Concern #1: Sexuality

We know that many of you are sexually active or at least curious. You, like many other teens, may have important questions that you are hesitant to ask your parents or medical team. So, we asked them for you.

Question 1:

How do you, the experts, handle the issue of teens being sexually active while in treatment?

First, we ask them if they are sexually active. If they say they're not, we say,

"OK, but if you are, we need to discuss it because it's important to your care. No judgment. It's not up to me - it's your personal choice. But if you are sexually active, you need to do certain things to protect yourself."

Some kids will openly tell you they are sexually active. You usually get better information when their parents aren't around, to be honest with you. Sometimes kids going off to college will say they're not having sex yet. Our usual response is,

"Well, you probably will be, so listen up."

They usually laugh - but they listen. Hormones are raging, you know?

Then, we educate them about the important ways they can protect themselves. One is birth control. We don't want girls getting pregnant. If girls are still ovulating, they could get pregnant. Some girls go on the pill for reasons other than birth control, but if they continue to menstruate on therapy and are sexually active, we would prescribe birth control pills.

We also advocate safe sex and use of condoms for guys to prevent sexually transmitted diseases (STD's). Another reason to use condoms is not to impregnate someone with sperm that's been affected by chemotherapy. We don't know what it would do to an unborn fetus. There could be congenital abnormalities, prematurity and many other problems.

We advise them not to have sex when their counts are low for a couple of reasons. With low white counts (neutropenia), they are very susceptible to infection and with low platelet count, there's the risk of bleeding. Some kids ask about having anal sex. First, we tell them they probably won't feel like it! But if they're determined to have sex and given the choice, there's less risk of infection and bleeding with vaginal vs. anal intercourse.

We also remind them that there are lots of other ways to express affection and be close. There's more to love than sex!