary. Some girls have periods that last just 2 or 3 days. Other girls may have periods that last 7 days or longer. The menstrual flow — meaning how much blood comes out of the vagina — can vary widely from girl to girl, too.
Some girls may be concerned that they're losing too much blood. It can be a shock to see all that blood, but it's unlikely that a girl will lose too much, unless she has a medical condition like von Willebrand disease. Though it may look like a lot, the average amount of blood is only about 2 tablespoons (30 milliliters) for an entire period. Most teens will change pads 3 to 6 times a day, with more frequent changes when their period is heaviest, usually at the start of the period.
Especially when menstrual periods are new, you may be worried about your blood flow or whether your period is normal in other ways. Talk to a doctor or nurse if:
your period lasts longer than a week
you have to change your pad very often (soaking more than one pad every 1–2 hours)
you go longer than 3 months between periods
you have bleeding in between periods
you have an unusual amount of pain before or during your period
your periods were regular then became irregular
Cramps, PMS, and Pimples
Some girls may notice physical or emotional changes around the time of their periods. Menstrual cramps are pretty common — in fact, more than half of all women who menstruate say they have cramps during the first few days of their periods. Doctors think that cramps are caused by prostaglandin, a chemical that causes the muscles of the uterus to contract.
Depending on the girl, menstrual cramps can be dull and achy or sharp and intense, and they can sometimes be felt in the back as well as the abdomen. These cramps often become less uncomfortable and sometimes even disappear completely as a girl gets older.
Many girls and women find that over-the-counter pain medications (like acetaminophen or ibuprofen) can relieve cramps, as can taking a warm bath or applying a warm heating pad to the lower abdomen. Exercising regularly throughout the monthly cycle may help lessen cramps, too. If these things don't help, ask your doctor for advice.
Some girls and women find that they feel sad or easily irritated during the few days or week before their periods. Others may get angry more quickly than normal or cry more than usual. Some girls crave certain foods. These types of emotional changes may be the result of .
PMS is related to changes in the body's hormones. As hormone levels rise and fall during a woman's menstrual cycle, they can affect the way she feels, both emotionally and physically. Some girls, in addition to feeling more intense emotions than they usually do, notice physical changes along with their periods — some feel bloated or puffy because of water retention, others notice swollen and sore breasts, and some get headaches.
PMS usually goes away soon after a period begins, but it can come back month after month. Eating right, getting enough sleep, and exercising may help relieve some of the symptoms of PMS. Talk to your doctor if you are concerned about your premenstrual symptoms.
It's also not uncommon for girls to have an acne flare-up during certain times of their cycle; again, this is due to hormones. Fortunately, the pimples associated with periods tend to become less of a problem as girls get older.
Pads, Tampons, and Liners
Once you begin menstruating, you'll need to use something to absorb the blood. Most girls use a pad or a tampon. But some use menstrual cups, which a girl inserts into her vagina to catch and hold the blood (instead of absorbing it, like a tampon).
There are so many products out there that it may take some experimenting before you find the one that works best for you. Some girls use only pads (particularly when they first start menstruating), some use only tampons, and some switch around — tampons during the day and pads at night, for example.
Girls who worry about leakage from a tampon often use a pantiliner, too, and some girls use liners alone on very light days of their periods.
Periods shouldn't get in the way of exercising, having fun, and enjoying life. Girls who are very active, particularly those who enjoy swimming, often find that tampons are the best option during sports.
If you have questions about pads, tampons, or coping with periods, ask a parent, health teacher, school nurse, or older sister.
Jeff hates gym class. It's not that he minds playing soccer or basketball or any of the other activities. But he does dread going into the locker room at the end of class and showering in front of his friends. Although the other guys' bodies are growing and changing, his body seems to be stuck at a younger age. He's shorter than most of the other guys in his grade, and his voice hasn't deepened at all. It's embarrassing to still look like a little kid.
Abby knows what it's like to feel different, too. The bikini tops that her friends fill out lie flat on her. Most of them have their periods, too, and she hasn't had even a sign of one. Abby doesn't even really have to shave her legs or underarms, although she does it just to be like everyone else.
Both Jeff and Abby wonder and worry, "What's wrong with me?"
What Is Delayed Puberty?
Puberty is the time when your body grows from a child's to an adult's. You'll know that you are going through puberty by the way that your body changes. If you're a girl, you'll notice that your breasts develop and your pubic hair grows, that you have a growth spurt, and that you get your period (menstruation). The overall shape of your body will probably change, too — your hips will widen and your body will become curvier.
If you're a guy, you'll start growing pubic and facial hair, have a growth spurt, and your testicles and penis will get larger. Your body shape will also begin to change — your shoulders will widen and your body will become more muscular.
These changes are caused by the sex hormones (testosterone in guys and estrogen in girls) that your body begins producing in much larger amounts than before.
Puberty takes place over a number of years, and the age at which it starts and ends varies widely. It generally begins somewhere between the ages of 7 and 13 for girls, and somewhere between the ages of 9 and 15 for guys, although it can be earlier or later for some people. This wide range in age is normal, and it's why you may develop several years earlier (or later) than most of your friends.
Sometimes, though, people pass this normal age range for puberty without showing any signs of body changes. This is called delayed puberty.
What Causes Delayed Puberty?
There are several reasons why puberty may be delayed. Most often, it's simply a pattern of growth and development in a family. A guy or girl may find that his or her parent, uncle, aunt, brothers, sisters, or cousins developed later than usual, too. This is called constitutional delay (or being a late bloomer), and it usually doesn't require any kind of treatment. These teens will eventually develop normally, just later than most of their peers.
Medical problems also can cause delays in puberty. Some people with chronic illnesses like diabetes, cystic fibrosis, kidney disease, or even asthma may go through puberty at an older age because their illnesses can make it harder for their bodies to grow and develop. Proper treatment and better control of many of these conditions can help make delayed puberty less likely to occur.
A person who's malnourished — without enough food to eat or without the proper nutrients — may also develop later than peers who eat a healthy, balanced diet. For example, teens with the eating disorder anorexia nervosa often lose so much weight that their bodies can't develop properly. Girls who are extremely active in sports may be late developers because their level of exercise keeps them so lean. Girls' bodies require a certain amount of fat before they can go through puberty or get their periods.
Delayed puberty can also happen because of problems in the pituitary or thyroid glands. These glands produce hormones important for body growth and development.
Some people who don't go through puberty at the normal time have problems with their chromosomes (pronounced: kro-muh-soamz), which are made up of DNA that contain our body's construction plans. Problems with the chromosomes can interfere with normal growth processes.
Turner Syndrome is an example of a chromosome disorder. It happens when one of a female's two X chromosomes is abnormal or missing. This causes problems with how a girl grows and with the development of her ovaries and production of sex hormones. Women who have untreated Turner syndrome are shorter than normal, are infertile, and may have other medical problems.
Males with Klinefelter syndrome are born with an extra X chromosome (XXY instead of XY). This condition can slow sexual development.
What Do Doctors Do?
The good news is that if there is a problem, doctors usually can help teens with delayed puberty to develop more normally. So if you are worried that you're not developing as you should, you should ask your parents to make an appointment with your doctor.
In addition to doing a physical examination, the doctor will take your medical history by asking you about any concerns and symptoms you have, your past health, your family's health, any medications you're taking, any allergies you may have, and other issues like growth patterns of your family members. He or she will chart your growth to see if your growth pattern points to a problem and also may order blood tests to check for thyroid, pituitary, chromosomal, or other problems. You may also have a "bone age" X-ray, which allows the doctor to see whether your bones are maturing normally.
In many cases, the doctor will be able to reassure you that there's no underlying physical problem; you're just a bit later than average in developing. If the doctor does find a problem, though, he or she might refer you to a pediatric endocrinologist (pronounced: en-doh-krih-nah-leh-jist), a doctor who specializes in treating kids and teens who have growth problems, or to another specialist for further tests or treatment.
Some teens who are late developers may have a difficult time waiting for the changes of puberty to finally get going - even after a doctor has reassured them that they are normal. In some cases, doctors may offer teens a short course (usually a few months) of treatment with hormone medications to get the changes of puberty started. Usually, when the treatment is stopped a few months later, the teen's own hormones will take over from there to complete the process of puberty.
Dealing With Delayed Puberty
It can be really hard to watch your friends grow and develop when the same thing's not happening to you. You may feel like you're never going to catch up. People at school may joke about your small size or your flat chest. Even when the doctor or your parents reassure you that things will be OK eventually - and even when you believe they're right — it's difficult to wait for something that can affect how you feel about yourself.
If you're feeling depressed or having school or other problems related to delays in your growth and development, talk to your mom or dad, your doctor, or another trusted adult about finding a counselor or therapist you can talk to. This person can help you sort out your feelings and suggest ways to cope with them.
Delayed puberty can be difficult for anyone to accept and deal with — but it's a problem that usually gets solved. Ask for help if you have any concerns about your development. And remember that in most cases you will eventually catch up with your peers.
Al's friend Rachel invited him to go to the lake for the day with her family. Rachel thought Al was fun to be around — plus he was cute. Rachel really hoped he'd say yes.
Al turned Rachel down. He liked Rachel, too, but was self-conscious about taking off his T-shirt. He worried that her family and others at the lake would see what he saw when he looked in the mirror — a scrawny excuse for a man. Al hadn't gone to the pool in more than a year because he was so self-conscious about his appearance.
The Truth About Guys
Many people think of guys as being carefree when it comes to their appearance. But the reality is that a lot of guys spend plenty of time in front of the mirror. It's a fact — some guys care just as much as girls do about their appearance.
You may hear a lot about being a tough guy, but how often do you hear that being a guy is tough? Guys might think that they shouldn't worry about how they look, but body image can be a real problem for them. Unlike girls, guys are less likely to talk to friends and relatives about their bodies and how they're developing. Without support from friends and family, they may develop a negative self-image. The good news is that self-image and body image can be changed.
Why Is Body Image Important?
Body image is a person's opinions, thoughts, and feelings about his or her own body and physical appearance. Having a positive body image means feeling pretty satisfied with the way you look, appreciating your body for its capabilities and accepting its imperfections. Body image is part of someone's total self-image. So how a guy feels about his body can affect how he feels about himself. If he gets too focused on not liking the way he looks, a guy's self-esteem can take a hit and his confidence can slide. (The same thing can happen to girls, too.)
How Puberty Affects Body Image
Although body image is just one part of our self-image, during the teen years, and especially during puberty, it can be easy for a guy's whole self-image to be based on how his body looks. That's because our bodies are changing so much during this time that they can become the main focus of our attention.
A change in your body can be tough to deal with emotionally — mainly because, well, your body is yours and you have become used to it.
Some guys don't feel comfortable in their changing bodies and can feel as if they don't know who they are anymore. Being the only guy whose voice is changing or who's growing body hair (or the only guy who isn't) can also make some guys feel self-conscious for a while.
Some guys go into puberty not feeling too satisfied with their body or appearance to begin with. They may have wrestled with body image even before puberty started (for example, battles with weight or dissatisfaction with height). For them, puberty may add to their insecurities.
It Could Be in Your Genes
It can be tough to balance what you expect to happen to your body with what actually does happen. Lots of guys can have high expectations for puberty, thinking they'll develop quickly or in a certain way.
The best way to approach your own growth and development is to not assume you'll be a certain way. Look at everyone in your family — uncles, grandfathers, and even female relatives — to get an idea of the kinds of options your genes may have in store for you.
When Everyone Else Seems Bigger
Not everyone's body changes at the same time or even at the same pace. It can be tough if all of your friends have already matured physically and are taller and more muscular. Most guys eventually catch up in terms of growth, although some will always be taller or more muscular than others — it's in their genes.
It's natural to observe friends and classmates and notice the different ways they're growing and developing. Guys often compare themselves with other guys in certain settings, and one of the most common is the locker room. Whether at a local gym or getting ready for a game at school, time in the locker room can be daunting for any guy.
Try to keep in mind in these situations that you aren't alone if you feel you don't "measure up." Many guys feel exactly the same way about their own bodies — even those whose physiques you envy. Just knowing that almost everyone else will go through the same thing can make all the difference.
You could try talking to a trusted male adult — maybe a coach, a doctor, a teacher, or your dad. Chances are they went through similar experiences and had some of the same feelings and apprehensions when their bodies were changing.
Picture Perfect?
Guys put enough pressure on themselves, but what about the pressure society puts on them to be perfect?
It used to be that only girls felt the pressure of picture-perfect images, but these days the media emphasis on men's looks creates a sense of pressure for guys, too. And sometimes (actually many times) that "as advertised" body is just not attainable. The men you see in those pictures may not even be real. Magazines and ad agencies often alter photographs of models, either by airbrushing the facial and muscular features, or by putting a good-looking face on someone else's buff body.
Building a Better Body Image
So in the face of all the pressure society places on guys — and guys place on themselves — what can you do to fuel a positive body image? Here are some ideas:
Recognize your strengths. Different physical attributes and body types are good for different things — and sometimes the things you did well as a kid can change during puberty. What does your body do well? Maybe your speed, flexibility, strength, or coordination leads you to excel at a certain sport. Or perhaps you have non-sports skills, like drawing, painting, singing, playing a musical instrument, writing, or acting. Just exploring talents that you feel good about can help your self-esteem and how you think of yourself.
A good body doesn't always translate into athletic success. Too often, the way guys see their body image is closely associated with their performance on a sports field or in the gym. The upside to this is that if you're good at a team sport, you might have a pretty good view of your body. But what if you don't like team sports or you got cut from a team you really wanted to make? In these cases, it helps to look at individual accomplishments.
If you don't like team sports, that's OK. Try finding another form of physical activity that really gets you going. Depending on your interests and where you live, that may be mountain biking, rock climbing, dancing, yoga, or even jogging. This will help you stay in shape and help you to appreciate skills may not have realized you had in a team environment.
If you like team sports but didn't make a particular team, don't let it get you down. Use this as an opportunity to discover what you're good at, not to lament what you aren't best at. Maybe try out for another team — so soccer wasn't for you, but maybe cross-country running will be.
If none of these appeal to you, continue to practice the sport you were cut from and try again next year. The people around you probably won't remember that you didn't make the team — not being picked was a much bigger deal to you than it was to them.
Look into starting a strength training program. Exercise can help you look good and feel good about yourself. Good physiques don't just happen — they take hard work, regular workouts, and a healthy diet. There's no need to work out obsessively. A healthy routine can be as simple as exercising 20 minutes to 1 hour three days a week. Another benefit to working out properly is that it can boost your mood — lifting weights can lift your spirits.
Don't trash your body, respect it! To help improve your view of your body, take care of it. Smoking and other things you know to be harmful will take a toll after a while. Treating yourself well over time results in a healthier, stronger body — and that contributes to a better body image. Practicing good grooming habits — regular showering; taking care of your teeth, hair, and skin; wearing clean clothes, etc. — also can help you build a positive body image.
Be yourself. Your body is just one part of who you are — along with your talent for comedy, a quick wit, or all the other things that make you unique. Your talents, skills, and beliefs are just as much a part of you as the casing they come in. So try not to let minor imperfections take over.
While it's important to have a positive body image, getting too focused on body image and appearance can cause a guy to overlook the other positive parts of himself. If you're like most guys who take care of their bodies and wear clothes that look good, you probably look great to others. You just might not be aware of that if you're too busy being self-critical.
