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Contraception

Methods to prevent pregnancy and STIs

Contraception – also known as birth control – is any method used to reduce the chances of unplanned pregnancy. Some forms of contraception also reduce the risk of sexually transmitted infections (STIs). Keep reading to learn about different types of birth control and how they work.

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The different types of birth control

Some forms of contraception act as a physical barrier to prevent sperm from meeting an egg, while others use hormones to prevent pregnancy. To choose the right contraceptive for you, talk to your healthcare provider. You can see your primary care provider or visit your local health department or family planning clinic.

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Contraceptives that don’t require a prescription include:

  • Abstinence: This means not engaging in oral, anal or vaginal sex. With abstinence, there is no risk of pregnancy or STIs. It can be hard to maintain. Abstinence provides 100% protection against pregnancy and STIs.
  • External condoms (use every time): An external condom is a barrier method that collects semen and other fluids, preventing them from entering a person’s vagina. It protects against pregnancy and STIs. They’re free at your local health department. Condoms must be used correctly every single time. Condoms break down over time, so pay attention to the expiration date. They’re 98% effective with perfect use and 85% effective with typical use. They’re available over the counter.
  • Internal condoms (use every time): An internal condom is a barrier type of contraception (material much like an external condom) that is inserted into the vagina or anus before sexual intercourse. They can be inserted up to eight hours before sexual contact, help prevent pregnancy and don’t require a prescription. Internal condoms may cause skin irritation around the genitals, you must remember to use them every single time and it only protects against some STIs. With perfect use, they’re 95% effective and 79% effective with typical use.
  • Withdrawal method (use every time): This is the removal of the penis before ejaculation occurs in the vagina. This method is free and more effective when using another birth control method, such as a condom. The cons are you may not be able to withdraw in time, pre-ejaculate may still contain sperm and this method doesn’t offer protection against STIs. With perfect use, it’s 96% effective and with typical use, it’s 78% effective.
  • Spermicide (use every time): Spermicide comes in creams, gels, foams, films and suppositories that have chemicals to stop sperm from reaching an egg to fertilize. It doesn’t protect against STIs, must stay in place for six hours after intercourse and may cause irritation to the genitals. Spermicide is 71% effective when used alone and 97% effective when used with a condom.

Birth control methods that require a prescription include:

  • Pill (take daily): This is a monthly pack of hormonal pills that must be taken once a day. It may help regulate the menstrual cycle and may be free or low-cost. The cons are you must take it at the same time every day, it may cause side effects (like headaches, nausea or weight gain) and doesn’t offer protection against STIs. With typical use, they’re 91% effective. With perfect use, they’re 99.7% effective.
  • Patch (replace weekly): A small patch placed on the body that releases hormones. It must be replaced weekly and you can still shower or swim normally with the patch on. The patch doesn’t protect against STIs and may cause skin irritation. With typical use, it’s 91% effective and with perfect use, it’s 99% effective.
  • Shot (get every 12 weeks): A short with hormones injected into the upper arm or buttocks every 12 weeks. It’s low-maintenance, can be injected at home after the first injection at the doctor’s office, and is effective one week after the first injection. It is usually not recommended for long-term use, doesn’t provide protection against STIs and may cause irregular periods. The effectiveness rate for perfect use is 99%.
  • Vaginal ring (replace monthly): A flexible ring that is inserted into the vagina and releases hormone. It provides nonstop protection against pregnancy if used correctly, may regulate menstrual cycles and reduce cramping, and is low-maintenance. It doesn’t offer protection against STIs and may cause vaginal discomfort, headaches or breast tenderness. It’s 91% effective with typical use and 99% effective with perfect use.
  • IUD (replace every three to 12 years): An intrauterine device is t-shaped and contains copper or progestin (hormone). It is inserted into the uterus by a healthcare provider. It provides long-term protection against pregnancy, is effective immediately and is comfortable. It may cause a slightly higher risk of infection during the first month of use, may fall out or puncture the uterus (rare) and doesn’t provide STI protection. They are more than 99% effective at preventing pregnancy.
  • Implant (replace every three to five years): A small, plastic-like rod is inserted under the skin of the upper arm that releases hormones. The implant provides long-term protection against pregnancy, can shorten or lighten periods and reduce cramps, and is low-maintenance. It may cause irregular periods, nausea headaches or weight gain. IT doesn’t protect against STIs. The implant is more than 99% effective.

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Less common methods include:

  • Sponge (use every time): This is a small, round sponge that is made of soft, flexible plastic and contains spermicide. It can be inserted up to 24 hours before intercourse and is easily available. It must stay in place for six hours after intercourse, is less effective for women who have given birth and doesn’t protect against STIs. With typical use, it’s 80% effective and with perfect use, it’s 91% effective.
  • Diaphragm (use every time): A diaphragm is a dome-shaped silicone or latex cup with a flexible rim that’s inserted into the vagina before sexual contact. It can be inserted up to six hours before sexual contact, you can leave it in for up to 24 hours and multiple sexual encounters, and you can reuse it for up to a year. You must leave it in for six hours after intercourse, it may increase the risk of urinary tract infection or toxic shock syndrome, and doesn’t protect against STIs. It’s 88% effective with typical use and 94% effective with perfect use.
  • Cervical cap (use every time): A soft, dome-shaped silicone cup with a firm rim that can be used for up to 48 hours. You can use the same cap for up to a year with proper care between uses and can use it for up 48 hours. The cons are it may increase the risk of urinary tract infection and toxic shock syndrome, it’s less effective after giving birth, and it may move or shift during intercourse. The cap is 86% effective if a woman has never given birth and 71% effective if she has given birth.

Emergency contraception

The emergency contraception pill (sometimes called the “morning-after pill”) can reduce the chance of pregnancy after unprotected sex or if another method of birth control fails. Most options are available over the counter and don’t require a prescription. The pill must be taken within three to five days – the sooner it is taken, the more effective it is.

The copper IUD can also be used if inserted by a medical professional within five days of unprotected sex or birth control failure.

STI Prevention

The following methods are used to prevent STIs:

  • Abstinence
  • Condoms
  • Dental dams: A thin, flexible piece of latex that is placed over the genitals or anus before oral sex. It can easily be made by an unused condom and hard to find in stores.
  • PrEP, which stands for pre-exposure prophylaxis and is prescribed to people who are at risk for contracting HIV. This method only protects against HIV, not other STIs, and is best used with a barrier method. It must be taken daily.

Talk to your healthcare provider about which method is right for you.

Need more info? Ask an Expert.

Resources

For more information about staying in charge of your health and future, visit:

A Step Ahead: How to access free LARC methods in Tennessee

Centers for Disease Control and Prevention (CDC)

HHS Office of Population Affairs

Planned Parenthood

Home / Teen / Sex and Relationships

Gender, sexuality and self-expression

Gender, sexuality and self-expression for teens

As a teen, you may notice feelings of romantic or sexual attraction to other people. You may be attracted to people of the same sex, a different sex or both. Or you may not be attracted to anyone at all. You may also have questions about your gender identity and expression. This is all completely normal! Read on to learn more about sexual orientation, gender identity and gender expression.

Need more info? Ask an Expert.

What is sexual orientation?

Sexual orientation refers to the people someone is attracted to. The following terms describe some people’s sexual orientations:

  • Heterosexual (or straight) refers to someone who is sexually attracted to people of the opposite sex.
  • Homosexual (or gay) refers to a person who is attracted to people of the same sex.
  • Lesbian refers to a woman who is sexually attracted to other women.
  • Bisexual refers to a person who is sexually attracted to both men and women.
  • Pansexual refers to someone who is attracted to people of any sex, gender or gender identity.
  • Asexual refers to a person who isn’t sexually or romantically attracted to anyone or who has a low interest in sexual activity.
  • Questioning is the process of exploring your gender identity, gender expression and sexual orientation.
  • Queer is an umbrella term for sexual and gender minorities. Typically, people who identify as queer do not consider themselves heterosexual or part of the gender binary.

If you don’t identify with any of the terms listed above, check out this list for more types of sexual orientations.

What is biological sex?

Biological sex refers to the anatomy that defines people as male, female or intersex. This includes your internal and external sex organs, chromosomes, and hormones.

  • Biological females have two XX chromosomes.
  • Biological males have XY chromosomes.
  • Intersex persons have a different chromosome set from biological males or females. They may develop sex or reproductive organs or characteristics of both biological males and females.

What’s the difference between gender and gender identity?

Your gender identity is how you see yourself and your personal experience of your gender. Gender expression is how you communicate your gender to others, such as your clothes, makeup or haircut.

Just because you were born a biological male or female doesn’t mean you must identify with that sex or gender identity. For example, if you were born a biological male, you may not identify with the traits society often assigns to males. Here are some helpful terms to know in understanding gender and gender identity:

  • Cisgender refers to someone whose gender identity conforms with the gender that corresponds with their biological sex.
  • Genderqueer/gender non-conforming refers to someone whose gender identity doesn’t conform to the conventional gender distinctions. This person may identify with both, neither or a combination of genders.
  • Transgender refers to someone whose gender identity doesn’t correspond to the biological sex they were born with.
  • Non-binary refers to the spectrum of gender identities that are not exclusively masculine or feminine.

Sexual orientation, gender identity, gender expression and biological sex all exist on a spectrum – this means everyone can be different. Here are some examples of what that can look like:

  • A person who is a biological female may have a masculine gender expression.
  • A person who identifies as a male and is biologically male may choose to express their gender on a scale of feminine, masculine or androgynous.
  • A person who is transgender can identify as any sexual orientation, such as straight, gay, bisexual or any other orientation.

Support for LGBTQIA+ youth

LGBTQIA+ youth can face many challenges, such as discrimination, bullying and cyberbullying. Bullying has been shown to increase the risk of depression, suicidal thoughts, misuse of drugs and alcohol, risky sexual behavior, and academic problems.

If you need support, The Trevor Project has a crisis line for LGBTQIA+ youth, where you can call 1-866-488-7386, use TrevorChat to instant message with a counselor or use TrevorText by texting START to 678678.

Being an ally

It’s important to know that just because someone is different from you doesn’t mean they are bad or wrong. Always treat others with respect and understanding, no matter who they are or how they live their life. Be open-minded, willing to talk and a good listener. Let family and friends know you find anti-LGBT comments and jokes offensive.

Need more info? Ask an Expert.

Resources

For more information about staying in charge of your health and future, visit:

Home / Teen / Sex and Relationships

Relationships

How to know if you’re in a healthy or unhealthy relationship

As a teenager, you probably have many relationships in your life. Some may feel fun and easy, while others may be more complicated. Keep reading to learn more about the different types of relationships, plus how to know if they’re healthy or unhealthy.

Need more info? Ask an Expert.

Types of relationships

There are many different kinds of relationships. These include:

  • Family relationships: Family relationships can look different for everyone. Examples of these relationships can be parents/guardians, siblings, children, grandparents, aunts, uncles and cousins.
  • Friendships: Friends are people we like and choose to be around. They may be people who have similar interests, people you met at school or work, or those who live near you. Who you’re friends with can change over time as you grow and change.
  • Romantic relationships: Romantic relationships develop between people who are attracted to each other emotionally and/or sexually. These relationships also look different for everyone.
  • School relationships: You may have relationships with people at school, such as your teachers, classmates, principals, guidance counselors, administrators or nurses.
  • Other relationships: You may have different relationships that don’t fit into these categories. These may be with people you know, but with whom you don’t have an emotional connection.

Signs of healthy vs. unhealthy relationships

In each relationship, there can be red flags or green flags. Red flags are signs that the relationship may not be healthy or that something is wrong. Green flags are things that happen in your relationships that make you feel good about that person and yourself.

Examples of green flags:

  • Fair decision-making
  • Good communication
  • Good listener
  • Honesty
  • Nonjudgmental
  • Respects your boundaries
  • Supportive of your other healthy relationships

Examples of red flags:

  • Controlling behavior
  • Dishonesty/lying
  • Disrespectful to you or others
  • Domestic abuse (abuse that occurs in your home)
  • Emotional or verbal abuse (like verbal aggression, humiliation or intimidation)
  • Manipulation
  • Physical abuse (such as kicking, hitting or slapping)
  • Poor communication
  • Sexual abuse (any sexual conduct without your consent)

How to get out of an unhealthy relationship

You have a right to healthy relationships. If someone treats you poorly or exhibits these red flags, you can take steps to get out of that relationship. Here are strategies that can help:

  • Talk to someone, such as a trusted adult or close friend, about what’s happening.
  • If you choose to end the relationship, do so in a place that makes you feel safe. You can break up over the phone or in a public place. You can also bring friends or family with you if you’re concerned about your safety.
  • You don’t have to repeat your reasons for breaking up over and over. Calmly explain why you’re ending the relationship and then end the conversation.
  • Know that it’s normal to miss that person, even if the relationship was unhealthy or abusive. If you’re struggling, make a list of reasons to remind you of why you broke up with them. You can also talk to a trusted adult, like a parent, teacher, coach or guidance counselor, for support.
  • Seek support from family and friends to help you feel safer and more confident.
  • If someone sends you harassing messages, save them in case you need to report them to local authorities.
  • Make your social media profiles private and ask your friends to do the same. Block anyone who harasses or threatens you.
  • Trust your gut instincts. If you feel unsafe, there’s probably a reason why. Don’t answer the door if the person shows up at your home, school or workplace. If you feel like you’re in immediate danger, call 911.

Remember, your relationships should make you feel good about yourself. If they don’t, it’s time for a change.

Need more info? Ask an Expert.

Resources

For more information about staying in charge of your health and future, visit:

Home / Teen / Sex and Relationships

Sexual health care

Sexual health care for teens

As a teen, it’s normal to have questions and concerns about sex, hormones and your changing body. Access to sexual health care is an important part of your overall health. Read on to learn more about your sexual health, where to get care, what questions to ask and what to expect during your visit.Need more info? Ask an Expert.

What is sexual health care?

Sexual health care includes services that promote your sexual and reproductive health. A sexual health care appointment can cover:

You can get this type of care with:

Will my parents know about my visit?

Because of HIPAA laws, your health care provider must keep your health information private. Most providers will not tell your parents/guardians about your visit, even if you’re a minor (under age 18).

Some states have laws that allow you to consent to care without parent/guardian permission. Every state is different, so if you’re concerned about privacy, call your provider’s office and ask if they’ll keep your information private and if you need permission from a parent/guardian to get testing or prescriptions.

If you use health insurance during your visit, the primary insurance holder (such as your parent/guardian) will get an explanation of benefits (EOB) that may show that insurance paid for a pregnancy test, STI test or prescribed birth control.

Find out your state’s policies or laws on sexual health.

What to expect during your sexual health care visit

When you first arrive at the office or clinic, you may be asked to fill out basic information (like your name, age, medical history and gender) and provide health insurance information. If you don’t have health insurance, some clinics and health departments offer care at little to no cost.

During the visit, you will see a health care provider, such as a doctor, nurse, physician assistant or nurse practitioner. They may ask you:

  • About your past and current sexual and reproductive history
  • What protection you use if you’re sexually active
  • If you’ve ever been tested or treated for a sexually transmitted infection (STI)
  • If you’ve ever received the HPV vaccine
  • If you have any medical issues or medication allergies
  • When your last period was and if you have irregular periods
  • If you smoke, drink alcohol or use drugs

During the visit, your provider may also:

  • Ask for a urine sample (where you pee in a cup)
  • Check your blood pressure and listen to your heart
  • Look at your genital area to make sure everything looks healthy
  • Perform a pelvic exam (if you have a vagina)
  • Give you a Pap test (if you have a cervix; this test is generally not done until you’re 21)
  • Examine your breasts
  • Examine your testicles or check for signs of testicular cancer (if you have testicles)

This visit is a good time to talk about any physical or mental health concerns you have, such as:

  • What contraception methods are available to you
  • If you should get tested for STIs
  • How to protect yourself from STIs
  • If you’re experiencing intense sadness or anxiety
  • If you think you may be pregnant
  • If you notice a lump in your breast or genital area
  • If you’ve been sexually assaulted or raped
  • If you don’t feel safe at home

What to do if you feel uncomfortable during your visit

While it’s normal to feel uncomfortable during this visit, know that your provider has likely heard it all before and is there to help you, not judge you. It’s essential to be open and honest with them so they can help you.

Some offices allow you to bring a family member, partner or friend with you. If that’s something you’d like to do, call ahead and ask if it’s possible.

If you have anxiety or concerns about a certain exam or procedure, ask your provider to explain it to you. Remember, even health care providers must ask for your consent before they touch you.

If your provider makes you feel uncomfortable, it’s OK to ask to see someone else or find another place to get care.

Need more info? Ask an Expert.

Resources

For more information about staying in charge of your health and future, visit:

CDC: A Teen-Friendly Reproductive Health Visit (PDF)

CDC: Get Tested: National HIV, STD, and Hepatitis Testing

Home / Teen / Sex and Relationships

STIs / STDs

How to prevent sexually transmitted infections (STIs)

If you have a sexual encounter – whether that’s vaginal (penis-in-vagina) sex, oral sex or anal sex – you could be at risk for a sexually transmitted infection (STI). Some STIs (like herpes and HPV) can even be spread from skin-to-skin contact, meaning you don’t have to “go all the way” to get them.

STIs are also called sexually transmitted diseases (STDs).

While some STIs cause symptoms, others can live in your body without any signs. They can affect anyone, regardless of age, sex, race or sexual orientation. In 2018, there were 26 million new STIs in the United States. STIs are especially common in young people ages 15 to 24, accounting for nearly half of all new cases each year.

Keep reading to learn about the different STIs, how to prevent infection, symptoms to watch for and when to get tested. Need more info? Ask an Expert.

What are STIs?

Some STIs are curable; others are not. They can be caused by bacteria, parasites or viruses.

Curable STIs:

Bacterial and parasitic STIs can be cured with antibiotics. However, if left untreated, they can cause irreversible damage. These include:

  • Chlamydia
  • Gonorrhea (also known as “the clap”)
  • Syphilis
  • Pubic lice (also known as “crabs”)
  • Trichomoniasis (also known as “trich” or “trick”)

These infections can show symptoms, though many people may not experience any symptoms at all.

Incurable STIs:

Viral STIs cannot be cured with medication; however, these STIs are manageable through medication and treatment by a doctor. These include:

  • Human immunodeficiency virus (HIV)
  • Human papillomavirus (HPV)
  • Herpes
  • Hepatitis B

Signs of STIs

Some STIs cause no symptoms; others can cause:

  • Rashes, sores or bumps in the genital area (on or around the vagina or penis)
  • Pelvic, back or abdominal pain
  • Unusual discharge from the vagina or penis
  • Burning or frequent urination

Left untreated, even curable STIs can cause permanent damage to the body like:

  • Infertility
  • Ectopic pregnancy
  • Cancer of the cervix, anus, throat or penis
  • Blindness
  • Paralysis
  • Liver damage
  • Brain damage
  • Death

Having an STI also makes you more susceptible to contracting HIV.

How to prevent STIs

The only 100% effective way to prevent STIs is to not have vaginal, anal or oral sex. If you choose to be sexually active, you should stay as safe as possible by using protection. Learn more about how to protect yourself from STIs.

You can also lower your risk of STIs by:

  • Having fewer sexual partners
  • Getting tested with your partner before becoming sexually active
  • Using condoms or dental dams
  • Getting the HPV vaccine, which can guard against certain strains of the virus, some of which can cause cancer and genital warts
  • Getting the Hepatitis B vaccine
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When to get tested for STIs

The only way to know if you have an STI is to get tested. Many people with STIs have mild or no symptoms. There’s no way to tell if someone has an STI just by looking at them. While some STIs can cause visible symptoms, others have no signs at all. Before you engage in sexual activity with someone, you should both get tested for STIs.

Your doctor’s office, local health department or a family planning clinic should offer STI testing. Visit the CDC’s website to find a free testing location near you.

Will your parents find out you got an STI test?

While all states give minors some control over keeping their sexual health confidential, the extent varies from state to state. To know your state’s laws, visit Sexetc.org or contact your doctor’s office or local health .

Need more info? Ask an Expert.

Resources

For more information about staying in charge of your health and future, visit:

Centerstone Sexual Healthcare

Centers for Disease Control and Prevention (CDC): Get Tested

CDC: Sexually Transmitted Diseases

Sex, Etc.

 

Home / Teen / Sex and Relationships

Teen Pregnancy

What you need to know about teen pregnancy

If you’re a teenager and are sexually active or thinking about having sex, you may be wondering how pregnancy happens and what you can do to prevent it. Or perhaps you think you or your partner may already be pregnant and you may feel scared, overwhelmed or worried about what to do. If so, you’re in the right place. Read on to learn how pregnancy occurs, how to prevent getting pregnant and what to do if you think you may be pregnant.

Need More info? Ask an Expert.

What causes pregnancy?

During vaginal sex (where the penis enters the vagina), it’s possible for pregnancy to occur. It’s also possible to get pregnant if semen gets on the vulva or near the vagina.

For pregnancy to happen, sperm must meet an egg. Here’s how that works:

  • In a biological male, sperm is made in the testicles and combines with other fluids to make semen, which is released from the penis during ejaculation.
  • Eggs live in the ovaries of biological females. Each month during a menstrual cycle, a mature egg is released from the ovaries (this process is called ovulation). The egg travels through the fallopian tube to the uterus.
  • If semen gets into the vagina, sperm can travel to the fallopian tubes and potentially fertilize the egg, which can lead to pregnancy.
  • Sperm can live in a uterus and fallopian tubes for up to six days after sex, so fertilization can occur up to six days after sex.
  • If the sperm fertilizes the egg, the fertilized egg will move into the uterus, where it divides into more cells and eventually attaches itself to the lining of the uterus. Once this happens, pregnancy officially starts.

If a fertilized egg implants itself in the uterus, this keeps the lining of the uterus from shedding, which is why periods stop while someone is pregnant.

Later in life, some adult couples may need some assistance from their medical team to have children on their own; there are still options for these couples. Doctors can help a pregnancy to occur via artificial insemination or in vitro fertilization (IVF).

How to prevent teen pregnancy

The only 100% effective way to prevent pregnancy is to not engage in vaginal sex. The only 100% effective way to prevent sexually transmitted infections (STIs) is to not participate in sexual activity that involves skin-to-skin touching with another person or where body fluids are involved.

If you plan to have sex, it’s important to protect yourself and your partner from pregnancy and STIs. Use a condom to reduce your risk of pregnancy and STIs and another method to prevent pregnancy (like the pill, patch or an IUD). Learn about your contraception options.

Early signs of pregnancy

If you’re worried you or your partner may be pregnant, here are the most common early signs of pregnancy:

  • Missing your period (some spotting could still occur and in rare cases, a menstrual cycle can continue during pregnancy)
  • Bloating
  • Feeling tired
  • Nausea or throwing up
  • Peeing more often than usual
  • Constipation
  • Swollen or tender breasts
  • Backaches
  • Headaches
  • Aversions to certain foods

Sometimes, these symptoms are caused by premenstrual syndrome (PMS). To know for sure if you’re pregnant, you can take a home pregnancy test (which you can buy at most pharmacies or grocery stores or your local health department or Planned Parenthood clinic) or see your doctor to get tested.

What to do if you think you may be pregnant

If you’re a teen and think you or your partner may be pregnant, you may be feeling scared and overwhelmed. First, know that you’re not alone. Many other teens have felt the way you do and have been in your shoes.

  • Seek support from an adult. Talk to a family member, teacher, school nurse, guidance counselor, coach or another trusted adult in your life.
  • Get tested. Next, it’s important to find out if you’re pregnant or not. You can take a home pregnancy test or get tested at your doctor’s office, health department or local Planned Parenthood clinic. Bring a support person with you if you can.
  • Be honest with your healthcare provider. You may feel awkward and that’s OK and totally normal. Your provider has seen and heard it all before, so feel free to ask questions and express your concerns.
  • Know your rights. If you feel uncomfortable with your doctor or nurse, it’s OK to ask to see someone else or find another place to get care. You have a right to receive healthcare without judgment.

If you’re pregnant, your healthcare provider will discuss your options with you. And if you aren’t pregnant, you can talk about birth control options to reduce your chances of pregnancy.

Need more info? Ask an Expert.

Resources

For more information about staying in charge of your health and future, visit:

Need more info? Ask An Expert