Teenagers - Frequently asked questions

I don't want to tell my mum about my problem

You might be surprised that your mum is more understanding than you expect. However if you really cannot approach her, do you think you would be able to talk to your family doctor? Doctors will keep any information you give them private and there is no way they would tell your parents unless you specifically ask them to.

You might even find that after talking to your doctor that what was worrying you is something you don’t feel so bad about telling your mum after all.

If you don’t have a family doctor or don’t want to talk to someone who doesn’t know you or your parents there are other sources of medical help you can approach. These include Family Planning clinics which offer many more services related to sexual health than just family planning or Sexual Health Centres which you will often find at your nearest public hospital or women’s hospital. You do not need a referral from a family doctor, and often you do not need to make an appointment.

It’s itchy down there. What should I do?

The first thing to do is try not to scratch! Scratching damages the skin and then makes the itching worse.

The second thing to do is don’t panic. You might be worried that you have picked up a sexually transmitted infection. In fact, these rarely cause itching. Or you might assume you have thrush. It’s true: you may, but not everything that is itchy is thrush. There are other causes and it’s important to work out what is wrong so going to the chemist and buying a tube of antifungal cream is not the solution. You should see a doctor and make sure the doctor conducts an appropriate examination: this means having a look and taking vaginal swab. This isn’t unpleasant and just involves putting a long cotton bud about 2-3 cm into the vagina.

In the meantime, wear loose cotton underwear ( try to avoid tight and heavy clothes), wash with a soap substitute and during your period use tampons rather than pads , and avoid wearing panty liners.

See Essential Information for more info

I had sex with a boy and now I think I have genital warts

Genital warts are the commonest sexually transmitted infection. They are slightly rough, can range in number from a few to many, and can be found anywhere in the genital area. See Genital Warts in Medical Information on this website.

Not every lump and bump on the vulva is a genital wart. They can be confused with other things that are completely normal. So if you suspect you have genital warts it is important you see a doctor to get a correct diagnosis.

Genital warts are not dangerous and they are hardly ever a serious problem. If you do have warts they can be treated either by freezing or with a cream.

Have you received the wart virus vaccine yet? If not, you consider this carefully as it will significantly reduce your chance of catching genital warts and will reduce your chance of later on getting cause cancer of the cervix ( neck of the womb).

On this subject it is very important to have regular Pap smears once you have started having sex. This is to pick up the earliest changes which may lead to the development of cervical cancer.

I don't look like the pictures on the internet

Don’t worry! There is a huge variation in what is normal, especially in colour, hair, size ( especially of the labia - the lips). If you are not sure, see a doctor or nurse.

Is it OK to wax my pubic hair?

Many women have hair removed from different parts of their bodies, by different methods, including shaving, waxing, chemical hair removal creams, or laser.

Waxing can be quite painful, and sometimes causes a pimply reaction around the hairs but is a commonly performed procedure.

But don’t feel under any pressure to remove hair. Many women don’t. A lot of teenagers feel that pubic hair is dirty or embarrassing but it’s really natural and normal: everyone has it.

Can I get my vulva pierced?

Yes you can, but you should be prepared to look after the piercing site with good hygiene practices. The site may become inflamed and red while it is healing and there is a risk of infection which would need treatment with antibiotics. There is a low risk of developing an allergy to the metal in the piercing.

If you do decide to go ahead with piercing , make sure you go to a reputable place and ensure the equipment used is sterile ( or only used once). Many piercing salons now use non allergenic studs or rings which reduce the risk of development of allergy.

Is it ok to use tampons before you have had sex?

Absolutely. Sometimes tampons require some practice to learn how to insert them but this information is provided in the packet.

You have probably heard about the hymen. This is a ring of tissue around the opening of the vagina. It can make the vaginal opening smaller but never closes it completely and it is certainly still big enough for you to get a tampon in. If you are having trouble using tampons for the first time see a sympathetic female doctor or sexual health nurse who will show you how it’s done.

Tampons come in different sizes: mini, regular and super. Choose the super ones on the first few days of your period when flow is heavy and regular and mini ones when flow is lighter.

What are the correct names for parts of the vulva?

It’s useful to know the correct names for parts of your vulva, because it helps you to understand things you are reading on the internet and it will also help you communicate effectively with your doctor.

Have a look at the diagram in Essential Information "Some Facts About the Vulva". It shows you what the correct names are.

How do I know if there is something wrong?

There is a big variation of normal anatomy. Some types of lumps and bumps are just normal for you.

The sort of thing you experience when something is wrong are persistent itch, rawness, pain, burning, and discharge. If you notice lumps, blisters and ulcers something may be wrong as well.

Periods: “Menstruation”

There is a big variation in how frequent and how long periods last. It is common to experience some discomfort and cramping in the lower abdomen.

You can use either pads or tampons to absorb menstrual blood.

Pads come in different ‘strengths’, depending on absorbency. You may need a thicker pad on the days your period is heavier. Pads with wings are useful to prevent leaking onto underwear. You need to change pads when they look soaked.

Some girls find tampons easy to use from the beginning, others need a little practice.

Tampons should be changed every few hours as necessary. You can tell a tampon needs to be changed by tugging on the string: if it is ready to be changed it will glide out easily. Don’t leave tampons in place for more than a few hours. You can leave them in overnight towards the end of your period, but during the first two days, they may not last all night.

If you are using tampons and your period is light, it is okay to go swimming.

Pads and tampons should be wrapped and then placed in the bin if at home or a private house. Public toilets usually contain special disposal bins for direct deposition of “sanitary waste”.

Never flush pads or tampons down the toilet; they can block the plumbing, especially if it is a septic system.

Is there anything special I need to use to wash down there?

The genital area is just skin, like the rest of your body.

Because the vulva is close to the anus ( where the bowel opens onto the skin) bowel bacteria can sometimes contaminate your genital skin and cause infection of the urinary tract.

The vulva contains a lot of sweat glands and it gets sweaty just like your armpits and often has a sweaty smell. This is completely normal.

Apart from this, the vulva is not a dirty area, and vulval problems are not due to poor hygiene. All that is required for cleaning the vulva is a mild soap (that means not one with an antiseptic or perfume) or a non soap cleanser once daily. There are many brands, available in supermarkets and chemists. Typical products that will usually be okay are often called pure soap, simple soap or non-perfumed soap.

Shower gels, or liquid soaps can be irritating to vulval skin.

You will probably come across special “feminine hygiene” deodorants in the supermarket. The perfume in them can be irritating so before you use them, test on a small area. Never spray them into your vagina.

If you are not sure, ask your chemist.

What is the best underwear?

The best type of underwear is one that feels comfortable for you.

If you have sensitive skin the type of underwear that is least likely to cause problems is loose underwear made of cotton blends.

G- strings, synthetic nylon fabrics and control pants can cause quite a lot of irritation and itching because they rub on your skin and make you more sweaty.

What are some common genital diseases?

  • Dermatitis
  • Psoriasis
  • Lichen sclerosus
  • Thrush
  • Warts
  • Herpes
  • Chlamydia
  • Trichomonas
  • Bacterial vaginosis ( BV)

I’m really nervous about going to the doctor. What can I expect? I’m too scared to go without my mum but I don’t want her to know.

Is there something you would really like to talk to a doctor about but don’t want your mum to know? Do you know what to do to get to see a doctor on your own?

It is important for you to understand that it is OK for you to see a doctor on your own and you should know that it is actually the law that you have a right to insist that your mum wait outside from the age of 14. From that age, your doctor is also, by law, not allowed to tell your mum anything that has been said between you unless you give permission. From the age of 14, a doctor can prescribe the birth control pill for you without asking permission from your parents.

Of course the thought of doing this may feel pretty terrible and you might be scared that your mum will be suspicious or angry. That is very possible and it’s a good idea to talk to the doctor about how you will handle this at home.

Do you think you would be strong enough to ask your mum if you could see the doctor on your own? If you are too scared to ask before the doctor's appointment, ask in front of the doctor. Doctors are used to this and they will defuse the situation with your mum. The doctor will probably ask you how much you want them to tell your mum. A sympathetic doctor will ask your mum to come in at the end of the appointment to fill her in on what you are prepared to let her know.

If there is something serious going on, the doctor will encourage you to tell your mum, but you won’t be forced. That’s the law. But try to imagine how your mum feels too. She loves you and wants to protect you and might feel very hurt that you would want to talk to a doctor without her being there. Chances are your doctor can help the two of you get together on your problem.

If you feel that the only way you could see a doctor on your own would be to go by yourself or with a friend then you will need to make an appointment yourself. If you are worried that you won’t be able to afford to go to the doctor, you should also know that you can apply for a medicare card of your own when you turn 15. Not all doctors accept a medicare card as full payment but if you explain your situation to the doctor's receptionist you will probably find that she will be sympathetic to the fact that you are at the doctor on your own and will ask the doctor if it OK for you to pay for your appointment with your medicare card.

If you are seeing a doctor on your own about a genital problem you may feel more comfortable with a female doctor. In many big practices you will find there will be a particular doctor who is interested in seeing young adults. Ask for an appointment with that person.

During the appointment the doctor will ask you questions about your symptoms, and your past medical problems and your social habits. Some of the questions can be very personal and seem a bit intrusive but everything you tell the doctor is confidential. It is important for the doctor to know this kind of information about you so he/she can find out what your problem is.

Then the doctor will ask to examine you. If the doctor is male, he will probably ask a female nurse to come in to accompany him while he does this so that you are not alone in a room with a male person. If he doesn’t and you feel uncomfortable you can ask for someone else to be present, or take a girlfriend with you.

You will be asked to lie on your back, bend your knees and then let your legs flop apart. Being examined like this can be very embarrassing. You can ask the doctor to stop at any time. If you have a vulval problem it is important for the doctor to examine the genital area, just the same as any other area of the body to be able to reach a diagnosis.

If a vaginal problem is suspected ( for example, abnormal discharge ) or if you need a Pap test, the doctor may have to perform a speculum examination. This will mean putting a plastic or metal instrument that looks like a bird’s beak into your vagina to open it so the doctor can see inside. The doctor will tell you exactly what is going on. If you feel any discomfort tell him or her immediately.

If the thought of having an examination like this is just too frightening or painful your general practitioner will probably refer you to a specialist. Sometimes if it very important to have an examination but you just can’t handle it, you can have a general anaesthetic to be examined. It isn’t usually necessary, but it can be arranged.

What causes thrush and how can I avoid it?

Thrush is a very common vaginal infection which causes itching and discharge. It often happens after a course of antibiotics but in some people it just happens out of the blue with no obvious cause. Thrush is often more of a problem once you start having sex.

Some people are much more prone to having thrush than others.

If thrush has happened to your more than a couple of times a year you should avoid taking antibiotics unless they are really necessary but apart from that there isn’t a lot of other things you can do. Some people believe that taking probiotics during courses of antibiotics reduces the likelihood of getting thrush but they don’t always work and are quite expensive.

Thrush is usually easy to treat with a single oral antifungal capsule or a 3 day course of vaginal anti-thrush pessaries.

If I don’t treat thrush will it cure itself?

Yes, that can happen but it can take a long time. It’s best to get some treatment because treatment is safe and effective. It can be bought over the counter at the chemist. However if treatment doesn’t work right away (within a week) don’t just buy another dose. See your doctor.

If I have a lot of attacks of thrush will it make me infertile one day?

Absolutely not! But it can make you to uncomfortable to have sex and that can certainly affect your chances of getting pregnant. If you have 4 or more attacks of thrush in a year don’t just keep getting antifungals from the chemist. See your doctor. You may need to see a specialist.

How do I know if I have a sexually transmitted infection? (STI)

In order to get an STI you usually need to have had unprotected sex (sex without a condom). Condoms do not completely protect you from STIs.

Oral sex also does not protect you from sexually transmitted disease.

Sexually transmitted diseases are NOT picked up from toilet seats. You can only catch them from having sex with another person.

The warning signs of sexually transmitted infection are:

  • A change in your discharge, particularly if it becomes itchy, yellow, irritating or smelly.
  • Sudden painful blisters or ulcers appearing on your vulva.
  • Lumps on your vulva
  • Tender lumps under the surface of the skin of your groin. These are swollen lymph glands that may come with some infections.

It is important to realize that all of these things can be the result of things other than STI’s. If you are worried see your doctor or visit a sexual health clinic.

What is Chlamydia and why does it cause infertility?

Chlamydia is a sexually transmitted bacterial infection. You catch it by having unprotected vaginal, anal or oral sex from someone who has the infection.

You usually know you have Chlamydia because of a change in your normal discharge, unusual vaginal bleeding or lower abdominal pain.However it is common not to have any symptoms at all.

Chlamydia is easily cured with a course of antibiotics but if it isn’t treated it can lead to Pelvic Inflammatory Disease (PID). This causes inflammation of your internal reproductive organs which in turn can scar your fallopian tubes (the tubes that lead from your ovaries to your uterus, or womb). This is what causes infertility. It can also lead to chronic pain.

When you have Chlamydia, your partner should always be treated at the same time as you.