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For Teens: How to Make Healthy Decisions About Sex

Before you decide to have sex or if you are already having sex, you need to know how to stay healthy. Even if you think you know everything you need to know about sex, take a few minutes and read on. Your doctor wants to make sure you know the facts.

Important Reminders:

  • No one should ever be forced to have sex! If you are ever forced to have sex, it's important to never blame yourself and to tell an adult you trust as soon as possible.
  • Not using alcohol and drugs will help you make clearer choices about sex. Too many young people have sex without meaning to when they drink alcohol or use drugs.

Are You Ready for Sex?

Sex can change your life and relationships. Having sex may affect the way you feel about yourself or how others feel about you.

Many teens believe waiting until they are ready to have sex is important. The right time is different for each teen. For example, some teens may want to wait until they are older (adults); other teens may want to wait until they feel their relationship is ready.

You may feel that your relationship is ready when:

  • You can be completely honest and trust the other person, and the other person can trust you.
  • You can talk with the person about difficult topics, such as feelings, other relationships, and if the person has had a sexually transmitted infection (STI).
  • You can be responsible, protecting yourself and your partner against STIs and pregnancy with condoms and birth control.
  • You can respect the other person's decisions about not having sex and about using protection.

However, if you are in love or really like someone, you may ignore the signs of an unhealthy relationship.

The following signs mean your relationship is not ready for sex:

  • Your partner is jealous or possessive. For example, your partner prevents you from spending time with your family or other friends, texts or instant messages you constantly, or checks your cell phone to see who you are talking with.
  • Your partner pressures you to have sex and refuses to see your point of view.
  • Your partner manipulates you by either bullying you or threatening to hurt himself if you end the relationship.

Why Wait?

There's nothing wrong if you decide to wait. Not everyone is having sex. Half of all teens in the United States have never had sex. If you decide to wait, stick with your decision. Plan ahead how you are going to say no so you are clearly understood. Stay away from situations that can lead to sex.

Here are reasons why waiting to have sex makes sense:

  • Sex can lead to pregnancy. Are you ready to be pregnant or become a teenaged parent? It's a huge responsibility. Are you able to provide food, clothing, and a safe home for your baby?
  • Sex has health risks. A lot of infections can be spread during sex. Sexually transmitted infections include chlamydia, gonorrhea, hepatitis B, herpes, HIV (the virus that causes AIDS), human papillomavirus (HPV), or syphilis.
  • Sex can lead to emotional pain and distractions. You may feel sad or angry if you let someone pressure you into having sex when you're not really ready. You also may feel sad or angry if you choose to have sex but your partner leaves you. Your partner may even tell other people that you had sex with her.

How Can You Prevent Getting an STI?

Nothing works perfectly to prevent STIs except abstinence (no sex). However, if you're going to have sex, using condoms is the best way to reduce the risk for getting STIs. You can also get a vaccine to protect against HPV.

Remember to use a latex condom every time you have sex—no matter what other type of birth control you and your partner might also use. To protect against getting an infection from having oral sex, use a condom, dental dam, or non-microwavable plastic wrap. Your doctor can explain all these things to you.

To make sure you stay healthy, get regular medical checkups. If you have had sex in the past or are having sex, your doctor may recommend testing for STIs.

What Do You Need To Know About Condoms?

  • Condoms work best when used correctly.
  • Most teens use male latex condoms. Buy the type with a reservoir (nipple) at the tip to catch semen, if available. Female condoms are another option. Never use a male and female condom at the same time; they might tear.
  • Follow the instructions on the package to make sure you are using them the right way.
  • Check the expiration date on the package. Don't buy or use expired condoms.
  • You can carry condoms with you at all times, but do not store them where they will get hot (such as in the glove compartment of a car). Heat can damage a condom.
  • The following additional tips about using male condoms are from the "Condom Fact Sheet In Brief" published by the Centers for Disease Control and Prevention.
    • Use a new condom for every act of vaginal, anal, and oral sex throughout the entire sexual act (from start to finish). Before any genital contact, put the condom on the tip of the erect penis with the rolled side out.
    • If the condom does not have a reservoir tip, pinch the tip enough to leave a half-inch space for semen to collect. Holding the tip, unroll the condom all the way to the base of the erect penis.
    • After ejaculation and before the penis gets soft, grip the rim of the condom and carefully withdraw. Then gently pull the condom off the penis, making sure that semen doesn't spill out.
    • Wrap the condom in a tissue and throw it in the trash where others won't handle it.
    • If you feel the condom break at any point during sexual activity, stop immediately, withdraw, remove the broken condom, and put on a new condom.
    • Ensure that adequate lubrication is used during vaginal and anal sex, which might require water-based lubricants. Oil-based lubricants (ie, petroleum jelly, shortening, mineral oil, massage oils, body lotions, and cooking oil) should not be used because they can weaken latex, causing breakage.

What Types of Birth Control Are Effective?

Talk with your doctor about birth control. Your doctor can answer questions about safe and effective methods, side effects, and costs. Here are some forms of birth control (all types for females; condoms for males) from most effective to least effective at preventing pregnancy.

  • Intrauterine devices (IUDs): IUDs are small T-shaped devices placed inside the uterus by a doctor. They are highly effective at preventing pregnancy and may also be prescribed to help decrease menstrual bleeding and pain. The copper IUD contains a small amount of natural copper and prevents pregnancies for up to 10 years. There are 2 levonorgestrel IUDs, both of which contain a hormone and prevent pregnancy for 3 to 5 years depending on which one is used. Intrauterine devices when used as prescribed are about 99% effective in preventing pregnancy.
  • Contraceptive implant: A contraceptive implant is a tiny flexible rod that a doctor puts under your skin in your upper arm. It slowly releases a hormone that prevents pregnancy for 3 years. A contraceptive implant when used as prescribed is about 99% effective in preventing pregnancy.
  • Contraceptive injection: Depo-Provera is a shot given every 3 months. It's effective, and you don't have to remember to take a daily pill. The contraceptive injection when used as prescribed is 99% effective in preventing pregnancy. However, when used typically (eg, women may occasionally forget to get a shot exactly on time), it is 94% effective in preventing pregnancy.
  • Birth control pills, patch, and ring: "The pill," the birth control patch, and the ring all contain 2 hormones, an estrogen and a progestin.
    • Birth control pill: You take one pill each day. Birth control pills when used as prescribed are about 99% effective in preventing pregnancy. However, when used typically (eg, women may occasionally forget to take a pill), they are 91% effective in preventing pregnancy.
    • Birth control patch: The birth control patch is an adhesive patch that is placed on the skin. You wear the patch 3 weeks, remove the patch for 1 week, put on a new patch at the end of the fourth week, and repeat these steps. The birth control patch when used as prescribed is about 99% effective in preventing pregnancy. However, when used typically (eg, women may occasionally forget to replace the patch on time), it is 91% effective in preventing pregnancy.
    • Birth control ring: You insert the birth control ring in your vagina, it stays in for 3 weeks, you remove it for 1 week, and you put in a new one at the end of the week. The birth control ring when used as prescribed is about 99% effective in preventing pregnancy. However, when used typically (eg, women may occasionally forget to put in a new birth control ring on time), it is 91% effective in preventing pregnancy.
  • Condoms: Male condoms used the right way have about a 98% chance of preventing pregnancy, and female condoms have a 95% chance, but they must be used each time you have sex and used correctly. When they are not used correctly, male condoms may only have an 82% chance of preventing pregnancy, while female condoms may only be effective 79% of the time.

What Are Other Types of Birth Control?

The following types of birth control are less common and not as effective at preventing pregnancy:

  • Withdrawal: The male "pulls out" before he ejaculates or "cums." It does not prevent pregnancy or STIs. Even a small amount of sperm can lead to pregnancy or an STI.
  • The "rhythm method:" You avoid having sex during certain times of your monthly cycle. Because teens tend to have more irregular periods, this method is less effective at preventing pregnancy.
  • Spermicides: These are creams and foams used during sex to kill sperm. They may add protection to other methods but are not effective when used alone.

What Is Emergency Contraception?

Emergency contraception (EC) is a form of birth control that you use after you have unprotected sex. Unprotected sex includes not using birth control, condoms breaking during sex, or forgetting to take birth control pills.

  • Emergency contraception can be taken up to 5 days after sex but is most effective when taken as soon as possible after sex.
  • You can buy EC pills over the counter and no longer need to show proof of age. The types of EC pills available over the counter are levonorgestrel at 1.5 mg (eg, Plan B One-Step or Next Choice One Dose).
  • Another type of EC pill is ulipristal acetate 30 mg (eg, Ella), which you can only get with a prescription.
  • A doctor can also put in a copper IUD that will provide both EC and regular birth control.

Remember:

If you decide to have sex, it's important that you know the facts about birth control, infections, and emotions. Decisions of when to become sexually active, how to protect yourself from STIs, and how to prevent pregnancy are yours. These are important decisions and are worth talking about with adults who care about you, including your doctor.

Additional Resources:

Last Updated
8/20/2015
Source
Making Healthy Decisions About Sex (Copyright © 2005 American Academy of Pediatrics, Updated 12/2014)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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