Teen Sex Questions

I really enjoy teenagers. NO, that is not sarcasm, and YES, we have our own at home! Pre-teens & teens have always been my favorite group to work with, as a physician or girl scout leader or school volunteer. I love seeing how much potential they have, and more importantly, seeing THEM recognize their own strengths, and figure out how to most effectively use those talents to ultimately shape their future career choices. I think many adults make the mistake of talking down to teens, dismissing their heartaches, homework loads and stresses as trivial in the scheme of life (which, in fairness, is often how they look from our vantage point.) The reality is that their stress level is enormous, and that even if it is "puppy love" or "just a middle school test", these challenges are the greatest they have faced so far in their young lives. I believe we as adults can give perspective, but it is important not to minimize what they are going through.

All that being said, one of my educator roles is talking to youth about sexually transmitted diseases. I have been speaking to teens on this topic for roughly three years, and every time, I require the participants to write down a question at the end of my talk. I give them index cards (so they all look the same) and have them directly hand me the cards, so no one sees what anyone else has written. Not surprisingly, there are some common themes, though it might surprise you that I am primarily talking to straight A, service-minded, "good kid" student leaders. I thought I would spend the next several blog entries sharing some of their questions (and my answers) so both teens and parents can see what is being discussed. I'll start today with some questions about pregnancy:

1. Does birth control work?
Yes, but it is not foolproof. Oral contraceptives (the pill) are 99% effective when they are taken correctly- at the SAME TIME, every day; no skipped pills. Combining the pill with condom use as well is highly recommended. Remember, condoms alone are only effective 11-20% of the time, but adding them to the pill decreases the chances of conceiving as well as offering some protection against STDs.

2. Is it better to use two condoms at the same time, “doubling up”, in case one breaks?
NO, absolutely not. Using two condoms at once actually decreases effectiveness (due to sliding and breakage.)

3. Can you get pregnant without intercourse?
Usually not, but if semen enters the vagina, which can happen with “outercourse” or in the process of anal sex, it is possible. Young girls are very fertile – that is the take home message.

BOTTOM LINE: Talk with your teens about STDs, LISTEN to their questions, and help them find the correct answers!
PS. For more details, FAQ, answers & stories, check out Seductive Delusions

If You Take "The Pill" to Avoid Pregnancy- READ THIS!

Are you taking generic birth control? There is a PACKAGING ERROR that has reversed the order of the weekly pills, which significantly decreases the contraceptive effectiveness (translation- you can get pregnant more easily.) Qualitest Pharmaceuticals is recalling multiple lots of the following pills:

Cyclafem 7/7/7, Cyclafem 1/35, Emoquette, Gildess FE 1.5/30, Gildess FE 1/20, Orsythia, Previfem and Tri-Previfem

To find out if your generic pill has been affected, click on the link above to check your lot number, or head to your local pharmacy and ask your pharmacist if your prescription is included in the recall.

This is a great opportunity to talk about birth control effectiveness. When used correctly, oral contraceptives are considered to be 99% effective. If that is true, why do we hear about so many cases of women getting pregnant while they were on the pill? The primary reason is that many people forget to take it. Skipping a day, especially the first day of the cycle, greatly increases your risk of ovulating (and therefore, your risk of conceiving.) Additionally, it is important to take the pill at the same time every day. Taking it "when you get up" does NOT work if you sleep in on weekends! Fluxuating your time by minutes is no big deal, but by HOURS is NOT okay. Additionally, other medications can decrease the effectiveness of the pill, particularly antibiotics or antifungals (like oral medications for yeast infections.) Whenever you receive a new prescription, ask your pharmacist if there is a potential interaction. Finally, do the math- if the pill is 99% effective, but you have millions of women taking it, by sheer numbers there are going to be a significant number of pregnancies from that 1%.

BOTTOM LINE: Birth control effectiveness is maximized by taking the pill at the same exact time every day, and being aware of possible decreased efficacy with other medications. If you take a generic pill, make sure it is not part of this nationwide recall.

Teen Pregnancy- New CDC Report has Good News & Bad News

The CDC released "Vital Signs: Teen Pregnancy" this week, which looks at teenage pregnancy statistics over the last two decades. On the plus side, the total national teen birth rate in the United States was the lowest we have recorded, down, in fact, by 37% from 1991. Unfortunately, we still had over 400,000 teenage births, which is 4% of female teens aged 15-19, and the annual estimated cost of teen childbearing is- gulp- over $9 BILLION. The USA birth rate is up to 9 times higher than most other developed countries.

Please note, my fellow southerners (Texas, Oklahoma, Arkansas, New Mexico and Mississippi), that we have the very WORST rates of teenage pregnancy in the country: >60/1000 females vs. <20/1000 for the best states, up in New England. Not something to boast about...

Today, and every day, 1,100 teenage girls will give birth in the US. That's 1 out of 10 new mothers. The cycle continues as 1/3 of kids born to teenage moms become teenage parents themselves. Not surprising, only half of teenage moms earn their high school diplomas- even by age 22.

The media is still portraying teen motherhood and sex in general as glamorous, fun, and enticing, which is far from the truth. Unpaid bills, screaming kids and exhausted parents are more the rule. We are slowly creeping in the right direction, but we've got much work to do to effectively educate our kids.

BOTTOM LINE: America has embarrassingly high rates of teenage pregnancy, costing our nation billions of dollars and heartache. We can do better.