Do I Have to Talk With My Kids About Sex?

The Importance of Providing Sex Education for Your Kids
By Cory Silverberg, About.com

Updated: March 30, 2008

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

Many parents would rather not talk with their kids about sex. Of course many parents would rather not talk with anyone about sex. And while you can choose to avoid sexual communication in your adult life with romantic partners (but I wouldn’t recommend it) if you choose to never talk with your kids about sex you do so not only at your own peril, but theirs as well. There are lots of good reasons to talk with your kids about sex. Here are a few of my favorites.

Talking with your kids about sex can help keep them safer.

There is a lot of research that has shown that when parents talk with their kids about sex, their children are:

• more likely to use contraception
• more likely to delay intercourse
• less likely to have a teenage pregnancy

To be clear, it’s not just any kind of sex talk that helps, and some of the survey research offers conflicting reports on the impact of talking with your kids about sex, which may reflect the fact that it is possible to talk with your kids about sex in ways that are not helpful. So while it’s a good idea to talk with your kids about sex, it’s equally important to know what makes for good sex education and what the best way is to do it.

Kids listen to their parents when they talk about sex.

It might surprise some people who think of teens as extremely disaffected and contradictory to find out that both adolescents and teens, when asked, say they listen to what their parents have to say about sex:

• One study in 1995 found that adolescents rated parents higher in credibility than school and friends when it comes to getting sex information (although they rated them low in “accessibility”).
• A more recent 2006 survey by the Canadian Association for Adolescent Health found that sixty three percent of teens considered their parents a major source of information, and forty three percent thought parents were the most useful and valuable source of information.

It may be true that when they reach a certain age your kids are less likely to listen to what you have to say about many things. Interestingly, sexuality doesn’t seem to be on that list.

You’ll learn things from talking with your kids about sex.

Having to talk with your kids about sex means having to re-think many aspects of sexuality you may now take for granted. Even answering a simple question like “why would anyone want to have sex?” (not an uncommon question among kids of a certain age) requires us to think carefully about what sex means for us. In another example, with an older child, you might have to do some research just to keep up with sexual options on line, and this means learning for yourself as well as your child.

The fact is that when it comes to sex we’re all life long students. Our sexuality never stops changing as we age and this means that as long as we don’t turn away from it, there is always something new to learn. Talking with your kids about sex is another way to keep your mind open to the meaning of sex in your own life.

Talking about sex with your kids can further develop your relationship.

Any relationship that’s based on communication is going to have its challenges, and often its in overcoming those challenges that the relationship grows. Your relationship with your kids is no different, particularly as they get older and become more independent adults. Talking with your kids about sex won’t always be easy, but it’s well worth the effort, and the payoff can be more than a healthy child, it can be a healthier relationship overall. _{Sources:
Eisenberg, M.E., Sieving, R.E., et. al. “Parents’ Communication with Adolescents About Sexual Behavior: A Missed Opportunity for Prevention?” Journal of Youth and Adolescence. Vol. 35, No. 6 (2006): 893-902.}

When Should Sex Education Start?

What Age Do You Talk with Your Kids About Sex?

Many parents want to know at what age is it appropriate to start teaching their children about sex. What most of us don’t think about is that the question presumes that there is an age at which sexuality becomes important or “an issue”. This presumption is 100% wrong. Sexuality is an intrinsic part of who we are, from birth to death. And while our sexuality isn’t the same when we’re six as when we’re sixteen, or sixty, it is always there and always a part of us. So the question isn’t so much when to start talking with your children about sex, but how to do it at every age and stage of their lives.

Many, possibly most, parents are less than proactive in talking about sex with their children, and don’t deal with it until moments like these:

• Your toddler begins exploring his or her body in public and you’re not sure how to deal with it.
• You wonder at what point it’s “not okay” to let your child see you without clothes on.
• Your child asks you where they came from or where other babies come from.
• Your child begins to ask questions about their body and why it looks different from their brothers or sisters.

Each of these are important teaching moments, and if you want to avoid dealing with situations and questions at awkward or inconvenient times (say, in the middle of a holiday service, at a family dinner, or just as your rushing off to work) you’re best protection is to be proactive, and make space for sex talks on an ongoing basis.

Teaching your children about sex should begin as soon as you’re communicating with them. If they have questions they’ll let you know. And even if they don’t, you can let them know that you’re open to the questions by including sex education in all the things you teach them.

A good example is body parts. A common early learning experience between parents and children is teaching the names of body parts. We all learn about our ears and eyes and nose and mouth. In fact we usually cover all the major parts of the body but many parents don’t include names for parts of the body they consider sexual (e.g. penis, nipples, vagina, etc…). They’ll ignore those parts of the body even while young children are learning about them by touching themselves. Make no mistake, children learn as much by what parents don’t talk to them about, as they do from what parents do tell them.

Of course talking with your children about sex is extremely difficult when you have questions of your own, and no comfort level or practice. But waiting doesn’t make it easier, and the most important thing for you to do is be willing to listen to your child and help them find answers even when you don’t have them.

Asthma and Pregnancy:

Does Asthma Get Worse During Pregnancy?

Asthma tends to follow a “rule of thirds” during pregnancy. This means that one-third of pregnant asthmatics get better, one-third get worse, and one-third remain the same as prior to pregnancy. Women who follow one pattern with one pregnancy tend to have a similar pattern with future pregnancies.

It is common for severe asthmatics to get worse during pregnancy, while those with mild asthma tend to improve. The majority of asthma exacerbations occur during 24 to 36 weeks of gestation; only rarely does the asthma worsen significantly during labor and delivery. Usually asthma returns to its pre-pregnancy state within 3 months of delivery.

What are the Risks of Asthma During Pregnancy?

Asthma is the most frequent chronic respiratory disease affecting pregnancy, occurring in approximately 4% of pregnant women. There are numerous complications that affect mother and baby if the asthma is uncontrolled. After all, the fetus is relying on the mother’s lungs for oxygen. If the mother’s oxygen level is low because she is having as asthma attack, then the fetus is not likely getting enough oxygen either.

Maternal complications of uncontrolled asthma include:

• High blood pressure

• Toxemia of pregnancy

• Uterine hemorrhage

• Need for caesarian section

Fetal complications of uncontrolled asthma in the mother include

• Risk of stillbirth

• Premature birth

• Low birth weight

• Growth Retardation

• Low Apgar score

How Should a Pregnant Asthmatic Be Monitored?

It is recommended that all pregnant women with asthma are followed closely by an asthma specialist during their pregnancy. This may include monthly evaluations of asthma history and lung function testing. An obstetrician may plan to perform more frequent ultrasound examinations in women with under-controlled asthma. It is important to tell your obstetrician if you have asthma.

What Medication is Safe to Take During Pregnancy?

According to the Food and Drug Administration (FDA), no asthma drugs are considered completely safe in pregnancy. This is because no pregnant woman would want to sign-up for a medication safety study while she is pregnant. Therefore, the FDA has assigned risk categories to medications based on use in pregnancy.

Pregnancy category “A” medications are medications in which there are good studies in pregnant women showing the safety of the medication to the baby in the first trimester. There are very few medications in this category, and no asthma medications. Category “B” medications show good safety studies in pregnant animals but there are no human studies available. Pregnancy category “C” medications may result in adverse effects on the fetus when studied in pregnant animals, but the benefits of these drugs may out weight the potential risks in humans. Category “D” medications show clear risk to the fetus, but there may be instances in which the benefits outweigh the risks in humans. And finally, category “X” medications show clear evidence of birth defects in animals and/or human studies and should not be used in pregnancy.

Before any medication is taken during pregnancy, the doctor and patient must have a risk/benefit discussion. This means that the benefits of the medication should be weighed against the risks – and the medication should only be taken if the benefits outweigh the risks.

What Asthma Medication is Safe to Take During Pregnancy?

Again, safety of asthma medications during pregnancy is a determination of risks and benefits to be made by a physician. However, the professional organizations of obstetricians (ACOG) and allergists (ACAAI) have published guidelines on the management of asthma during pregnancy. In general, treatment of asthma during pregnancy is not different from guidelines for asthma in non-pregnancy. This is also true for recommended medications based on level of severity of asthma.

Rescue medications for acute asthma symptoms include inhaled beta-agonists such as albuterol. While these medications are all category “C”, the experience of these drugs in pregnant women is enormous and shows no evidence of adverse effects on the baby, either during pregnancy or breastfeeding.

Controller medications for persistent asthma include inhaled steroids, which are the preferred method to control the underlying inflammation in asthma. Other medications in this group include long-acting beta-agonists (used in combination with inhaled steroids such as in Advair®) theophylline, cromolyn, nedocromil, and leukotriene blocking medications (such as montelukast).

The preferred inhaled steroids include beclomethasone (category “C”) and budesonide (category “B”). However, ACOG/ACAAI considers it reasonable to continue another types of inhaled steroid during pregnancy if the mother was well-controlled with using that medication.

A combination product such as Advair® may be required in patients with more severe asthma. These medications combine inhaled steroids with a long-acting beta-agonist (albuterol-like medication), and is used as a controller therapy. Patients still require albuterol for “as needed” or rescue use. Long-acting beta-agonists, such as salmeterol, are considered to have safety comparable to albuterol.

Other controller medications such as theophylline (category “C”) and cromolyn, nedrocromil and the leukotriene blocking drugs (all category “B”) are reasonable to continue during pregnancy if the mother has had good benefit from the medications prior to pregnancy. However, none of these medications would be considered a “first choice” to start during pregnancy.

menopause

Some women continue to menstruate normally until the onset of menopause and then simply cease to have periods. But for most women, the transition is not so orderly. You can expect to see a variety of changes. What they are and why they happen is the subject of the discussion that follows. Under other headings, you'll find more on the symptoms and management of the most troubling of these problems.

Changing Hormonal Patterns

A woman's egg supply, as much as 2 million in the ovaries at birth, is programmed for depletion. When the supply is almost exhausted because of the aging process, or the ovaries are surgically removed, the menstrual cycle comes to an end. In fact, the reproductive cycle begins to change several years before menopause, a period referred to as perimenopause.

During this time, typically starting in the late 40's, the ovaries' response to the various stimulating hormones produced by the brain becomes unsynchronized, until eventually the aging ovaries fail to respond at all. They start to produce less progesterone, losing their ability to ovulate and develop the subsequent corpus luteum. When ovulation stops, estrogen levels decline and menstruation ceases.

As ovulatory cycles become more irregular throughout perimenopause, the body's sensitive hormonal rhythm is thrown off and menstruation may vary more from month to month. In addition, two hormones known as androgens begin to play a bigger role. Though referred to as male sex hormones, they are in fact produced in small amounts by the female body as well. As levels of the female hormones decline, the impact of these "male" hormones can increase.

The bottom line is that fluctuating blood levels of hormones during the transitional years can create a number of physiological changes. These may be less unsettling for women who have an understanding of what their bodies are going through.

Menopause at a Glance
The wide array of problems shown in this diagram may seem daunting; but fortunately, few women experience every one of them. Hot flashes are the most common complaint. However, these annoying sensations pass in due course, while other symptoms may pose a much greater long-term threat. Be particularly alert for lower back pain, which may signal the onset of osteoporosis, the bone-weakening disorder that leaves older women prey to fractures. Remember, too, that menopause robs you of estrogen's protective effect on the heart, and that heart disease is the Number One killer of women. (For more information, see "Heart Disease: The Greatest Threat of All.")

Changes in the Menstrual Cycle
Cyclical Changes occur for the vast majority of women whose periods do not just stop. The perimenopausal years may be marked by skipped menstrual periods, heavier or lighter than usual bleeding, and changes in the frequency of cycles. During some menstrual cycles, no egg may be produced; these are called anovulatory cycles.

Light, short, or skipped periods occur as the ovaries' hormonal response becomes unpredictable. Heavy and prolonged bleeding arise when a longer than normal release of estrogen overstimulates growth of the uterine lining. The lining may be irregular or thickened and may not slough off completely or evenly, causing menstruation to stop and start again. Clotting may be noticeable in menstrual bleeding.

The physical changes that accompany the menstrual cycle may also become less predictable and regular. Such signs as breast tenderness, fluid retention and headache may occur at unpredictable times.

Fertility declines as a woman enters her 40s, but it does not disappear entirely until menopause is complete. To avoid unplanned pregnancies, doctors recommend using birth control until a full year has passed since the last menstrual cycle.

Menopause: Myths and Realities

Myth: Menopausal women are unhappy and depressed.
Reality: Most women cope very well with the physical challenges of menopause. Serious mental health problems do not increase. While some women may experience emotional distress, this is often related to sleep disturbance and deprivation due to hot flashes.

Myth: All women going through menopause are plagued by hot flashes.
Reality: About 80 percent of American women experience only mild symptoms, or none at all, during menopause. When hot flashes do occur, in most cases they are mild and disappear after a few months, rarely persisting for more than 2 or 3 years.

Myth: Menopause is the end of your sex life.
Reality: Libido, or sexual desire, does decline with aging, but many women continue to enjoy a satisfying sex life deep into old age. Some women find sex more enjoyable after menopause when concerns about pregnancy are past.