Common Health Concerns for Girls and Young Women

In Liane MacPherson’s decades-long career, women have asked the certified nurse-midwife hundreds of questions.

“There are very few things that anyone could tell me that I haven’t heard before,” she said. “You’re not going to shock me.”

But despite the wealth of answers from professionals like MacPherson, an adjunct faculty member of the Georgetown School of Nursing & Health Studies, adolescent girls today are more likely to seek answers to personal, sensitive health questions online to avoid feelings of embarrassment or shame that may result from an in-person conversation.

This guide from Nursing@Georgetown is meant to empower young women, ages 10 to 19, to engage with their health care providers. Use the information below to gain an understanding of what to expect in appointments and how providers can address common concerns related to development.

Legal Disclaimer: Please note that this article is for informational purposes only. Individuals should consult their health care professionals before following any of the information provided.

Common Health Concerns of Girls

Below, learn about common concerns that young women search for online. Remember that the best resource is a trained health care professional and to use this section to inform conversations with your provider.

Anxiety


What Could be Happening

Anxiety can be a normal reaction to a difficult situation. An anxiety disorder is present when anxious feelings, worry, or fear are not temporary but constant, according to the National Institute of Mental Health (NIMH). Often, these feelings worsen over time and interfere with a person’s relationships and ability to go to school.

There are several types of anxiety disorders, including:

  • Generalized anxiety disorder (worrying about many things even if there is no cause to worry)
  • Panic disorder (having panic attacks or sudden, strong feelings of fear)
  • Phobia-related disorders (fear of particular things, such as social interaction)
  • Post-traumatic stress disorder (reaction to and re-experiencing of a traumatic event)
  • Obsessive-compulsive disorder (having intrusive thoughts that drive compulsive behaviors)

Possible causes of anxiety and anxiety disorders include family history of mental health concerns and negative life events.

How to Get the Best Help From a Provider

What to Bring: Be prepared to share with your provider your family’s history of mental health concerns.

What to Expect: The provider should listen to your concerns and possibly make a referral to a mental health professional. You may be asked to complete a questionnaire or survey.

Next Steps: The provider may recommend talk therapy or medication to improve symptoms. Options outlined by the NIMH include anti-anxiety medications, antidepressants, and beta-blockers. A provider can discuss the pros, cons, and side effects of each to assist you and your family in developing a treatment plan.

What to Say

  • “I want to talk to you about how I’ve been feeling lately.”
  • “Can you help me understand the pros and cons of taking medications for anxiety?”

Depression


What Could be Happening

Depression, also called major depressive disorder or clinical depression, is considered a mood disorder. Several types exist, including general depression, seasonal affective disorder, and bipolar disorder.

Symptoms include persistent sad or anxious mood, irritability, loss of interest in activities that were once pleasurable, and hopelessness — as well as feelings of guilt, worthlessness, or helplessness.

Not all of these symptoms are necessary in order to receive a diagnosis. Risk factors of depression include personal or family history of depression, major life changes, and some medications and physical illnesses.

How to Get the Best Help From a Provider

What to Bring: Be prepared to share with your provider your family’s history of mental health concerns.

What to Expect: The provider may give an annual depression screening, per their practice guidelines. These checkups are standard practice and this does not mean the provider necessarily thinks you are depressed.

Next Steps: If the provider does have reasons to believe you are experiencing a form of depression, he or she can talk through options for follow-up care. Depression is typically treated with medications, psychotherapy, or a combination of both.

What to Say

  • “I haven’t been feeling like myself lately, and I think I might be depressed. Can we talk about it?”
  • “I think I might be struggling with depression. Some of my symptoms are: [insert symptoms].”

Disordered Eating


What Could be Happening

Many girls and women experience fear or negative thoughts about food, weight, and body image. But that does not mean the feelings are healthy. Sometimes these emotions drive irregular and unhealthy behaviors around food, called disordered eating. The National Eating Disorders Association says that an eating disorder is typically marked by the quantity of disordered eating behaviors, obsessive thinking, and decreased functionality. Examples include having the same meals every day, eliminating an entire food group, and missing social activities in order to exercise.

Disordered eating patterns can develop into an eating disorder, which can be life-threatening and difficult to treat. Types of eating disorders include but are not limited to anorexia; bulimia; and other specified feeding or eating disorder (OSFED), a newer classification that replaced the outdated clinical term eating disorder not otherwise specified (EDNOS).

How to Get the Best Help From a Provider

What to Bring: Be prepared to share with your provider a list of food consumed in the past week.

What to Expect: There may be an opportunity to reflect with the provider on food- and exercise-related behaviors. The provider will be best able to determine the kind of follow-up care that is necessary.

Next Steps: Treating an eating disorder often requires a team, including a mental health professional, a registered dietitian, and the individual’s family system. Along with caregivers or an advocate, the provider can discuss options for care and make referrals for other health care professionals as needed.

What to Say

  • “I have been struggling to eat healthily for about [insert an approximate time frame: e.g., three months] and spend a lot of my time thinking about food. I want to be in a better place. Can you help connect me to people who can support me?”
  • “My friends and family have been concerned about my behavior around my body image and my weight. I want to be healthy. Can you help me?”

Excessive Gas


What Could be Happening

Everyone has gas, released through either burping or flatulence. Still, having gas pains or more gas than normal can be uncomfortable and may be accompanied by bloating or abdominal pain. Excessive gas could be due to diet; for example, consuming too much fiber or a food you are sensitive to may contribute to the issue. Another possible cause is swallowing too much air when sleeping or eating.

Gassiness could be an indication of more serious concerns, such as irritable bowel syndrome (IBS). Address symptoms that are painful or interfere with daily life with a provider.

How to Get the Best Help From a Provider

What to Bring: Be sure to bring to this appointment your medical history and dietary habits.

What to Expect: The provider may conduct a physical exam and feel your abdomen (the area that starts just below the breasts and ends at the top of the pelvic bones). The provider might use a stethoscope to listen to abdominal sounds.

Next Steps: If IBS or another condition is causing gas pains, the provider will treat the underlying condition. If there is no apparent cause, he or she might suggest dietary changes or over-the-counter medications.

What to Say

  • “My stomach has been bothering me lately, more than a usual stomachache. Can you help me understand what’s going on?”
  • “I’ve been having more gas than usual, but my eating habits haven’t changed. What do you think is going on?”

Excessive Hair (Hirsutism)


What Could be Happening

Most women have fine hair on the upper lip and chin, chest, abdomen, or back. Hair growth that is especially plentiful, dark and coarse is called hirsutism. Hirsutism occurs when the female body produces too many male hormones (called androgens). Genetics and ancestry may contribute to hirsutism, but experts say neither is a certain cause.

Excessive hair growth could be a symptom of polycystic ovary syndrome (PDF, 222 KB), a condition affecting one in 10 women. Symptoms that typically accompany PCOS:

  • Irregular, heavy, or lack of periods
  • Pelvic pain
  • Acne
  • Weight gain or difficulty losing weight
  • Patches of dark skin

Other conditions can cause hirsutism, such as tumors or Cushing’s syndrome, but they are more rare.

How to Get the Best Help From a Provider

What to Bring: Be sure to bring to this appointment your family history and menstrual cycle data (average length and menstrual flow).

What to Expect: The provider may draw blood to measure hormone levels. If androgen levels are high, the provider may recommend an ultrasound of the ovaries and adrenal glands to check for tumors or cysts. If the provider suspects either of these, he or she may conduct a pelvic exam.

Next Steps: To manage hair growth, the provider may recommend prescription creams or oral medications. Your provider can offer guidance on cosmetic options, too.

What to Say

  • “I’ve been noticing more hair growth on my face and chest lately. Can you help me understand what’s going on?”
  • “I know most girls have some hair on their faces, but I’m starting to feel self-conscious about mine. What are the safest ways of removing it?”

Excessive Sweating (Primary Hyperhidrosis)


What Could be Happening

Certain health conditions, such as anxiety or heat exhaustion, can make the skin produce more sweat than usual. But if you are sweating heavily and have ruled out another cause, you may be experiencing primary hyperhidrosis. This condition occurs when the nerves that activate the sweat glands become overactive, often on the palms, underarms, face, and soles of the feet. As a result, the body sweats more than is necessary to cool down.

Individuals should seek immediate professional attention if heavy sweating is accompanied by chills, lightheadedness, chest pain, or nausea; these symptoms may require further evaluation if they co-occur with excessive sweating. However, sweating that causes only mild discomfort can still be addressed with a provider.

How to Get the Best Help From a Provider

What to Bring: Be sure to bring to this appointment specific examples and a history of the amount and frequency of sweating.

What to Expect: The provider may ask for a urine or blood specimen for testing.

Next Steps: Your provider may recommend over-the-counter or prescription medications and topical antiperspirants.

What to Say

  • “I am sweating more than I used to, even when I am not exercising. Is this something I should be concerned about?”
  • “I have been sweating a lot lately, which is starting to ruin my clothes. Are there any treatments or medications you would recommend to manage this?”

Irregular Periods


What Could be Happening

Menstrual cycles can vary in length and regularity, especially in the first few years after they start. Illness, weight change, and stress can affect how long a cycle lasts and when it occurs. While irregular periods are not necessarily a cause for alarm, they could also be due to over-exercise, undereating or overeating, or hormone imbalance — concerns that should be discussed with a provider.

How to Get the Best Help From a Provider

What to Bring: Be sure to bring to this appointment your menstrual cycle data (average length and menstrual flow).

What to Expect: The provider will ask questions about your menstrual cycle and lifestyle, including exercise and eating habits.

Next Steps: He or she may prescribe medications or suggest changes to your lifestyle that support your reproductive health.

What to Say

  • “I had been having normal periods around the same time each month, but for the last six months, they have become more irregular. Is this normal, or should I be concerned?”
  • “I have not gotten my period in the past three months, and I don’t know why. Can you help me figure out what is happening?

Menstrual Cramps (Dysmenorrhea)


What Could be Happening

Pain related to menstruation is called dysmenorrhea. Primary dysmenorrhea refers to menstrual cramps that typically occur one to two days before bleeding starts and sometimes is accompanied by nausea, fatigue, and diarrhea. Secondary dysmenorrhea is menstrual pain because of a disorder in the reproductive organs, such as endometriosis or an infection.

How to Get the Best Help From a Provider

What to Bring: Be sure to bring to this appointment your menstrual cycle data (average length and menstrual flow)

What to Expect: The provider may need to conduct a physical exam, including an exam of the pelvic area. If he or she believes there is an underlying condition, you may receive additional testing, such as an ultrasound.

Next Steps: The provider may recommend pain relievers or other appropriate medications. For secondary dysmenorrhea, the provider may discuss surgical options with you.

What to Say

  • “My menstrual cycles are becoming unbearable around the time my period starts. What would you recommend for the pain?”
  • “Pain relievers have not been easing my cramps. What other options are available for me?”

Vaginal Odor


What Could be Happening

Slight vaginal odor is normal and could be due to sweat or the menstrual cycle. A strong odor, though, could indicate an infection or other serious issue. Patients experiencing burning, itching, irritation, or discharge should address their concerns with a provider. Other possible causes of vaginal odor include poor hygiene or a tampon left in place longer than recommended.

How to Get the Best Help From a Provider

What to Bring: Be sure to bring to this appointment your menstrual cycle data (average length and menstrual flow).

What to Expect: The provider may need to conduct a vaginal exam, especially if you’re exhibiting additional symptoms.

Next Steps: To reduce the odor, prioritize hygiene and avoid using products like vaginal deodorants or douches, which can worsen irritation. If the odor is a symptom of a more serious concern, the provider will likely recommend follow-up care.

What to Say

  • “I have been noticing a stronger smell than usual, even when I am not on my period. Should I be concerned?”
  • “What steps can I take to lessen vaginal odor?”

Resources for Further Reading

Citation for this content: Nursing@Georgetown, the online Women’s Health Nurse Practitioner program from the Georgetown University School of Nursing & Health Studies