Sex myths teens sometimes believe

Rima Himelstein, M.D., of Crozer-Keystone Health System wrote this for the "Healthy Kids" blog.

 
Can we talk?

Though most of us agree it would be best for our teenagers to wait until they are older to have sex, at least half are having sex by the time they graduate from high school. And what's more troubling is that their behavior is sometimes based on myths, which puts them at high risk for sexually transmitted infections (STIs) and pregnancy. Here are eight myths I hear most often from my teenage patients, and how I respond:

1. STIs and pregnancy won't happen to me.

Me: You are normal to believe "it won't happen to me" because it is normal in adolescence to feel that way. But STIs and pregnancy can happen to you.

2. I know I don't have an STI. I was tested and so was my partner.

Me: That's great, that you both got tested, and you should continue to get tested at least once a year. But there are certain common STIs that we don't routinely test for in teenagers, such as human papilloma virus (HPV) and herpes.

3. I feel fine - I know I don't have an STI.

Me: Most people with STIs (and who spread STIs) don't know they have an infection because they have no symptoms. Estimates suggest that people 15 to 24 acquire nearly half of all new STIs. For some STIs, such as chlamydia, adolescent females are especially at risk.

4. I don't need contraception because I've had PID (pelvic inflammatory disease).

Me: Untreated STIs in a female can lead to PID, a serious infection of the uterus, fallopian tubes, and ovaries. One complication of PID is infertility. The percentage of women who experience infertility due to PID is proportional to the number of episodes of PID they have had. So, even if you have had PID, most likely you can still get pregnant.

5. If the condom breaks, I just put on another.

Me: Pre-ejaculation fluid contains sperm, so this is not a reliable method of contraception.

6. I won't get pregnant; I use condoms . . . sometimes.

Me: It only takes one time to get pregnant. Of the 22 million 15- to 19-year-olds in the U.S., three million did not use a condom the last time they had sex.

7. I use two condoms at one time for extra protection.

Me: I like that you want to be as careful as possible, but two is not better than one. This can actually increase the friction between the condoms and make them more likely to tear. Other condom errors can occur, as well. A recent review of 50 articles from 14 countries looked at the frequency of various condom use errors and problems including:

Timing issues: late application of condoms after intercourse began or early removal of condom followed by unprotected intercourse.

Technical issues: not leaving space at the tip, not squeezing air from the tip before use, putting the condom on inside out and having to flip it over, not using water-based lubricant, and incorrect withdrawal.

Condom problems: breakage, slippage, leakage, and problems with fit.

8. I won't get a girl pregnant because I pull out.

Me: Pulling out is not a reliable method of birth control because pre-ejaculation fluid contains sperm. Also, pulling out does not provide protection from STIs.