It is normal for preteens and teens to have many questions concerning sex and sexuality. It is also normal to be shy or embarrassed when talking to adults or professionals about such issues. Our goal is to help provide a supportive environment for patients to navigate this important part of overall health and well-being. OB/GYN Specialists of Tulsa aims to provide a wide range of information that will help adolescents feel prepared to approach this aspect of their life.
What is Sexuality?
Human sexuality is more than biological sex, male or female, or having sexual intercourse with someone else. A person’s sexuality includes several factors, like physical features, self-concept, interpersonal relationships, and sociocultural influences. Practitioners view sexual maturation as an essential indicator of health much like height and weight and other measures for physical growth. It is an essential part of human development.
Adolescent or Teenage Sexual Growth
Sexual growth starts during the pre-adolescent years and continues into adulthood. Different hormones cause certain physical changes, such as breast enlargement in females and penis enlargement and testicle growth in males. Both males and females experience body hair growth.
Puberty typically occurs between the ages of 10 and 14 and is the time for emotional and cognitive changes. During this stage, a person might feel attracted to people of his/her sexual orientation, get involved in new relationships, or even wish to feel physically attracted. The attraction can be toward someone different from you or the same sex and can develop over time.
Confusion about one’s sexuality is normal within this age range. The majority of adolescents will eventually describe themselves as heterosexual, homosexual, or bisexual. Others will self-identify with more diffuse language regarding gender and sexuality (e.g. gender queer, queer, pansexual, fluid). At OB/GYN Specialists of Tulsa, we, as healthcare providers, aim to use terminology that supports each adolescent’s individual experience, personal perspective, and needs.
During middle adolescence, ages 15 to 18, experimenting with sex is very common. At this stage, adolescents can begin to imagine the consequences of their actions though they still might not fully understand them. Before getting involved in intimate relationships, we encourage adolescents to weigh all of their options and are available to provide support in a time when it is common to engage in risk-taking behaviors such as unprotected sexual activity or substance use.
The Truth About Sexual Activity
Kissing, hand-holding, and penetrative sex are classified as sexual activity. In this regard, it is important to have an understanding of sexual boundaries, both for yourself and respecting others. The act of sex should be among those who are fully consenting. Any forceful sexual act where a partner is not consenting is considered rape; it is a very serious crime with serious consequences.
There are some key terms:
– Genitals: The external sex organs are sensitive and are stimulated when touched during sexual activity. Male genitals are comprised of the penis and scrotum; female genitals include the vulva, clitoris, and vaginal opening.
– Petting: Refers to touching parts of another person’s body, usually genitals or other areas that can be sexually sensitive, such as breasts.
– Orgasm: The final part of the sexual act when one experiences tension release, contraction of sexual organs, and release of endorphins leading to intense pleasure. In males, this is usually accompanied by the release of semen.
– Sexual intercourse: The insertion of a male’s penis into a female’s vagina. This may lead to pregnancy if sperm fertilizes an ovum in her body.
– Oral sex: Involves use of the mouth and/or tongue for stimulation of another person’s genitals; it may involve any two genders.
– Anal sex: Refers to penetration of the anus in the form of sexual activity.
– Masturbation: Manual stimulation of one’s own genitals or those belonging to someone else using bodily contact or devices with the aim of sexual pleasure.
– Sexual boundaries: All sexual activity should be consensual and must be engaged by people who are mature enough to understand the consequences of the decision to engage in sexual acts.This also refers to what you’re comfortable with in your sex life and the boundaries that you’ve set for yourself.
Health Issues Associated With Sexuality
Sexually Transmitted Diseases (STDs):
Also known as STIs, sexually transmitted infections are caused by four main types of pathogens: viruses, bacteria, protozoa, and fungi. Adolescents have a higher chance of contracting them than adults. Some frequently occurring STDs are:
– Human Papillomavirus (HPV): The most common STD in teens and associated with the development of genital warts and cervical cancer.
– HIV (Human Immunodeficiency Virus): The virus that causes AIDS (Acquired Immunodeficiency Syndrome) and an incurable disease that impairs the immune system.
– Gonorrhea and Chlamydia: Common sexually transmitted bacterial infections that can infect the urogenital tract and lead to long-term problems, such as infertility.
– Herpes Simplex Virus: A virus transmitted through oral secretions during close contact. Infection is chronic and associated with mouth sores or painful, itchy genital ulcers.
– Hepatitis B/C: Viruses that cause inflammation of the liver. Some infections can lead to long-term liver damage or failure.
– Syphilis: A bacterial infection that is curable though, if untreated, can lead to serious health issues, such as damage to the brain, nerves, eyes, or heart.
– Trichomonas: An infection caused by a parasite that can be asymptomatic, though it can cause abnormal vaginal discharge or irritation.
Screening for STDs is important for all sexually active individuals. The probability that STIs will occur decreases when condoms are used or when dental dams or a latex barrier are employed in oral sex. Vaccination is also an important intervention for prevention.
Prevention and Screening for STIs
Condom and Dental Dam/Latex Barrier Use:
The risk of STIs can be significantly reduced if condoms are used during intercourse. An external (formerly male) condom is worn on the male penis, while an internal (formerly female) condom is placed inside the vagina. Both types of condoms can prevent pregnancy and decrease transmission of STIs. Dental dams or a latex barrier are used during oral-vaginal or oral-anal sex and also decrease the risk of transmission of a sexual infection.
Immunizations:
Vaccines for HPV and hepatitis B are accessible and recommended. HPV vaccination is recommended for males and females and can be administered from ages 9-26 years old. Certain vaccinations are approved to be given at older ages following a discussion with your healthcare provider. The HPV vaccine is most effective if received before any form of sexual activity. The Hepatitis B vaccination series is recommended to begin soon after birth. If not received at that time, a healthcare provider can provide recommendations for a catch-up immunization schedule.
Check-Ups:
For all adolescents, especially those who are sexually active, regular check-ups with a healthcare clinician are necessary. We typically recommend the initial reproductive health visit to be between the ages of 13 and 15 years old. Your clinician should have conversations about STI prevention, contraceptive options, and the need for preventative healthcare screenings/vaccinations. These visits usually do not require an internal pelvic examination, unless indicated by symptoms. Cervical cancer screenings, such as a pap smear, typically begin at age 21 post-adolescence.
Pregnancy and Birth Control:
Three-quarters of adolescent pregnancies are unintended. Long-acting reversible contraceptive (LARC) methods are particularly useful in the adolescent population. These methods include intrauterine devices (IUDs) or implants (e.g., Nexplanon). These routes of birth control have a higher efficacy, higher continuation rates, and higher satisfaction rates compared with short-acting options in the teenage population. They are an excellent option for adolescents. Other forms of birth control include pills, patches, injections (e.g. Depo-Provera), and vaginal rings. It is important to have a risk and benefit discussion about available contraception methods with a provider before selecting the right option for you.
Summary
Adolescent sexuality is influenced by many factors, including gender identity, sexual orientation, and sociocultural factors. Once established, having a healthy relationship with one’s sexuality will lead to mature, meaningful sexual relationships later in life.
For further assistance or for questions about adolescent health and sexuality, please reach us at OB/GYN Specialists of Tulsa. The medical specialists in our team are Dr. Danni Hardin, Dr. Sarah Shepherd, Dr. Cate Hildebrand, Dr. Gena Gray, Dr. Grant Cox, and Dr. Paul Gehring. We are happy to provide a comprehensive evaluation at every stage of life, specifically early in a patient’s journey to reproductive health and wellness.
