CHAPTER 10: Sexual Questions

Contents

CHAPTER 10: Sexual Questions

Questions about human sexuality begin as soon as we can talk and continue until very old age. Differences between men and women, boys and girls, are the stuff of most books, movies, and conversation. In some areas of the world, sexual discussions and actions are not allowed. In others, they are openly encouraged.

Since most adolescents will have had some discussion of sexual questions before reading this section, we will be brief. If you have additional or private questions, please talk to a nurse, doctor or an adult you can trust about them. You can also read the sections about "Growth" and "Menstruation" if you have questions about these topics.

The Good Things

The obvious good thing about human sexuality is the way the good feelings of sex can make a relationship even stronger than a good friendship. In this relationship sexual experimentation can be very satisfying. And, of course, human sexuality allows us to have children. For many this is the real payoff of sex, love, and marriage. The importance of sexual feelings and discussions in everyday life means that you will normally have sexual questions. Thinking about your sexuality may make you worry about a lot of problems (see "Bad Things" in the next section). But let's start with the "Good Things".

As a teenager, you will be most interested in the "how to" question. But sex is not about how you do it. Many books and movies can show you how easy it is to do it. Sex is about a relationship.

A loving relationship can overcome many differences. Persons who feel that they are not attractive, are the wrong size, have the wrong skin color, go to the wrong church, or come from the wrong side of town can find that a loving relationship does not directly depend on these things. "Love can conquer all!"

If you are in love with someone with whom you comfortably share secrets and problems, you will find that sex might fit into your relationship easily. It will "feel right".

The Bad Things

Throughout human history sex has gotten people into trouble. Unwanted babies, sexual diseases, bad relationships, and bad feelings about yourself are serious troubles sex can cause. In 1990, about 30,000 deaths resulted from HIV infection, cervical cancer, hepatitis B, and excess infant mortality rates secondary to unintended pregnancy. A vaccine is now available for cervical cancer, but it does not help any of the other "Bad Things".

Unwanted Babies-Birth Control

Abstinence to most people means not having sexual intercourse (inserting the penis into the vagina). People express sexual feelings and emotions in many ways. Holding hands, kissing, dancing, massage, and even masturbation are some of the many ways that people express their sexuality without having intercourse. Many persons of all ages do not have intercourse and explore their sexual feelings in other ways.You need to decide what you want. It helps to decide in advance in which sexual activities you want to engage. Communicating your wishes to your partner is very important.

Every unmarried boy and girl must decide whether to have sex, not have sex, or have sex and use birth control. If she has decided to have sex, she has to face the fact that getting pregnant is a likely consequence. Then she would have to consider having the baby or having an abortion. These are really big decisions at any age.

The simplest and safest birth control method is abstinence.

If you are sexually active, the next safest form of birth control is the condom or "rubber" (a balloon-like device worn over the penis). The most important thing to remember about condoms is that it has to be used every time. Overall success of condoms for preventing pregnancy is 90% and condoms are the only way to reduce the risk for sexual diseases.

Never use baby oil, petroleum jelly, or cold cream with a condom because these will weaken it. Water-based lubricants can be used.

A diaphragm (worn inside of the woman) and vaginal sponges are usually less effective than a condom. The success rate of these methods ranges from 65-85%. Condoms and diaphragms may be made more effective by using a spermicide with them. (A spermicide is a jelly that kills sperm). Using a condom with a diaphragm increases protection from unwanted pregnancies.

Natural family planning or the "rhythm" method if very difficult because you have to time your sexual activity with the least productive time of your monthly cycle. About 2 of 10 women who use this method will become pregnant in a year (in comparison to 8 of 10 who use no method of birth control). Birth control pills reduce the chance of getting pregnant about ten times better than natural family planning. In young women the chances of getting pregnant using a condom are about four times better than natural family planning. Birth control pills are easy to take but do require a prescription. They do have some problems as well. Pills are quite safe, especially for women who don't smoke. The success rate is over 95%. BUT BEWARE OF THE PILLS - SOME TEENAGERS THINK THE PILLS PROTECT THEM FROM SEXUAL DISEASES. THEY DO NOT. ONLY CONDOMS DO.

Other forms of birth control include placing match stick-sized "pills" under the skin of the upper, inner arm. The implants can be removed any time and last up to five years. Birth control shots are available. These shots can protect for several months. Intrauterine devices are best used by women who have had children.

Emergency contraception after intercourse will be over 80% effective for the prevention of pregnancy if standard contraceptives are used within 72 hours.

Remember, over half of the pregnancies in teenagers happen within six months of the first time the girl has had sex. Girls who are thinking about having sex should talk to a doctor, nurse, or a family planning clinic such as "Planned Parenthood".

Sexual Diseases

Viruses make themselves at home in your body. They are really tough to get rid of. AIDS is the biggest virus to worry about because it kills and there is no good treatment. You will not get AIDS if you don't have sex, don't shoot drugs, or if you have sex with a person who does not have AIDS. Otherwise, you are at risk for getting AIDS. You can also get AIDS from oral (mouth) sex. There are other virus diseases that spread in the same way as AIDS. Herpes causes sores on your mouth, penis, or vagina. One in five persons in the United States now has herpes and the percentage has increased by 30% since 1970! For teens, the overall rate is about one in twenty because a lot of teens have not had sex. A large number of sexual partners greatly increases your risk. An anti-virus medicine can help but will not cure herpes.

Infection of the liver by a virus called hepatitis B is more common in sexually active teenagers. For this reason sexually active teenagers may need a vaccine for hepatitis B.

Warts that grow on the skin of your penis or vagina are growths caused by viruses. They can be treated but the treatments often don't cure the problem.

A lot of sexual diseases are caused by bacteria. Syphilis, gonorrhea, and chlamydia are the three most common ones. All usually cause sores, pain, or dripping. Early treatment is important. Gonorrhea and chlamydia can cause problems for women who want to have babies later in their life. Sexually active young women should have Pap tests and a test for chlamydia.

You can lower your chances of getting a sexual disease by using a condom. The chances may be made even lower if you use a spermicide with the condom.Viruses make themselves at home in your body. They are really tough to get rid of.

Teenagers who are sexually active say that the biggest problem about condoms is not knowing how to talk about using them. Think about it! A boy and girl are about to have sex -- the most intimate form of relationship and an act that can have huge impacts on their future -- and they don't know how to talk about a little protection. The best advice is that if you can't talk about protection, don't have a relationship.

Bad Relationships

A weak relationship will usually get worse if sex becomes part of it. The weak relationship will really get bad if a baby arrives. Please read the Chapter called "Problem Solving" if you are not having a good relationship with someone. Deal with the relationship before you deal with sex. In the Chapter on "Problem Solving" there are pressure lines that you may run into if your relationship is not good. The answers came from teenagers who talked about how they deal with this kind of pressure.

Bad Feelings About Yourself

Everyone feels bad about themselves some of the time. A guy may worry that he is "not a man" unless he has had sex. Guys and girls always worry about their sexual equipment and looks-- that is what advertisers want you to worry about so that you will buy their products.

And you may even have a time when you are confused about sexuality. At some time about 10-20 out of 100 teenagers are attracted to someone of the same sex.

Later in life men and women will worry about whether they have sex enough or too little or reach climax enough or too little. The point is: don't let sex be the focus. Reread the section on "Good Things" if you are feeling bad about yourself because of sex.

We have tried to make the How's Your Health error-free. However, those involved in its preparation can not warrant that all of the information is accurate and complete. When you use How's Your Health as a guide for your health and medical care, be sure to discuss any questions about it with your doctor, nurse, or other health care worker.

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