Teens, 11-19

Adolescents between the ages of 11 and 19 years experience a period of rapid growth, bodily development, and emotional and intellectual progression.

In addition to physiological concerns, physicians may also counsel teens about lifestyle choices like sexuality and pregnancy, substance abuse, and peer pressure. Adolescent patients should undergo at least one physical examination every year between the ages of 11 and 19, during which the doctor will evaluate the following:

Common Issues in Adolescents

For many young men and women, teenage years herald behavioral changes that can lead to problematic habits or activities if unaddressed. An increased level of socialization has been linked to many ‘risky behaviors’ among teens. Physicians can counsel teenage patients about the following topics ― and, if necessary, prescribe medication or treatment:

  • Sexuality: In 2009, the CDC reported that more than 400,000 girls between the ages of 15 and 19 gave birth. Sexually-transmitted diseases are another major concern among teens; roughly 8,300 men and women in the U.S. between the ages of 13 and 24 were diagnosed with HIV infections in 2009, and approximately 19 million STD cases involving patients between the ages of 15 and 24 are reported each year.
  • Substance abuse: A 2013 survey from the National Institute of Drug Abuse found that 3.5% of 8th graders, 12.8% of 10th graders, and 26% of 12th graders claimed to have consumed alcohol to the point of drunkenness at least once in the past month. Another 9.6% of teens surveyed claimed they were addicted to cigarettes. While the use of some illegal drugs (such as heroin, cocaine, methamphetamine, and hallucinogens) has decreased in the last 23 years, doctors have noted an increased number of teens who abuse prescription drugs (most notable Adderall, Vicodin, and cough medicine).
  • Gang and criminal activity: According to the National Youth Gang Survey, which is administered by the Office of Juvenile Justice and Delinquency Prevention, a gang presence has been reported in 100% of U.S. cities with populations in excess of 250,000 (as well as 35% of suburban counties and 11% of rural counties). There are currently about 772,500 gang members in the country, 94% of whom are male and 37% of whom are 18 years of age or younger.
  • Bullying: According to StopBullying.gov, 1 in 3 U.S. students say they have been bullied at their school; in recent years, the prevalence of cyberbullying (bullying conducted via email or online social media outlets) has also risen dramatically.
  • Eating disorders: The National Association of Anorexia Nervosa and Associated Disorders (ANAD) reports that anorexia (habitual non-eating or self-starving) is the third most common chronic mental illness in the country. Roughly 95% of those with anorexia or bulimia (chronic purging of undigested food, usually through self-induced vomiting) are between the ages of 12 and 25; as many as 90% of anorexia or bulimia patients are female.
  • Self-injury: According to Mental Health America, more than 2 million people in the U.S. (primarily teenagers) have admitted to self-injury, most often self-mutilation (or ‘cutting’). This practice is almost always linked to depression, anxiety, or other mental health disorders.
  • Oral hygiene: In addition to annual examinations from their physician, adolescent males and females should also visit the dentist at least twice per year for tooth cleanings, fluoride rinsing, and other steps to maintain healthy levels of oral hygiene. Additionally, many teenagers will be referred to an orthodontist if irregularities are noted in their bite or tooth spacing; the most common course of action for these patients is the implementation of metallic braces, which gradually improve the irregularity over an extended period of time (typically about two years). In cases of severe irregularity, oral surgery or advanced dental appliances may be recommended.

Recommended Vaccinations

Most physicians recommend the following vaccinations for adolescents between the ages of 11 and 19:

  • HPV: Human Papillomavirus: HPV is the most common sexually-transmitted infection (STI) in the United States. Most carriers will remain asymptomatic; however, some untreated cases can lead to genital warts or cancer of the throat, ovaries, vulva, penis, or anus. Three doses (administered over a six-month period) are recommended for all males and females between the ages of 11 and 12; currently, the vaccine is not available for any patients over the age of 26. Pregnant women are urged not to receive the vaccine at this time.
  • Influenza (Flu): Just like young children, teenage males and females should receive one flu shot on an annual basis.
  • Meningococcal: This vaccine is used to prevent meningococcus, a condition commonly referred to as meningitis. Physicians urge all teenagers to receive this vaccination, especially if they plan to attend college (numerous campus outbreaks have been reported, likely due to the tight living quarters in collegiate residence halls). Two doses are recommended using the following benchmarks.
    • 11-12 years
    • 16 years
  • Tetanus Diphtheria Acellular Pertussis (Tdap): While DTAP, which protects against the same illnesses as the Tdap vaccine, is given to infants and children ― covered in our Infants and Children section ― Tdap is a booster shot given to preteens and teens. Tdap should be administered at the ages of 11 or 12. Anyone under the age of 18 who has not received Tdap ― or, for that matter, any adult who has never received a Tdap vaccine ― should contact a doctor immediately. After the initial Tdap vaccine, patients should plan to receive a Td vaccine every 10 years. Note that this vaccine only covers tetanus and diphtheria, as the vaccination against acellular pertussis received in the Tdap vaccination protects a patient for life.