Teens Clinic

The teenage years are also called adolescence. Adolescence is a time for growth spurts and puberty changes. The World Health Organization (WHO) defines adolescents as those people between 10 and 19 years of age. Many parents get confused at this period as teens change both physically and mentally. Often parents are worrying to see their kids with emotional disturbances. Kids start moving slowly away from parents’ circle to friend’s circle. This period of turbulence can easily be managed by knowing the facts of this age. Hope the following collection of questions could be useful for both parents and kids.


Medical care should include screenings for high blood pressure obesity, eating disorders, depression and if indicated, hyperlipidemia (an excess of cholesterol and/or other fats in the blood). Older teens may be screened for alcohol, drugs, and sexually transmitted diseases (STDs). A tuberculin (PPD) test may be done if a teen is at risk for tuberculosis.

Vision and hearing will be checked. Teens are also checked for scoliosis (curvature of the spine).

What Are the Signs & Symptoms of High Blood Pressure?

Most of the time high blood pressure doesn't cause symptoms. In rare cases, severe high blood pressure can cause headaches, blurry vision, dizziness, nose bleeds, a fluttering or racing heartbeat, and nausea.

If your child has high blood pressure and gets any of these symptoms, get medical care right away.


If high blood pressure is due to a condition like kidney disease or lung disease, treating it might be enough to get the blood pressure back to normal. Doctors also might recommend lifestyle changes for teens with hypertension, such as:

Eating a healthy diet:

  1. Eat more fruits, vegetables, and low-fat dairy
  2. Limit salt
  3. Avoid caffeine (found in sodas, tea, coffee, and energy drinks)
  4. Avoid alcohol

Teens must try to do the regular exercise for 30–60 minutes at least 3 times a week. Teens with severe hypertension should not do any weightlifting or power-lifting, bodybuilding, or strength training until their blood pressure is under control and a doctor accepts it. People with high blood pressure should not smoke and their homes and car should be smoke-free. If diet and exercise changes do not improve blood pressure, doctors may prescribe medicine.

What Else Should I Know?

Even though teens with high blood pressure generally feel fine, it's important to follow the advice of the care team. A healthy diet and exercise, giving medicine if needed, and getting regular blood pressure checks can help healthy kids grow into healthy adults.

Why Do teens Become Overweight or Obese?

Several things contribute to a person becoming overweight. Diet habits, lack of exercise, genetics, or a combination of these can be involved. In some instances, too much weight gain may be due to an endocrine problem, genetic syndrome, or some medicines.

Diet and Lifestyle Much of what we eat is quick and easy — from fat-filled fast food to processed and prepackaged meals. Daily schedules are so busy that there's little time to make healthier meals or to squeeze in some exercise. Portion sizes in the home and out, are too large. Plus, modern life is sedentary. Kids spend more time playing with electronic devices than actively playing outside. Kids who watch TV more than 4 hours a day are more likely to be overweight compared with kids who watch 2 hours or less. And kids who have a TV in the bedroom also are more likely to be overweight.

Exercise and Physical Activity Many kids don't get enough physical activity. Older kids and teens should get 1 hour or more of moderate to vigorous exercise every day, including aerobic and muscle- and bone-strengthening activities. Kids ages 2 to 5 years should play actively several times each day.

Genetics can play a role in what kids weigh. Our genes help determine body type and how the body stores and burns fat. But genes alone can't explain the current obesity crisis. Because both genes and habits are passed down from one generation to the next, multiple members of a family may struggle with weight. People in the same family tend to have similar eating patterns, levels of physical activity, and attitudes toward being overweight. A child's chances of being overweight increase if one or both parent is overweight or obese.

What Health Problems Can Obesity Cause?

Obesity puts kids at risk for medical problems that can affect their health now and in the future. These include serious conditions like type 2 diabetes, high blood pressure, and high cholesterol — all once considered adult diseases. but now teens too fall as victims.

Overweight and obese teens are also at risk for:

  1. Bone and joint problems.

  2. Shortness of breath that makes exercise, sports, or any physical activity more difficult. This also can make asthma symptoms worse or lead kids to develop asthma.

  3. Restless sleep or breathing problems at night, such as obstructive sleep apnea.

  4. A tendency to mature earlier. Overweight kids may be taller and more sexually mature than their peers, raising expectations that they should act as old as they look, not as old as they are. Overweight girls may have irregular menstrual cycles and fertility problems in adulthood.

  5. Liver and gallbladder disease cardiovascular risk factors (including high blood pressure, high cholesterol, and diabetes) that develop in childhood can lead to heart disease, heart failure, and stroke in adulthood. Preventing or treating overweight and obesity in kids may help protect them from these problems as they get older.

    Obese kids also might have emotional issues to deal with (such as low self-esteem) and may be teased, bullied, or rejected by peers.

  6. Kids who are unhappy with their weight can be at risk for:
    • Unhealthy dieting and eating disorders
    • Depression
    • Substance abuse
How Can We Prevent Overweight and Obesity?

The key to keeping kids of all ages at a healthy weight is taking a whole-family approach. Make healthy eating and exercise a family affair. Get your kids involved by letting them help you plan and prepare healthy meals. Take them along when you go grocery shopping. Teach them how to make good food choices.

Try to avoid these common traps:
  1. Don't reward kids for good behavior or try to stop bad behavior with sweets or treats:

    Find other ways to change behavior.

  2. Don't have a clean-plate policy:

    Even babies turn away from the bottle or breast to send signals that they're full. If kids are satisfied, don't force them to keep eating. Reinforce the idea that they should only eat when they're hungry.

  3. Don't talk about "bad foods" or completely ban all sweets and favorite snacks:

    Kids may rebel and overeat forbidden foods outside the home or sneak them in on their own. Serve healthy foods most of the time and offer treats once in a while.

Recommendations by Age:
  1. Ages 13 to 18:

    Teach teens how to prepare healthy meals and snacks at home. Encourage them to make healthy choices when outside the home and to be active every day.

    Cut down on TV, phone, computer, and video game time and discourage eating in front of a screen (TV or otherwise). Serve a variety of healthy foods and eat family meals together as often as possible. Encourage kids to eat breakfast every day, have at least five servings of fruits and vegetables daily, and limit sugar-sweetened beverages.

    Talk to teens about the importance of eating well and being active. Be a role model by eating well, exercising regularly, and building healthy habits in your own daily life. Make it a family affair that will become second nature for everyone.


By age 13, teens should have already had these immunizations

  1. Chickenpox vaccine (if they have not had chickenpox)
  2. Measles, mumps, and rubella (MMR) vaccine
  3. Hepatitis B vaccine (HBV) series
  4. Hepatitis A vaccine (HAV) series
  5. Meningococcal vaccine
  6. Human papiiloma virus(HPV)
  7. Diphtheria, tetanus, and acellular pertussis booster (Tdap)

Doctors recommend a Tdap booster at 11–12 years of age, with tetanus and diphtheria booster (Td) every 10 years after that. The Tdap vaccine is also recommended for all pregnant women during the second half of each pregnancy, regardless of whether or not they had it before, or when it was last given. The flu vaccine is given before flu season each year also is recommended.


As teens go through puberty, issues of sexual health will be addressed. Young women may be referred to a gynecologist for a first visit. Young men will be checked for hernias and testicular cancer and taught how to do a testicular self-exam.

Teens should be asked about behaviors or emotional problems that may indicate depression or the risk of suicide. The doctor will provide counseling about risky behaviors and other issues, including:

  1. Sexual activities that may result in unintended pregnancy and STD`'S
  2. Use of alcohol and other substances, including anabolic steroids
  3. Use of tobacco products, including cigarettes and smokeless tobacco
  4. Drinking and driving
  5. The importance of bicycle helmets, seat belts, and protective sports gear
  6. How to resolve conflicts without violence, including how to avoid the use of weapons
  7. Learning problems or difficulties at school
  8. Importance of regular physical activity
What are the Common Medical Problems?

sports injuries and other problems, such as knee pain and headaches, are common concerns. Meet your doctor to evaluate any pain that is severe or long-lasting.

Issues involving puberty and sexual development are typical concerns for teens. Doctors can be a valuable resource by answering questions and giving guidance during this period of physical and emotional changes. Teens can be reassured that anything they discuss with their doctor will be kept confidential unless their health or the health of others could be in danger.

If You Have Concerns, what to do?

Parents or other caregivers should receive health guidance from their teen's doctor during these routine checkups. The doctor will share information about normal development, including signs and symptoms of illness or emotional distress and ways to watch for and manage potentially harmful behaviors.

If you think that your teen has a physical disorder, a psychological problem, or a problem with drugs or alcohol, contact the doctor.

What Is Vaginal Discharge?

Vaginal discharge is fluid that comes from the vagina. You might see this on the toilet paper when you wipe or in your underwear.

Normal vaginal discharge has several purposes: cleaning and moistening the vagina, and helping to prevent and fight infections. It's normal for the color, texture, and amount of vaginal discharge to change at different times of the month during a girl's menstrual cycle. But some changes in discharge may mean there is a problem.

What Is Normal Vaginal Discharge?
Normal vaginal discharge can be:
  1. Somewhat thin, sticky, and elastic
  2. Thick and gooey

For some girls, it's normal to have a lot of vaginal discharge. They may even need to wear a pantiliner to keep their underwear dry. Other girls may not have much vaginal discharge at all. Vaginal fluids should be clear, white, or off-white in color.

What Are the Signs of a Problem with Vaginal Discharge?
These signs can mean there's a problem with a girl's discharge:
  1. A change in odor, especially an unpleasant odor
  2. A change in color, especially greenish, grayish, or anything looking like pus
  3. A change in texture, such as foamy or looking like cottage cheese
  4. Vaginal itching, burning, swelling, or redness
  5. Vaginal bleeding or spotting that is not a menstrual period
What Can Cause Changes in Vaginal Discharge?

Infections are the most common cause of unusual vaginal discharge. These infections include:

  1. Yeast infections
  2. Bacterial infections
  3. STD's such as gonorrhea
What Should I Do If I Notice a Change in My Vaginal Discharge?

If you think your vaginal discharge has changed, make an appointment with your doctor. Vaginal discharge can be treated.

What Are Irregular Periods?

Even though girls get their periods on a cycle, that cycle can take different amounts of time each month. For example, a girl might get her period after 24 days one month and after 42 days the next. These are called irregular periods.

Irregular periods are very common, especially in a girl's first few years of getting her period.

What Are Regular Periods?

Most girls get their first period between the ages of 10 and 15, but some get it earlier and some later.

A girl's monthly cycle is the number of days from the start of her period to the start of the next time she gets her period. You often hear this is a 28-day cycle. But 28 is just an average figure that doctors use. Cycle lengths may vary — some are 24 days, some are 34 days.

Early in a girl's cycle, her ovaries start preparing one egg. At the same time, the lining of the uterus becomes thick to prepare a nesting place for a fertilized egg if the girl becomes pregnant. About 2 weeks before a girl gets her period, the egg is released from the ovary (this is called ovulation). The egg travels through the fallopian tube into the uterus. If the egg isn't fertilized by sperm, it starts to fall apart. Then the lining and egg leave a girl's body as her period and the whole thing starts all over again — that's why we use the word "cycle." The first day a girl's period comes is Day 1 of her cycle.

A girl's body may not follow an exact schedule. It's common, especially in the first 2 years after a girl starts getting her period, to skip periods or to have irregular periods. Illness, rapid weight change, or stress can also make things more unpredictable. That's because the part of the brain that regulates periods is influenced by events like these. Going on a trip or having a major schedule change can also make your period come at a different time than expected. All of this is perfectly normal.

It's also normal for the number of days a girl has her period to vary. Sometimes a girl may bleed for 2 days, sometimes it may last a week. That's because the level of hormones the body makes can be different from one cycle to the next, and this affects the amount and length of bleeding.

If a girl's Period Is Irregular, How can she Know When she Gets It?

If a girl's menstrual cycle is not regular, she has to pay attention to the clues her body may give her that her period is coming soon. These may include:

  1. Back cramps or stiffness
  2. Heavier breasts or breast soreness
  3. Headaches
  4. Acne breakouts
  5. Disturbed sleep patterns
  6. Mood swings
  7. Bloating
  8. Loose stools
What Causes Irregular Periods?

Most of the time, irregular periods are part of the normal changes that can happen when a girl is a teen. when a girl gets older, her cycle will probably settle into a recognizable pattern. Sometimes, irregular periods can be caused by some medicines, exercising for a long period, having a very low or high body weight, or not eating enough calories.

Hormone imbalances can also cause irregular periods. For example, thyroid hormone levels that are too low or too high can cause problems with periods. Some girls have extra androgen, a hormone that can cause hair growth on the face, chin, chest, and abdomen. Extra androgen can also make girls gain weight and have irregular periods.

Should I Worry About Irregular Periods?


  1. Having regular periods that then become irregular.
  2. Stop getting period.
  3. Have extra hair growth on the face, chin, chest, or abdomen.
  4. Having periods that last longer than 7 days, are heavy or are coming more often than every 21 days.
  5. Period comes less often than every 45 days.
  6. Have severe cramping or abdominal pain.
  7. Have bleeding in between your periods.
  8. Periods are irregular for 3 years or more.

The doctor may prescribe hormone pills or other medicines, or recommend lifestyle changes that can help to have regular periods.