Teen Survival Guide

Teen
Survival
Guide
Health Tips for On-the-go Girls
U.S. Department of Health and Human Services

Office on Womens Health
Introd
Introduction
ave you ever had a question that you were too shy to
ask? Maybe something like:
Does chocolate cause pimples?

What do I do if the kids at school make fun of me?
Can I get a sexually transmitted disease from kissing?
Dont worryyoure not the only one! Every young woman has questions like these. Everyone can use some advice.
Having questions is a sign that you are growing up. It
shows that you want to take care of yourself. Dont be
afraid to go to a parent or guardian, school nurse, or other
trusted adult for honest and straight answers. They were
young once, too!
You can also look to this guide for helpful information. It
offers:
teen tips
activities
fun quizzes
a glossary of new words
questions from young women
And, if you want to learn more, you can check out
www.girlshealth.gov or the other web sites listed here.
You can also share what you know by posting your
thoughts on issues facing teens in the Speak Up section
of www.girlshealth.gov.
Be informed so that you can make healthy choices!
Teen Survival Guide: Health Tips for On-the-go Girls
Table of Contents
Taking care of your reproductive health
Your body .................................................................................................4
Your period...............................................................................................7
Premenstrual syndrome (PMS)...............................................................10
Sexually transmitted diseases (STDs)....................................................12
Seeing your doctor.................................................................................17
For more information.............................................................................19
Taking care of a beautiful you, inside and out

Hair and skin care...................................................................................20
Sleep.........................................................................................................24
Exercise....................................................................................................26
Eating well................................................................................................30
Fighting germs.........................................................................................33
Smoking...................................................................................................35
Alcohol and other drugs.........................................................................37
Feeling good about yourself

Self-esteem..............................................................................................40
Body image .............................................................................................42
When youre not happy..........................................................................44
www.girlshealth.gov
Taking charge of your world

Stress and how to deal...........................................................................48
Healthy relationships..............................................................................50
Peer pressure and how to say no...........................................................53
Dealing with bullies.................................................................................55
Staying safe..............................................................................................57
If your parent uses drugs or alcohol...................................................... 61
Planning your future

Discovering your interests and talents..................................................64
Thinking about a career..........................................................................67
Glossary
Bold words are listed.............................................................................70
Taking care of your

reproductive health
Your body
The way the female body is
designed is really cool if you
think about it. Check out these
graphics to learn about the major
reproductive organs. These are
the parts of the body involved in
making a baby.
OvaryWomen have two ovaries,
which have eggs (ova) and make
female hormones. One of the
www.girlshealth.gov
ovaries lets go of an egg about once

each month as part of the menstrual cycle. This is called ovulation.
Fallopian tubeWhen an egg is
released, it travels through the
fallopian tube toward the uterus.
FertilizationWhen a mans sperm
and a womans egg join together.
This usually happens in the fallopian
tube.
mons
pubis
clitoris
labia
vaginal
opening
urinary
opening
anus
Outside of the body, the

entrance to the vagina is
covered by the vulva,
which has five parts:
mons pubis, labia,
clitoris, urinary opening
and vaginal opening.
UterusThe uterus is a pearshaped, hollow organ where a

baby grows during pregnancy. The
lining of the uterus is called the
endometrium. This lining is shed
during a womans period. Eggs
that are not fertilized are shed
along with the lining of the uterus.
vix are flexible so that it can expand

to let a baby pass through during
birth. (Very cool!)
CervixThe cervix is a slim

entrance between the vagina and
the uterus. The muscles of the cer-
VaginaThe vagina is a muscular

passage that leads down from the
cervix to the outside of the body.
HymenThe hymen is a thin piece

of tissue that covers the opening of the vagina. This tissue can
be broken through with the first
sexual intercourse.
Know your Breasts
Nipple
Areola
(the dark area

around the nipple)
Every girls breasts are different

in shape, size, and in color. You can
get to know the way your breasts
look and feel by doing a monthly
breast self-exam. (Check out the
web sites listed at the end of this
section to learn how.) This way,
you can ask your doctor about
anything you are unsure about.
Fun quiz
The ovaries begin to
make more e_ _ _ _ _ _ _
and other hormones
during puberty.
*Hint: You can find the answers in
one of the web sites listed at the
end of this section.
Answer: estrogen
To: girlshealth.gov
From: Cecelia (11), Corpus Christi, Texas
I hear people call parts of a womans body names that I
dont understand. How do I know the right terms to use?
Youre right. There are many slang words people use for
the parts of a womans body. You may hear them used by
kids at school and even on TV, in movies, or in some of
your favorite songs. Some of these terms can be really
negative and even make you feel ashamed about your
body. You need to use the right names for sexual organs
for two reasons: to be respectful of a womans body and
to be able to talk about any problems with your doctor.
(See pages 4 and 5 for the right terms.)
www.girlshealth.gov
Your period
Your period doesnt have to keep
you from doing the things you
like to do. Nobody even needs to
know youre having it but you!
Tampons or pads? Its your

choice
What you should know about
tampons:
] Tampons are put inside of your
vagina to soak up blood before
it leaves your body. Instructions
come with tampons to show
you how to put them in.
] Some tampons have a plastic
or cardboard coveringcalled
the applicatorthat makes
it easier for you to put the
tampon in. Do not leave the
applicator inside your vagina.
] All tampons have a string at

the end to help you take it out
when it needs to be changed (at
least every 4 to 8 hours).
] Tampons will not get lost in
your vagina or slip up.
] You can wear tampons when
you swim. Water does not
enter your vagina.
] It is VERY important that you
use the tampon with the lowest
level of absorbency (the amount
it can soak up) for your needs.
Dont use a super tampon
if you only need a regular
tampon.
Teen tip:
To clean menstrual blood
from your
underwear or
clothes, soak
the spot for
a few minutes in COLD water
mixed with a little laundry
detergent. Once the blood is
washed out, wash with other
clothes as usual.
] Using tampons that are too absorbent or not changing them
often enough can put you at
risk for toxic shock syndrome
(TSS), a rare yet dangerous
infection.
Tell an adult and call a doctor if
you are using tampons and have
the following:
High fever that comes on all
of a sudden
Muscle pains
Dizziness or fainting
A rash that looks like sunburn
Bloodshot eyes

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Strange vaginal discharge

(fluid) with an unusual scent,
look, or feel
Feeling of confusion
It is possible to tear your hymen
by putting in a tampon, but this is
rare. If it does tear, this does not
mean you are no longer a virgin.
You are a virgin until you have
sexual intercourse.
What you should know about
pads:
] Pads stick to the inside of your
underwear and soak up the
blood that leaves the vagina.
] Some pads are thin, for days
when your period is light. Some
are thick, for when you are
bleeding more. You also can use
thicker pads at night when you
sleep.
] During the day, it is best to

check your pad every couple of
hours so that you can change it
before it is soaked with blood.
] If you are worried about any
smell, changing pads often and
] You probably dont want to

wear pads when you swim.
They will soak up water and be
bulky.
keeping up good hygiene will

help control this. You do not
need to use deodorant pads.
To: girlshealth.gov
From: Nicole (age 12), Greeley, Colorado
Do I need to douche?
Vaginal discharge and having your period might feel

messy to you at first. But rinsing or cleaning out the vagina with douche, (cleansing with a special product that
is sold for this purpose), is not a good idea. Douching
can make you more likely to get dangerous infections. To
keep feeling fresh, wash your vulva with gentle, scentfree soap and try using panty liners when youre not
having your period. Over time, you will get used to these
feelings and may not notice them at all!
Premenstrual
syndrome
(PMS)
Are you feeling grumpy, tense, tired
or depressed? Maybe you cry a lot
and crave certain foods, too. Or
maybe you have felt changes in your
body, like acne, a bloated stomach,
breast aches or slight weight gain. If
you feel this way and its also a few
days before your period, you might
have premenstrual syndrome or
PMS. Dont worry! PMS is a normal
part of having a period, and you will
feel better soon!
If you get PMS, try

] Eating more healthful foods and
less sugar and fat.
Teen tip:
To make menstrual cramps better, put a warm water bottle or
heating pad on your lower back
or lower belly. You may also
try hugging a pillow. Dont ever
take medicine without permission from a parent or guardian.
10
www.girlshealth.gov
] Eating less salt the few days

before your period, which can
help stop bloating.
] Drinking less caffeine (found
in soda, tea and coffee) to feel
less crabby and help ease breast
aches and cramps.
] Eating small meals often each
day rather than big ones.
] Exercising for at least 30 minutes, four to six times a week.
If you have cramps or aches and
pains, dont exercise so hard
you can walk instead of jog.
] Sleeping at least 8 hours each
night.
] Talking to your doctor about

your PMS symptoms. Your doctor may have you take a pain
reliever that has ibuprofen or
naproxen, which you can buy
at a grocery store or drugstore
without a doctors orders.
Make sure you have permission from a parent or guardian first. Your doctor may
give you other medicines if the
symptoms are really bad.
Fun quiz
No one knows for
sure what causes PMS,
but it seems to be
linked to the changes in
h _ _ _ _ _ _ levels that
happen during your
menstrual cycle.
*Hint: You can find the answer in
Answer: hormone
] Keeping a regular schedule for

exercise, meals and bedtime.
To: girlshealth.gov
From: Traci (age 14), Anchorage, Alaska
I feel really down before my period. Is this normal?
The blues are a normal part of PMS. If your mood doesnt
get better within a few days after starting your period, talk
with your doctor or a parent or guardian. Also, check out
the signs of depression on page 45.
11
Sexually
transmitted
diseases (STDs)
Sexually transmitted diseases
(STDs) are on the rise among
young people. STDs are caused by
many different viruses and bacteria that spread through sexual
contact. Some examples of STDs
are chlamydia, crabs (pubic lice),
genital herpes, gonorrhea, hepatitis B, HIV/AIDS, and syphilis. Even
if youre not sexually active now,
its vital to know how to protect
yourself later.
Four key things you need to

know about STDs
1. STDs can affect anyonewomen and men of all ages and racial
and ethnic backgrounds. Teens
and young adults get STDs
more often than any other age
group. About three million
teens get STDs every year. That
means about one in four sexually active teens gets an STD.
12
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2. You can get an STD by having any kind of sex, including

vaginal (penis is put into vagina),
oral (sucking and/or licking of
sex organs), and anal (penis is
put into butt). You can also get
an STD by having other close
sexual contact with someone
who already has an STD.
3. Often, STDs cause no symptoms at first. Even if you have
no symptoms, you can still pass
an infection on to another person. If you get symptoms, they
can seem like other problems
that arent STDs, such as yeast
infections.
4. While some STDs can be

treated and will go away, others
cant be cured. You can only try
to make the symptoms better.
If untreated, some STDs can
lead to pelvic inflammatory
disease, infertility, cancer of
the cervix, or even death. If
you think you have a problem,
see your doctor right away.
Your doctor will check your
skin, throat and genital area.
Your doctor may also test your
blood, urine, or a sample of
tissue or fluid from your body.
If you have an STD, your doctor
can start taking care of you
right away. Even if your STD is
cured with treatment, you can
still get it again if you are sexually active and do not protect
yourself.
Protect yourself from STDs

] You cant get an STD if you
do not have sex of any kind or
close sexual contact with someone. The best way to protect
your health is to wait until you
are married to have sex.
] Condoms cant protect you

from all STDs. But, if used
correctly and used all the
time, condoms will lower your
chances of getting some STDs.
Condoms will also lower your
chances of getting pregnant.
] Talk to your parents or guardians, an older brother or sister,
or another trusted adult about
sex to help you make wise
choices.
Abstinencenot having sexis
the only 100 percent sure way to
not get an STD.
How do I know if I have an

STD?
You should see a doctor right
away if you have lower stomach
pain or have vaginal discharge
(fluid) that is yellow, gray, or green
with a strong smell. In between
periods, it is normal to have a
clear or whitish fluid (discharge)
coming from your vagina.
See your doctor if you have any
of the other symptoms of common STDs that follow.
13
STD
Chlamydia
Genital
herpes
Syphilis
Crabs
(pubic lice)
14
Symptoms
Often no symptoms
Abnormal vaginal discharge
Burning sensation when urinating (peeing)
Painful small red bumps, blisters, or open sores on
or around your genital area or rectum
Some infected people may never have sores
Fever, headache, or other muscle aches
Swollen glands in the genital area
Pain in legs, buttocks, or genital area
Abnormal vaginal discharge
Pain when urinating (peeing)
Early on: Painless sores in the genital area, on
the lips, or in the mouth and swollen lymph
glands
Later: Skin rash on the palms and feet, fever,
swollen lymph glands, sore throat, patchy
hair loss, headaches, weight loss, and
tiredness
Left untreated: Damage to the brain, nerves,
eyes, heart, and blood vessels; can lead to
death
Itching in the pubic area
Often people have no symptoms
Sometimes rust colored spots on underwear from
bleeding where you have been bitten
Mild fever and tiredness if you have been bitten by
a large number of lice
www.girlshealth.gov
STD
Gonorrhea
Hepatitis B
HIV
(Human
immunodeficiency
virus)
HPV
(Human
papillomavirus)
Symptoms
Most have no symptoms
Pain or burning sensation when urinating (peeing)
Yellowish and sometimes bloody vaginal discharge
Vaginal bleeding between menstrual periods
Anal discharge, itching, and soreness if the rectum is
infected
Yellow skin or yellowing of the whites of the eyes
Tiredness
Dark-colored urine
Lower stomach pain
Loss of appetite
Nausea and vomiting
Diarrhea
Joint pain
Some have no symptoms
Extreme tiredness
Rapid weight loss
Swollen lymph nodes
Getting low fevers and night sweats often
Getting oral or vaginal yeast infections and other
STDs often
Red, brown, or purplish marks on or under the
skin or inside the mouth, nose, or eyelids
Most people have no symptoms and do not know
they are infected
Some types of HPV can cause wartssome painful,
some notin the genital area
15
Having a baby while you are a teen

can be very hard.
1. Teen mothers are less likely to
finish school and more likely to
be single parents.
2. There are serious health risks
for teen girls who have babies.
3. Teen pregnancy is closely linked
to poverty and single parenthood.
Not having sex is the only 100
percent sure way to not get pregnant. If you do become pregnant,
talk to a trusted adult such as a
school counselor or parent or
guardian. Also, see a doctor right
Fun quiz
By the age of 21, almost
___ in 5 people in the
U.S. will need to be
treated for an STD.
Answer: 1
What about pregnancy?
away. It is important to get good

prenatal care, which is special
health care for pregnant women. If
you have a friend who is pregnant,
urge her to talk to an adult and
see a doctor right away.
To: girlshealth.gov
From: Allyson (age 14), Portland, Maine
Can I get an STD from kissing?
Kissing is pretty safe. But, you can catch a common virus

that causes cold sores if you kiss someone who has a
cold sore at the time. This virus is called herpes simplex
virus one or HSV-1. STDs are usually spread during
risky acts like vaginal intercourse, oral sex, and skin-toskin contact in the genital area.
16
www.girlshealth.gov
Seeing your
doctor
As you become a woman, its
important to have checkups once
a year with a doctor or other
health care provider. He or she
will check out your general health
and reproductive health.
Your doctor might ask you

questions about:
] your vagina, such as if you have

had any unusual discharge, itching, or odor
Even if these questions make
you feel a little embarrassed, it
is important to be honest. Your
doctor needs the right information about your health and body.
This way, he or she can help you
out if you have a problem. Keep in
mind your doctor has heard these
questions before.
] your general health, allergies, medicines you are

taking and your health
concerns
] your mental health, depression, and stress level
] whether or not you feel safe
] your period, such as how
long it lasts, how old you
were when you first got it,
and when the first day of
your last period was
] when your breasts started
to grow
] whether you have ever had
sex or have been sexually
abused
17
You should see a gynecologist or ] you are having problems with

your periods
another doctor who specializes
in womens reproductive health
if any of these apply to you:
] you have ever had sex (vaginal,
oral, or anal) or intimate sexual
contact
] you are 21 or older
] you have lower stomach pain,
fever, and vaginal discharge
that is yellow, gray, or green
with a strong smell (these may
be signs of PID)
To: girlshealth.gov
From: Jody (age 15), Rockaway, New Jersey
Will my doctor tell my parents about anything I share
during my visit?
Most states have laws that allow teens to see a doctor for
their reproductive health without getting a parents okay.
Your doctor will do his or her best to make sure your visit
stays confidential (private), but you can always ask him
or her what the rules are before your exam. If the doctor
thinks that you may harm yourself or others, he or she
may have to tell your parents, guardians, or others about
the visit. Even though its important to trust your doctor,
talking to your parent or guardian about your health care
is the smart way to go.
18
www.girlshealth.gov
More information on taking care of your reproductive health

How to do a breast self-exam:
] www.kidshealth.org/teen/
sexual_health/girls/bse.html
Your reproductive health:
] www.girlshealth.gov/body/
reproductive_health.htm
sexual_health/changing_body/
female_repro.html
Your period:
period.htm
sexual_health/girls/
menstruation.html
Different types of STDs and

protecting yourself:
reproductive_std.htm
] www.iwannaknow.org
General health and
gynecological care:
reproductive_gynecologist.htm
sexual_health/girls/obgyn.html
Learn more about teenage
pregnancy:
] www.teenpregnancy.org
Notes
19

Taking care of a
beautiful you, inside and out
Hair and skin
care
Beauty magazines show tons of
beautiful girls and women in ads
for hair and skin products. But,
dont be fooled into thinking you
need these products to look your
best. Instead, try these time-tested beauty basics, which will keep
you looking naturally beautiful!
This is the same girl!
Skin care 101

] Wash your face regularly using a
mild cleanser and warm water.
Be gentledont scrub hard!
Avoid astringents, which can
dry out and irritate skin.
Dont compare yourself to models. They have a team of stylists

as well as camera tricks to make
them look so perfect.
20
www.girlshealth.gov
] Use only light, water-based

moisturizers. Look for one that
has SPF 15 or a higher number
sunscreen.
] For sensitive skin, try products
that say fragrance-free or
without perfume.
] Always wear broad-spectrum

sunscreen, which protects
against UVA and UVB rays.
Wear sunscreen even on cloudy
days. SPF alone does not protect
against these two types of harmful rays. Follow the directions on
the bottle to put more on after
a while. Wear lipscreen with
at least SPF 15. And, your skin
needs more than just sunscreen.
Wear long-sleeve shirts,
pants, and a hat.
Stay in the shade.
] If youre allowed to wear

makeup, use only water-based
products that say noncomedogenic or nonacnegenic on
the label. Make sure to take off
your makeup before going to
bed.
] To control acne, try over-thecounter products that you can
buy without a doctors order.
These products come as gels,
lotions, creams, and soaps.
Your doctor can treat more
serious acne problems.
Stay out of the sun in the

middle of the day, when rays
are strongest.
Hair care 101

] Wash your hair regularly, but
only as often as you need to.
Washing too often can strip
away the natural oils that give
hair shine and body.
] Drink plenty of water.

21
] If you see white flakes in your

hair or on your shoulders, try a
shampoo that treats dandruff.
These shampoos are sold near
other hair-care products.
] Use shampoo, conditioners,
and styling products that are
right for your hair type.
Teen tip:
Wear wrap-around sunglasses
that provide 100 percent UV
ray protection. They look cool
and keep your eyes safe.
] Try different styles and looks.

But beware of products that
perm, relax, or color hair at
home. They have chemicals that
can damage your hair. Also,
over styling with hairdryers or
curling and flattening irons can
cause your hair to dry out or
break.
Fun quiz
The suns UV rays are
strongest between ___
a.m. and ___ p.m.
Answer: 10 a.m. and 4 p.m.
22
www.girlshealth.gov
] Protect your hair and face from

sun damage by wearing a hat
or scarf that covers the back of
your neck and face.
] Protect your hair from chlorine
(found in pool water) by wearing a swim cap or rinsing out
your hair right after swimming.
Soaking your hair with regular
water before you put on your
swim cap can also help.
Beauty Dos and Donts

] DO look your age. Heavy makeup hides your young, natural
beautythe beauty older
women try so hard to get back!
] DONT pop zits. This can cause
infections and scars that are
hard to get rid of.
] DO wear sunscreen. Protect

your skin from the sun to help
stop early wrinkles.
] DONT be hard on yourself.
Instead of thinking about what
you dont like about your body,
love the things that make you
unique.
To: girlshealth.gov
From: Lena (age 11), Emporia, Kansas
Does eating chocolate cause pimples?
No wayand neither do dirt, fried foods, or sexual activity. Changes in your skin during puberty trigger acne.
Stress, your period, picking at or popping your pimples,
scrubbing your skin too hard, getting too much sun and
using oil-based lotions, makeup, or hair gels can cause
breakouts to get worse.
23
Sleep
Heres what some teen girls say
about how their mornings go:
My alarm goes off, but I hit the

snooze button and go back to
sleep until my mom shakes me
awake.
I skip breakfast a lot because I
have to rush to get myself ready
for school.
Sometimes I miss the bus, and
my mom has to drive me to
school. She gets really mad
about that.
I dont wake up until my little
sister screams at me,Get up!
Youre going to be late!
I get to school on time, but then
Im like a zombie in class.
] Wake up at the same time each

morning and go to bed at the
same time each night.
] Relax before bedtime. A bath, a
book or a little TV can mellow
you out. But, dont watch TV in
bed.
Can you relate? Likely yes, since

some research shows only 20 percent of teens are getting enough
sleep! Try these ideas to make
sure youre not losing out on the
sleep you need.
24
www.girlshealth.gov
] Try a small snack with milk to

bring on the zzzs. Pigging out
before bed can make it harder
to doze off.
] Make sure your room is dark,
quiet, cool, and comfortable.
] Dont drink beverages with caffeine (like colas, coffee, and tea)
from afternoon until bedtime.
] Do homework and study earlier
in the evening. A good nights
sleep is the best way to get
ready for an important test or
quiz.
] Finish exercising at least three

hours before bedtime.
Teen tip:
Most teens need 8.5 to 9 hours
of sleep each night to be their
best at school, at sports, and on
the go.
To: girlshealth.gov
From: Samantha (13), Fort Wayne, Indiana
I get so sleepy after lunch. I keep zoning out in class.
What should I do?
Being part of class discussion can help perk you up. Or,
try taking notes to keep alert. Also, ask your teacher if
you can sit at the front of the class. And, try to cut back
on sugary foods at lunchthese foods can make you
sleepy.
25
Exercise
You may know girls who complain
about exerciseIts boring, Its
too hard, or It takes too much
time. Sure, keeping fit can challenge your mind and body. Just
keep in mind that exercise is key
to good health. Exercise can:
] help you keep a healthy weight
] help prevent serious illness,
like heart disease, certain
cancers, type 2 diabetes, and
osteoporosis
] boost your energy level and
mood
] help you to feel good about
yourself
Plus, it can be fun! So, dont make
excusesget active and keep
moving!
Keys to keeping active

] Just starting out? Begin with
small goals you can reach. Over
time, reach for higher goals.
If you want to run, start by
switching between running and
walking. Build up your distance
and speed over time.
26
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] Find the right activity for you.

Ask yourself: Will I enjoy it? Is
it safe? Do I have time to do it?
Do some of my friends want to
try it with me? Stick with the
things that you like, that you
have time for, and that you can
do safely.
] Protect yourself as needed by
wearing a helmet, mouth guard,
special eyewear or wrist, knee
and elbow pads. Make sure
your shoes are sturdy and fit
well. Ask a coach or adult to
help you pick out the proper
footwear.
Fun quiz
Not being active is called
s _ _ _ _ _ _ _ _. This
kind of lifestyle can
cause weight gain and
even obesity (dangerously high weight). It can
also put you at risk for
certain diseases.
Answer: sedentary
] Stretch your muscles for 5 minutes before and after working

out so that you dont get hurt.
] Dont overdo it! A good way
to know if youre working out
too hard (or not hard enough)
is the talk-sing test. If you can
talk while working out, you are
moving at a pace that is good
for you. If you are too breathless to talk, slow down. If you
can sing, pick up the pace.
] Drink water before, during, and
after your workout to keep
your body from overheating or
getting dehydrated. Dehydration
Activity:
For one week, give up 30
minutes of TV watching every
day to do something active.
You could walk the dog, turn
on some music and dance, or
go roller-blading with a friend.
When your week is up, write
down here how keeping active
has made you feel: __________
_________________________
_________________________
_________________________
27
happens when the body loses too

much water and it is dangerous.
] Do not exercise outdoors if it
is really hot and humid. Also,
avoid outdoor exercise if air
pollution levels are high.
] Dont overdo it! If working out
is all you do or think about,
talk with a parent or guardian,
coach, or another trusted adult.
Exercise is important, but too
much exercise can be very bad
for you.
For help getting started, check

out your local community or recreation center or look into your
activities at your school today!
Teen tip:
Teenagers need to exercise
about 60 minutes every day. The
exercise you get in your gym
class is probably not enough to
add up to the total amount you
need each week.
To: girlshealth.gov
From: Julie (age 15), Fremont, Nebraska
Why do people make such a big deal about heart

disease?
Heart disease is the number one killer of both men

and women. When you are young, its easy not to think
about this kind of problem. But heart disease comes on
over time, which is why it is so important to start having
a heart-healthy lifestyle when you are young. You can
lower your risk of getting heart disease by eating right
and exercising regularly. This also will help protect your
body from other health problems that are linked to eating
habits and physical fitness.
28
www.girlshealth.gov
think-about-what-you-can-do
Aerobic exercise
(burns fat, makes your heart stronger, and boost your energy level)
Fast walking
Jogging
Swimming
Dancing
Biking
Basketball
Jumping rope
Hiking
Roller-blading
Cross-country
skiing
Tennis
Kickboxing
Anaerobic exercise
(tones muscles and works with aerobic exercise to burn fat)
Stomach
crunches
Push-ups
Lifting weights
Pull-ups
Yoga
Pilates
(or, use canned

foods as weights!)
*Make sure to check with your doctor first if you have an injury or health concern.
29
Have you ever been asked, Are

you a healthy eater? What does
that even mean? Healthy eating
means getting the right amount of
calories, vitamins, and nutrients
your body needs to be its best.
How to be a healthy eater

] Follow the MyPyramid guide to
healthy eating. The colored sections stand for the food groups
and how much you need from
each group. Orange is much
wider than yellow because you
need plenty of grains each day,
but should limit how much oil
and fat you have. Choose foods
from each food group every
daydont forget about red just
because you love purple foods!
Fun quiz
Teens need roughly
_______ calories a day.
Answer: 2,000
Eating Well
] Learn how to read food labels.

If you know whats in your food
and how much, you can limit
those nutrients that you want
to cut back on and up the ones
you want to eat more of. For
example, you may want to eat
less saturated fat, but more
calcium.
] Be sure to check serving size.
One cup of breakfast cereal or
one slice of bread is a serving. A
serving of meat, chicken, or fish
is about the size of a deck of
cards.
] Get regular exercise. Teens need
about 60 minutes every day.
] Unless your doctor gives you
the okay, do not diet to lose
weight. Instead, change your
habits to focus on healthy foods
and exercise. Most teens are
30
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able to keep a healthy weight

simply by being more active.
] Dont skip meals. Breakfast is
especially important!
] Dont deprive yourself of foods
you love.
] Avoid emotional eatingeating because you are bored,
stressed, or feeling blue. Try
writing in a journal, talking to
someone you trust, working
out, or volunteering in your
community.
Teen tip:
There are no shortcuts to eating
right. Choose all kinds of healthful foods to get the calories, vitamins, and nutrients your body
needs. Do not take any dietary
supplements (like vitamins,
herbs, or protein powders) before checking with your doctor.
] Dont forget to enjoy food
and mealtimes with friends and
family!
Orange = grains (bread, cereal, rice,
crackers, pasta, tortilla)
Green = vegetables
Red = fruit
Yellow = oils, fats (butter,
mayonnaise, margarine, nuts,
salad dressings)
Blue = dairy, calcium-rich
foods (milk, cheese,
yogurt)
Purple = meats,
beans, fish,
poultry
31
Activity:
Make your own healthy eating plan online with MyPyramid Plan at
www.mypyramid.gov/mypyramid/index.aspx. This tool will help you
figure out how much you need to eat from each food group to be
healthy. Next, print out your plan and keep a copy in your purse. You
also might want to write down on your printout the foods that you like
from each food group. That way, when youre in the lunch line or out
with a group of friends, you can take a quick look at your plan to help
you choose what to eat.
To: girlshealth.gov
From: Tina (age 14), Chula Vista, California
My friend eats fast food and junk food all the time, but
she looks great. Does someone like her need to eat
healthy?
Eating right does help you to look your best, but its not
just how you look on the outside that counts. The body
needs certain vitamins and nutrients to build strong
bones and teeth, carry oxygen around the body, power
the brain, and lower your chances of getting certain diseases. Healthy food choices are packed with these kinds
of vitamins and nutrients, while fast food and junk food
are mainly empty calories, which means they have little
nutritional value. Eating poorly will catch up with you over
time.
32
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Fighting germs
It doesnt sound nice, but there
are germs everywhere. These
germs are so small that they can
hurt your body without you even
knowing. Germs can cause infections such as a cold or the flu.
They also can cause infections that
can put your life in danger, such as
HIV, the virus that causes AIDS.
You can fight germs by

] Washing your hands often: after
using the bathroom, after blowing your nose or coughing, after
touching animals, after gardening, before and after spending
time with someone who is sick,
Fun quiz
Wash your hands with
warm water and soap
for at least ____ seconds
before and after you
touch food.
and before and after handling

food.
] Making sure your immunizations are up-to-date. Immunizations also are called vaccines.
Immunizations protect you
from diseases that are easily
spread, such as the measles,
chicken pox, and the flu. Immunizations are usually given
as a shot. Ask your parents or
guardian if your shots are up-todate.
] Waiting until you are married
to have sex. If you are sexually
active, you can get a sexually
Answer: 20 seconds
33
transmitted disease or STD.

When used right and all the
time, condoms can help protect you from getting some
STDs. Condoms do not protect
against all STDs 100 percent
of the time. See the section
Taking care of your reproductive healthSTDs for more
information.
] Not sharing needles used for

drugs, tattoos, or pierced ears.
Sharing dirty needles (you cant
tell it is dirty by looking) can
give you HIV or hepatitis, which
can put your life in danger.
] Learning proper food handling
and storage.
To: girlshealth.gov
From: Casey (age 12), Fort Myers, Florida
Are hand-cleaning gels just as good as soap and water

at cleaning hands?
Washing your hands with soap and clean running water

for 20 seconds is best. But when soap and clean water
are not handy, an alcohol-based hand rub is very good
at lowering the number of germs on skin. Keep one
handy in your purse or coat pocket. Make sure to rub
the product all over your hands and fingers until your
hands are dry.
34
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Smoking
Did you know that most adult
smokers began smoking as teens?
Maybe they thought smoking
would make them look cool, help
them gain friends, or help them
deal with problems. Maybe they
thought they would try it only
once, or that they could quit at
any time. Youre smartdo these
sound like good reasons to you?
Before you light up, consider
that
] Most teens dont smoke. And
most teens think using tobacco
is gross and a turn-off. After all,
smoking makes your clothes
and hair stink, stains your teeth,
and causes bad breathyuck!
It also causes emphysema,
different types of cancers, and
wrinkles.
] The damage begins with the
first puffand gets worse as
you keep smoking. That means
if you play sports, are a dancer,

or sing or play an instrument,
you will not be able to do any
of these things very well.
] Social smoking is bad for you,
too. Smoking only at parties
is still dangerous. People who
only light up sometimes may be
less likely to ever try to quit!
Teen tip:
Many girls falsely think that
smoking is a good way to lose
weight. Eating healthy foods and
exercising are the only ways to
stay fit, healthy, and beautiful!
Activity:
Gross yourself out. Visit www.girlshealth.gov/substance/
tobaccoquiz.htm to find out whats inside a cigarettelike chemicals
used to kill rats!
35
] Smoking costs big bucks! It

will cost you about $1,000 a
year if you smoke a pack of
cigarettes each day. It will only
continue to get even more
costly. Think how many CDs or
clothes you could buy for this
money!
] Tobacco companies do not
care about you! Their goal
is to make their customers
addicts so that they can stay in
business. Dont get caught in
their trap.
P.S. If you are a smoker, you can

make quitting tobacco easier by
talking with your doctor, getting help
from your parents and guardians,
and hanging out with teens who
dont smoke or who have quit.
Fun quiz
N _ _ _ _ _ _ _ is the
addictive ingredient
found in all tobacco
products.
Answer: nicotine
] Its easier to never light up

than it is to quit. Most longterm smokers started in their
teens.
To: girlshealth.gov
From: Deanna (age 12), Muskogee, Oklahoma
Some girls at my school smoke light cigarettes. Are they
safe?
There is no such thing as a safe tobacco product. Even
though cigarette companies say that light cigarettes have
less nicotine and tar, they are just as dangerous as regular cigarettes. Cigars, cigarillos, and smokeless tobacco
(dip, spit, chew and snuff) also are addictive. These products can also cause serious health problems like cancer.
36
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Alcohol and
other drugs
Want to know the real truth
about drugs and alcohol?
] Drugs and alcohol change the
way your brain and body work.
] Drugs and alcohol can cause
life-long damage to your body.
] Alcohol and many drugs are
addictive, which means it can be
super hard to quit.
] Drugs and alcohol make it
harder to make safe choices and
protect yourself.
] Your body can have a bad
reaction to alcohol and drugs
you can become really sick or
even die. This happens to teens
every day.
] Its against the law to drink
alcohol before you are 21 years
old. Its also against the law to
have certain drugs, no matter
what your age. If you are at a
party with alcohol or illegal
drugseven if you are not usingyou could be arrested.
Dont allow anyone to give you
drugs without you knowing it.
Teen tip:
Making weekend plans? Ask
someone you trust, such as a
friend or older sibling, to go
along. Sticking together will
keep both of you safe and make
it easier to make smart choices.
] Dont accept drinks from
people you do not know or just
met.
] If possible, get drinks that are
unopened and open them for
yourself.
] Watch your drink and keep it
with you at all times, even when
you go to the bathroom. If you
didnt watch it the whole time,
get rid of it!
Activity:
So you know that drugs and
alcohol can cause awful problems. Now what? Practice so
that you can be ready to tell
your friends or anyone who offers you drugs or alcohol NO.
Check out page 53 for tips on
saying no and dealing with
peer pressure.
37
] Dont share drinks with anyone.

] Dont drink from punch bowls
or other large open containers.
They may already have drugs in
them.
] Dont drink anything that

tastes, looks, or smells strange.
To: girlshealth.gov
From: Danni (age 13), Gettysburg, Pennsylvania
rape drugs, such as rohypnol and GHB, are used

Date
to force sexual contact with someone. Often, they have
which makes themeasy
no color, smell, or taste,
to add
What are date rape drugs?
to a persons drink without anyone knowing. These drugs

make victims helpless and unable to remember what
happened. To protect yourself, open your own drink and
keep it with you at all times. For more information on
date rape, go to www.girlshealth.gov/safety/relationships.
htm#4.
38
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More information on taking care of a beautiful you, inside and out

Taking care of your hair and
skin:
] www.girlshealth.gov/body
] www.aad.org/public/
Parentskids/KidsConnection/
KCSunSafety101.htm
] www.cdc.gov/cancer/nscpep
] www.cdc.gov/chooseyourcover
Your bodys sleep needs:
quiz.sleep.cfm
] www.sleepfoundation.org
Staying physically fit:
] www.girlshealth.gov/fitness
] www.presidentschallenge.org/
home_teens.aspx
Nutrition and eating right:

] www.girlshealth.gov/nutrition
] www.mypyramid.gov
Fighting germs and
immunizations:
germs.htm
Staying tobacco free:
] www.girlshealth.gov/
substance/tobacco.htm
] www.cdc.gov/tobacco
Alcohol and drugs:
] www.girlshealth.gov/substance
] www.teens.drugabuse.gov
] www.freevibe.com
Notes
39
Feeling good about

yourself
] Think positively about yourself and the things you can
do. When you start to put
yourself down, STOP THAT
THOUGHT! Remind yourself
about the things that make you
special.
] Do things that you like, rather
than what others say you
should do.
] Give yourself the chance to do
well. Do something hard, but
within your reach, like speaking
Self-esteem means how you feel

about yourself. Many young women have low self-esteemeven the
prettiest, smartest, nicest, most
popular girl in school can feel
not good enough. Its normal
for teens to feel this way some of
the time, but you can boost your
own self-esteem. You dont have
to wait for someone else to do or
say something to make you feel
good about yourself.
40
www.girlshealth.gov
Fun quiz
Low self-esteem can
put you at risk for
serious problems, like
d _ _ _ _ _ _ _ _ _, drug
and alcohol use and
e _ _ _ _ _ disorders.
Answer: depression, eating
Self esteem
up in class or trying out for the

school play.
] Allow yourself to fail. Its okay
not to be the best at everything. No one is perfect!
] Stop thinking about you, you,
you! Help out by doing chores
around the house and volunteering in your community.
] If you are angry, try talking it
over with a friend or adult you
trust.
Activity:
Visit the Just4Me log at
www.girlshealth.gov/mind/
just4me.htm to track special
information just about you.
You can print out this log and
keep a copy in your locker, your
notebook, or your bedroom
to remind you of all the good
things that make you the great
person you are.
] If you feel down about yourself,

share your feelings with a family
member or friend.
To: girlshealth.gov
From: Rachel (age 11), Oakland, California
The kids in my school call me a geek just because I get
good grades. I wish that what they say didnt bother me,
but it does. Sometimes, I wish I were just average.
Being singled out can make anyone feel unsure and
upset. Still, you will never be happy with yourself if you
dont let the good things about you shine through. Stick
with people who like you for who you are. This will make
it easier to cope with name-calling and labels. And be
proud of your success!
41
Body image
Do you ever think that there is
something wrong with the way
you looklike youre too short or
too tall, too heavy, or too skinny?
These feelings about how you
look are called body image. Body
image can affect how you feel
about yourself in general. To build
a strong body image, keep these
dos-and-donts in mind:
] DONT think of the images
of girls and women you see in
magazines, in the movies, and on
TV as normal. They are not!
] DO make the most of your

unique shape by wearing
clothes that you feel good in.
] DONT compare yourself to
others, including your friends.
Body types come in all different
sizes, shapes, and colors.
] DO look your best by eating
healthy foods, exercising, and
taking care of your hair and skin.
42
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] DO walk with your shoulders

back and head high. Good posture says I like me!
Are you at risk for an eating

disorder?
Take the Quiz at www.anred.com/
slf_tst.html to find out.
Fun quiz
People who try to
become thinner and
thinner by not eating
have a _ _ _ _ _ _ _
nervosa.
*Hint: You can find the answer
in one of the web sites listed at
the end of this section.
Answer: anorexia
] DONT judge yourself on looks

alone. The secret to being beautiful is feeling beautiful, using
your mind.
To: girlshealth.gov
From: Kim (age 12), Suwanee, Georgia
A friend of mine throws up in the restroom after lunch.

What can I do to help her?
Try telling her: I am worried about you because I hear

you throwing up after lunch. I think you should talk to your
mom about this. Id like to be there for you if thats okay.
Your friend may get mad or deny it, or even ask you to
keep it a secret. Being a good friend also might mean
you need to tell her parents, your parents, or another
adult who can get your friend the help she needs. The
school nurse is also a good person for you to talk to
about your friend.
Teen Survival Guide: Health Tips for

On-the-go Girls
43
you have five or more of the following symptoms of depression

for at least two weeks, OR any
one of these symptoms gets in the
way of school or family life.
] sadness or crying that you cant
explain
] major changes in the way you
eat, such as not eating or overeating
] being crabby, angry, worried, or
nervous
When youre
not happy
Does your mood sometimes
change from one minute to
the next? This roller coaster of
emotions is normal when youre
a teen. But some feelingslike
strong sadness, anger, loneliness,
and fearcan keep you from
enjoying life. Ask yourself these
questions:
Are you depressed?

Its okay to have the blues
sometimes. But depression is a
serious illness that needs treatment. See your doctor or school
counselor if:
44
www.girlshealth.gov
] feeling negative or not caring

about anything
] feeling guilty or worthless
] thinking about death or suicide
] sleeping more or having trouble
sleeping
Activity:
On a piece of paper, write down
the things you are grateful for.
List the people who care about
you. Write about your hopes for
the future. Keep what you have
written in a safe place. Whenever you are hurting or feeling
mixed up, read what you have
written to remind yourself that
your life is IMPORTANT!
] not being able to focus or make

choices
] not being able to enjoy the
things you normally like
] not wanting to spend time with
your friends
] feeling restless or tired most of
the time
Do you hurt yourself?

Teens who hurt themselves on
purposecalled self-injuryoften
keep painful or confusing feelings bottled up inside. Teens that
self-injure say that it helps them
to feel better. But self-injury is
VERY dangerous. It can lead to
infections, scars, hospital stays,
and even death. If you cut yourself,
burn yourself, pull out your hair, or
hurt your body in other ways, GET
Fun quiz
___ in 100 people hurts
himself or herself on
purpose.
Teen tip:
Try these pick-me-ups when
youre feeling down:
Relax! Take a shower, watch a
funny movie, or listen to some
feel-good music.
Talk! Your friends, parents,
teachers, or other trusted adult
can help you sort through your
feelings.
Work out! Your body makes
mood-boosting chemicals called
endorphins when you exercise.
Get a good nights sleep. Its
hard to cope with strong feelings when youre tired.
HELP RIGHT AWAY! Talk to a parent or guardian, counselor, or other
trusted adult. You can learnwith
helphealthy ways to cope with the
things that bother you.
Do you think about suicide?

If you are thinking about hurting
yourself or suicide, talk to an adult
right away. Call 911 or 1-800SUICIDE (1-800-784-2433), or
check in your phone book for the
number of a suicide crisis center.
Answer: 1
45
The centers offer experts who

can help callers talk through their
problems. The hotlines also can
tell you where to go for more
help in person. Dont waitthere
are ways to help you deal with
your pain and work on feeling better in the future.
To: girlshealth.gov
From: Jamie (age 15), Greenville, South Carolina
My friend talks about suicide, but I know shes never tried
it. Should I take her seriously?
YES! The first thing you should do is tell an adult you
trust right away. You may wonder if your friend will be
mad at you, but telling an adult is the right thing to do.
This can be someone in your family, a coach, a school
nurse, a school counselor, or a teacher. You cant help
your friend alone. If your friend is ever in danger of
hurting herself, do not leave her alone. You may need
to call 911.
46
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More information on feeling good about yourself

Self-esteem:
] www.girlshealth.gov/mind/
feelinggood.htm
] www.girlpower.gov/girlarea/
bodywise/bodyimage
] www.self-esteem-nase.org
Dealing with emotional ups and

downs:
Body image:
] www.girlshealth.gov/mind
bodyimage.htm
] www.save.org
Notes
47
Taking charge of
your world
] Work it out. Playing sports,
fast walking, or dancing can
lower your stress level.
] Write it out. Express your
feelings in a journal, or
through music or art. To
make your own journal go to
www.girlshealth.gov/mind/
journal_create.cfm.
] Play it out. Have fun doing
something you love.
Stress and
how to deal
Being a teen is stressful! You
might feel pressure to get good
grades, fit in with a group, or
make a sports team. Or maybe
your home life stresses you out.
Everybody has some stress. But
too much stress, or allowing
stress to build up, is unhealthy.
] Talk it out. Vent to a friend
or a trusted adult to blow off
steam.
48
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Teen tip:
To blow off steam:
1. Close your eyes.
2. Take a deep breath through
your nose, slowly and quietly.
3. Hold it for a few seconds.
4. Let it out, quickly and noisily
through your mouth. Imagine
that you are blowing away a
worry or problem that you
have.
5. Do this several times.
] Laugh it out. Watch a funny

movie or read cartoons.
q I laugh out loud and/or cry for

no reason.
] Chill it out. Kick back and relax, catch up on sleep, or read.
q I want to be alone all the time.
Is your stress out of control?

Check any of these that describe
you.
q I feel down, edgy, guilty, and/or
tired.
q I have headaches and/or
stomachaches.
q I worry about my body and
how its changing.
q I have too many things to do,

but not enough time to get
things done.
q I dont enjoy doing the things

that I used to enjoy.
If these feelings do not go away

after trying the tips above, talk to
your parent or guardian, a school
counselor, or another trusted adult.
q I have trouble sleeping.
q I am not able to see the positive

side of things.
To: girlshealth.gov
From: Terri (age 11), Fairmont, Minnesota
Is stress always bad for you?
No. A little bit of stress can push you to do your best or

get your work done. Take time each day to let go of any
built-up stress to allow the good things that stress you
out to kick in.
49
Healthy
relationships
Healthy relationships are fun
and make you feel good about
yourself. You can have a healthy
relationship with anyone in your
lifefamily members, friends, and
the people you date. If you are unsure about a relationship in your
life, check it out here by circling
agree or disagree.
] This person makes me feel bad
about myself. Agree/disagree
] This person makes most of
the choices in our relationship.
Agree/disagree
] This person pressures me to
do things I dont want to do.
Agree/disagree
Teen tip:
If you have a fight with a friend,
dont shout, blame or use fists.
Try putting yourself in your
friends shoes. Its a lot easier to
work things out when you can
see where the other person is
coming from.
50
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] This person isnt willing to

work through conflicts.
Agree/disagree
] This person bosses me around.
Agree/disagree
] This person loses her/his temper a lot and always blames me
for things. Agree/disagree
] This person says bad things
about me and embarrasses
me in front of other people.
Agree/disagree
] This person tries to keep me

from spending time with my
friends and family.
Agree/disagree
] This person uses drugs and
alcohol and wants me to try.
Agree/disagree
] This person has pushed,
grabbed, or touched me in a
way that hurt or I didnt like.
Agree/disagree
] This person does things that

make me feel afraid.
Agree/disagree
Agreeing with any of these
points is a warning sign that you
might be in an unhealthyor
even unsaferelationship. Be
willing to end the relationship
if it cant get better or doesnt
make you happy. Talk to a
trusted adult if you feel afraid
to leave the relationship.
To: girlshealth.gov
From: Maria (age 14), Providence, Rhode Island
My friends are talking about skipping school. I dont want
to, but Im afraid they wont like me anymore if I dont go
along.
You should never be afraid of losing a friend because you
say no. Good friends should not give you a hard time for
saying no. Also, if this group of friends is doing things that
you dont feel right about, start hanging out with people
you like and who also make smart choices.
51
Who can you count on to listen,

support you, and keep the things that you share private?
[Attach pictures of those people here!]
52
www.girlshealth.gov
This sends the message, I really

mean it. Dont ask me again!
] Find an excuse to leave. My
parents said I have to be home
by 9:30 or I have to baby sit
my brother this afternoon.
Peer pressure
and how to
say no
Have your friends ever asked you
to do something that you really
didnt want to dolike maybe
cheating on your homework,
cutting class, or making fun of
someone? Or maybe theyve
asked you to try cigarettes, drugs,
or alcohol? Some friends might
even push you to be closer than
you want to be. Good friends can
handle it when you say, No. But
some people will pressure you to
go along.
Be ready to handle peer pressure. Try these ideas when
youre put on the spot:
] Just say, No thanks. Stand up
straight and make eye contact.
] Stand up to peer pressure. Try

one of these lines:
I feel really weird about this.
This makes me feel uncomfortable.
I dont think we should do
this.
Are you guys crazy?
My parents will kill me if they
find out.
You may be surprised by how
many of your friends feel the same
way you do.
Teen tip:
Think ahead! Dont put yourself
in an unsafe or hard situation.
You are less likely to have to say
no if you hang out with friends
who dont smoke, drink, or do
drugs, and make other good
choices.
53
Flashback!
Think back to a time when you
gave into peer pressure (cmon,
admit it!)
Why did you go along? ______
_________________________
] Ask for help from friends or an

adult if someone keeps pressuring you.
] Have a code that you can use
when calling your parents or
guardians to pick you up if you
ever feel uneasy somewhere.
_________________________
How did you feel? __________
_________________________
_________________________
Use the tips listed here to come
up with a better way you could
have handled the pressure.
_________________________
_________________________
To: girlshealth.gov
From: Bethany (age 12), Shreveport, Louisiana
It seems like everyone I know is using makeup. But I

dont want to. Why do I feel like I have to wear eye
shadow and lipstick to fit in?
When you feel like you have to act or dress a certain way
because everyone else is doing it, thats called unspoken pressure. Its okay to follow a trend, but being yourself is also cool.
54
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embarrass, threaten, or scare

others.
q She gossips and spreads rumors.
q She makes fun of others for being different.
q She pressures others to do
things they dont want to do.
Dealing with
bullies
Do you know a girl in your school
or by your home who does any of
these things? If you can think of
someone, check the box.
q She leaves someone out of
group activities on purpose.
q She uses people to get something she wants, like making
friends with someone who is
smart just so she can do her
homework for her.
q She uses the Internet, instant
messenger, and/or e-mail to
Did more than one girl cross your

mind? Maybe you even thought of
yourself? Well, all of these actions
are forms of bullying. Bullying is
when one person or a group of
people hurts someone else over
and over. For young women,
bullying is often more hurting
someones feelings than physical
Activity:
I,_______________________,
pledge not to bully and to help
others who are bullied.

_________________________
(sign here)

_______________
(date)
55
hurting. If someone does hit you,

though, it is best to walk away.
You dont want to get in trouble
or get hurt worse by fighting back.
What can you do if you are being
bullied?
] Tell an adult.
] Stand up for yourself if it feels
safe.
] Tell the bully to stop. Then
calmly walk away.
] Do not fight back!

] Dont blame yourself.
] Make new friends and get
involved in activities.
] Be strong and believe in
yourself.
Remember, its okay if you dont
like everyone you meet. But, it is
important to be nice to everyone
you meet.
To: girlshealth.gov
From: Amy (age 11), Memphis, Tennessee
I dont want to hurt anyones feelings, but I dont want
to include just anyone in my circle of friends. Is that
bullying?
Having a close group of friends, or clique, is not bad. But,
leaving out others from your group on purpose IS bullying. Be willing to get to know other girls, even if you think
you know about them already. And, let other girls get to
know you. Some girls wont have things in common with
your friends, but they will figure this out for themselves
and try to find people who are more like them. But, by
being okay with a bigger circle of friends, you wont miss
out on meeting a really cool girl.
56
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What-if: A stranger says he needs

help and wants to use your phone.
You can: Say no, dont open the
door, and then call a neighbor, parent or guardian, or the police and
let them know what happened.
In Relationships
Staying safe
Now that you are doing more
on your own, you need to take
charge of your safety. Check
out the tips below. Then, think
through the what-if scenes that
follow and how you would deal.
At home
] Always know who is at the
door before opening it. Ask for
ID if you are unsure.
] If youre home by yourself,
dont let others know.
] If someone has gotten into the
house, get out right away! Call
911 from a neighbors.
] If you think that you are in a

relationship that is unhealthy,
talk to a parent or guardian,
friend, counselor, doctor,
teacher, coach, or other trusted
person. See pages 50-51 for the
list of warning signs to help you
explain whats happening to an
adult.
] If you are the victim of violence
or abuse, it is not your fault!
You are NOT the reason for
the violence. Violence is NEVER
okay!
] With help, you can get out
of an unhealthy relationship.
Sometimes, leaving an abusive
relationship can be dangerous,
so it is very important for you
to make a safety plan.
Stay away from the person.
Spend time with your other
friends, and dont walk alone.
57
The National Sexual Assault

Hotline: 1-800-656-HOPE
(4673)
What-if: Your boyfriend tells you
that he will hurt you if you try to
break up with him.
You can: Tell your parents or
guardian, or another trusted
adult, right away. If you are afraid
to do so, call one of the hotlines
listed above for help right away.
On the go
Think of safe places to go in

case of an emergency, like
a police station or a public
place like a restaurant or
mall.
] There are free hotlines that you
can call 24 hours a day for help
leaving an unhealthy relationship:
The National Domestic
Violence Hotline: 1-800-799SAFE (7233)
The Youth Crisis Hotline:
1-800-HIT-HOME (448-4663)
58
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] Tell your parents and friends

where you are going, who you
will be with, and when you will
be back.
] Carry money, a phone card, or
cell phone for emergency calls.
] With your family, decide on a
code word that you can use on
the phone when you need their
help or need to be picked up
right away.
Teen tip:
Check out pages 57-58 for tips
on relationship safety and pages
58-59 for tips on staying safe at
parties.
] Walk in areas you know, on

main streets that are well-lit.
What-if: Your friend says she
wants you to leave a party with
some people you just met.
What-if: You ride with a friend

who just got her license. Shes
busy talking and doesnt seem to
be watching the road.
You can: Say No, thank you and

urge her not to go either. If she is
your ride and leaves, call a parent or guardian, or other trusted
adult for a safe ride home.
You can: Tell her you want to hear

what she has to say, but to wait
until after you get to where youre
headed. Tell her you arent good
at talking and driving at the same
time either!
At the wheel
At work
] Always wear your seatbelt.
] Follow all safety rules.
] Never get into a car with someone (even an adult) who has
been drinking or using drugs.
] Use safety equipment and protective clothing when needed.

] Look out for coworkers.
] If you find yourself in the car

with someone driving without
care, get out of the car as soon
as possible after it has stopped.
] Keep work areas clean and

neat.
] Know what to do in an emergency.
] Report any health and safety
hazards to your boss.
What-if: A coworker asks you
to watch the shop by yourself,
while she runs out.
You can: Ask the coworker to
stay, explaining that you dont feel
okay alone. If he or she leaves anyway, call the manager, if you can.
59
On the Internet
] Ask a parent or guardian before
going into a chat room.
] Dont tell anyone your Internet
or e-mail passwords.
] Never share your name, address, phone number, or other
information about yourself.
] Dont share other information
that can identify you, such as
where you go to school and
where you hung out last night.
] Dont post information about
yourself on your blog. Anyone
can read what you write!
] Dont agree to meet strangers
you chat with online in person.
This is very unsafe!
] If a stranger keeps trying to

contact you or meet you in
person, or sends you anything
that makes you uneasy, report
it at www.cybertipline.com or
1-800-843-5678.
What-if: Someone you meet online
suggests you meet for coffee.
You can: Say no! Its never safe
to meet someone you have met
online in person.
To: girlshealth.gov
From: Deedra (age 11), Rochester, New York
My stepfather hits my mom and sometimes he hits me.

Is there anything I can do?
No
matter what, parents and caregivers are supposed
to protect and care for their children. Talk to an adult
National Domestic
Violence
you trust or call the 24-hour
Hotline (1-800-799-SAFE).
60
www.girlshealth.gov
If your parent
uses drugs or
alcohol
If your parent or guardian drinks
too much alcohol or uses drugs, a
lot of things in your life might seem
out of your control. But you can
make things better for yourself.
Heres how:
] DO talk with an adult you trust.
Sharing your feelings with this
person is not tattling on your
parent.
] DO join a support group. Alateen is a group for teens who
have parents who abuse drugs
and alcohol. You will find that
Fun quiz
About ___ million children in our country are
growing up with at least
one alcoholic parent.
Youre not alone!
many teens are struggling with

the same problems. It holds
meetings, like a club. Call Alateen toll-free at 1-888-425-2666
to find out where to go. Ask
a caring adult if you need help
getting there.
] DO get involved in activities at
school or in your town. You can
learn new things about yourself
and about how other people
live their lives drug- and alcoholfree.
] DO remember to have fun!
Hang out with friends, go to
the movies, or play sports. Do
what makes you happy.
Answer: 11
61
Teen tip:
You can never become an addict
if you choose not to drink or do
drugs.
] DONT ride in a car when the
driver has been drinking or
doing drugs. Walk or try to get
a ride with a safe adult. If you
are forced to ride with a parent
who has been drinking, sit in
the back seat in the middle.
Lock your door. Put on your
safety belt. Try to stay calm.
] DONT think that because
your parent is addicted to drugs
or alcohol, that you will be
too one day. Most children of
addicts dont become addicts

themselves.
] DONT pour out or water
down your parents alcohol or
get rid of your parents drugs.
The plain fact is that it wont
work. You have no control over
your parents drinking or drug
use. Addiction is a disease. You
didnt cause it and you cant
make it stop.
Activity:
Write down the names and
phone numbers of three people
whom you can call for help or if
you feel like talking. Keep this list
in a safe place in your room and
also in your wallet.
To: girlshealth.gov
From: Kara (age 12) Suffolk, Virginia
I want to take care of my mom, but I hate the way she is
when she is drunk.
Its normal to hate the disease of alcoholism or drug
addiction and at the same time love your addicted parent.
Talking about these feelings with someone you trust or
through a support group like Alateen will help you to feel
less alone and afraid.
62
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More information on taking charge of your world

Handling stress:
stress.htm
] www.bam.gov/sub_yourlife
Healthy relationships:
relationships
] www.safeyouth.org/scripts/
teens/dating.asp
Resisting peer pressure:
relationships/friendships.htm
] www.thecoolspot.gov
Dealing with bullies:

] www.girlshealth.gov/bullying
To learn how to handle the
what-if situations in this
section:
] www.girlshealth.gov/safety
safety
] www.ndvh.org/educate
Living with a user:
] www.ncadi.samhsa.gov/
features/kidsarea
] www.nacoa.org
] www.al-anon.org/alateen.html
Notes
63
Planning your
future
thinking about your likes, dislikes,
interests, and values. Try this exercise to find out what you enjoy,
what you are good at, and whats
important to you. Once you know
these things, you can start setting
goals and going after them.
My favorite subjects in school are:
___________________________
___________________________
___________________________
___________________________
Discovering
your interests
and talents
Its good to have fun, but its
also important to have goals for
your future. You may not know
that you can look ahead just by
64
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When I have time for myself, I like

to:
___________________________
___________________________
___________________________
___________________________
People tell me that I am good at:

___________________________
___________________________
___________________________
___________________________
I think some of my special skills
and talents are:
If I could change something about

my community or the world, I
would:
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
I would like to learn more about:
___________________________
___________________________
___________________________
___________________________
Activity:
Once you find out what you
would like to do or learn more
about, the next step is to find
ways to try it out. Check out
www.girlshealth.gov/future/
passion.htm to get ideas on how
to do this.
65
To: girlshealth.gov
From: Kendra (age 15), Flagstaff, Arizona
Between after-school activities and hanging out with my

friends, I barely have time to do my homework. What
should I do?
When you are in school, your job is to get good grades,

so finding time for your homework should be the first
thing on your to-do list. You can try to better plan out your
time by using a calendar to keep track of homework assignments, practices, and meetings. Also, make a to-do
list each day and check off important tasks as they get
done. Make sure you get the most important things on
your list done first, and then move on to things like hanging out with friends or watching TV. If these ideas dont
work, you might have to cut out an activity.
66
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2. Find out what careers there are

for people who like what you
like. Check out www.bls.gov/
k12/ for ideas. Write a career
idea that interests you here:
_________________________
_________________________
_________________________
3. Find out what kind of training
or education you will need to
do this job.
4. Figure out what you can do
now to get ready for a job you
might like. A parent or guardian, guidance counselor, or
teacher can help you to think
through what you can do.
Thinking about
a career
What do you want to be when
you grow up? Whatever it is, you
will learn that there are many
paths to a career. Even though
you are young, its not too early
to start working toward school
and career goals. Heres how:
1. Learn your interests and talents
by doing the exercise on pages
64-65.
Classes I can take: __________

_________________________
_________________________
School clubs/activities I can try:
_________________________
_________________________
_________________________
Community organizations I can
volunteer with: ____________
_________________________
_________________________
67
People I can talk to: _________
What about college?
_________________________
After high school, you can choose

to begin a career right away or continue school by going to college. A
college education is needed to do
many jobs. And, you have to have
some training after high school
for almost all jobs. Many people
are able to work and take college
classes at the same time. If college
is a goal, talk to your guidance
counselor to find out what you can
do now to get ready.
_________________________
Places I can go to learn more:
_________________________
_________________________
You can repeat this exercise
with new interests as they come
up. Also, you can take on a job
to gain experience once you are
old enough and ready to work.
68
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To: girlshealth.gov
From: Melissa (age 14), Cincinnati, Ohio
Theres so much pressure for me to get good grades.
How can I explain to my parents that I am doing my best?
Parents want the best for their children, which is why it
might seem like they are being hard on you. Talk to your
parents about how they make you feel. Also, tell them
what you are doing to keep up with your schoolwork and
offer to keep them updated on how you are doing.
More information on planning your future

Deciding your future:
Career and college planning:
] www.girlshealth.gov/future/
discover.htm
] www.girlshealth.gov/future/
career.htm
] www.students.gov
Notes
69
Glossary
Abstinence not having sex of
any kind.
Addiction needing physical
things, such as drugs or alcohol,
or an activity, such as stealing or
lying, to the point that stopping
it is very hard. Stopping can also
cause bad physical and mental reactions. Addiction can be treated
with counseling, which means talking to an expert. In some cases,
medicine is needed.
Aerobic exercise that burns fat,
gets your heart rate going, and
makes your heart muscle stronger.
It helps your blood carry more
needed oxygen to blood vessels
throughout your body.
AIDS a disease that hurts the
immune system, the bodys way
of protecting itself. Having AIDS
makes it easy to get certain infections and cancers. It is caused by
the HIV infection.
Alcoholism drinking a lot of
alcohol and needing alcohol. Also
called alcohol abuse, this disease
70
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can lead to injury, liver disease,

and problems with the people
around you.
Anaerobic exercise that builds
muscle strength in different parts
of your body. This type of exercise
goes along well with aerobic exercise. Stronger muscles help you to
burn more calories.
Astringents a product that
cleans the skin and tightens the
pores.
Cancer when cells that are not
normal grow and can spread.
There are at least 200 different
kinds of cancers, which can grow
in almost any organ of the body.
Cervix the narrow entry between the vagina and the uterus.
The muscles of the cervix are flexible so that it can expand to let a
baby pass through during birth.
Clitoris a sensitive female sexual
organ that can become erect. The
clitoris is part of the vulva.
Douche/douching rinsing or
cleaning out the vagina, usually with a fluid mix you can buy.
The liquid is held in a bottle and
squirted into the vagina through
tubing and a nozzle. Doctors do
not suggest douching to clean the
vagina. It changes the chemical balance in the vagina, which can make
you more likely to get infections.
Emphysema a disease that
damages the air sacs in the lungs.
The air sacs have trouble deflating
once filled with air, so they are unable to fill up again with the fresh
air you need. Cigarette smoking
is the most common cause of
emphysema.
Endometrium the lining of the
uterus.
Fallopian tube organs that connect the ovaries to the uterus.
There is a fallopian tube on each
side of the uterus. When one
of the ovaries lets go of an egg,
it travels through the fallopian
tube toward the uterus. Fertilization (when a mans sperm and a
womans egg join together) usually
happens in the fallopian tube.
Heart disease coronary artery
disease, the most common type of
heart disease, happens when the

heart doesnt get enough blood.
Other types of heart disease involve the heart muscle and blood
vessels.
Herpes simplex virus a common virus that has two types:
type 1 (HSV-1) and type 2 (HSV2). Herpes on the mouth shows
up as cold sores or fever blisters.
This type is mostly caused by
HSV-1. Herpes in the genital area
is mostly caused by HSV-2, also
causing sores. But, both types can
affect either the genital area or
the mouth.
Hymen a piece of tissue that
covers all or part of the entrance
to the vagina. This tissue can be
broken the first time a woman has
sexual intercourse.
Immunizations these keep people from getting sick by protecting
the body against certain diseases.
Also called vaccines, they have
parts or products of infectious
germs that have been changed or
killed. A vaccine gets the bodys
immune system ready to fight
off that germ. Most immunizations that stop you from catching
diseases like measles, whooping
71
cough, and chicken pox are given

by a shot.
Infertility when a couple has
problems getting pregnant after
one year of regular sexual intercourse without using any types
of birth control. Infertility can be
caused by a problem with the man
or the woman, or both.
Labia the folds of tissue that
make up part of the outside female genital area. There are both
inner and outer labia.
Lymph glands a group of cells
that make and send out other
cells that fight infection throughout the body. These cells help
filter out bacteria. Lymph glands
are also called lymph nodes.
Mons pubis the fatty tissue that
covers the pubic area in women.
During puberty, hair grows on this
area.
Nonacnegenic makeup or skin
products that should not cause
acne.
Noncomedogenic makeup or
skin products that should not clog
pores.
Nutrient a source of energy,
mainly a part of food.
72
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Osteoporosis a disease that

causes bones to become thinner
and weaker. This disease causes
bones to break easily.
Ovary/ovaries two small organs
on each side of the uterus, in the
pelvis of a female. The ovaries
have eggs (ova) and make female
hormones. When one of the ovaries lets go of an egg about once
each month as part of the menstrual cycle, it is called ovulation.
Pads sanitary products that
stick to the inside of underwear
and soak up the blood that leaves
the vagina during a menstrual
period.
Pelvic inflammatory disease
(PID) -- a general term for infection of the lining of the uterus,
fallopian tubes, or the ovaries.
PID is mostly caused by bacteria
that causes STDs, such as chlamydia and gonorrhea. The most
common symptoms include abnormal vaginal discharge (fluid),
lower stomach pain, and sometimes fever.
Premenstrual syndrome
(PMS) a group of symptoms
that start around 7 to 14 days before the period begins. There are
many symptoms, including tender

breasts and mood swings. Women
may have none, some, or many
PMS symptoms. Some months
may be worse than others.
Tampon use can make it easier for

bacteria to enter the body. Signs
include high fever that comes on
suddenly, dizziness, rash, and feeling confused.
Pubic the area on and around

the genitals.
Type 2 diabetes people with

diabetes have problems changing
food into energy. The body makes
insulin to help change glucose
(sugar) into energy. Type 2 diabetes usually starts with the muscle,
liver, and fat cells not using insulin
in the right way. The body tries
to make more insulin to meet the
demand, but in time, it isnt able
to make enough.
Rectum the last part of the

digestive tract, from the colon to
the anus. This is where feces is
stored before leaving the body.
Reproductive this body system
is in charge of making a baby. In
women, the body parts involved
are the uterus, ovaries, fallopian
tubes, and vagina.
SPF stands for sun protection
factor rating system. SPF 15 or
higher sunscreen should be worn
every day.
Tampons these go inside the
vagina to soak up blood before it
leaves the vagina during a menstrual period. Instructions come
with tampon products to show
how to use them.
Toxic shock syndrome (TSS) a
very rare but dangerous illness
that affects the whole body. TSS
is caused by bacteria that make
toxins (poisons) in the body.
Uterus a pear-shaped, hollow

organ in a females pelvis where a
baby grows during pregnancy. It is
also called a womb. The uterus is
made up of muscle with an inside
lining called the endometrium.
This lining builds up and thickens
during the menstrual cycle to get
ready for a possible pregnancy
each month. If no pregnancy happens, the extra tissue and blood
are shed during menstruation.
UVA a type of ultraviolet light
which that can harm the skin.
UVA rays can reach deep into the
skin and cause damage. Broad-
73
spectrum sunscreens can block

both UVA and UVB rays.
UVB a type of ultraviolet light
which can harm the skin. UVB
rays are most often the cause of
sunburns you can see. Broad-spectrum sunscreens can block both
UVA and UVB rays.
Vagina a muscular passage that
leads down from the cervix, the
lower part of the uterus, to the
outside of a females body. During
menstruation, menstrual blood
flows from the uterus through
the cervix and out of the body
through the vagina. The vagina is
also called the birth canal.
Vaginal discharge this fluid
cleans the vagina and keeps it
moist to help fight infections. The
color, amount, and the way it feels
will vary during the menstrual
cycle. The fluids should be clear,
white, or off-white. Discharge that
has a foul odor, a change in color,
or a change in how it feels should
be checked out by a doctor or at
a clinic.
74
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Vulva this covers the entrance

to the vagina and has five parts:
mons pubis, labia, clitoris,
urinary tract opening, and vaginal
opening.
Warts genital warts in women
are found near or on the vulva,
vagina, cervix, or anus. They look
like bumps or growths that can be
flat or raised, alone or in groups,
and big or small. These warts are
caused by HPV or human papillomavirus, which is passed by sexual
contact.
Yeast infections a common
infection in women caused by an
overgrowth of the fungus Candida.
It is normal to have some yeast in
the vagina, but sometimes it can
overgrow during pregnancy or because of taking certain medicines,
such as antibiotics. Symptoms
include itching, burning, and irritation of the vagina. There may also
be pain when urinating and vaginal
discharge that looks like cottage
cheese.
Notes
75
Notes
76
www.girlshealth.gov
U.S. Department of Health and Human Services

Office on Womens Health
200 Independence Avenue, SW, Room 712E
Washington, DC 20201
Printed 5/2007

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Teen

U.S. Department of Health and Human Services

Does chocolate cause pimples?

Taking care of a beautiful you, inside and out

Feeling good about yourself

Taking charge of your world

Planning your future

Teen Survival Guide: Health Tips for On-the-go Girls

Taking care of your

ovaries lets go of an egg about once

Outside of the body, the

UterusThe uterus is a pearshaped, hollow organ where a

vix are flexible so that it can expand

CervixThe cervix is a slim

VaginaThe vagina is a muscular

HymenThe hymen is a thin piece

Know your Breasts

(the dark area

Every girls breasts are different

Teen Survival Guide: Health Tips for On-the-go Girls

Tampons or pads? Its your

] All tampons have a string at

Teen Survival Guide: Health Tips for On-the-go Girls

Strange vaginal discharge

] During the day, it is best to

] You probably dont want to

keeping up good hygiene will

Vaginal discharge and having your period might feel

Teen Survival Guide: Health Tips for On-the-go Girls

If you get PMS, try

] Eating less salt the few days

] Talking to your doctor about

] Keeping a regular schedule for

Teen Survival Guide: Health Tips for On-the-go Girls

Four key things you need to

2. You can get an STD by having any kind of sex, including

4. While some STDs can be

Protect yourself from STDs

] Condoms cant protect you

How do I know if I have an

Teen Survival Guide: Health Tips for On-the-go Girls

Having a baby while you are a teen

What about pregnancy?

away. It is important to get good

Can I get an STD from kissing?

Kissing is pretty safe. But, you can catch a common virus

Your doctor might ask you

] your vagina, such as if you have

] your general health, allergies, medicines you are

Teen Survival Guide: Health Tips for On-the-go Girls

You should see a gynecologist or ] you are having problems with

More information on taking care of your reproductive health

Different types of STDs and

Teen Survival Guide: Health Tips for On-the-go Girls

This is the same girl!

Skin care 101

Dont compare yourself to models. They have a team of stylists

] Use only light, water-based