Much to the dismay of parents, many teens are indeed sexually active and rely on the "advice and expertise" of their friends to guide them "safely” through high school without becoming pregnant.

What we’re hearing:
• I can’t get pregnant if he pulls out.
• I only have oral sex.
• We don't use condoms because he doesn't like them …but we only have sex when I am at the end of my period.
• We wear condoms every time. I couldn't possibly have a STD, could I?
• A condom broke once. I was so scared that whole month I didn't know what to do!
• The Gardasil vaccine will give you HPV ….oh and I heard that the second one really hurts.

For some people, this list might be very shocking, even outrageous. We hear such comments every day—these are not exaggerated examples.

We live in an era where no woman needs to become pregnant without that being her desire. We also live in an era where because the risk of pregnancy has been removed young men and women begin having sex earlier, have more partners and thus spread sexually-transmitted diseases.

In 2007, results of a Centers for Disease Control survey showed that 48 percent of high school students have been or currently are sexually active. Fifteen percent of them said they've had at least four sexual partners. Not surprisingly, the CDC survey went on to show that one in four American girls aged 14-19 has a sexually transmitted disease. HPV (human papilloma virus, which is the virus known to cause abnormal Pap smears, genital warts and in rare cases cervical cancer) is the most common virus among the teenage girls. Herpes and Chlamydia also are common.

Abstinence is the core of much of our teaching at Virginia Women’s Center, but the fact is by the time healthcare providers meet with teens for the first time it is often much too late. Having already had more than one sexual partner, they have been exposed to the HPV virus and are at risk for other STDs, including Chlamydia, gonorrhea, trichomoniasis, Hepatitis B, Hepatitis C and even HIV/AIDS.

What you can do
While not all teens are sexually active or headed toward sexual activity early most teens do have a lot on their mind. Body image, boys, friends, family and school continue to raise questions and concerns for women whose bodies and minds are still developing. Today especially—in the age of information—they will get answers to their questions, though they may not be the right answers. They don’t want to talk to their parents about sex for fear of: punishment, embarrassment or never being allowed to see their boyfriends again. Ensuring a trusted source is critical.

Our advice to parents is to bring your teens in to see a nurse practitioner at age 15 or earlier if you feel it’s a good idea for health promotion and disease prevention counseling. We can meet with mother and daughter or just daughter. The young woman will not need a pelvic exam, unless she’s having any gynecological complaints or is sexually active. (If a woman is not having problems or sexually active, she should have a Pap test at age 21.) This is an excellent way to establish a trusting relationship with a health care provider, and begin to set in motion clear, open communications at home, too. It also establishes the GYN office as a safe place and trusted resource, setting the stage for a lifetime of good health practices and care.

Finally, knowledge is power. Here are the facts about teens and sex:

We don't use condoms because he doesn't like them …but we only have sex when I am at the end of my period.
Two issues are critical here: pregnancy prevention and disease prevention. Young women are particularly fertile, and cycles are usually irregular in youth. Not using birth control—no matter what phase in the menstrual cycle—is risking pregnancy. Additionally using a condom offers some protection against sexually-transmitted diseases, which a man who has been with other women can transfer to you. And vice versa. Sexually-transmitted diseases are embarrassing, occasionally painful and can lead to grave circumstances.

I can’t get pregnant if he pulls out.
Yes you can. As soon as a man gets an erection, seminal fluid surfaces. This pre-ejaculate, especially in young men, contains numerous sperm which love to swim. Young women are particularly fertile. Just a drop of pre-ejaculate near the vagina means a woman can get pregnant even if the man doesn’t penetrate, much less if he pulls out before ejaculating.

I only have oral sex.
Any of the sexually-transmitted diseases can be spread/given orally. Though not common, cases of Chlamydia and gonorrhea have been documented in the throat and eyes. HPV and Herpes 1 and 2 can also be spread through shedding around the pelvis and groin. Penetration does not need to occur. Additionally, oral sex creates a heated situation that can lead to unplanned sexual intercourse.

We wear condoms every time. I couldn't possibly have a STD, could I?
Condoms are highly effective against STDs and pregnancy when used properly, but they’re not foolproof. HPV, herpes and even Chlamydia can be spread through oral contact. HPV and Herpes can also be spread through shedding around the pelvis and groin.

A condom broke once. I was so scared that whole month I didn't know what to do!
By law, girls under age 18 can seek out medical care/counsel without parental consent at any time for STD counseling/testing, birth control and pregnancy-related issues. Plan B is a progesterone only component of birth control pills. If given within 72 hours of unplanned intercourse or in the instance of a condom breaking, it decreases pregnancy chances by 70% by thickening the mucous and making pregnancy more difficult. This is not the abortion pill (RU 486) Girls under 18 will need an prescription from a health care provider. Older girls can ask a pharmacist.

The Gardasil vaccine will give you HPV ….oh and I heard that the second one really hurts
Gardasil is the first vaccine specifically designed to prevent cancer. It is approved by the Food and Drug Administration to prevent cervical cancer and genital warts, a precursor to cervical cancer. It is designed to protect girls before they ever become sexually active. The vaccine, which is administered in three shots, does not contain HPV and will not give you HPV. The shots shouldn’t cause any more pain than a routine shot. The shot for syphilis is very painful, however this sexually-transmitted disease does not occur as frequently as some of the others.

The Centers for Disease Control offers detailed information on all sexually-transmitted diseases. Go to www.cdc.gov/std.