I think I have trichotillomania. When I was 12 years old, I started pulling my hair out of my head to the point where I developed a bald spot. My parents are both doctors, but I don’t think they know what trichotillomania is because they’ve noticed, but haven’t really done anything to help me. I am really insecure about it…help!

Glad you wrote us about this problem because it happens to lots of other youth who may have similar questions. Trichotillomania (trik-o-till-o-MAY-nee-uh) (TTM), also called the “hair pulling disorder,” is thought to be a type of obsessive-compulsive disorder (OCD). When people think about OCD, they imagine someone doing something multiple times in a row. For example, a person goes to wash their hands, seems like a simple task right? It might not be for a person with OCD, if hand washing is their trigger, their minds may tell them that they must wash their hands for a minimum of 10-12 times before their compulsion (hand-washing) is satisfied.

Trichotillomania can occur in both boys and girls and in children, teens, and adults. Hair pulling can occur anywhere there is hair on the body and is typically removed from the root in large clumps, providing people with a feeling of accomplishment and relief. Once the hair is pulled out, people with TTM typically play with it or put it in their mouths. People affected by TTM usually hide it from their family and friends because they are embarrassed about their habit. It’s possible to stop TTM and experience hair regrowth in areas that may be balding. If you think you have TTM, talk to your health care provider (HCP). There are different medications and behavioral therapies that can help you stop TTM.

I am really self-conscious about my labia. It doesn’t look like everyone else’s. My labia is big and stretched out. I am curious about labiaplasty (plastic surgery). Is it possible for me to get it now or should I wait until I am older?

Thank you for your question. It is common for girls to feel self-conscious about their labias and we hope our response will help you feel a bit better. Labia is Latin for “lips.” Typically you have two different labia, labia majora and labia minora. The labia majora is usually the larger and thicker of the two labias. The labia minora is usually smaller  with thinner tissue. Labia come in a variety of sizes, colors, and shapes. It’s important to remember that everyone’s body is different and that it’s normal for your labia to look different from your Mom’s or even other women in your family. We are all special and unique in our own way.

However, if you are still feeling self-conscious about your labia, it’s important to talk to your health care provider (HCP) and to know that professional organizations such as the American College of Obstetricians and Gynecologists do not recommend that women have plastic surgery to make the labia smaller.  Surgery to change the size and or shape of the labia without being medically necessary may violate federal or state laws.  A young woman should be 18 or older before making the decision to change a normal part of her body.  Women who chose to have a labiaplasty usually have experienced significant symptoms such as pain with intercourse, chronic irritation, or discomfort.  Talk with your health care provider and let them know what your concerns are so they can answer all your questions.

How would I know if I have a bicornuate uterus, but I’m still a virgin?

Thank you for your question. Most girls are born with a very important organ called a uterus. The size, shape, and structure of a uterus is important because it’s where babies grow and develop during pregnancy. A normal uterus shape is similar to an upside down triangle, with two upside down horns on either side (fallopian tubes), each connected to two ovaries.  It’s uncommon for girls to be born with abnormal uterus, but the most commonly seen are bicornuate uterus.

 

 

A bicornuate  (“bahy-kawr-nyoo-it”) uterus is a is one with a different kind of shape and structure. The bicornuate uterus is best known as the “heart-shaped” uterus, because–you guessed it–it looks like a heart! Most girls born with a “heart-shape” uterus won’t know they have a different shape unless they have an ultrasound or MRI, usually for some other reason.  Having a bicornuate uterus is unlikely to affect your ability to become pregnant; however, some women may have a higher risk of miscarrying (losing the baby during pregnancy) than those with a normal shaped uterus.  If you are concerned that you may have a bicornuate uterus, speak with your health care provider (HCP) about why you are concerned.

How safe is it to use ride-share services?

We are glad you want to know more about ride-share services!

Ride-share services are companies (like Uber and LYFT) that allow you to order a ride using an app on your smartphone. Most ride-share companies have rules in place to keep riders safe – like background checks for drivers and rating systems. Whenever you get in a car with a stranger (driver or other passenger), especially alone, there are risks. Most rides are completed safely, but there have been reports of car accidents, physical assaults, and sexual assaults while using ride-share services.

If you use ride-share services, general car safety rules apply, like always wear your seatbelt. Riding with friends can help keep you safe, and also make the ride cheaper! Here are some other ways to stay safe:

Make sure it’s the right car and driver.

• Check all details for your ride (license plate, make/model of the car, driver’s name/photo) before getting in. If something doesn’t match, don’t get in the car.
• Confirm that the ride is for you. Ask, “Who are you here to pick up?”
• Never give out your personal information (full name, phone number, address, school) to your ride-share driver.

Be alert.

• Sit in the back seat on the passenger’s side to be aware of the driver’s actions.
• Don’t ride alone if you are drunk or high. It is a great decision to avoid driving while drunk or high, but drugs and alcohol could affect your ability to keep yourself safe in a car with a stranger. Try getting a ride from a friend or family member instead.

Share your trip details.

• You can use the app to share information about your trip with a parent or friend. This includes your location during your ride, so someone will know if your driver takes you to a different location or makes an unexpected stop.
• Tell your driver you are sharing your ride. Try calling someone and saying, “Hey, I’m in my ride-share. I’ll share my ride details with you. See you soon.”

Stop your trip at any time.

• If you don’t feel comfortable for any reason, trust your instincts. You can always end your trip, no questions asked.
• If you are ending your trip early, please make sure you are in a location where you can safely exit the car and can safely wait for another ride. If you do not know the area well consider stopping in a well-lit crowded area.

Call for help.

• If you are immediately concerned for your safety, please call 911 (in the US).
• If you use a specific ride-share service frequently, get familiar with the app and its emergency options before you ride.

 

Remember that no one has a right to treat you badly or discriminate against you based on your race, gender identity, sexual orientation, nor any other identity. If this happens to you while using a ride-share service, rate your driver, contact the company, and talk to someone you trust (like a parent, friend, or healthcare provider).

I am in anorexia recovery right now. I am scared that I am going to lose control and gain too much weight because of my metabolism and not eating anything. Will my metabolism speed up and burn enough calories as I recover?

Thank you for asking this question. When anyone restricts food intake for an extended period of time, the body’s metabolism responds by slowing down because the body needs to conserve energy for other, extremely vital organs (such as the brain and heart). In fact, metabolism slowing down is often a sign we need to eat more. As you start to eat more, your metabolism will naturally increase because your body will gain enough energy to carry out all its necessary processes.

While recovering from anorexia nervosa, your body may change and this is normal. It’s important to have health care providers who can support you during this process. If you need more support, you can contact a confidential Helpline at: nationaleatingdisorders.org/help-support/contact-helpline.

 

How safe is it to jog in the dark?

It is great that you are interested in jogging and want to learn about how to run safely.

Jogging has many positive benefits on physical and mental health. Running outside also has some risks, including activity-related injuries (injuries due to running), vehicle-related injuries, or assault (physical or sexual). Running in the dark increases all these risks due to decreased visibility (ability for you to see your surroundings or for others to see you).

Overall, we recommend not jogging in the dark if you can avoid it. If you decide to jog in the dark, here are some things you can do to lower your risk:

• Jog with a friend or a group. A running partner can keep you motivated. They can also keep an extra eye on your surroundings. Running with others may also discourage a potential attacker.
• Wear reflective clothing or gear. This helps you stand out in the dark, especially to cars and other vehicles.
• Bring a light. This will let you see more of your surroundings, and help you avoid potential obstacles, such as tripping on an uneven sidewalk because you couldn’t see it well.
• Take your headphones out. The dark makes it harder for you to see what is going on around you. Being able to hear your surroundings will help keep you safe. Being aware of your surroundings is always important. Consider running without headphones or with one ear bud out even in the daytime.
• Choose your route wisely. It is best to run on well-lit crowded roads with sidewalks instead of in parks or paths. If you are running often, try changing your routine, including where you are running and the time of your run. Changing your routine may help prevent an assault.
• Tell someone. Let a friend, parent, or other trusted adult know where you are running and how long it will take, that way someone will know if something goes wrong. You can also share your location if you have a smartphone.
• Trust your instincts. If you feel unsafe at any point, run to a safe location. Call 911 (in the US) if you are in immediate danger.

If you have any additional questions about how to jog safely, talk to your health care provider.

I’m not a vegetarian. I eat chicken rarely, and I sometimes drink milk, but I don’t have any other source of protein. How do I get protein in my diet?

Great question! Protein is really important to eat because it helps build bones and muscles. It acts as a building block for enzymes, hormones, and other body chemicals that are necessary for us to function. Hair and nails are also made up of mostly  protein.

As you mentioned, both chicken and cow’s milk are dietary sources of protein. Other animal sources of protein include turkey, beef, fish, and eggs. Dairy products such as cheese and Greek yogurt also contain protein. If you do not eat many animal products, vegetarian sources of protein such as beans, lentils, tofu, tempeh, seitan, nuts, and nut butters are great choices.

It is important to have  protein with every meal so your body can function and grow the best it can. In general, meals and snacks should be balanced and contain all of the food groups, including protein. For example, you could have Greek yogurt with granola and fruit for breakfast, nuts for snack, a chicken sandwich for lunch, cheese with crackers for snack, and tofu stir-fried with vegetables and a brown rice for dinner. If you are not familiar with many vegetarian sources of protein, try some out to see which you like.