Question: My daughter is 15 but has not started her periods. Is this reason for concern?
In the seventeenth century, it was unusual for girls to start their periods until they were 16 or 17. Today, they may start at 12 or earlier, the change being due to the better diet, health and hygiene in the twentieth century, more rapid growth, and therefore faster maturation of the body. The onset of periods in a girl can be estimated by the experience of her mother, sisters or cousins, but there may still be significant variations. The trend is continuing for periods to start earlier every generation.
By 15, you would expect breast buds to have developed and some early wisps of pubic hair to be present. If this is not the case your daughter should be checked by a doctor. There are some medical conditions that can lead to a delay in the onset of periods. These include any severe illness earlier in life that may have slowed maturation, diseases of the ovaries or other glands, and some rare congenital disorders.

Question: Can you explain endometriosis for me? I have been told that this is the cause of my painful periods.
Your uterus (womb) is lined with special cells, which during the second half of your monthly cycle, are prepared to accept any fertilized egg and allow it to grow into a baby. If no pregnancy occurs, these cells degenerate, break away from the inside of the uterus, and with the resultant bleeding, pass out of the body in a woman’s period.
From the top of the uterus, the two Fallopian tubes lead out to the two ovaries. In a very small number of unlucky women, the cells that normally go out during a period, may go in and through these Fallopian tubes. The cells are then in an abnormal position around the ovary, on the outside of the uterus or in the pelvic cavity, and they can attach to these tissues and start growing and spreading further. They will still respond to the hormonal cycle every month, as these hormones pass through the bloodstream to every cell in the body. As a result, these cells in abnormal positions will bleed every month, releasing blood in places where it can cause pain and other symptoms. The cells may also block the Fallopian tubes causing infertility, or settle on the outside of the intestine to cause irritation and diarrhea.
The condition can only be diagnosed by examining a woman’s pelvis by means of an operation or a laparoscopy. A laparoscopy involves a small tube being put through the belly button into the abdomen, and through this a doctor can see the spots of endometriosis in its abnormal positions.

Question: I am 19 and have had three sexual relationships with men. Over the past few months I have had a thick white discharge from my vagina, and it is itchy and sore around that area. I am getting married in two months and am worried that I might have some sort of sexually transmitted disease, and I would feel embarrassed and dirty seeing a doctor about this. What can I do?
What you are describing is a typical case of vaginal thrush. Tight jeans, pantyhose, the contraceptive pill, nylon bathers, antibiotics and sex are the common aggravating factors involved in catching this modern woman’s curse. Thrush, also known as candidiasis or moniliasis, is a fungal infection caused by a fungus called Candida albicans, which lives in the gut where it causes little or no trouble. Usually when it comes out on to the skin around the anus, it dies off; but if that skin is warm, moist and irritated, it can grow and spread forward to the lips of the vagina (the vulva).
Entry of the fungus into the vagina from the skin outside is aided by the mechanical action of sex, and the alteration in the acidity of the vagina caused by the contraceptive pill. Once established, this fungus causes an unpleasant white vaginal discharge, intense itching of the vulva and surrounding skin, and often inflammation of the urine opening so that passing urine causes discomfort. You should see your doctor as soon as possible to confirm the diagnosis and obtain the correct treatment.
Your fiance must also be treated with a cream, because although he may show no signs of the infection, it may be present under his foreskin, and he can give the thrush back to you after you have been successfully treated.