My Doctor Online The Permanente Medical Group

Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

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Overview

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Sexuality is a natural, basic part of life. Sex and sexuality are not just physical; they are also emotional. They affect the way you think and feel about yourself and others.  

When you reach puberty, your brain starts sending certain hormones to different parts of your body. These hormones cause you to develop adult features like facial hair or breasts. They also affect sexual feelings, thoughts, and desires.

All teens have questions about these new sexual feelings, and many wonder if they’re normal. Try not to worry. You have time to figure it out. So don’t rush into sex. Give yourself time to understand these new feelings and changes in your body. Waiting until you (and your partner) are emotionally, physically, and mentally ready for sex will make it a more pleasurable and positive experience.

Not having sex, known as abstinence, is the best way to avoid pregnancy, sexually transmitted diseases, and other possible consequences of sex. If you do decide to have sex, it is important to be safe. Using condoms correctly every time will prevent pregnancy and diseases like HIV/AIDS.

Physical and Emotional Changes

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It is normal to think about sex a lot when you hit your teenage years. You may be excited or ashamed about the changes your body is going through. This could be the first time you have thought of yourself as attractive or been attracted to others. These feelings can be intense or sometimes confusing. During this time you might wonder if you are straight or gay.

Sexual development

People start puberty at different times. For most girls, puberty begins between the ages of 10 and 14. Boys typically enter puberty a little later, between the ages of 12 and 16. Everybody goes through the stages of puberty a little differently. Just remember, soon all these differences will even out.

As your body changes, you will also start to develop your own thoughts and opinions. Relationships with friends become more important. It is common for talk to turn to sex.

You might hear a lot about sex from friends, magazines, TV shows, or information on the Internet. Not everything you hear or read is correct. To make sure you are getting the right information about sex, talk with your parents. If you feel funny talking to your parents, speak with your doctor, school nurse, or teacher. A trusted adult can help you find accurate information and support you as you figure out your own personal values about sex. 

Masturbation

As you continue to grow, you will likely have thoughts and sensations you have not felt before. It is normal to explore your own body as you begin to have these sexual feelings. Touching yourself or masturbating is nothing to feel bad about. Masturbation will not harm your body and it feels good.

You should base your decision to masturbate on your own personal beliefs. Be careful about putting unclean objects inside the vagina or urethra (the opening at the tip of the penis), this can tear or harm sensitive tissue and possibly cause an infection. Too much masturbation may irritate the penis or vagina, but it will not blind you or stunt your growth.  

Additional References:

Understanding Sexual Feelings

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Not all sexual thoughts and feelings are the same. Often the passion or strength of a sexual thought starts small and then grows. The sexual response cycle describes what happens to our bodies when thinking about sex or when actually having a sexual interaction. Every person experiences each of these phases a little differently.

Sexual Response Cycle

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The sexual response cycle includes:

Desire

This is the attraction we feel to someone and the thoughts that make us crave intimacy with another person. Remembering a person’s smile or smelling someone’s perfume could trigger the sexual thoughts that lead to desire.

Arousal 

The excitement that goes along with sexual desire is arousal. You may become excited when you think about sex or while being around someone you really like. Men and women are aroused in different ways. This phase can last from a few minutes to several hours.

During this phase you may feel:
  • Your heart beat faster.
  • Your breathing get faster and heavier.
  • You muscles tense up.
  • Blood rush to your penis or vagina. In males, this causes the penis to become hard. In females, this causes the vaginal walls and clitoris to swell.

Willingness and readiness are very important parts of arousal. Each person will become comfortable with these feelings at different times. It is healthy and normal for people not to feel ready for sex until they are older or married.

Release or orgasm

This is the high point or peak of excitement and arousal in males and females. Orgasm is a sudden and pleasurable release that may last a few seconds or longer.

Remember, you can explore these phases without having sex. Take things slow to figure out what feels good. Learning about these feelings could involve anything from holding hands with someone to kissing, touching, oral sex (sex acts using your mouth), or intercourse. People may use the word sex to describe any of these acts.

Exploring these feelings on your own does not mean you are ready to explore them with someone else. Every person experiences these phases in their own way and at different times. To feel good about yourself and your decisions, do what’s right for you. Only you can know what is right for your body, your mind, and your emotions. 

Sex and Emotions

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People may talk mostly about the physical parts of sex, but sex is first and foremost an emotional act. Sex will change a relationship and often times not for the better. Having sex before both you and your partner are ready can really hurt your relationship. If sex starts too early, it may cause confusion or even conflict. If you wait and take time to carefully think about your decision, you will more likely be happier with your choice.

Additional References:

Sexual Orientation

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Sexual orientation is a way of expressing your sexuality. It refers to the gender (male or female) of the people whom you romantically and physically desire. There are several types of orientations:

  • Heterosexuality. People who are sexually attracted to someone of the opposite sex are heterosexual (straight). This means a girl is attracted to a boy and a boy is attracted to a girl.
  • Homosexuality. People who are attracted to someone of the same sex are homosexual. Guys who mostly date other guys may call themselves gay. Girls who like girls may call themselves lesbians.
  • Bisexuality. Sometimes people are attracted to both sexes. This is called bisexuality.

Some people never or rarely feel sexual attraction to another person. They may call themselves asexual.

It’s okay to be unsure about your orientation. At your age, it is common to think about both sexes. It does not necessarily mean you are gay or straight. All the physical and hormonal changes you are experiencing can stir sexual feelings and attractions in a whole new way. With time, and by talking with supportive people you trust, you will figure it out.

Being a gay teen can be challenging, especially if you feel you do not have the support of family or friends. The teen years can be difficult enough without feeling as if you may be different from others, or even be teased or bullied for your choices. If you are bullied for your sexual orientation, be sure to tell your parents, school counselor, or another trusted adult.

It is important to feel positive about all aspects of yourself, including your sexuality. We offer many resources to support you through what can be a very confusing time. We can help make sure that you have a good support network and a safe place to discuss questions about sex and sexual orientation.

Additional References:

Deciding to Have Sex

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Use your best judgment when deciding to have sex and choosing your sex partner. Respect your own values and beliefs as well as those of your family and partner.

Deciding to have sex for the first time is a big decision. Sex is very emotional. It will affect how you feel about yourself (self-esteem) and how you feel about your partner. Make sure to talk things over with your partner, a trusted adult (a parent, an older brother or sister, or a teacher), and your doctor.

Some teens think they are ready when they are not. Sex can make life more complicated and give you adult worries. Having healthy sex means taking on a lot of responsibility, so you need to carefully consider if you are really ready.  

If your friends are having sex, you might feel pressured to become sexually active before you are ready. You may not want to feel different or left out. Those feelings are normal. But it is important to realize that plenty of teens choose not to have sex – 50 percent of teens do not have sex in high school.

It’s okay if your values do not match those of your friends. Everybody matures at different times and in their own unique way. To feel good about yourself and your decisions, do what’s right for you no matter what your friends say or do.

Abstinence, or not having sex, is the best way to avoid pregnancy, sexually transmitted diseases, and other possible consequences.

Respect

Always respect yourself and the decisions of others. Never pressure someone else into having sex before they are ready. Deciding to have sex is one of the biggest decisions you can make in life.

Respect means your partner is willing to use condoms with you every time and supports your decision about using birth control.

Finally, you might have sex one time and then decide you are not ready. It is okay to learn from your experience and say no to sex in the future. Only you can be responsible for your body.

Let us know if you do not feel safe or comfortable in your current relationship, or if you were pressured or abused in a past relationship. We will keep the conversation private and help you find support to deal with your feelings and make the best possible decisions. 

Avoid alcohol and drugs

Using alcohol or drugs makes it harder to think clearly. This clouded thinking could lead you to make decisions you will later regret, like having unsafe sex that could lead to a possible pregnancy or a sexually transmitted infection. Alcohol and drugs will make it more difficult to stand by your decisions and values.

If you have questions about sex or sexuality, let us know. We will keep the discussion private.

Find help if your partner has ever hurt or threatened you.

Physical, emotional, and sexual abuse is common. Abuse includes being pressured or forced to have sex. It is also abusive for your partner to refuse to use condoms to protect against pregnancy and sexually transmitted diseases. If you think you are being abused, you can get help by talking to us or you can contact the National Domestic Violence Hotline at 1-888-799-7233, where trained volunteers are available 24/7.

Healthy Sex

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Healthy sex means you and your partner are both ready for the added responsibility, have good communication, and are comfortable with your decision to be intimate. Take your time so that you can enjoy each other, whether you decide to have sex or not.

Sex can lead to pregnancy and other health risks. Sexually transmitted diseases (STDs) are diseases like genital warts, chlamydia, and HIV/AIDS that a person gets by having sex with an infected partner. We recommend that you have a yearly test for STDs, which involves a simple test of your urine (pee).

It can also hurt more to have sex before your body is physically developed. Girls who have sex before the age of 18 have a higher risk of developing cervical cancer as an adult.

Safer sex

Healthy sex is safe sex. So if you decide to have sex, be safe in order to protect yourself against sexually transmitted diseases (STDs) and pregnancy.

Use a latex condom every time you have sex. Condoms are the only way to prevent STDs. Read the condom package carefully to make sure that you use the condom correctly. Lubricated condoms help keep condoms slippery and make them less likely to break.

You may need prescriptions for other types of birth control, like the pill. Contact us if you would like to learn more about your birth control choices.

Sex play without vaginal or anal intercourse is an even safer way to have sex.

If you are thinking about or are already having sex, make an appointment with us. We will help you practice safer sex. Again, we will keep all information you provide us private.

What is good sex?

Sex should be pleasurable and enjoyable for males and females. If you find sex unpleasant, it may mean you are not ready. Stop and wait until you feel comfortable, safe, and excited.

Good sex depends on good communication. You should feel okay telling your partner what feels good, what does not, and when to stop. If you are not comfortable talking about sex, you are probably not ready to have it.

Good sex is not just about intercourse, orgasm, or arousal. Sex is a very emotional act. Many teens feel sad, angry, or depressed if they are pressured into sex before they are ready. Waiting until you really know, care, and trust someone can make sex better.

Additional References:

When to Call Us

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If you are thinking about having sex or are unsure about your sexual orientation, we have many resources to support you. Call us to schedule an appointment. We will support your privacy and will not share any information with your parents.

If you have had sex without a condom, call us and we can test you for STDs and pregnancy. If you just want to talk with someone about your experience, we offer private counseling and other resources.

We also can provide you with confidential and free emergency contraception (the morning after pill).

If you experience a violent or unwanted sexual act, call 911 and seek emergency medical attention. Do not take a shower or clean yourself before you have a chance to talk with us and the police.

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If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.

This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.

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