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Doctors Not Spending Enough Time Talking to Teens about Sexual Health

Thursday, January 16th, 2014

The sex lives of adolescents is a topic which many parents – and, apparently, doctors – would often prefer to avoid. But since almost half of high school students have had sex, we can’t pretend the sex lives of teenagers are nonexistent, nor can we neglect to teach adolescents about being responsible for their sexual health. Unfortunately, a recent study showed that only about 65% of physicians are talking to teens about sex, and when they do, the conversation lasts only an average of 36 seconds.

None of the 253 teenage patients in the study brought up sex themselves during their office visits, meaning that if the doctor did not initiate the conversation, it did not take place. The doctors were more likely to raise the topic with female patients. It may be true that girls are the ones who get pregnant, and must learn to protect themselves, but adolescent boys also need to know that they share equal responsibility when it comes to safe sex. Besides unexpected pregnancy, both girls and boys must be taught how to avoid contracting and spreading sexually transmitted infections.

And teens can’t count on learning the information they need at home or at school, either. Many sex-ed classes in schools fall short of comprehensive, and the subject is never brought up at all by many parents. For this reason, it is important for doctors to realize the magnitude of this need and be sure to talk to their adolescent patients about sex.

Parents can assist by not being present in the room during the exam – unsurprisingly, the study showed that doctors were much more likely to bring up the topic of sexual health when parents were absent. Longer visits were also more likely to include conversations about sex, one of many reasons why taking enough time with each patient and giving them individual, personal attention is so important.

Whether the doctors were uncomfortable talking about sex with teenagers, were concerned about making conservative parents angry, or were just too rushed isn’t clear. What is clear is that we can’t expect teens to make good choices if we don’t make the effort (uncomfortable as it may be) to educate them and provide them with the tools to make those good choices.

And since teens don’t bring up sex on their own during doctor appointments, it’s vital that we open up the conversation and give them a chance to ask any pressing or embarrassing questions they may have. Otherwise they will likely turn to their friends or the Internet, and there is far too much incorrect and downright dangerous information out there to neglect the job of teaching kids the facts and giving them the opportunity to talk to a trusted, knowledgeable adult about sex.

– Yvonne S. Thornton, M. D., M. P. H.

Sex, Lies, and HPV

Monday, December 3rd, 2012

All women have the right to keep their sex lives a secret and only share details with an intimate crowd of friends and partners. However, you might be surprised when your gynecologist asks for details about your first sexual experience. He or she might ask what age you had your first sexual partner and even what type of intercourse occurred. While you might be hesitant to share the details at first, it’s actually extremely important that you’re as honest as possible. Your gynecologist needs to know the details because recent studies have linked the age of your first intercourse with the likelihood that you’ll contract the human papillomavirus (HPV).  HPV has been found to be a precursor and is linked to cervical cancer.

In many cases, women who had sexual intercourse for the first time at a young age contracted HPV later in life. Even if you don’t have HPV now, your sexual history will help your gynecologist decide which types of infections and viruses to look out for.  Also, he or she may recommend being vaccinated against HPV with the Quadrivalent vaccine (Gardisil). The reasoning behind the connection between sexual history and HPV is partly because of sexual choices. There is a good chance that someone who had sex early on will have had more sexual partners than other adults, which will directly increase her likelihood of contracting HPV. Your gynecologist will also ask if you ever had any non-consensual sex, because the types of partners you’ve had and their health will also contribute to whether or not you’ll get HPV.

When your physician asks about your early sexual history, don’t worry about being judged. The best thing you can do for your own health is to be honest and share any detail you can remember. It might seem strange sharing such information with a stranger, but rest assured that she will keep the information confidential and within the walls of the office. If you’re concerned about your gynecologist’s honesty and you don’t trust that the information will remain private, it’s time to start looking for a new one. Your health is paramount, and you should feel comfortable sharing any information that will make for a more accurate diagnosis.

-Yvonne S. Thornton, M.D.,M.P.H.