Merck Manual

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Preventive Health Care Visits in Adolescents


Deborah M. Consolini

, MD, Thomas Jefferson University Hospital

Reviewed/Revised May 2023

Doctors also may encourage activities such as participation in sports, the arts, and community service. Most doctors interview and examine adolescents privately, although parents may be invited to participate and share concerns and receive their own counseling and guidance at the beginning or end of the visit.


The adolescent's height, weight, and blood pressure are measured at every yearly health care visit. The doctor then does a complete physical examination.

Once children become adolescents, certain areas of the body require a more detailed examination. For example, examination of the skin for acne, evaluation of the degree of puberty, and examination of the back for scoliosis Diagnosis Scoliosis is abnormal curvature of the spine. Scoliosis can be present at birth or can develop during adolescence. Mild forms may cause only mild discomfort, but more severe forms can cause... read more Diagnosis are particularly important in adolescence.

A pelvic examination Pelvic Examination For gynecologic care, a woman should choose a health care practitioner with whom she can comfortably discuss sensitive topics, such as sex, birth control, pregnancy, and problems related to... read more is not usually necessary in adolescent girls but may be appropriate if they have certain problems, such as vaginal bleeding or discharge, or if sexual abuse is suspected. The pelvic examination may include an examination of the external genitals (called the vulva or labia) or, if necessary, an internal examination.

The doctor may educate girls about breast self-awareness to become familiar with the usual appearance and feel of their breasts. If girls notice changes in how their breasts appear or feel (for example, masses, thickening, or enlargement), they should see a doctor. Girls are not advised to routinely do a breast self-examination Breast examination Breast disorders may be noncancerous (benign) or cancerous (malignant). Most are noncancerous and not life threatening. Often, they do not require treatment. In contrast, breast cancer can mean... read more Breast examination , such as every week or month, because this has not been shown to be an effective method of screening for breast cancer Symptoms Breast cancer occurs when cells in the breast become abnormal and divide into more cells uncontrollably. Breast cancer usually starts in the glands that produce milk (lobules) or the tubes ... read more Symptoms .


A blood cholesterol level test Measuring lipid levels The body needs fats (lipids) for growth and energy. It also uses them to synthesize hormones and other substances needed for the body’s activities. The body may deposit excess fat in blood vessels... read more should be done for all children between 9 and 11 years of age and again between 17 and 21 years of age. More frequent testing may be recommended for young children and adolescents with obesity or those with a family history of high cholesterol or heart disease.

Adolescents are screened for tuberculosis (TB) risk factors with a questionnaire at all well-child visits. Risk factors include exposure to TB, being born in or having traveled to areas of the world where TB is common (countries other than the United States, Canada, Australia, and New Zealand and Western and North European countries), having a family member who has TB, and having parents or close contacts who are recent immigrants from an area where TB is common or who have recently been in jail. Those with risk factors then usually have tuberculosis screening tests Screening Tests for Tuberculosis Tuberculosis is a chronic contagious infection caused by the airborne bacteria Mycobacterium tuberculosis. It usually affects the lungs, but almost any organ can be involved. Tuberculosis... read more Screening Tests for Tuberculosis done.

Doctors may screen an adolescent for human immunodeficiency virus (HIV) infection at least once between the ages of 15 years and 18 years. HIV screening should be done every year for adolescents who are sexually active, have another STI, or use or have used injection drugs. Screening is done with a sample of blood.

All people should be routinely screened for hepatitis C virus (HCV) infection at least once between the ages of 18 and 79. People at increased risk of HCV infection, including those who have used or who currently use injection drugs, should be tested for HCV infection and reassessed every year. Screening is done with a sample of blood.


Nutrition and exercise

Overweight and obesity Obesity in Adolescents Obesity is defined as a body mass index (BMI) equal to or greater than the 95th percentile for age and gender. Although genetics and some disorders cause obesity, most adolescent obesity results... read more are common in the United States and are associated with heart disease and type 2 diabetes. To combat the risk of obesity, parents should continue to provide adolescents with healthy food choices and limit their intake of unhealthy foods. Soda and excessive fruit juice drinking have been implicated as major contributors to obesity.

Inactivity is directly linked to obesity. Screen time (for example, television, video games, cell phones and other handheld devices, and noneducational computer time) may result in inactivity and obesity. Limits on the time a child spends using devices with screens should start at birth and be maintained throughout adolescence. Participation in sports and physical activity should continue to be encouraged as adolescents age.

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