Pregnancy and Sexually Transmitted Disease Prevention
Many teen-agers experiment with sexual activity, putting themselves and their partners at risk of unintended pregnancy and sexually transmitted diseases (STDs, also called sexually transmitted infections or STIs). Even if your teen does not come to you with questions, it is important that you talk with your teen about these issues. Adolescents need to know what becoming sexually active means and how they can protect themselves against pregnancy and STDs.
Sexually transmitted diseases
There are many germs (both bacteria and viruses) that can be passed from one person to another during sexual activity, causing STDs. These germs can be spread directly by physical contact (skin to skin) or through bodily fluids (blood, semen).
The two most common types of STDs caused by bacteria germs are gonorrhea and chlamydia. These infections can cause painful urination and discharge from the vagina or penis. Gonorrhea and chlamydia are serious infections that must be treated with antibiotics. It also is extremely important for all sexual partners to be treated as well. In females, these infections can spread from the vagina up into the uterus and cause an even more serious condition called pelvic inflammatory disease, which often requires hospitalization.
The most common types of STDs caused by virus germs include herpes, genital warts and HIV. Herpes causes painful sores on the vagina or penis. Herpes outbreaks can be treated with medications that lessen the pain and shorten the course of the illness, but there is no cure. Herpes stays in the body and from time to time will cause sores in the genital area. Females with herpes can pass this viral infection onto their babies during the birthing process, especially if there are active sores on the vagina at the time. This can result in serious illness, including life-threatening pneumonia and meningitis, or even death for the infant.
Genital warts (wartlike bumps on the vagina or penis) also are caused by a virus (human papilloma virus, or HPV) and spread by direct contact. These growths usually are painless, but are strongly associated with the development of cancer of the cervix in females. Like herpes, genital warts are very difficult to treat and often come back again and again.
HIV (human immunodeficiency virus) is the most serious of the sexually transmitted viruses. It is spread by body fluids and can lead to severe problems with the immune system (acquired immunodeficiency syndrome, or AIDS) and death. Although there are now treatments that hold off the virus for some time, there still is no cure for this disease. HIV infection can be, and most often is, fatal.
All parents need to give their teens the facts about STDs. Make sure teens understand all of the information outlined above. Explain to them that they are at risk of getting any and all of these infections if they have sex, and especially if they choose to have sex without taking any steps to prevent these types of infections.
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The best way for teens to protect themselves against STDs is to avoid any sexual activity, including intercourse and oral sex. If your teen decides to have sex, there are ways to reduce the risk of infection. The most effective method for protecting against all STDs, including HIV, is a condom. The condom is a thin, flexible cover placed over the penis to prevent semen (and germs) from entering the vagina during sexual intercourse. A condom must be worn for every sexual encounter, from start to finish. A sperm-killing cream or gel (spermicide) also should be used to help increase the effectiveness of the condom.
The diaphragm and cervical cap also are barrier devices. They fit over the cervix to block the opening to the uterus, preventing sperm from entering. These devices protect against some STDs, but are not as effective in preventing the spread of HIV infection as the condom. In addition, they are more difficult for teens to use. First, teens must get them from a physician's office. Then for each sexual encounter, they must be carefully inserted, used with a spermicide, and left in place for six to eight hours afterward. If not used properly, these devices are even less effective.
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The barrier methods mentioned above (condom, diaphragm and cervical cap) help to prevent STDs and also unwanted pregnancy. There are other methods that help to prevent pregnancy but do not prevent the spread of STDs. These methods include oral contraceptives, injectable contraceptives, intrauterine devices (IUDs), periodic abstinence, and withdrawal.
Oral contraceptive pills (OCPs), often simply called "the pill," contain female hormones (estrogen and progestin) that can be extremely effective in preventing pregnancy, but only when taken properly. The pill reduces the risk of pregnancy by preventing the release of eggs from the ovary (ovulation), by keeping the mucus in the cervix thick so that sperm cannot pass through, and by not allowing the attachment of a fertilized egg to the uterus (implantation). However, the pill needs to be taken every day to be effective. Missing even one dose can result in pregnancy. The pill also has some side effects and is not the best choice for everyone. Your teen should talk with her pediatrician if she is interested in this form of contraception. Remind your teen that this method is effective in preventing pregnancy but does NOT protect against STDs. Therefore, the pill only should be used in combination with a barrier method, preferably a condom.
To prevent pregnancy, hormones similar to those found in the pill also can be injected as a shot into the muscle. The benefit to this method is that your teen does not have to remember to take a pill every day. The shot is repeated once every three months at the doctor's office. Like the pill, it is not for everyone and has important side effects including weight gain, irregular bleeding and no menstrual periods.
IUDs are put into the uterus through the vagina and cervix by a physician, and can be left in place for months to years. These devices prevent pregnancy by preventing the attachment of a fertilized egg to the wall of the uterus. However, they do not prevent STDs, and they increase the risk of pelvic inflammatory disease. They usually are not recommended for adolescents.
Two other methods of birth control are periodic abstinence and withdrawal. Periodic abstinence (also called the rhythm method) involves attempting to predict the specific time of the month when a woman is likely to get pregnant and not having sexual intercourse during that time. Since teen-agers often have irregular menstrual cycles, this method is unlikely to be effective and is not recommended. The withdrawal method requires the man to withdraw his penis from the vagina before ejaculation. This method is popular among teen-aged males (so that they do not have to wear condoms), but it is highly ineffective in preventing pregnancy. Semen and sperm often leak from the penis before ejaculation, and failure rates are as high as 20% to 30%. Make sure your teen knows that periodic abstinence and the withdrawal method do not stop the spread of STDs.
Although there are quite a few methods of contraception, it is important that your teen knows the facts about each method and chooses one that will prevent pregnancy and STDs. For many teens, the best choice is to totally avoid having sex. For teens who are sexually active, the combination of an oral contraceptive and a condom offers the most effective protection against pregnancy and STDs. If your teen is sexually active, or even thinking about it, have him talk with his pediatrician about all of these methods to find the one that works best for him.