What are birth control placebo pills?

Great question! There are many different types of birth control pills and pill packages. The most common pill package contains 21 active pills (those with hormones) and 7 placebo pills (those without hormones). Placebo pills also called “sugar pills” or “reminder pills” are simply place holders. These pills exist at the end of the pill pack and are usually a different color than the rest of your pills. The purpose of the placebos is to help keep you on track with taking your pills every day at the same exact time, even during your period. As long as you have taken your “active” pills as prescribed, same time every single day, then during placebo week you will still have protection against pregnancy. Placebo week also allows you to have a period, which for most girls, is lighter and more regular due to the help of the pill.

However, it’s very important to have a clear understanding of your birth control pill. As we mentioned, there are many different versions of the pill. There are some pill packs that contain 28 pills total, 24 of those pills are “active”, while only 4 are placebos. Although the last 4 pills are placebos, some manufactures add in vitamins such as folic acid, which can help the body make healthy red blood cells.

If you are thinking of skipping your placebo pills or making any changes to your birth control pill, speak to your health care provider (HCP) first before making any changes.

I have a partner, but it seems they are drifting away. Is there anything I can do?

Thank you so much for your question. Relationships can be so hard, even when we’re not in a global pandemic! The world right now is under a lot of stress, even if you’re not directly impacted by the pandemic, everyone is feeling stress from it.  For starters, it’s super important to remember a few things, self-love and self-respect. Sometimes when we develop relationships with our friends, family, or significant others we lose sight of this. It’s a good thing to remember that relationships whether they are romantic or not should always be healthy, that means they make you feel good about yourself! There are several ways to make a relationship healthy, but the four most important points are communication, share, respect and trust.

You should feel comfortable sitting down with your partner and sharing your concerns and feelings. For starters, this is a great indicator that you have the foundation to a healthy relationship. If this remains true, your partner should be open and honest about their feelings as well. Allow time for your partner to respond and share their feelings, if they have any. It’s important that you both show mutual respect of one another by listening respectfully when the other is speaking. By having a constructive and respectful conversation, it’ll be easier to work on fixing an issue in the relationship, again if there are any. It’s also important to remember, that if your partner is drifting away, it may not be your fault. No relationship is perfect, everyone goes through the occasional argument or even an unfortunate break-up. As you grow, you goals and interests will change and that might have an impact on your relationships as well. However, it can be helpful to remember, “When one door closes, another will open.”

I have had trichotillomania for around 4-5 years and my mom wants to sign me up for a support group, but I kinda freak out when I talk in front of large groups even if it’s online and you can remain anonymous and not show your face. What should I do?

It is completely normal to be nervous about trying something new, especially when it involves sharing personal information with others. Most support groups are small, so it is unlikely that you will have to speak in front of a large number of people. You also can choose what and when you share – if you want to go to the group just to see what it is like and not speak, that’s completely ok! You and your mother can communicate with the group leader prior to your first meeting and let them you know you’d like to just observe before you’re ready to participate. You may also consider talking to your mother about finding an individual therapist, which would be one on one and eliminate the group dynamic altogether. Mental health support is all about finding what works for you, and the good news is there are many options!

I was recently treated for a yeast infection that I think I had for about a month. Ever since I received treatment I have lost sexual interest, which was never a problem for me before. I don’t think I’m asexual, but I don’t know what is happening. How can I get the feeling of sexual attraction back?

female gender symbolSorry that you are experiencing these feelings. We can’t think of any relationship to your recent treatment for a yeast infection unless you felt a lot of stress with the exam or worried that it could be something else or feel at risk of COVID 19.

A vaginal yeast (candidiasis) infection is common among women (of all ages) and happens when there is an overgrowth of fungus called candida aka yeast. It’s normal to have yeast growing in our vaginas, mouths, and digestive track, but you run into trouble when there is too much growth causing an infection. If you notice itching or (odorless) vaginal discharge that is usually thick, white, and looks similar to cottage cheese, you should make an appointment with your health care provider (HCP) sooner rather than later. Other signs or symptoms you may notice could be redness, burning, or irritation in your vagina. Symptoms usually appear either before or after your period. Once you visit your HCP, they will use a cotton swab to take a sample of your vaginal discharge. Once the sample is taken, your HCP can determine whether or not there is a yeast overgrowth. If you do have a yeast infection, your doctor will prescribe either a pill (that you swallow), a vaginal cream, or a vaginal suppository (a partially solid material that you insert into your vagina, where it dissolves and releases medicine). Your HCP will work with you to determine which type of treatment is best for you!

Both men and women experience libido (sexual drive or attraction) and it’s normal for your libido to fluctuate throughout life. However, if you’ve been experiencing decreased libido for a while now, it’s important that you speak with your health care provider (HCP).  The decrease in libido is not caused by a yeast infection, but there are many others things that might be a factor. Libido is impacted by stress, hormone imbalances, certain medications, fatigue, sexual problems, or surgery. If you’ve noticed a decrease in your libido, have a conversation with your health care provider (HCP). They may be able to help uncover somethings that may be contributing to your feelings.

I’m a homeschooler, and things at home are getting rough. I’m stressed all the time, but I don’t feel like I can tell my parents. I don’t have outside resources. How do I get counseling without them knowing?

We are sorry to hear things have been difficult at home. With COVID-19 precautions, so many young people are feeling stuck at home and many are struggling with challenging family situations. Your ability to access counseling without parental knowledge depends on where you live. Some states in the USA allow 16-year-olds to engage in therapy without their parent knowing. It may be worth having a conversation with your parents about your desire for additional support. Your primary care doctor can help you with this conversation. If talking to your parents is not an option, you can access crisis resources such as the Crisis Text Line (text HOME to 741741), which is free and private.


depressed girlLa adolescencia puede ser la época más complicada de tu vida: más tareas, cambios en tus relaciones, y cambios en tu cuerpo y cerebro son algunos de los retos que afrontas. A veces te puede costar manejar las emociones que acompañan estos cambios y a la vez manejar tu día a día. A algunos adolescentes les cuesta más que a otros, y ellos pueden hacer actividades dañinas como el alcoholismo, el abuso de drogas, o la autolesión.

¿Qué es la autolesión?

La autolesión, también conocida como autoagresión y automutilación, es el acto de hacerte daño deliberadamente en tu propio cuerpo. Algunas formas de autolesión incluyen cortes, rasguños, y quemaduras en la piel.

Las personas que se autolesionan a veces lo hacen repetidamente, lo cual muchas veces dejan cicatriz. Mientras que se autolesionan, es posible que no sientan dolor y que se hagan más daño de lo que esperaban.

¿Por qué las personas se autolesionan?

Muchas veces las personas que se autolesionan presentan emociones arrolladoras como ansiedad y tensión, y en el momento la autolesión les parece una forma de escaparse y aliviarse. Algunas personas también experimentan “despersonalización”, es decir, se sienten irreales o sienten que están observándose a sí mismas desde afuera de sus cuerpos. Pueden cortarse o hacerse daño para sentir “reales” nuevamente. Por otro lado, otras personas lo hacen para castigarse o castigar a las personas a quienes les importan. En algunos casos, las personas que se autolesionan han sufrido abuso físico, emocional o sexual, por lo tanto se sienten culpables.

Muchas personas que se autolesionan aún no han aprendido formas saludables de manejar emociones negativas. Aunque sientas que te vas a seguir autolesionando, existen técnicas saludables de sobrellevar estos hábitos.

¿Es la autolesión igual a la intención suicida?

No, pero a veces hay lesiones muy graves para causar muerte, y algunas personas que se autolesionan se vuelven suicidas.

Si tú o alguien que conoces se siente suicida, debes buscar ayuda profesional inmediatamente. Habla con tus padres, un adulto de tu confianza, u otra persona que pueda ayudar de inmediato. Si no consigues que alguien te ayude o no sabes qué hacer, llama al 911 o ve a la sala de emergencias más cercana.

¿Qué hago si me autolesiono?

Si tú o alguien que conoces se autolesiona, es importante que pidas ayuda. Habla con adultos de tu confianza como tus padres, parientes, consejeros o prestadores de servicios médicos. Aunque tus amigos te pueden ayudar mucho, es importante que hables con adultos.

Cuando hables con ellos, diles que te autolesionas y quieres parar de hacerlo. Pídeles apoyo y que te ayuden a encontrar recursos y hacer un plan para parar.

Nota: Si produjiste un corte que es infectado o que no para de sangrar, tendrás que ir a tu prestador de servicios médicos inmediatamente.

¿Puedo parar de autolesionarme?

Sí. Parar de autolesionarte es como parar de fumar o de beber alcohol. No será fácil, pero con apoyo, recursos y un buen plan, ¡tú puedes! Encontrarás maneras saludables de manejar tus emociones intensas y aprenderás a cuidarte bien de ti misma.

Tomar la decisión de parar de autolesionarte depende de ti, pero tomarla será mucho más fácil con el apoyo de tu familia, tus amigos y tu prestador de servicios médicos.

Lo primero que debes saber es que eres buena persona y mereces cuidar de tu cuerpo y mente. Puede que alguien te dijera algo diferente, pero es importante recordar esta verdad. Así te motivará aprender maneras saludables de manejar el estrés.

¿Cómo paro de autolesionarme en el momento?

Es importante que encuentres formas de relajarte y centrarte al sentir que vas a hacerte daño. Haz una lista de cosas que te van a ayudar a sentir relajada y real en vez de hacerte daño como escuchar música, hacer algo físico, meditar, dibujar o leer. Deja la lista en un sitio visible para ver tus opciones y decidir hacer otra cosa por si quieres autolesionarte.

Aquí te ofrecemos técnicas para usar tu energía cuando estás nerviosa:

  • Da un paseo largo
  • Baila con la música alta
  • Juga al baloncesto o al fútbol
  • Sale a correr
  • Limpia tu cuarto

A continuación te ofrecemos técnicas para relajarte y liberarte del estrés:

  • Toma un baño o una ducha calentita
  • Escucha música
  • Escribe en un diario
  • Habla con un/a amigo/a
  • Lee un buen libro

Muchos adolescentes descubren que mantenerse ocupados y pasar tiempo con amigos y familia es lo que más los ayuda.

¿Cómo puedo recuperarme?

La autolesión es un síntoma de un dolor emocional íntimo. Recibir psicoterapia te ayudará a entender tus sentimientos y tu situación. Un terapeuta te puede explicar por qué te haces daño, cuáles situaciones te ponen en riesgo, y qué pasos puedes tomar para aprender maneras saludables de manejar emociones intensas. Un terapeuta te puede ayudar a manejar la depresión, ansiedad, y otros problemas de salud mental. A veces los prestadores servicios médicos pueden recomendar medicamentos como parte de tu plan de recuperación.

La decisión de parar de autolesionarte es un gran primer paso. Recuerda que aprender maneras de manejar sentimientos intensos no va a ser rápido. La clave para recuperarte es obtener el apoyo de las personas que se preocupan por ti y el tratamiento de un terapeuta o consejero experto. Te mereces este cambio, así que sigue trabajando en ello. Recuerda que no estás sola en tu recuperación.

¿Cómo puedo ayudar a un/a amigo/a que se autolesiona?

Si tienes a un/a amigo/a que se autolesiona, hay pasos que puedes tomar para ayudarlo/la parar de hacerlo y recuperarse.

Primeramente, sugiérele que hable con un adulto de su confianza como su padre, consejero, o prestador de servicios médicos. En segundo lugar, préstale atención y déjale saber que te importa para mostrar su apoyo. Finalmente, imprime y dale esta guía, que puede leerla cuando esté preparado/a para hacerlo.

Si tu amigo/a no quiere hablar con un adulto y rechaza ayuda, deberías buscar un adulto que conozca a tu amigo/a y hablar con él o ella, aunque tu amigo/a te pidió que guardaras su secreto. Puede que tu amigo/a se quede enojado/a contigo, pero en esta situación es más importante buscar ayuda. La autolesión es muy grave y puede ser mortal, así que la seguridad de tu amigo/a es más importante que su privacidad. Puede que esté enojado/a por un tiempo, pero podrás pedirle perdón y hablar del tema después de saber que está seguro/a.


Red Nacional de Prevención del Suicidio: +1-888-628-9454

Sexual Assault and Rape

depressed girlEverybody deserves respect and to feel safe in their sexual relationships. We know that sexual assault and rape happen, and it can be hard to talk about or know what to do. This guide will talk about what sexual assault and rape are, what to do if you have been a victim of sexual assault, how you can help a friend, and where to go for more information.

 What are sexual assault and rape?

Sexual abuse is any unwanted sexual contact. Sexual assault and rape are legal definitions used for sexual contact without sexual consent. These definitions vary from country to country and region to region. Sexual assault and rape do not have to be violent or leave a physical mark. To learn more about the specific definitions in the United States and your specific state, visit this website.

Sexual assault and rape can happen to anyone regardless of age, gender identity, race, sexual orientation, intellectual ability, or physical ability, and it is never your fault. Sexual assault or rape cannot be blamed on what a person was wearing, how they were acting, where they were, or how late they were out.

Sexual assault or rape maybe committed by a stranger, friend, dating partner, or a spouse. In fact, most (80%) rapes are committed by someone the victim knows. More than half (55%) of sexual assaults occur near or in the victim’s home.

Sexual assault and rape may have immediate consequences including pregnancy and sexually transmitted infections. Sexual assault and rape may have lasting effects including post-traumatic stress disorder, depression, thoughts of suicide, attempted suicide, drug use, problems at school or work, and problems in personal relationships.

How common are sexual assault and rape?

Unfortunately, sexual assault and rape are common in the United States:

  • About 433,648 people over the age of 12 experience sexual assault or rape every year.
  • In the US, a person is sexually assaulted every 73 seconds.
  • More than half (54%) of people sexually assaulted are under 30 years old.

What should I do if I have been sexually assaulted or raped?

If you have experienced sexual assault or rape, it is not your fault and you are not alone. You may not know what to do, how to feel, or who to tell- and that is okay. These decisions are personal, and you get to decide what you do.

Here are some things you might want to consider immediately after a sexual assault:

  • If you are in danger or injured, call for emergency services (911 in the United States) or go to an emergency department for medical care.
  • Call your healthcare provider, a Sexual Assault hotline (see below) and/or go to the emergency department to discuss:
    • taking medications to prevent sexually transmitted infections including HIV (within 3 days)
    • taking medication (emergency contraception) to help prevent a pregnancy (within 5 days). The sooner you take the medication the most effective it is in reducing your chance of a pregnancy. Insertion of a Copper IUD can also prevent pregnancy from an assault.
    • having a sexual assault forensic exam or “rape kit” (within 3 days)
      • A sexual assault forensic exam or “rape kit” is used to collect evidence from a sexual assault. It is best to have the sexual assault forensic exam before doing things that could get rid of evidence such as showering, washing, changing clothes, going to the bathroom, or combing your hair. Even if you have the sexual assault forensic exam, you do not need to report the assault, “press charges,” or talk to the police.

Many people who have experienced sexual assault or rape never tell anyone about it. There are many reasons why someone may not report sexual assault including:

  • Not sure if it was sexual assault or rape
  • Don’t know who to tell
  • Relationship with abuser
  • Immigration status
  • Not sure if there is enough evidence or proof
  • Fear of judgment
  • Fear of police or justice system

It can take days, weeks, months, or years for someone to decide to talk about a sexual assault. You may consider telling someone you trust about the sexual assault, such as a friend, parent, counselor, or healthcare provider. You may also feel more comfortable talking to someone you don’t know confidentially (see numbers for hotlines below). Talking to a trained professional (counselor, therapist, healthcare professional, national hotline) may be helpful to process what happened to you, to get medical care, to treat depression or PTSD, or to be referred to resources in your area.

What should I do if someone I know has been sexually assaulted or raped?

It is hard to find out that someone you care about has been hurt. The most important thing you can do is support this person and remind them the assault is not their fault. They may or may not decide to tell other people or report the sexual assault or rape to the police. It is important to understand that this is a personal decision, and it is their choice. Let them know you are there for them no matter what they decide to do. If you are not sure how to help them, try talking to a trusted adult (like a counselor or healthcare provider), visiting the websites below, or calling the hotlines below.

You can also take an active role in preventing sexual assault or rape. Try to avoid being just a “bystander”; instead, if you see or hear something that is not right. For example, telling a friend it is not cool to joke about sexual assault or intervening at a party when you see someone try to hook-up with someone who can’t consent to sexual contact (they are drunk, high, or passed out).

If you or someone you know has experienced sexual abuse or rape:

Where can I learn more about sexual assault and rape?

Love Is Respect

Men Can Stop Rape

RAINN (Rape, Abuse & Incest National Network)

That’s Not Cool

The Network/La Red

In two weeks, I am having a hymenectomy because I have a microperforate hymen. I am really nervous about the procedure. Is there anything I should know about preparing for the procedure and what to expect postoperatively? Is there anything I can do that will help calm my nerves?

Thank you for your question. We hope that this information helps you feel more at ease regarding your upcoming surgery. Here is what we know: girls are born with a thin membrane that surrounds the opening of the vagina, called a hymen. The most common shape of hymens are similar to a half-moon or donut shape. This allows menstrual blood to flow out of the vagina and for a tampon to be inserted with little discomfort. However, some girls are born with a smaller opening in the hymen called a microperforate hymen. The thin membrane covers nearly the entire vaginal opening, except for the tiny hole.

Although menstrual blood can flow out of the vagina, it is impossible to insert a tampon. If a girl wants to use a tampon, a gynecologist can perform a minor surgical procedure called a hymenectomy (hi-men-ec-toe-me) in an outpatient surgical center. A hymenectomy takes less than one hour and recovery is rather quick, about one week. You may experience a little bit of discomfort following the procedure, but the pain is typically well controlled with over the counter medications such as ibuprofen. You will follow up with your doctor about 1-2 weeks following surgery, which is a great time to ask questions. Remember, it’s totally normal to be nervous about any surgical procedure. If questions come up write them down, that way you can ask your health care provider (HCP) before your procedure. Good luck!

How Safe is it to Eat Raw or Undercooked Animal Products?

On restaurant menus, there is usually a disclaimer at the bottom that states “consuming raw or undercooked meats, poultry, seafood, shellfish or eggs may increase your risk of foodborne illness.” You might have noticed a similar warning on labels of foods such as sushi or cookie dough at the grocery store. You might be wondering if it is actually safe to eat raw seafood, rare meat, and raw eggs. Determining the safety of eating these foods requires understanding the risks of eating raw or undercooked foods, and then deciding if you are comfortable with the possible side effects.


Popular seafood dishes that contain raw fish or shellfish include sushi, sashimi, oysters, poke, tuna tartare, and ceviche. Consuming any raw fish or shellfish poses a potential health risk because they could contain parasites, bacteria, and viruses. Infectious organisms commonly found in raw fish and shellfish include Listeria, Salmonella, and tapeworms, among others. These organisms can cause vomiting, diarrhea, stomach pain, and other symptoms. If raw fish and shellfish are not stored and transported at correct temperatures then it increases the risk of having unwanted organisms. It is important to purchase fish only from trusted sources and only order raw varieties at reputable restaurants to reduce the risk it will contain these harmful organisms. The FDA advises against eating raw seafood or shellfish if you have a compromised immune system, are pregnant or breastfeeding.


When you order a hamburger or steak at a restaurant, the waiter typically asks you how you would like it cooked. Asking for “rare” meat typically means the meat remains a pink color inside. When meat is undercooked, it has an increased risk of carrying pathogens/bacteria such as E. Coli and Salmonella. Alternatively, eating meat that is cooked to “medium” or “well done” means that your meat has been cooked to a temperature that will kill any potential pathogens that meat can carry.

When cooking at home, using a food thermometer to ensure your beef, veal, pork, or lamb has reached an internal temperature of 145 degrees Fahrenheit internally and then stands for 3 or more minutes is the only way to ensure proper doneness. Ground beef needs to reach an even higher temperature of 160 degrees Fahrenheit. Poultry products should reach an internal temperature of 165 degrees Fahrenheit before eating and should never under any circumstances be eaten undercooked or raw. Such as with raw seafood, the FDA recommends avoiding rare meats if you have a compromised immune system, are pregnant or breastfeeding.


Raw cookie dough might taste delicious, but it can also be harmful. You may have even noticed a recent trend of adding raw eggs or egg whites to drinks. Raw or undercooked eggs have a high risk of containing the bacteria Salmonella. Salmonella can travel in human or animal feces, and is most commonly contracted from contaminated foods and drinks. It causes food poisoning symptoms that can be especially dangerous for high-risk populations. It’s best to avoid raw eggs altogether and wait until your cookies are cooked, or choose to eat raw cookie-dough made without eggs. As with other raw animal products, people who have a compromised immune system, pregnant or breastfeeding women should avoid foods that contain raw egg as an ingredient.

Avoiding raw animal products is the best way to ensure you will not get sick. Eating raw meat, poultry, fish, or egg products poses the risk of getting food poisoning and experiencing vomiting, diarrhea, and other stomach-related symptoms. If you have any underlying illnesses that weaken your immune system or make you more susceptible to foodborne illness, such as being young, elderly, pregnant or breastfeeding, it is especially important to avoid these foods to prevent more dangerous side effects. Try choosing “medium” or “well-done” meats, eating raw fish only from sources you trust, and avoiding raw eggs altogether.

I’ve had this issue my whole life. I rarely feel thirst unless it’s extreme. I can’t drink more than a mouthful of any fluid or I feel nauseous. It’s an issue, as I can get dehydrated, but my body doesn’t tell me till it’s severe.

Thanks for asking this question! Fluids are essential for your body to function. Many of our organs, including our brain, skin, and kidneys, require water. Therefore, it is important for individuals of all ages to drink fluids every day.

In addition to fluids, some foods can also provide hydration. Fruits and vegetables are especially hydrating because they contain high water content and also have vitamins and minerals such as sodium. Some of the most hydrating fruits and vegetables are watermelon, strawberries, cucumbers and lettuce. Furthermore, you can try mixing any fluid into a smoothie to make it a thicker consistency and easier to swallow. If you do not like water, choosing flavored beverages or adding flavor to water (such as a lemon wedge) can make it taste better.

If your body does not do a good job of telling you when you are thirsty, you can try setting alarms on your phone or making sure to always drink with meals and snacks. Filling up a water bottle at the beginning of the day and keeping it with you throughout the day is another way to remind yourself to have fluids. It’s important that when your body does tell you it’s thirsty, that you respond by having a drink.

One way to tell if you are dehydrated is based on your pee color. If your pee is clear or light yellow, you are likely getting enough fluids throughout the day. If your pee looks darker yellow, you are likely not drinking enough. If you notice your pee is often dark yellow or have other symptoms of dehydration such as dry mouth, dizziness, or diarrhea, it’s a good idea to see a doctor. Feeling nauseous after drinking is another reason to consult with a doctor to determine why you are experiencing the nausea and ensure you are drinking enough fluids.

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.