Being a teenage girl is not easy. There are worries about school; friends; clothes; looks; relationships with parents and other family members; getting your period. And then there are worries about boysand sex. "As a doctor, I worry about girls who get far along in a relationship with a boy before they know the first thing about taking care of themselves," says Eve Faber, MD, a family practitioner at SUNY Downstate Medical Center. "Many girls cant, or wont, talk to a parent about sex, and they have no regular physician. Thats sad, because there are so many things they need to know to avoid troubles that could seriously complicate their lives."
When Sex Becomes an Issue
Often, today, girls become sexually active quite young, even before they have carefully weighed the consequen-ces of what they are doing. A girl should wait at least until she knows how to protect herself from pregnancy and infections. And always at a minimumuse a condom," Dr. Faber says.
In the best of all worlds, every girl would visit a gynecologist well before the time she begins to have sex. The exam includes a physical examination to make sure the sexual organs are healthy, and a "pap smear" to rule out cancer of the cervix. Equally important, the girl should receive advice and instruction on using birth control, and the doctor should explain the danger of sexually transmitted diseases (STDs).
"With so many sexually active young people, the risk of exposure is great these days," says Dr. Faber. More and more infections have become relatively common, from gonorrhea and syphilis, to chlamydia, herpes, genital warts, and HIV.
In real life, of course, teens may not stick to the ideal scenario, and sex often is not planned. Never mind, says Dr. Faber. "If a girl doesnt see a doctor before the first time, she should go afterward. She really should make this a priority."
Protection Against Pregnancy
Today, a girl has several options for pregnancy prevention. Condoms, sold in drugstores, convenience stores, and in some vending machines, are the most universally available. Besides protecting against STDs, condoms are far better than using nothing for pregnancy prevention. However, as birth control, condoms very often fail. Birth control pills ("the pill") are the most reliable form of birth control. They must, however, be prescribed by a doctor which underlines the importance of seeing a gynecologist or family practitioner before becoming sexually active.
Other forms of birth control, such as the diaphragm and contraceptive sponge, gels and foams, are fairly reliable if used properly every time. But these methods may be cumbersome or off-putting to girls and boys who are new to sex. They work best for couples involved in stable, long-term relationships.
Two practices that are all-too-popular with teenswithdrawal before ejaculation, and the rhythm method (in which a girl has sex only during infertile times in her menstrual cycle)have huge failure rates. "Dont even think about it," say the experts.
Something else girls should realize: "Even if they are taking birth control pills or using some other form of contraception, couples still should use male condoms for STD protection," Dr. Faber says. "The pill does nothing to protect from HIV, which is still life-threatening, or from other STDs that can have very serious consequences."
Sexually Transmitted Diseases (STDs)
Sexually transmitted diseases include all infections that can be conveyed during sexual intercourse or sex playany activity that could permit bacteria or viruses to move from one person to another through the exchange of body fluids, including semen, mucous, blood or saliva.
In the past, the most common infections were gonorrhea and syphilis. While their incidence declined some years ago, both are on the rise again. Fortunately, both of these can be detected by blood tests, and cured with antibiotics. The same is true of chlamydia, currently the most common STD, which is widespread among teens. Other common ailments are genital lice (crabs), genital herpes and genital warts. The last two are both viral infections that can be treated, but not cured.
How do you know if you or your partner has any of these three bacterial STDs? Syphilis, in its early stages, usually produces a "chancre" or sore in the genital area. Gonorhhea often causes a discharge, in both men and women, and/or difficult urination. Itching, discharge, odor or burning during urination can signal chlamydia. Unfortunately, many people infected with STDsespecially women experience no noticeable symptoms, and thus they may carry the infection for an extended period without knowing it. Clearly, this is an important reason for sexually active girls to seek frequent checkups by a doctor.
The consequences of untreated STDs can be grave over the long term. Chlamydia and gonorrhea can lead to complications including inflammatory pelvic disease, tubal pregnancy (which can be life-threatening) and possible sterility. Syphilis can affect the central nervous system, producing devastating symptoms many years later.
HIV and hepatitis B are very serious blood-borne viral diseases that can be transmitted during sex. Young people canand shouldbe vaccinated against hepatitis B, but there is no vaccine yet against HIV. Neither disease can be cured, but they can be controlled under medical supervision. Abstinence is the best protective measure; short of that, a woman should make sure her partner uses a condom at all times.
All STDs are a serious matter. Not only is a womans own health in danger; she also can infect a sex partner or her unborn infant. HIV, hepatitis B and genital herpes can be passed to a baby during birth, with possibly devastating health consequences.
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