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Ask the Doctor: How and When Should I Talk About Sex With My Teens?

Talking to your teenagers about sex...

Diane F. Merritt, MD, OB/GYN

How can I know if my teenagers are sexually active?

There is no way to know if your teenagers are sexually active unless they choose to tell you. Be sure to share your thoughts and values, and keep communications open.

Know your children’s friends and romantic interests. Let them know it is safest to practice abstinence. If your teens are sexually active, they need counseling on reliable birth control and prevention of sexually transmitted diseases. Contrary to popular opinion, a doctor cannot tell if an adolescent has had intercourse by doing an exam.

When should I bring my daughter to see a gynecologist?

The American College of Obstetricians and Gynecologists recommends that girls should first visit a gynecologist for health promotion, education, and prevention when they are 13-15 years old. Most girls do not need a pelvic exam at this time. Adolescents often see a gynecologist for problems such as painful periods, heavy or frequent periods, concerns about development, and prevention counseling. The first pap smear is performed at age 21 or within three years of sexual activity.

Should my daughter be vaccinated for HPV?

Yes, there are hundreds of strains of HPV and the vaccine offers protection against four that may lead to genital warts and cervical cancer. Side effects are minimal to none. Ideally, the vaccine is administered before girls become sexually active, but this is not a requirement. It is a series of three injections given at baseline, 2 months and 6 months. If your daughter is late for an injection, she does not need to start over with the series.

How should I discuss sex with my teenagers?

Teens who have talked with their parents about sex are more likely to postpone sex and to use birth control if they do begin. Teens with high self-esteem are more likely to make responsible decisions

about sex. Teens need accurate information to help protect them from pressure to have sex, unintended pregnancy and sexually transmitted diseases. The Center for Disease Control says that discussion combining abstinence and contraception works best to prevent teen pregnancy.

Don’t assume that one discussion is enough; talk to your daughters and sons early and on an ongoing basis.

Dr. Diane Merritt is a board-certified OB/GYN, director of the division of pediatric and adolescent gynecology at Washington University and on staff at Missouri Baptist. She received her medical degree from New York University, School of Medicine, and completed her internship and residency at Washington University School of Medicine.

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