Sex, STDs, and Birth Control

All Articles in the Category ‘Sex, STDs, and Birth Control’

Important conversations to have with your teen about intimacy

Parents often ask me for advice regarding sex and reproductive health. Many times this involves speaking with me separately from their teen and informing me they found a condom in a pocket or their teen has been in a long term relationship and they think they may be sexually active. Most parents are worried about pregnancy, some are concerned about sexually transmitted infections. For all, I also bring up some topics that aren’t always as obvious, but are just as important. In this post, we’ll discuss important conversations to have with teens about sex and relationships in addition preventing pregnancy and STD’s.

With the #metoo movement that is sweeping social media and the convictions of sexual assault by prominent men in Hollywood, the medical community, and other areas, people who have experienced sexual harassment and assault are beginning to have a voice. Unwanted sexual contact by anyone (regardless of gender) is criminal. Unfortunately, our culture is full of examples where (mainly) female bodies are objectified as sexual objects in movies, commercials, music lyrics, and music videos. The message this sends to youth (and adults) is that the body of whomever we’re attracted to is there for our pleasure. It also sends a message that those who experience harassment and/or assault are at fault or should keep quiet. This needs to change!

I counsel all teens on the importance of consent and mutual respect in any relationship in addition to pregnancy and STD prevention. As more and more parents are pulling me aside to ask for advice, I’m adjusting my counseling to them as well.

Read full post »

Consenting to intimacy

young loveThe recent trial of a Stanford undergrad has stirred up conversations about justice, consenting to sex, alcohol consumption, and unequal treatment in judicial proceedings this week. These are not light topics, but each of the issues discussed has implications for anyone raising a teen. The woman who was the victim of the sexual assault wrote an extremely powerful statement that was shared on social media. I read her statement and it has impacted me. The way I plan to approach these topics in clinical encounters as well as in my personal life (as a mom, aunt, and friend) has shifted from one of focusing on the individual to one of considering our cultural norms regarding sexual consent and women, not as fellow human beings but as sexual objects. Read full post »

Having The Talk with Your Teen

birds and beesRecently a friend described how she’d had ‘the talk’ with her teen son. She felt it was time to sit down and talk specifically about relationships (including sex) because her son has a girlfriend and they spend a lot of time together. Our conversation about her experience was entertaining and enlightening. She described how it was awkward for her, but she knew she needed to get her concerns out in the open. She also recognized that ‘the talk’ is really just the start of an ongoing dialogue about relationships and intimacy. Here were some of our take away tips for parents of teens who may be reluctant to talk about sex, feelings, and romantic encounters. Read full post »

What is a LARC?

IUDWith nearly half of teens initiating sexual activity by the time they graduate from high school, discussing pregnancy prevention is extremely important. Abstinence is the only way to 100% guarantee that a person will not become pregnant or obtain a sexually transmitted infection, but if a teen does become sexually active, health care providers can counsel them on the options that are most effective at preventing unwanted consequences. In this post we’ll focus on pregnancy prevention.

This week, the American Academy of Pediatrics provided a policy statement recommending long acting reversible contraception (LARCs) for adolescent females. LARCs come in two forms: an implantable rod that contains a hormone and is placed in the arm or an intrauterine device (IUD). There are 3 different IUDs available for teens. One contains copper and lasts for 10 years, 2 others contain a hormone and last from 3 to 5 years. We’ve posted about LARCs before and have described their safety and benefits, but a recent study was published this week in the New England Journal of Medicine that showcased amazing results when teens were provided with accurate information about LARCs and chose them as a form of birth control. Read full post »

Sexting and cellphones

Unrecognizable young girl using a touch phone modern gadget.We’ve posted about online safety as well as the dangers of sending sexually explicit text messages in the past, but a recent study in the journal Pediatrics, highlights the importance of making sure we educate teens and tweens about sexting early on.

In the study, researchers looked at the results of a national survey of middle school students. They found that 20% of students who had a cell phone reported receiving a sext and 5% reported sending a sext. For those students who send more than 100 text messages each day, they were over 2 times more likely to receive a sext and 4.5 times more likely to send a sext. They also found that those same students were more likely to be sexually active. In general, students who sent or received sexts were more likely to be sexually active and higher rates of texting were associated with higher rates of unprotected sex. Read full post »

Eight Ways Families Can Help End the Normalization of Sexual Violence

momanddaughterIn my last post, I discussed sexual violence and sexual harassment, and how common it can be in a teen environment. This week, as promised, I want to discuss how parents can try to help their teens recognize and reject this type of behavior, and the type of environment where it is tolerated.

I’ve posted about this in the “Teens and Sexual Assault” series, but I wanted to address a few more recommendations, and repeat a few key ones. These recommendations are not gender-specific; while the study that sparked my first post was about teen girls, any gender can perpetrate, or be the victim of, sexual violence.  Read full post »

A project to prevent unplanned pregnancy

The Centers for Disease Control shared an update that the teen pregnancy rate dropped by 8%. This was exciting news, but teen births for young women ages 15-19 are still exceedingly high in our nation at 31 out of  1000. Unplanned pregnancy is not just an adolescent concern. It is estimated that nearly 50% of pregnancies in the US are unplanned, however for teens the consequences are often more life changing. A few of the consequences of becoming a teen parent include: being more likely to be poor, less likely to complete their education, and more likely to have daughters who become teen mothers and sons with a criminal record.

I think most experts would agree there is not a single solution to prevention, but instead multiple things that can be done to help prevent unintended pregnancies. For teens, this includes parental involvement, teaching about reproductive health (including the importance of empowering youth to say no to sex if they’re not ready), delaying sexual debut, practicing abstinence, using effective birth control if sexually active, and perhaps most importantly, teaching/role modeling healthy relationships.

One research group in Missouri offered over 9,000 women extremely effective and reliable birth control in the form of long acting reversible contraception including the intrauterine device or progesterone implant. These methods are over 99% effective and 100% reversible. They don’t require a woman to remember to take a pill or go in at regular medical visits for a shot so once they’re in place, they work for years without any effort. The study found that most women chose one of these methods when offered. The amazing conclusions from this study were that unplanned pregnancies dropped significantly and so did abortion rates. To see more on this project click here for the YouTube video.

Why am I mentioning this study to parents?

Many teens who seek out birth control only know about the pill or the shot. In fact, the birth control pill is the number one method of hormonal contraception used by teens. However, this method also has the highest failure rate. With perfect use, about 8 out of 100 teens will get pregnant in a year if using the pill (about a quarter of teens who use the pill will get pregnant in a year with typical use). Only a little over 20% of sexually active teens used contraception at all with their last sexual encounter (60% used a condom, but condoms are better at preventing infection than pregnancy). It’s exciting that our teen birth rates have dropped, but we can do better!

Here are a few tips for parents:

Start talking to your teen early about relationships. Role model healthy relationships starting in childhood.

Educate about sex. Include the pros (pleasure, intimacy, affection, desire) and cons (pregnancy, sexually transmitted infection, strong emotions). Encourage your teen to be fully ready for all of these things before they embark on their sexual debut.

Discuss your family values. Talk about why you encourage abstinence until marriage or why you want your teen to wait until they’re ready.

Listen to your teen. They may have questions they’ve been embarrassed to ask, or worried about what you would think of their behavior. When having a discussion, remember that your teen as a point of view as well.

See a medical provider and ask about different forms of birth control. Both boys and girls need education about contraception. Some providers may not know that all options can be used safely in teens and the options are constantly being improved. If the provider isn’t comfortable, ask for a referral to a pediatric and adolescent gynecologist.

For previous blog posts on teen long acting reversible contraception check out the posts below:

More on birth control: long term options

More on birth control: long term options placement and removal

Ten tips for talking to your teen about sex

Teen Girls and the Normalization of Sexual Violence

sad teen girlAn article was recently published in the journal Gender & Society that is enlightening, sad, and for me, brought back memories. The researchers interviewed a hundred adolescent girls referred for sexual abuse about their lives, and discussed themes regarding not only specific incidences of sexual abuse, but day-to-day life as a teen girl. The teen girls interviewed seemed to view sexual harassment, and even sexual violence, as part of everyday life. A common viewpoint was that boys have uncontrollable sexual urges, and it was the responsibility of girls- for better or for worse- to try and dodge them.

As I read the article, I began recalling my own life as an adolescent girl, and how normal a lot of sexual violence seemed. I’ve touched on this topic before, and yet it was startling how familiar some of these themes were to me. I wanted to discuss some of the ideas presented in the study, as well as the overwhelming questions that emerge: Why aren’t teens experiencing sexual harassment or violence seeking help from adults? Why do the teens perpetrating sexual harassment and violence think that their actions are okay?

Read full post »

Does the HPV Vaccine Lead to Risky Sexual Behavior?

A current study in Pediatrics say: ivdruguseNo.

The argument that the HPV vaccine will somehow encourage teens to have risky sex has always seemed strange to me. It brings to mind a teen thinking, “I wanted to wait, it’s what my family, my religion, and my personal values tell me… but now I have a much lower risk of getting cancer in a few decades, so I might as well just start having sex.” Or alternately, a teen who’s not thinking, in a passionate situation with a romantic partner, suddenly remembering the possibility of an increased cancer risk in middle to late life, and stopping everything. Read full post »

Middle School Teens and Sexting: The Survey Says…

Unrecognizable young girl using a touch phone modern gadget.In a recent issue of Pediatrics, researchers studied a group of seventh-graders to see how prevalent sexting was in that age group (ages 12-14), as well as whether sexting is associated with sexual activity.

The answer for what percentage were sexting is 22%, which is good news or bad news depending on how pessimistic you are. They did find that those young teens who were sexting were more likely to be sexually active. (This makes sense to me; teens who are exploring their sexuality would be more likely to use different methods of sexual expression.)

Read full post »