Medical Care and Your 13- to 18-Year-Old

By meeting yearly with your teen, the doctor can keep track of changes in physical, mental, and social development and offer advice about avoiding unhealthy behaviors, such as smoking and drinking.

The doctor also can help your teen understand the importance of choosing a healthy lifestyle that includes good nutrition, proper exercise, and safety measures.

The more that teens understand about their physical growth and sexual development, the more they will recognize the importance of active involvement in their own health care.

What to Expect at the Doctor's Office

Teens should visit their doctors annually. Those with a chronic medical condition or certain clinical signs or symptoms might need more frequent visits.

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

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

Immunizations

By age 13, teens should have already had these immunizations:

• chickenpox (varicella) vaccine (if they have not had chickenpox)
• measles, mumps, and rubella (MMR) vaccine
• hepatitis B vaccine (HBV) series
• hepatitis A vaccine (HAV) series
• meningococcal vaccine
• human papillomavirus vaccine (HPV)
• diphtheria, tetanus, and acellular pertussis booster (Tdap)

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

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

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

• sexual activities that may result in unintended pregnancy and STDs
• use of alcohol and other substances, including anabolic steroids
• use of tobacco products, including cigarettes and smokeless tobacco
• drinking and driving
• the importance of bicycle helmets, seatbelts, and protective sports gear
• how to resolve conflicts without violence, including how to avoid the use of weapons
• learning problems or difficulties at school
• importance of regular physical activity

Common Medical Problems

Sports injuries and other problems, such as knee pain and headaches, are common concerns. Your teen's doctor should evaluate any pain that is severe or long-lasting.

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

If You Have Concerns

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

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