Teens Should Share Health Problems

Despite their claims to the contrary, most teenagers do not die of embarrassment.

But avoiding talking about embarrassing health problems may put the health of teens at risk, said Dr. Michelle Schmidt, an assistant professor of medicine at Baylor College of Medicine.

"The teen years are a time of tremendous physical and emotional change for both boys and girls, so it is natural that teens are uncomfortable talking about what's happening to them, even to their parents," Dr. Schmidt said. "They need to know that they can always talk honestly and openly to their health care providers."

Being open about teen sexuality is especially important, said Dr. Schmidt, who also runs an adolescent health clinic. Some teens become sexually active at a younger age than most parents expect, some as young as 12 and 13. While many teens learn about puberty and sex from their parents and from school-sponsored sex education classes, they may still be reluctant to seek out advice about sex from adults. Unplanned pregnancies and sexually transmitted diseases may result from that ignorance.

The Centers for Disease Control reports more than 15 million cases of sexually transmitted diseases in the United States every year. About one-fourth of new infections with STDs occur in teenagers. Chlamydia, the most common STD, causes about 3 million infections each year, mainly among teens and young adults.

In women, untreated chlamydial infections can cause serious complications, including pelvic inflammatory disease, a painful condition that can lead to infertility and other problems. Most teens infected with chlamydia have few or no symptoms, and without testing and treatment, the infection may continue for months or even years.

Dr. Schmidt advises teenage girls to have pelvic exams when they first become sexually active or make the decision to become sexually active. A thorough exam should include an annual pap smear, to check for cervical cancer, and a test for chlamydia or gonorrhea. Both girls and boys should be tested for AIDS if they have had unprotected sex.

Teen boys who are sexually active should also be screened annually. If they do not consistently use a barrier method of contraception, like condoms, they may be infected with an STD and not even know it, and may transfer the disease to their partner. A screening should include a genital exam to check for sores that may be a sign of an STD. Doctors should also check for hernias, and check the testicles for signs of testicular cancer. Dr. Schmidt said fear of getting an erection during the exam should not dissuade teen boys from getting screened.

"It is a natural response and nothing to be embarrassed about," Dr. Schmidt said.

Some health issues like pregnancy, eating disorders and depression are too difficult for teens to handle on their own, yet many feel they cannot talk to their parents. Doctors will treat a teenager's health concerns confidentially, unless the teenager will harm someone, or will be harmed by the health condition or behavior. Then confidentiality must be breached. Doctors can also help teens broach difficult subjects with their parents.

"When parents find out something about their child they don't want to hear, their initial reaction may be anger or devastation," Dr. Schmidt said. "But after that initial reaction, most parents really come through for their kids."

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©2006 Texas Medical Center

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