SEXUALITY OVERVIEW — Most teens and pre-teens have a lot of questions about sex and sexuality. This is normal and natural. It also is normal to feel shy or embarrassed about raising these issues with adults or doctors.
Sexual development is an important part of health, similar to other measures of physical growth, such as height and weight. It is particularly important that teens be well informed about all aspects of sex and sexual health.
ADOLESCENT SEXUAL DEVELOPMENT — Sexual development begins in the pre-teen years and continues into adulthood. The body produces hormones that cause outward changes, including breast development in girls, growth in size of the penis and testicles and the appearance of facial hair in boys, and growth of hair under the arms and in the genital area of both boys and girls.
However, puberty is more than physical changes. As your body grows into adulthood, your way of thinking, emotions and wants and needs will change as well.
You will probably start to feel strong attractions toward others. Sometimes these feelings include developing friendships with other teenagers. Other feelings include wanting to be physically close to another person.
HEALTH ISSUES RELATED TO SEX — The main reason it is important to postpone sexual activity until you are mature is that sexual activity affects both the physical and emotional health of the people involved. Here are some facts.
Sexually transmitted infections (STIs) — Infections can be spread through sexual intercourse, anal sex, oral sex, and using fingers. These diseases are called sexually transmitted infections, or STIs.
STIs often do not have any noticeable signs or symptoms. Still, all the STIs can have serious consequences for future health. For example, a woman who gets an STI may have difficulty becoming pregnant later in life or may be more prone to developing cervical cancer.
Some of the most important STIs are:
Human papillomavirus — (HPV) is the most common STI in adolescents. Most people who get HPV do not know they have it. Some types of HPV cause genital warts. Other types cause cervical cancer in women, penile cancer in men, and anal or oropharyngeal cancer in either sex. A Pap smear is one important way your doctor can screen for cervical cancer associated with HPV.
In addition, there are vaccines to protect against common types of HPV. The vaccine is recommended for both males and females. The ideal time to receive this vaccine is before you have engaged in any type of sexual activity.
HIV — (human immunodeficiency virus) is the virus that causes AIDS (acquired immune deficiency syndrome). HIV is a serious, incurable disease of the immune system. Although there is no vaccine to prevent it, there are treatments that help people with HIV infection live longer.
Gonorrhea and chlamydia — These are serious bacterial infections of the genital tract. They can lead to pelvic inflammatory disease (PID) in females, which can cause severe pain, can lead to infertility , and/or increase the risk of ectopic pregnancy. Both can be cured with antibiotics. It is important to be screened for these infections if you have had sex, because most people do not have any symptoms.
Herpes simplex virus — This is a viral infection that causes painful or itchy sores in the genital area. The sores heal but can reappear at any point later in life. There is no cure. The virus can be spread even when there are no sores present. Most people with herpes do not have symptoms so they do not know that they might infect a sexual partner.
Hepatitis B virus — This is a viral infection that can cause liver disease. Most children are being vaccinated against this infection with a series of three shots. You should speak to your doctor if you are not sure if you have had this vaccine.
Hepatitis C virus — Hepatitis C virus is a viral infection that can cause serious liver damage. Hepatitis C is diagnosed with a blood test. Hepatitis C infection can usually be treated with medications, and with newer treatments, many patients can be cured.
Syphilis — This is an infection caused by a small organism called a spirochete (/SPY-ro-keet/), which can cause an ulcer on a person's genitals or anus. Sometimes you may not notice the ulcer, because it does not usually cause pain or may be on the inside of the vagina (in females) or anus (in either sex). Syphilis can usually be cured with antibiotics.
Trichomonas — Trichomonas ("trich") is a common infection caused by a tiny parasite that can cause itching and/or a discharge from a female's vagina or a male's penis. If a sex partner informs you she or he has been diagnosed with trich, you should seek treatment for this infection right away even if you have no symptoms. Trichomonas can be cured with antibiotics.
PREVENTING AND SCREENING FOR STIS —
The only way to be sure you will not get an STI is to not have sex.
It is not possible to tell by looking at someone whether he or she has an STI
Condoms — People who are sexually active can reduce their risk of getting an STI by using a latex or polyurethane condom every time they have sex.
Condoms reduce the risk of getting an STI, but they do not take away the risk completely. Condoms can break or leak, allowing passage of body fluids and transmission of infection. In addition, condoms do not completely cover all of the skin that is exposed during sex; herpes and HPV can be passed by skin-to-skin contact. Other birth control methods do not reduce the risk of STIs.
Immunizations — Another way to reduce the risk of two specific STIs (HPV and hepatitis B) is to talk to your doctor about immunizations.
Check ups — Regular check-ups by your doctor are important to all adolescents, but it is particularly important to speak with a doctor if you decide to have sex.
Pregnancy and birth control —
Pregnancy in teens has serious health consequences. Pregnant teens are more likely to have babies who are premature or sick.
As with STIs, the only way a young woman can be sure she will not become pregnant is to not have sexual intercourse. There is no reliable way to determine a "safe" time when she will not become pregnant; menstrual cycles at this age can be irregular. Teens should know that pregnancy is possible each time they have sexual intercourse, including the first time, during the menstrual period, and anytime between menstrual periods.
Birth control methods are available that can reduce the risk of pregnancy to near zero. However, birth control methods other than condoms do not reduce the risk of STIs.