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Reproductive Health in Teens with Chronic Health Conditions

​Reproductive health is an integral component of physical, social, and emotional well-being. Most adolescents with chronic conditions can be expected to experience similar normative stages of physical and emotional development, including:

  • Puberty
  • Desire for romantic relationships
  • Envisioning future parenthood

Varying Concerns As Children with Chronic Conditions Mature

There may be specific risks of hormonal contraception, sexually transmitted infections, and pregnancy depending on disease processes or therapeutic regimens. A significant subset of teens with intellectual disability or developmental delay will experience the same physical maturation as their age-matched peers with a mismatch in expected emotional and cognitive development. Teens with severe neurodevelopmental disability often have difficulty during puberty with unpredictable mood swings and emotional outbursts, severe pain with menstruation, challenges with hygiene, and regulating normal sexual urges in socially acceptable ways.

Practical Ways for Parents of Teens with Chronic Conditions to Address Reproductive Health Issues Include the Following:

  • For some teens with chronic illness, menstrual challenges, such as difficulty wearing a sanitary napkin and knowing when to change it, are common issues. Resources can be provided, such as picture boards and incorporating self-care goals into an individualized educational plan (IEP).
  • Discuss boundaries in relationships. Crushes or sexual feelings for another person are normal and happen to everyone. Sometimes they can be mutual, but sometimes they are one-sided, which can be confusing. While difficult, most teens during adolescence experience unreciprocated feelings. It provides an opportunity to discuss respect for the feelings of others and that crushes are personal. Remind your child that, in time, they will likely be attracted to someone who has similar feelings for them.
  • Do not assume your child is not involved in romantic relationships because they have a chronic condition.
  • Disclosure in relationships is an important issue if a chronic illness is transmissible (eg, HIV or hepatitis) or requires daily ongoing care (eg, cystic fibrosis or diabetes). As adolescence progresses to young adulthood, how the chronic illness affects fertility or how it could be passed on to offspring might also affect disclosure. A key factor affecting one’s ability to disclose disease status is acceptance of one’s own medical condition.
  • Acceptance is necessary to adapt to an illness while tolerating the unpredictability of the disease while staying engaged in a meaningful life. The need for psychosocial support for teens with chronic conditions as they negotiate acceptance might only come to light during discussions regarding complex relationship dynamics. See Common Coping Styles of Teens Who Are Chronically Ill or Disabled.

Additional Information:

Edited by Kenneth R. Ginsburg, MD, MS Ed, FAAP, FSAHM and Sara B. Kinsman, MD, PhD
Last Updated
Reaching Teens: Strength-based Communication Strategies to Build Resilience and Support Healthy Adolescent Development (Copyright © 2014 American Academy of Pediatrics)
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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