Intro4u2u

Sometimes having your period can be a pain — literally. Most girls have to deal with PMS, cramps, or headaches around the time of their periods. These problems are usually normal and nothing to worry about. Here are the facts on which period problems are common and normal — and which ones might indicate there’s something else going on.
What Is PMS?

Premenstrual syndrome (PMS) is the term for the physical and emotional symptoms that many girls and women get right before their periods begin each month. If you have PMS, you might experience:

* acne
* bloating
* fatigue
* backaches
* sore breasts
* headaches
* constipation
* diarrhea
* food cravings
* depression or feeling blue
* irritability
* difficulty concentrating
* difficulty handling stress

PMS is usually at its worst during the 1 to 2 weeks before a girl’s period starts, and it usually disappears when her period begins.

Doctors have not pinpointed the exact cause of PMS, but it seems to be linked to changing hormone levels. During the second half of the menstrual cycle, the amount of progesterone (a female hormone) in a girl’s body increases. Then about 1 week before her period starts, levels of both progesterone and estrogen (another hormone) drop dramatically. The thinking is that these different hormone levels can lead to PMS symptoms. There are also theories that what you eat can affect how you feel, especially during the couple of weeks before a girl gets her period.

Luckily, there are several things you can do to ease PMS symptoms. Eating a balanced diet with lots of fresh fruits and vegetables and cutting back on processed foods like chips and crackers can help. You might also want to reduce your salt intake (salt can make you retain water and become more bloated) and, believe it or not, drink more water. Say no to caffeine (it can make you jumpy and anxious) and yes to certain vitamins: B-complex vitamins, calcium, magnesium, and vitamin E are thought to be helpful. Also, daily exercise and stress-relief techniques like meditation can help some girls.

When it comes to medicine, over-the-counter pain medicines like ibuprofen can relieve achy heads and backs. But for really serious PMS pain, see your doctor. He or she might be able to prescribe a different medicine or birth control pills to help with many of your PMS symptoms.
Why Do I Get Cramps?

Lots of girls have abdominal cramps during the first few days of their periods. Cramps are most likely caused by prostaglandins (pronounced: prass-tuh-glan-dunz), chemicals your body produces that make the muscles of the uterus contract. The good news is that cramps usually only last a few days. But if you’re in pain, medicine like ibuprofen may help.

Exercise may also make you feel better, possibly because it releases endorphins, chemicals in the body that literally make you feel good. Soaking in a warm bath or putting a warm compress on your stomach won’t make your cramps disappear but may help your muscles relax a little. If you have severe cramps that keep you home from school or from doing stuff with your friends, visit your doctor for advice.
Why Isn’t My Period Regular?

It can take up to 3 years from the time a girl starts menstruating for her body to develop a regular cycle. Even then, what’s regular varies from person to person. Girls’ cycles can range from 21 to 45 days.

Changing hormone levels might make your period short one month (such as 2 or 3 days) and more drawn out (such as 7 days) the next. You might skip a few months, get two periods almost right after each other, have a really heavy period, or one so light you almost don’t notice it. (If you’re sexually active and you skip a period, though, you should visit your doctor or a women’s clinic to make sure you’re not pregnant.)

All this irregularity can make planning for your period a real hassle. Try to keep track of when your last period started, and guess that about 4 weeks from that day you could be due for another. If you’re worried about wearing that cute dress and suddenly starting your period at school, just make sure you pack protection. Carry a pad or tampon in your backpack, and wear a pantiliner to handle the first wave.

When it comes to periods, every girl’s body has a unique (and unpredictable) timeline for getting on track. If your period still has not settled into a relatively predictable pattern after 3 years, or if you have four or five regular periods and then skip your periods for a couple of months, make an appointment with your doctor to check for possible problems.
Why Haven’t I Started My Period Yet?

Everybody goes through puberty at different speeds. Some girls begin menstruating as early as age 8 or 9; others don’t get going until they’re 15 or 16. It all depends on your hormones — and your family. Want to guess when you’ll get your period? Ask when your mom and grandmothers (from both sides of your family) started theirs. When you start puberty is partly linked to genetics. So although there’s no guarantee that you’ll follow in their footsteps, your relatives could give you a pretty good clue about your own period.

One thing that can delay puberty — and your period — is excessive exercising, usually distance running, ballet, or gymnastics, combined with a poor diet. For exercise to be excessive, it means more than just playing soccer for a couple of hours a few times a week or working out once in a while with an exercise tape. To exercise so much that you delay your period, you would have to train vigorously for several hours a day, most days of the week, and not get enough calories, vitamins, and minerals.

Unless compulsive exercise has postponed your period, there’s nothing you can do on your own to hurry things along. If you haven’t started to menstruate by the time you’re 16, consult your doctor. He or she will probably do a pelvic exam and take a blood test to determine the hormone levels in your body. Then the doctor might prescribe hormones to jump-start your cycle.
Menstrual Problems

Although most of the strange stuff that goes along with a girl’s period is completely normal, there are a few conditions that can be more serious. If you suspect you have any of these conditions, see your doctor for advice.

Amenorrhea (pronounced: a-meh-nuh-ree-uh) is the absence of periods. Girls who haven’t started their periods by the time they are 16 may have primary amenorrhea, usually caused by a hormone imbalance or developmental problem.

There’s also a condition called secondary amenorrhea, when someone who had normal periods stops menstruating for at least 3 months. Low levels of gonadotropin-releasing (pronounced: go-nah-duh-troh-pun) hormone (GnRH), which controls ovulation and the menstrual cycle, frequently bring on amenorrhea. Stress, anorexia, weight loss or gain, stopping birth control pills, thyroid conditions, and ovarian cysts can all throw your hormones out of whack. To get everything back on course, your doctor may use hormone therapy. As mentioned earlier, lots of strenuous exercise combined with a poor diet can also cause amenorrhea. Cutting back on exercise and eating a balanced diet with more calories will help correct the problem, but be sure to talk with your doctor as well.

Menorrhagia (pronounced: meh-nuh-ray-jee-uh) is the term doctors use for extremely heavy, prolonged periods. Menorrhagia is more than just 1 or 2 days of a heavier-than-average flow. Girls who have menorrhagia soak through at least a pad an hour for several hours in a row or have periods that are more than 7 days long. (Clotting during your period is not necessarily a sign of menorrhagia, though — lots of girls, with both heavy and light periods, pass clots when they menstruate.)

The most frequent cause of menorrhagia is an imbalance between the amounts of estrogen and progesterone in the body. Because of this imbalance, the endometrium (pronounced: en-doh-mee-tree-um, the lining of the uterus) keeps building up. Then when the body gets rid of the endometrium during a period, the bleeding is very heavy.

Many girls have hormone imbalances during puberty, so it’s not uncommon to experience menorrhagia during the teen years. Other cases of heavy bleeding may be caused by thyroid conditions, blood diseases, or inflammation or infections in the vagina or cervix. To help figure out the cause of abnormal bleeding, a doctor can do a pelvic exam, a Pap smear, and blood tests. If you do have menorrhagia, it can be treated with hormones, medicine, or removal of any growths in the uterus that may be the cause of excessive bleeding.

Dysmenorrhea (pronounced: dis-meh-nuh-ree-uh) is the medical term for very painful periods. Primary dysmenorrhea — painful periods that are not caused by a disease or other condition — is more common in teens than secondary dysmenorrhea (painful periods caused by a disease or condition).

The culprit in primary dysmenorrhea is prostaglandin, the same naturally occurring chemical that causes cramps. In large amounts, prostaglandin can cause nausea, vomiting, headaches, backaches, diarrhea, and severe cramps when you have your period. Fortunately, these symptoms usually only last for a day or two. Doctors usually prescribe anti-inflammatory medicines to treat primary dysmenorrhea. As with cramps, exercise, hot water bottles, and birth control pills might also bring some relief.

Some of the more common conditions that can cause secondary dysmenorrhea include:

* endometriosis (pronounced: en-doh-mee-tree-oh-sis), a condition in which tissue normally found only in the uterus starts to grow outside the uterus
* pelvic inflammatory disease, a type of bacterial infection
* fibroids or growths on the inside wall of the uterus

All of these conditions require that a doctor diagnose the problem and then treat you appropriately.
What to Do if You Suspect a Problem

When you have questions about your period or anything else related to your development, talk to your doctor. This is particularly true if you notice a change in your menstrual cycle. Though most period problems turn out to be nothing to worry about, it’s always good to be safe.

See your doctor if:

* You have not started your period by the time you are 16. This may indicate that you have a problem that requires medical attention.
* You stop getting your period or it becomes really irregular after it has been regular for a while (like 6 months or more). This can be a sign that you may have a hormone imbalance or a problem with nutrition, which can harm your body if left untreated.
* You have very heavy or long periods, especially if you have a short cycle and get your period frequently. In rare cases, lots of blood loss can cause anemia (iron deficiency) and leave you feeling really weak and tired.
* Your periods are really painful. You might have endometriosis or benign growths that should be removed. Or if you’re sexually active, you might have pelvic inflammatory disease (PID).

Chances are that your painful periods are nothing to worry about. But if there is something going on, the sooner you get it taken care of, the sooner you’ll be on your way to feeling great again.

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.

Anne had never had problems with her periods the way some of her friends did. But over time her periods started getting so painful that she dreaded their arrival. Every month for a few days she would curl up on the couch with a heating pad and take a pain reliever. But the cramps eventually became so bad that she was missing school a couple of days a month, and the pain even started happening between periods.

Anne’s doctor thought Anne might have endometriosis. So she referred her to a specialist in treating this condition. It turned out Anne’s doctor was right.
What Is Endometriosis?

Endometriosis (pronounced: en-doe-mee-tree-o-sus) takes its name from the endometrium, the tissue that lines the uterus. When a woman has endometriosis, tissue that looks and acts like the endometrium starts growing outside the uterus. The most common locations for these growths - called endometrial implants - are the outside surface of the uterus, the ovaries, the fallopian tubes, the ligaments that support the uterus, the internal area between the vagina and rectum, and the lining of the pelvic cavity.

Endometriosis affects more than 5 million American women, including teen girls. It’s not always diagnosed right away in teens because at first they or their doctors assume that their painful periods are a normal part of menstruating. But continuing, excessive pain that limits activity isn’t normal and should always be taken seriously. Because severe endometriosis can make it complicated for a girl to have children in the future, it’s a good idea to get medical help for endometriosis and not wait too long.

To understand why endometriosis causes problems, it helps to have a basic understanding of how the monthly menstrual cycle works: During the course of each cycle, the lining of a woman’s uterus builds up with blood vessels and tissue. This happens because the uterus is getting ready to receive the egg that will be released from one of the ovaries. If the egg isn’t fertilized by sperm, though, the uterus sheds the tissue and blood near the end of the cycle, preparing for the next cycle. The tissue that is shed is the menstrual period. This entire process is controlled by the female sex hormones and usually takes about 28 to 30 days.

Because the abnormal growths associated with endometriosis are made up of the same kind of tissue and blood vessels found in the uterine lining, any endometrial implants will act just like the endometrium in the uterus. That means they respond in the same way to the hormonal changes of the menstrual cycle. However, in the uterus, if the egg isn’t fertilized, the extra tissue and blood leave a girl’s body in the form of menstrual fluid. With endometriosis, though, there’s nowhere for the accumulating blood and tissue to go once the implants start to break down. For this reason, the implants usually become somewhat larger with each cycle, and the symptoms of endometriosis tend to become more painful over time.
What Causes Endometriosis?

Doctors aren’t sure what causes endometriosis. They do know that it is slightly more common in teens and women who have a family member who has been diagnosed with endometriosis.

There are several theories about how the endometrial tissue actually gets outside the uterus in the first place. One theory suggests that the menstrual blood flow somehow “backs up” into the fallopian tubes, carrying some tissue from the uterine lining with it. In effect, the tissue gets transplanted and starts growing outside the uterus. Another theory is that endometrial tissue cells travel out of the uterus through blood or lymph vessels, and then start growing in the new locations where they’re deposited. Yet another theory suggests that some girls are born with “misplaced” cells that can turn into endometrial implants later in life. Scientists continue to research the condition to help doctors fully understand and treat it.
What Are the Signs and Symptoms?

The most common sign of endometriosis is severe pelvic (lower abdominal) pain. It may occur occasionally or constantly, and it may be associated with a girl’s period. Although slight cramps for a couple of days before or during a menstrual period are normal, lasting or intense pain that disrupts a person’s day is not. With endometriosis, the pain is usually so bad that it causes a girl to miss school, sports, and social activities.

Other possible symptoms include:

* pelvic pain that gets worse during exercise, after sex, or after a pelvic exam
* a very heavy period
* lower back pain
* constipation, diarrhea, or feeling pain or seeing blood when going to the bathroom (endometrial implants can press on some of the organs involved in getting waste out of the body, such as the bladder, intestines, and rectum)

If a girl notices these symptoms, it doesn’t necessarily mean that she has endometriosis. Lots of other things - like an infection - may cause similar symptoms. But it’s important to see a doctor right away if you notice these symptoms. If you haven’t been examined by a gynecologist for the first time yet, this is a good time.

With dreams of college scholarships in her mind, Hannah joined the track team her freshman year and trained hard to become a lean, strong sprinter. When her coach told her losing a few pounds would improve her performance, she immediately started counting calories and increased the duration of her workouts. She was too busy with practices and meets to notice that her period had stopped — she was more worried about the stress fracture in her ankle slowing her down.

Although Hannah thinks her intense training and disciplined diet are helping her performance, they may actually be hurting her — and her health.
What Is Female Athlete Triad?

Sports and exercise are part of a balanced, healthy lifestyle. Girls who play sports are healthier; get better grades; are less likely to experience depression; and use alcohol, cigarettes, and drugs less frequently than girls who aren’t athletes. But for some girls, not balancing the needs of their bodies and their sports can have major consequences.

Some girls who play sports or exercise intensely are at risk for a problem called female athlete triad. Female athlete triad is a combination of three conditions: disordered eating, amenorrhea (pronounced: ay-meh-nuh-ree-uh, which means loss of a girl’s period for 3 or more months), and osteoporosis (pronounced: oss-tee-oh-puh-row-sis, meaning a weakening of the bones). A female athlete can have one, two, or all three parts of the triad.
Triad Factor #1: Disordered Eating

Most girls with female athlete triad try to lose weight primarily to improve their athletic performance. The disordered eating that accompanies female athlete triad can range from avoiding certain types of food the athlete thinks are “bad” (such as foods containing fat) to serious eating disorders like anorexia nervosa or bulimia nervosa.
Triad Factor #2: Amenorrhea

Because a girl with female athlete triad is simultaneously exercising intensely and not eating enough calories, when her weight falls too low, she may experience decreases in estrogen, the hormone that helps to regulate the menstrual cycle. As a result, a girl’s periods may become irregular or stop altogether. Of course, it is normal for teen girls to occasionally miss periods, especially in their first year of having periods. A missed period does not automatically mean a girl has female athlete triad. A missed period could mean something else is going on, like pregnancy or a medical condition. If you have missed a period and you are sexually active, talk to your doctor.

Some girls who participate intensively in sports may never even get their first period because they’ve been training so hard. Other girls may have had periods, but once they increase their training and change their eating habits, their periods may stop.
Triad Factor #3: Osteoporosis

Low estrogen levels and poor nutrition, especially low calcium intake, can lead to osteoporosis, the third aspect of the triad. Osteoporosis is a weakening of the bones due to the loss of bone density and improper bone formation. This condition can ruin a female athlete’s career because it may lead to stress fractures and other injuries.

Usually, the teen years are a time when girls should be building up their bone mass to their highest levels — called peak bone mass. Not getting enough calcium during the teen years can also have a lasting effect on how strong a girl’s bones are later in life.
Who Gets Female Athlete Triad?

Most girls have concerns about the size and shape of their bodies, but girls who develop female athlete triad have certain risk factors that set them apart. Being a highly competitive athlete and participating in a sport that requires you to train extra hard is a risk factor.

Girls with female athlete triad often care so much about their sports that they would do almost anything to improve their performance. Martial arts and rowing are examples of sports that classify athletes by weight class, so focusing on weight becomes an important part of the training program and can put a girl at risk for disordered eating.

Participation in sports where a thin appearance is valued can also put a girl at risk for female athlete triad. Sports such as gymnastics, figure skating, diving, and ballet are examples of sports that value a thin, lean body shape. Some girls may even be told by coaches or judges that losing weight would improve their scores.

Even in sports where body size and shape aren’t as important, such as distance running and cross-country skiing, girls may be pressured by teammates, parents, partners, and coaches who mistakenly believe that “losing just a few pounds” could improve their performance.

The truth is, though, that losing those few pounds generally doesn’t improve performance at all. People who are fit and active enough to compete in sports generally have more muscle than fat, so it’s the muscle that gets starved when a girl cuts back on food. Plus, if a girl loses weight when she doesn’t need to, it interferes with healthy body processes such as menstruation and bone development.

In addition, for some competitive female athletes, problems such as low self-esteem, a tendency toward perfectionism, and family stress place them at risk for disordered eating.
What Are the Signs and Symptoms?

If a girl has risk factors for female athlete triad, she may already be experiencing some symptoms and signs of the disorder, such as:

* weight loss
* no periods or irregular periods
* fatigue and decreased ability to concentrate
* stress fractures (fractures that occur even if a person hasn’t had a significant injury)
* muscle injuries

Girls with female athlete triad often have signs and symptoms of eating disorders, such as:

* continued dieting in spite of weight loss
* preoccupation with food and weight
* frequent trips to the bathroom during and after meals
* using laxatives
* brittle hair or nails
* dental cavities because in girls with bulimia tooth enamel is worn away by frequent vomiting
* sensitivity to cold
* low heart rate and blood pressure
* heart irregularities and chest pain

How Doctors Help

An extensive physical examination is a crucial part of diagnosing female athlete triad. A doctor who thinks a girl has female athlete triad will probably ask questions about her periods, her nutrition and exercise habits, any medications she takes, and her feelings about her body. This is called the medical history.

Poor nutrition can also affect the body in many ways, so a doctor might order blood tests to check for anemia and other problems associated with the triad. The doctor also will check for medical reasons why a girl may be losing weight and missing her periods. Because osteoporosis can put a girl at higher risk for bone fractures, the doctor may also request tests to measure bone density.

Doctors don’t work alone to help a girl with female athlete triad. Coaches, parents, physical therapists, pediatricians and adolescent medicine specialists, nutritionists and dietitians, and mental health specialists can all work together to treat the physical and emotional problems that a girl with female athlete triad faces.

It might be tempting for a girl with female athlete triad to shrug off several months of missed periods, but getting help right away is important. In the short term, she may have muscle weakness, stress fractures, and reduced physical performance. Over the long term, she may suffer from bone weakness, long-term effects on her reproductive system, and heart problems.

A girl who is recovering from female athlete triad may work with a dietitian to help get to and maintain a healthy weight and ensure she’s eating enough calories and nutrients for health and good athletic performance. Depending on how much the girl is exercising, she may have to reduce the length of her workouts. Talking to a psychologist or therapist can help a girl deal with depression, pressure from coaches or family members, or low self-esteem and can help her find ways to deal with her problems other than restricting her food intake or exercising excessively.

Some girls with female athlete triad may need to take hormones to supply their bodies with estrogen so they can get their periods started again. In such cases, birth control pills are often used to regulate the menstrual cycle. Calcium and vitamin D supplementation is also common for a girl who has suffered bone loss as the result of female athlete triad.
What If I Think Someone I Know Has It?

A girl with female athlete triad may try to hide it, but she can’t just ignore the disorder and hope it goes away. She needs to get help from a doctor and other health professionals. If a friend, sister, or teammate has signs and symptoms of female athlete triad, discuss your concerns with her and encourage her to seek treatment. If she refuses to seek treatment, you may need to mention your concern to a parent, coach, teacher, or school nurse.

You may worry about being nosy when you ask questions about a friend’s health, but you’re not: Your concern is a sign that you’re a caring friend. Lending an ear may be just what your friend needs.
Tips for Female Athletes

Here are a few tips to help teen athletes stay on top of their physical condition:

* Keep track of your periods. It’s easy to forget when you had your last visit from Aunt Flo, so keep a calendar in your gym bag and mark down when your period starts and stops and if the bleeding is particularly heavy or light. That way, if you start missing periods, you’ll know right away and you’ll have accurate information to give to your doctor.
* Don’t skip meals or snacks. Girls who are constantly on the go between school, practice, and competitions may be tempted to skip meals and snacks to save time. But eating now will improve performance later, so stock your locker or bag with quick and easy favorites such as bagels, string cheese, unsalted nuts and seeds, raw vegetables, granola bars, and fruit.
* Visit a dietitian or nutritionist who works with teen athletes. He or she can help you get your dietary game plan into gear and determine if you’re getting enough key nutrients such as iron, calcium, and protein. And if you need supplements, a nutritionist can recommend the best choices.
* Do it for you. Pressure from teammates, parents, or coaches can turn a fun activity into a nightmare. If you’re not enjoying your sport, make a change. Remember: It’s your body and your life. You — not your coach or teammates — will have to live with any damage you do to your body now

AIDS stands for acquired immunodeficiency syndrome, a disease that makes it difficult for the body to fight off infectious diseases. The human immunodeficiency virus known as HIV causes AIDS by infecting and damaging part of the body’s defenses against infection, namely the white blood cells known as CD4 helper lymphocytes (pronounced: lim-fuh-sites).

The only known way for the HIV virus to be transmitted from one person to another is when it is spread from the inside of an infected person’s body to the inside of another person’s body. This can happen when infected fluids - such as semen (also known as “cum,” the fluid released from the penis when a male ejaculates), vaginal fluids, or blood - are passed from one person to another. A person can become infected even if only tiny amounts of these fluids are spread.

How does someone become infected? HIV can be spread through sexual intercourse if one of the partners has the virus. The virus can be spread through an infected person’s blood, semen, and secretions from the cervix (part of a female’s uterus) or vagina. HIV can travel to another person through cuts and sores on the penis, rectum (the last part of the intestine that connects to the anus), vagina, or skin around the genitals and probably the mouth and other mucous membranes. These cuts or sores are often so small that a person isn’t even aware of them. Girls and guys who have a discharge (an abnormal fluid coming from the vagina or penis) or genital sores because they have a sexually transmitted disease are at increased risk for infection. HIV can be spread sexually from a man to a woman, a woman to a man, a man to a man, and a woman to a woman.

People who inject themselves with drugs also risk infecting themselves with HIV. Many people who use needles to take intravenous drugs or steroids share the needles with others. If a person with HIV shares a needle, he or she also shares the virus, which lives in the tiny amounts of blood attached to the needle. Sharing needles can also pass hepatitis and other serious infections to another person.

Also, a newborn baby is at risk of getting the HIV virus from his or her mother if she is infected. This can happen before the baby is born, during birth, or through breastfeeding. Pregnant teens and women should be tested for HIV because infected women who receive treatment for HIV are much less likely to spread the virus to their babies. Babies born to mothers infected with HIV are also given special medicines to try to prevent HIV infection.

If you have never had sex and you don’t inject drugs, you don’t need to worry about whether you have HIV. But if you have had sex or are planning to in the future, HIV is definitely something you should be prepared to prevent. If you do have sex, using latex condoms properly every time can help protect you. Condoms work by providing a barrier to the body fluids that can be shared during sexual activity (including oral sex). Always follow the directions exactly and never use the same condom twice.

Asking people if they have HIV is not a reliable way of finding out whether they are infected. People may not answer truthfully. They may be embarrassed to tell you or may not want you to know. Or they may not even know they have the virus because it can take many years for symptoms to develop. An infected person will look healthy for many years and can still spread the virus. The most certain way of preventing HIV infection is by not having sex (abstinence) and by not sharing needles to do drugs.

There are many places you can get more information about HIV and AIDS, personal counseling, and, when appropriate, testing. Talk with your doctor about any concerns you might have

Cecily never really worried that her periods weren’t regular because, like many girls, she assumed her monthly cycle would take time to settle down. But then Cecily’s periods stopped for several months, so she went to see her doctor. The doctor noticed that Cecily’s acne had worsened and that she had gained a lot of weight since her last appointment. She said she wanted to check Cecily for a condition called polycystic (pronounced: pah-lee-sis-tik) ovary sydrome (PCOS).
What Is Polycystic Ovary Syndrome?

You can’t see them, hear them, or feel them, but the hormones that regulate a girl’s reproductive system make themselves known in many ways - they are responsible for her periods, breast development, and other aspects of becoming a woman.

Both girls and guys produce hormones called androgens (pronounced: an-druh-junz), which play a role in sexual function. Although androgens are sometimes referred to as male hormones, every female produces them, too.

In girls with PCOS, the ovaries produce higher than normal amounts of androgens, and this can interfere with egg development and release. Some of the eggs develop into cysts (pronounced: sists), which are little sacs filled with liquid. Instead of being released during ovulation, as an egg is during a normal menstrual cycle, the cysts build up in the ovaries and may become enlarged. Because of the way the cyst production interferes with the menstrual cycle, it’s common for girls and women with PCOS to have irregular or missed periods.

Although PCOS (which used to be called Stein-Leventhal syndrome) was first recognized in the 1930s, doctors can’t say for sure what causes it. Research has suggested that PCOS may be related to increased insulin production in the body. Women with PCOS may produce too much insulin, which signals their ovaries to release extra male hormones. PCOS seems to run in families, too, so if someone on your mom’s or dad’s side of the family has it, you might be more likely to develop it.

If PCOS is not treated properly, it can put a girl at risk for lots of problems, such as infertility, excessive hair growth, acne, diabetes, heart disease, abnormal bleeding from the uterus, and cancer. The good news is that, although there’s no cure for PCOS, it can be treated. The most important step is diagnosing the condition, because when a girl gets treatment for PCOS, her chances of having serious side effects are reduced.

It hurts to even think about it. A baseball takes an unexpected bounce when you’re crouched and waiting to field a grounder, an opponent misses a kick on the soccer field and his foot has only one place to go, or you’re speeding along on your bike and you hit a big bump. All result in one really painful thing - a shot to the testicles, one of the most tender areas on a guy’s body. Testicular injuries are relatively uncommon, but guys should be aware that they can happen. So how can you avoid injury?
Why Do Testicular Injuries Happen and What Can You Do?

If you’re a guy who plays sports, likes to lift weights and exercise a lot, or leads an all-around active life, you’ve probably come to find out that the testicles are kind of vulnerable and can be injured in a variety of ways. Because they hang in a sac outside the body (the scrotum), the testicles are not protected by bones and muscles like other parts of your reproductive system and most of your other organs. Also, the location of the testicles makes them prime targets to be accidentally struck on the playing field or injured during strenuous exercise and activity.

The good news is that because the testicles are loosely attached to the body and are made of a spongy material, they’re able to absorb most collisions without permanent damage. Testicles, although sensitive, can bounce back pretty quickly and minor injuries rarely have long-term effects. Also, sexual function or sperm production will most likely not be affected if you have a testicular injury.

You’ll definitely feel pain if your testicles are struck or kicked, and you might also feel nauseous for a short time. If it’s a minor testicular injury, the pain should gradually subside in less than an hour and any other symptoms should go away. In the meantime, you can do a few things to help yourself feel better such as take pain relievers, lie down, gently support the testicles with supportive underwear, and apply ice packs to the area. At any rate, it’s a good idea to avoid strenuous activity for a while and take it easy for a few days.

However, if the pain doesn’t subside or you experience extreme pain that lasts longer than an hour; if you have swelling or bruising of the scrotum or a puncture of the scrotum or testicle; if you continue to have nausea and vomiting; or if you develop a fever, get to a doctor immediately. These are symptoms of a much more serious injury that needs to be addressed as soon as possible.

Turner syndrome (TS) is a medical problem that affects about one in every 2,500 girls. Although researchers don’t know exactly what causes Turner syndrome, they do know that it’s the result of a problem with a girl’s chromosomes (pronounced: krow-muh-soamz). Most girls are born with two X chromosomes, but girls with Turner syndrome are born with only one X chromosome or they are missing part of one X chromosome. The effects of the condition vary widely among girls with Turner syndrome. It all depends on how many of the body’s cells are affected by the changes to the X chromosome.

Girls with Turner syndrome are usually short in height. Girls with Turner syndrome who aren’t treated reach an average height of about 4 feet 7 inches (1.4 meters). The good news is that when Turner syndrome is diagnosed while a girl is still growing, she can be treated with hormones to help her grow taller.

In addition to growth problems, Turner syndrome prevents the ovaries from developing properly, which affects a girl’s sexual development. Because the ovaries are responsible for making the hormones that control breast growth and menstruation, most girls with Turner syndrome will not go through all of the changes associated with puberty unless they get treatment for the condition. Nearly all girls with Turner syndrome will be infertile, or unable to become pregnant on their own.
What Other Effects Can Turner Syndrome Have?

There are a number of other health problems that occur more often in girls with Turner syndrome. These include kidney problems, high blood pressure, heart problems, overweight, hearing difficulties, diabetes, cataracts, and thyroid problems. Some girls with the condition may experience learning difficulties, particularly in math. Many have a difficult time with tasks that require skills such as map reading or visual organization.

In addition to short stature and lack of sexual development, some of the other physical features commonly seen in girls with Turner syndrome are:

* a “webbed” neck (extra folds of skin extending from the tops of the shoulders to the sides of the neck)
* a low hairline at the back of the neck
* drooping of the eyelids
* differently shaped ears that are set lower on the sides of the head than usual
* abnormal bone development (especially the bones of the hands and elbows)
* a larger than usual number of moles on the skin

Because Turner syndrome can affect how a girl looks and develops, some girls may have problems with body image or self-esteem.

People with TS are all different. Some may have many physical differences and symptoms, whereas others experience only a few medical problems. With early and appropriate medical care and ongoing support, most people with TS can lead normal, healthy, and productive lives.
How Do Doctors Know If a Girl Has Turner Syndrome?

Girls with Turner syndrome are usually diagnosed either at birth or around the time they might be expected to go through puberty. If a baby girl has some of the signs of Turner syndrome, a doctor will usually order a special blood test called a karyotype. The test counts the number of a person’s chromosomes and can identify any that are abnormally shaped or have missing pieces. In some cases, there are no recognizable signs that a girl has the condition until she reaches the age at which she’d normally go through puberty.

If the karyotype blood test reveals that a girl has Turner syndrome, her doctor may order additional tests to check for problems with the kidneys, heart, hearing, and other problems that are often associated with Turner syndrome.
How Is Turner Syndrome Treated?

Because Turner syndrome is a condition that is caused by a chromosomal abnormality, there’s no specific cure. However, scientists have developed a number of treatments that can help correct some of the problems associated with the condition - such as growth problems - and researchers are constantly looking into new forms of treatment.

Growth hormone treatment can improve growth and influence a girl’s final adult height. In fact, in many cases, the treatment can help many girls with Turner syndrome reach a final height in the average range, especially if treatment is started early enough.

Another treatment for Turner syndrome is estrogen replacement, which helps the girl develop the physical changes of puberty, including breast growth and eventually menstrual periods. This treatment is often started when a girl reaches about age 12 or 13. And a technique called in vitro fertilization can make it possible for some women with Turner syndrome to become pregnant. A donor egg can be used to create an embryo, which is then put into the uterus (womb) of the woman with Turner syndrome. With proper supportive care, the woman can carry the pregnancy to term and deliver a baby through the normal birth process.
Living With Turner Syndrome

Although people with Turner syndrome may have certain learning difficulties, the majority are able to attend regular school and classes and are generally able to:

* write well
* learn well by hearing
* memorize information as well as others
* develop good language skills

If you have Turner syndrome, you know that it can affect you in several ways. But it’s only a small part of your total physical, emotional, and intellectual self. The following are some suggestions that can help people cope:

* Join a support group for girls with Turner syndrome. Ask your doctor or parents for more information or for help finding a Turner Syndrome Society chapter in your area.
* Stay active in sports or hobbies that you enjoy.
* Consider doing volunteer work. Helping other people can boost your self-esteem and your confidence, too.
* Consider talking to a professional therapist. A qualified counselor or other mental health professional can help you build your self-esteem and address your concerns about living with Turner syndrome. Discuss this with your parents if you think you might need help.
* Keep a journal or diary in which you can record your thoughts and feelings about the challenges you’re dealing with.
* Talk to your parents or school counselor if you are having problems at school.

If you have a friend who has Turner syndrome, remember to respect her emotional and physical needs. For example, she may not always feel comfortable talking about her condition, so let her share only what she feels OK with. You can also support your friend just by hanging out and doing things you enjoy together and by being a good listener if she turns to you for advice or comfort.

Andy’s a good tennis player. Correction, Andy is a great tennis player. He loves the competition and intensity of the game and is known for his dominating serve.

Recently Andy developed a sharp pain in his elbow. At first he thought nothing of it and continued his training, but the pain became unbearable. The pain was so bad he went to see his doctor, who informed him he had elbow bursitis.

What Is Bursitis?

From your head down to your big toes, your body has lots of differently shaped and sized joints. Many have something in common near the area of the joint — a customized fluid sac that provides cushioning for movement and pressure. These small cushions are known as bursae (a single one is called a bursa).

If a bursa becomes irritated, either by a direct hit or from a nearby joint repeating the same movement (like a tennis serve), then bursitis can occur. People can also get bursitis when the body has to change its balance or movement to adapt to differences; for example, if a person has one leg that’s longer than the other.
Where Does Bursitis Occur?

Bursitis, especially in teens, is often likely to happen because of sports-related injuries, usually from repeated use of a particular joint or trauma from a direct hit in a contact sport. It’s not only sporty types who get bursitis, though. It can sometimes be caused by other problems, such as arthritis or a bacterial infection of the bursa.

Here are some of the areas in which teens most commonly get bursitis:

* Elbow. Because the elbow is an essential part of many activities, like throwing a ball or swinging a tennis racket, elbow bursitis is one of the most common types of bursitis in teens.
* Knee. Bursitis in the knee can be the result of falling directly on the knee or any activity that requires long periods of kneeling.
* Hip. Bursitis of the hip is often associated with running injuries.
* Shoulder. Bursitis of the shoulder can be the result of something as simple as an awkward fall or as complicated as a rotator cuff injury (the rotator cuff keeps the shoulder secure).
* Ankle. Someone who goes overboard jumping, running, or walking can get ankle bursitis. Just wearing the wrong type of shoes for a particular activity can lead to ankle bursitis.

How to Detect Bursitis

Bursitis can cause a number of different symptoms:

* Pain and sensitivity in or around a joint. This is the most common and obvious sign that a person may have bursitis.
* Difficulty moving the affected joint. This happens because the bursa has swollen and made it tough to move the joint properly.
* Reddening of the skin. The inflamed bursa may cause the skin around the joint to change color.
* Burning. The irritated bursa can cause the skin to sting and feel warmer than usual.

How to Treat Bursitis

In most cases, you will probably be able to treat bursitis at home.

The key part of at-home treatment, as with many injuries, is rest. Besides resting the affected joint or region, to help get rid of bursitis try:

* Ice ice, baby. Ice should be used on the bursitis while the inflamed area is still warm to the touch. Ice can be applied several times a day for up to 20 minutes. Icing the area will also help to lessen the swelling that can occur with bursitis.
* The heat is on. Putting heat on the joint when it is no longer warm to the touch can reduce the pain. As with ice, don’t apply heat for more than 20 minutes at a time.
* Elevation. Raising a joint that is swollen for any reason can help to reduce swelling. That goes for bursitis, too. If possible, elevate the affected joint so it is above the level of the heart.
* Under pressure. Avoid placing pressure on the joint. This will aggravate bursitis rather than help it to heal.
* Just like a pill. Anti-inflammatory drugs like ibuprofen may help.

Avoiding Bursitis

Bursitis is often the result of a hard impact on a joint or overworking a joint, and sometimes these injuries are unavoidable. But there are some steps you can take to avoid getting bursitis:

* Stay in shape. Working out regularly strengthens muscles and joints, which helps protect against bursitis.
* Don’t overdo it. Too much of anything can be bad, and the same goes for overworking joints.
* Start and stop workouts properly. One of the best ways to prevent bursitis is by working out properly. Warming up and cooling down are essential parts of working out and should never be skipped. Gradually starting and stopping your workout is less stressful for your joints and body.
* Stretch it out. Stretching not only helps improve flexibility but it is also useful in preventing bursitis.
* Mix it up. Whether you’re rotating exercises while lifting weights or just taking a breather from a strenuous activity, your joints will thank you.
* Better padded than sorry. Use cushions on wooden or metal chairs and kneepads when kneeling on hardwood or concrete floors to help reduce the risk of developing bursitis. Also avoid putting extreme amounts of pressure or weight directly on joints.
* Keep it moving. Don’t stay planted on your butt, knees, or other joints for long periods of time. Even if it’s for a few minutes, get up and move around.

If you realize that a particular activity causes you to get bursitis, stop doing it and talk to your doctor or coach about safer methods.

Be on the lookout for bursitis if you participate in a sport. The best way to avoid it is by using the proper techniques and equipment. If your bursitis was caused by something like ill-fitting shoes or other equipment, replace that equipment with something that fits you better.

With dreams of college scholarships in her mind, Hannah joined the track team her freshman year and trained hard to become a lean, strong sprinter. When her coach told her losing a few pounds would improve her performance, she immediately started counting calories and increased the duration of her workouts. She was too busy with practices and meets to notice that her period had stopped — she was more worried about the stress fracture in her ankle slowing her down.

Although Hannah thinks her intense training and disciplined diet are helping her performance, they may actually be hurting her — and her health.
What Is Female Athlete Triad?

Sports and exercise are part of a balanced, healthy lifestyle. Girls who play sports are healthier; get better grades; are less likely to experience depression; and use alcohol, cigarettes, and drugs less frequently than girls who aren’t athletes. But for some girls, not balancing the needs of their bodies and their sports can have major consequences.

Some girls who play sports or exercise intensely are at risk for a problem called female athlete triad. Female athlete triad is a combination of three conditions: disordered eating, amenorrhea (pronounced: ay-meh-nuh-ree-uh, which means loss of a girl’s period for 3 or more months), and osteoporosis (pronounced: oss-tee-oh-puh-row-sis, meaning a weakening of the bones). A female athlete can have one, two, or all three parts of the triad.
Triad Factor #1: Disordered Eating

Most girls with female athlete triad try to lose weight primarily to improve their athletic performance. The disordered eating that accompanies female athlete triad can range from avoiding certain types of food the athlete thinks are “bad” (such as foods containing fat) to serious eating disorders like anorexia nervosa or bulimia nervosa.
Triad Factor #2: Amenorrhea

Because a girl with female athlete triad is simultaneously exercising intensely and not eating enough calories, when her weight falls too low, she may experience decreases in estrogen, the hormone that helps to regulate the menstrual cycle. As a result, a girl’s periods may become irregular or stop altogether. Of course, it is normal for teen girls to occasionally miss periods, especially in their first year of having periods. A missed period does not automatically mean a girl has female athlete triad. A missed period could mean something else is going on, like pregnancy or a medical condition. If you have missed a period and you are sexually active, talk to your doctor.

Some girls who participate intensively in sports may never even get their first period because they’ve been training so hard. Other girls may have had periods, but once they increase their training and change their eating habits, their periods may stop.
Triad Factor #3: Osteoporosis

Low estrogen levels and poor nutrition, especially low calcium intake, can lead to osteoporosis, the third aspect of the triad. Osteoporosis is a weakening of the bones due to the loss of bone density and improper bone formation. This condition can ruin a female athlete’s career because it may lead to stress fractures and other injuries.

Usually, the teen years are a time when girls should be building up their bone mass to their highest levels — called peak bone mass. Not getting enough calcium during the teen years can also have a lasting effect on how strong a girl’s bones are later in life.
Who Gets Female Athlete Triad?

Most girls have concerns about the size and shape of their bodies, but girls who develop female athlete triad have certain risk factors that set them apart. Being a highly competitive athlete and participating in a sport that requires you to train extra hard is a risk factor.

Girls with female athlete triad often care so much about their sports that they would do almost anything to improve their performance. Martial arts and rowing are examples of sports that classify athletes by weight class, so focusing on weight becomes an important part of the training program and can put a girl at risk for disordered eating.

Participation in sports where a thin appearance is valued can also put a girl at risk for female athlete triad. Sports such as gymnastics, figure skating, diving, and ballet are examples of sports that value a thin, lean body shape. Some girls may even be told by coaches or judges that losing weight would improve their scores.

Even in sports where body size and shape aren’t as important, such as distance running and cross-country skiing, girls may be pressured by teammates, parents, partners, and coaches who mistakenly believe that “losing just a few pounds” could improve their performance.

The truth is, though, that losing those few pounds generally doesn’t improve performance at all. People who are fit and active enough to compete in sports generally have more muscle than fat, so it’s the muscle that gets starved when a girl cuts back on food. Plus, if a girl loses weight when she doesn’t need to, it interferes with healthy body processes such as menstruation and bone development.

In addition, for some competitive female athletes, problems such as low self-esteem, a tendency toward perfectionism, and family stress place them at risk for disordered eating.
What Are the Signs and Symptoms?

If a girl has risk factors for female athlete triad, she may already be experiencing some symptoms and signs of the disorder, such as:

* weight loss
* no periods or irregular periods
* fatigue and decreased ability to concentrate
* stress fractures (fractures that occur even if a person hasn’t had a significant injury)
* muscle injuries

Girls with female athlete triad often have signs and symptoms of eating disorders, such as:

* continued dieting in spite of weight loss
* preoccupation with food and weight
* frequent trips to the bathroom during and after meals
* using laxatives
* brittle hair or nails
* dental cavities because in girls with bulimia tooth enamel is worn away by frequent vomiting
* sensitivity to cold
* low heart rate and blood pressure
* heart irregularities and chest pain

How Doctors Help

An extensive physical examination is a crucial part of diagnosing female athlete triad. A doctor who thinks a girl has female athlete triad will probably ask questions about her periods, her nutrition and exercise habits, any medications she takes, and her feelings about her body. This is called the medical history.

Poor nutrition can also affect the body in many ways, so a doctor might order blood tests to check for anemia and other problems associated with the triad. The doctor also will check for medical reasons why a girl may be losing weight and missing her periods. Because osteoporosis can put a girl at higher risk for bone fractures, the doctor may also request tests to measure bone density.

Doctors don’t work alone to help a girl with female athlete triad. Coaches, parents, physical therapists, pediatricians and adolescent medicine specialists, nutritionists and dietitians, and mental health specialists can all work together to treat the physical and emotional problems that a girl with female athlete triad faces.

It might be tempting for a girl with female athlete triad to shrug off several months of missed periods, but getting help right away is important. In the short term, she may have muscle weakness, stress fractures, and reduced physical performance. Over the long term, she may suffer from bone weakness, long-term effects on her reproductive system, and heart problems.

A girl who is recovering from female athlete triad may work with a dietitian to help get to and maintain a healthy weight and ensure she’s eating enough calories and nutrients for health and good athletic performance. Depending on how much the girl is exercising, she may have to reduce the length of her workouts. Talking to a psychologist or therapist can help a girl deal with depression, pressure from coaches or family members, or low self-esteem and can help her find ways to deal with her problems other than restricting her food intake or exercising excessively.

Some girls with female athlete triad may need to take hormones to supply their bodies with estrogen so they can get their periods started again. In such cases, birth control pills are often used to regulate the menstrual cycle. Calcium and vitamin D supplementation is also common for a girl who has suffered bone loss as the result of female athlete triad.
What If I Think Someone I Know Has It?

A girl with female athlete triad may try to hide it, but she can’t just ignore the disorder and hope it goes away. She needs to get help from a doctor and other health professionals. If a friend, sister, or teammate has signs and symptoms of female athlete triad, discuss your concerns with her and encourage her to seek treatment. If she refuses to seek treatment, you may need to mention your concern to a parent, coach, teacher, or school nurse.

You may worry about being nosy when you ask questions about a friend’s health, but you’re not: Your concern is a sign that you’re a caring friend. Lending an ear may be just what your friend needs.
Tips for Female Athletes

Here are a few tips to help teen athletes stay on top of their physical condition:

* Keep track of your periods. It’s easy to forget when you had your last visit from Aunt Flo, so keep a calendar in your gym bag and mark down when your period starts and stops and if the bleeding is particularly heavy or light. That way, if you start missing periods, you’ll know right away and you’ll have accurate information to give to your doctor.
* Don’t skip meals or snacks. Girls who are constantly on the go between school, practice, and competitions may be tempted to skip meals and snacks to save time. But eating now will improve performance later, so stock your locker or bag with quick and easy favorites such as bagels, string cheese, unsalted nuts and seeds, raw vegetables, granola bars, and fruit.
* Visit a dietitian or nutritionist who works with teen athletes. He or she can help you get your dietary game plan into gear and determine if you’re getting enough key nutrients such as iron, calcium, and protein. And if you need supplements, a nutritionist can recommend the best choices.
* Do it for you. Pressure from teammates, parents, or coaches can turn a fun activity into a nightmare. If you’re not enjoying your sport, make a change. Remember: It’s your body and your life. You — not your coach or teammates — will have to live with any damage you do to your body now