Adolescent sexuality and pregnancy

The adolescent pregnancy rate has decreased throughout the USA. However, compared with other industrialized countries, US rates remain high. Efforts to decrease the number of teenage pregnancies are centered on sex education, postponing sexual activity, and safe sex practices.     

Adolescent sexuality and issues in contraception.

The influence of physiologic, psychologic, and cultural influences on human sexuality is reviewed. These factors are considered in the exploration of how adolescents express their sexuality and the consequences of that expression.     

Couple, sexuality and sexual health

Sexuality remained for a long time in the intimacy domain, judged worthy of a consultation reason only and yet as an illness cause or a male failure. Besides, dyspareunia and various women's illnesses took more time to be worthy of interest and care. And now it seems almost as if a turnaround were taking place. This mutation will probably induce some cultural changes. This paper focuses on the fifty-year-old man, in a world in which sexuality, from a universal right, becomes an obligation with the need for means and results, a requirement for performance. In order to discover how to approach these old problems with nowadays tools, we carried out a Medline review on sexuality and impotence, or erectile dysfunction (ED), which is a real problem in public health policy concerning more than 150 million men all over the world and more than 2 million in France. The analysis of the main papers associated with our own experience, allows us to better understand the changes in men/women relationship and the disclosure of male fragility, visible in the management of their well-being, their state of anxiety fowards this new women's control which probably influences their attitude in front of ageing and its consequences.     

Adolescent sexual and reproductive health

This paper assesses how young people and adolescents are defined within each country according to its laws and policies. Additionally, the reproductive health situation of adolescents varies with gender and age. Age of onset of intercourse, age of marriage and child bearing, use of contraception, and the status of women in society all vary with country and region of the world. These variations have direct implications for the population's reproductive health, with potential consequences leading to disability, infertility, sexual violence and abuse, and even death. Nutritional status, access to educational opportunities, access to reproductive health services and commodities, and some life style behaviours such as alcohol, tobacco and other drug abuse, may all have an impact on the future reproductive health of the current and the next generations.     

Adolescent sexual risk assessment

This article describes the use of a self-administered event history calendar and interviews about sexual partners, sexual activity, and contraception within the broader context of the adolescent's life. Constant comparative analysis was used to analyze the event history calendar interview data. Detailed 5- to 9-year sexual histories were obtained on the event history calendars, including patterns of sexual activity progression and triggers for unintended sexual intercourse. Discussions of protective and risky sexual decision making were stimulated by adolescents' self-report of sexual risk behavior in their own words and reflective responses on the event history calendar. Both the adolescents and the interviewers thought the calendars encouraged recall and discussion of sexual risk behavior.     

Female adolescent sexuality. Promoting healthy sexual development

Health care providers must recognize the specific challenges and rewards of providing services for adolescents. Quality care begins with the establishment of trust, respect, and confidentiality between the health care provider and the adolescent. Data suggest that the normal age for beginning puberty is decreasing, which has important clinical, educational, and social implications. The health care provider should be aware of the broad range of potential sexual behaviors involving adolescents, as well as the teen's acceptance of such behaviors, often dictated by age, gender, culture, and education. When providing gynecologic care to adolescent girls, the physician should not only provide contraception and screen for sexually transmitted diseases but should contribute to the development of the patient's sexual health. Especially when providing care for the younger teen, the health care provider must focus on involving a member of the family or another significant adult to provide needed support and guidance. Anticipatory guidance for parents should focus on assessing their parenting styles and promoting supervision. Although parents should strive to maintain open communication with their adolescents, they may not accurately estimate the sexual activity of and the sexual risk for their teenage children. Parents need to be encouraged to consider the implications of their own sexual behaviors. The provider should attempt to foster a comfortable environment in which youth may seek help and support for appropriate medical care while reserving the right to disclose their sexual identity when ready. Health care professionals cannot exclude heterosexual behavior on the basis that a young woman self-identifies as homosexual. Her reported sexual behaviors may not indicate her sexual orientation. Self-definition of sexual orientation is a dynamic process including factors such as fantasies, desires, and behaviors. Self-definition of sexual identity is affected by individual variations in sex, gender, sexual roles, and sexual orientation. Most adolescents want to discuss sexual-related issues with their health care providers and will welcome direct questions about sexual behaviors and possible risks when posed in a confidential and nonmoralistic manner. Discussion of the physical, emotional, familial, and social changes related to adolescence will encourage healthy sexual development.     

Childhood sexuality and child sexual abuse in southwest Nigeria.

There is paucity of information and research on childhood sexuality and child sexual abuse in Nigeria. This low level of information may not be unconnected with the fact that generally discussions on sexual matters still remain a taboo in our culture. It is almost abominable to discuss sex with children. There is need for a radical departure from this position in view of the fact that at least 5% of the respondents in this study admitted having had sex between 6 and 10 years of age and 81 respondents (2.1%) were sexually abused in childhood. The urgent need for more research and a multidisciplinary problem resolution approach to childhood sexuality and child sexual abuse is stressed.     

Adolescent sexuality,cultural sensitivity and the teachings of the Catholic Church

In recent years it has been increasingly recognized that physicians must be sensitive to the cultural beliefs of their patients. This is especially important for physicians who deal with sexuality, especially when dealing with adolescents. Despite this, many mainstream text-books and journal articles ignore the teachings of the largest single religious denomination in the United States, the Roman Catholic Church. The Church has clear teachings regarding sex education, masturbation, contraception and abortion. Physicians should be aware of these teachings and be sensitive to the needs of Catholic adolescents when dealing with these issues.     

Nursing actions concerning sexual problems with special reference to sexuality

A nurse in the maternity ward of a hospital helped a pregnant diabetic overcome her sexual problem. The 28-year-old woman has been diabetic for the past 9 years and has learned to monitor and control her blood sugar level. She has been married for 5 years and just gave a birth to her 2nd child. She also requested and underwent Madlener tubal sterilization to avoid future pregnancy. It was during her recent hospital stay for childbirth that she finally confided her sexual problem with the nurse in the maternity ward. She complained of a pain at the vaginal opening in copulation and attributed it to her diabetic condition. After counseling the patient and her husband separately, the nurse concluded that this was a psychosomatic condition due to many factors. Both the patient's husband and mother-in-law who lived with them were extremely secretive about their complicated family history. Consequently their home environment lacked peace, harmony, understanding, and mutual trust needed to nurture their marital relationship. In addition, the diabetic condition made the patient fearful of pregnancy and she was never relaxed at the time of sex. Because of her pain, frequency of sex was reduced to once a month. The pain was located at labia minora. Ejaculation took place only at the vaginal opening. The nurse suggested the following for solution: The couple should try to be more open and communicative toward each other. They should rebuild a relationship based on understanding and trust and have more understanding of and a positive attitude about human sexuality. The patient should use some lubricant to reduce pain.     

Adolescent sexuality and the internet: the good, the bad, and the URL

The Internet has become a widely used resource for sexual health information, especially among adolescents. The appeal lies in the ease and anonymity with which online seekers can obtain advice and reassurance, particularly regarding sensitive topics. This article reviews the positive and negative influences of the Internet on this age group. Specific aspects of how this medium affects adolescents as well as how it can be used to assist them are discussed.     

Adolescent sexual and reproductive health: The challenge for society

Within almost all countries of the world there is a growing concern about the sexual and reproductive health of adolescents. This concern has resulted from either a real or a perceived increase in adolescent sexual activity, coupled with high rates of unplanned pregnancies, early childbearing and the transmission of sexually transmitted infections, including HIV. Although many adults have difficulties in accepting young people as sexual beings, there is now a growing consensus that young people need more information and services to help them ensure their sexual and reproductive health. Many of the programmes designed to make sexual and reproductive health information and services available to young people have used ‘top down’ approaches, based on adult-led risk and lifestyle orientation. In such programmes, young people are often looked upon negatively, in terms of their problems, rather than positively, in terms of their potential and capabilities. This article argues that a focus on the negative aspects of adolescent sexual and reproductive health means that young people are seen as collections of discrete problems. Furthermore, such approaches tend to view all young people as one homogeneous group when in reality adolescents are an enormously diverse group, not only in terms of age and gender, but also in terms of ability and beliefs. Such approaches therefore fail to address the vulnerabilities of particular young people and fail to contextualize sexual health within a wider framework of young people's lives. A challenge for the next century is to move away from focusing on risks, towards embracing needs and rights, and to involve young people in identifying issues and developing solutions.     

Adolescent sexual and reproductive health: the challenge for society

Within almost all countries of the world there is a growing concern about the sexual and reproductive health of adolescents. This concern has resulted from either a real or a perceived increase in adolescent sexual activity, coupled with high rates of unplanned pregnancies, early childbearing and the transmission of sexually transmitted infections, including HIV. Although many adults have difficulties in accepting young people as sexual beings, there is now a growing consensus that young people need more information and services to help them ensure their sexual and reproductive health. Many of the programmes designed to make sexual and reproductive health information and services available to young people have used 'top down' approaches, based on adult-led risk and lifestyle orientation. In such programmes, young people are often looked upon negatively, in terms of their problems, rather than positively, in terms of their potential and capabilities. This article argues that a focus on the negative aspects of adolescent sexual and reproductive health means that young people are seen as collections of discrete problems. Furthermore, such approaches tend to view all young people as one homogeneous group when in reality adolescents are an enormously diverse group, not only in terms of age and gender, but also in terms of ability and beliefs. Such approaches therefore fail to address the vulnerabilities of particular young people and fail to contextualize sexual health within a wider framework of young people's lives. A challenge for the next century is to move away from focusing on risks, towards embracing needs and rights, and to involve young people in identifying issues and developing solutions.     

Parity and sexual behavior in pregnancy

Correlation between parity and sexual behavior during pregnancy was studied in 106 pluriparous and 69 primiparous patients. Sexual desire, frequency of coitus, frequency of orgasm, which partner initiated sexual activity, and level of sexual satisfaction were analyzed in the year before pregnancy and during pregnancy. Sexual desire, frequency of coitus, and sexual satisfaction were qualitatively equal in both groups. The frequency of coitus in particular decreased progressively in the three trimesters of pregnancy and more evidently in the pluriparous. The partner who initiated sexual activity most frequently was the male in the pluriparous group.     

Body mass index and sexual behavior

OBJECTIVE: To characterize the relationship between body mass index and sexual behavior, including sexual orientation, age at first intercourse, ever having had sex with a male partner, number of partners, and frequency of intercourse. METHODS: This study employed the 2002 National Survey of Family Growth, a cross-sectional, nationally representative database in which women between the ages of 15 years and 44 years were surveyed regarding reproductive health outcomes. Sexual behavior was compared between body mass index groups-normal (less than 25 m/kg2), overweight (25-30 m/kg2), and obese (greater than 30 m/kg2)-using self-reported height and weight. Multiple logistic regression with adjustment for the sampling design was used to measure associations of interest. RESULTS: Body mass index was not significantly associated with sexual orientation, age at first intercourse, frequency of heterosexual intercourse, and the number of lifetime or current male partners. Overweight women and obese women were more likely to report ever having male sexual intercourse (P<.001). This difference persisted when we adjusted for age as well as type of residence. CONCLUSION: With the exception of ever engaging in sexual intercourse with a man, sexual behavior differs little between women of different body mass indices.     

Factors affecting sexuality in older Australian women: sexual interest, sexual arousal, relationships and sexual distress in older Australian women.

OBJECTIVE: To investigate the sexual behavior, sexual relationships, sexual satisfaction, sexual dysfunction and sexual distress in a population of older urban Australian women. METHOD: In 2004, 474 women participating in the Longitudinal Assessment of Ageing in Women (LAW) Study completed a series of questionnaires about sexuality. They included the Short Personal Experiences Questionnaire (SPEQ), Relationship Assessment Scale (RAS), Female Sexual Distress Scale (FSDS), questions concerning past sexual abuse based on the Sex in Australia Study, and questions comparing present and past sexual interest and activity. RESULTS: The percentage of women with partners ranged from 83.3% in the 40 - 49-year age group to 46.4% women in the 70 - 79-year age group. The sexual ability of partners diminished markedly with age, with only 4.8% of the partners using medication to enable erections. Only 2.5% of women reported low relationship satisfaction. The incidence of sexual distress was also low, being reported by only 5.7% of women. Younger women and women with partners had higher levels of distress than older women. Indifference to sexual frequency rose from 26.7% in women aged 40 - 49 years to 72.3% in the 70 - 79-year age group. Past sexual abuse was recalled by 22.7% of women and 11.6% recalled multiple episodes of abuse. Women who recalled abuse had lower scores for satisfaction with sexual frequency. CONCLUSIONS: It appears from this study that there is a wide range of sexual experience amongst aging women, from never having had a sexual partner, to having solitary sex, to having a relationship with or without sex into the seventh decade. As women age, they experience a decrease in sexual activity, interest in sex, and distress about sex. This may be associated with the loss of intimate relationships as part of separation, divorce or bereavement. Decreased sexual activity with aging may be interpreted as a biological phenomenon (part of the aging process) or as sexual dysfunction, or it may be the result of adapting to changed circumstances.