Puberty is a time of many changes. A girl's body starts changing after about age 8. Many girls worry that they are not developing fast enough, or are concerned if they develop before their friends do. Remember, each person has her own timetable. Some girls start puberty early, and some start later.
Most of the changes of puberty are caused by chemicals called "hormones" that the body starts to produce. The main female hormones are estrogen and progesterone.
Breasts start to grow when a girl is between 9 and 13. Many girls are concerned about the size and shape of their breasts. Breasts come in many different sizes, so girls shouldn't worry if theirs are different from their friends'. One breast may grow more quickly than the other; however, they will be about the same size when they finish growing. Pubic and underarm hair will start to grow next.
Menstrual periods usually start between the ages of 11 and 15; however, periods can begin as early as 9 and as late as 17.
This is what causes a period: about once a month, a woman's body gets itself ready for pregnancy. The lining of the womb, or uterus, starts to thicken. About 2 weeks later, one of the ovaries releases an egg, or ovum. If sperm from a man's body does not join with the egg, that is, it is not fertilized, then the thick lining of the uterus is not needed. In about another two weeks, her body gets rid of this lining through the vagina. This is called having a period, or menstruation.
Many women are uncomfortable or have cramps during their periods. Exercise, a heating pad or hot water bottle, and a pain reliever can help. If these ideas don't work, ask a doctor or school nurse for help.
Periods usually last between 3 and 7 days. They may be longer or shorter, and bleeding may be heavier in some months than in others -- especially when you first start having your period. Many things can affect your period, such as stress or sickness or fast weight loss. After a while, most women find that their periods become regular. Once periods are more regular, they happen about every 21 to 35 days, or 3 to 5 weeks.
If a woman has intercourse then misses her period, she might be pregnant. If sperm joins with an egg a pregnancy begins. The fertilized egg attaches itself to the thick lining of her uterus and starts to grow. Her body does not get rid of the lining and she does not have a menstrual period.
The female hormones also cause a woman's vagina to produce a discharge or mucus. This does not hurt or itch or smell bad. However, if you have a discharge that does hurt or itch or smell strong, see your doctor; you might have an infection.
Pimples or acne are a common problem. Some suggestions are to wash with plain soap, not eat foods with lots of fat, not use skin moisturizers, and use lotions with benzoyl peroxide which can be bought without prescription at a drug store. A doctor may also be able to prescribe medication.
Body odour is caused by perspiration. Many people stop it by washing often with regular or deodorant soap and using deodorants.
Girls usually grow quickly between 10 and 13. After their periods start, most grow about another inch or 3 centimeters. Most reach their adult height by age 16.
Puberty may be a time of strong sexual feelings and fantasies. These feelings may be confusing or a worry or very pleasant. Daydreaming about kissing or sex, developing a crush, feeling romantic are all normal. Respect your body, respect yourself for what you are today, and demand respect from others.
If you want more information, you can read books on puberty. Or, talk with someone you trust. You can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
A woman's sexual parts are harder to see than a man's, so many people don't know much about them. Some women have been taught that this area of their body is dirty or ugly, and that it is shameful to touch it or talk about it. These parts are not dirty or shameful. Like any other parts of your body, the more you know about how they work, the easier it is to stay healthy.
It is useful to see what this part of your body looks like. You will need a small mirror to do this. Second, you will need some facts.
The whole area between your legs is called "the vulva". You will see two sets of lips, called "labia". After puberty, the outer lips have pubic hair growing on them. The inner lips vary in size and shape and colour. One lip may be larger than the other.
Inside the lips are the clitoris and two openings. Starting at the front of the body, where the inner labia meet, is the clitoris. In adult women, the clitoris is about the size of the eraser on the end of a pencil. In some women, it is covered with skin and in others it is uncovered.
The clitoris is extremely sensitive and is the source of much sexual pleasure. Some women like to have it touched directly, when they are ready. However, others find this painful and prefer to have the area around the clitoris rubbed.
The opening closest to the clitoris is the urethra, where urine comes out. It is small and hard to see.
Next is the opening to the vagina. This is where menstrual blood and vaginal discharge come out, and where the penis goes during vaginal intercourse. Sperm travel up the vagina, through what's called the cervix, into the womb (or uterus). If it meets and fertilizes an egg, or ovum, a pregnancy begins. When a baby is born, it moves out of the uterus, down the vagina and out the same opening.
Inside the vagina there is usually a thin tissue called the "hymen". Other names for it are "cherry" and "maidenhead". The hymen can become stretched or torn by things like using tampons and having sexual intercourse for the first time. For some women, this can be uncomfortable and cause a bit of bleeding; others don't even notice it.
The opening further back is the anus. It is where bowel movements come out.
From puberty, girls will notice a vaginal discharge or mucus on their underwear. It is perfectly normal. It may be yellow or milky-white, watery or thick. The appearance and amount of this change at different times in a woman's cycle. These changes can help tell when she is most likely to get pregnant.
If the discharge has a strong or bad smell, if it itches, or if it is a strange colour, it could be a sign of an infection or a sexually transmitted disease. This should be checked by a doctor, as some of these are serious and spread easily.
To find out more about a woman's body, get books on the subject. Talk to someone: a parent, counsellor, or health care worker. Or, you can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
Puberty is a time of many changes. A boy's body starts changing when he is in between 11 and 20. Many boys worry that they are not developing fast enough. Remember, each person has his own timetable. Some boys start puberty early, and some start later. You will go through puberty at your own speed.
Most of the changes of puberty are caused by the male hormone testosterone which the body is starting to produce. Testosterone is made in the testicles. The testicles are inside a sac or bag below the penis, called the scrotum.
As the amount of testosterone increases, the scrotum gets darker. The penis and testicles start to grow. Pubic hair also starts to grow. Underarm and facial hair will come later. The voice gets deeper, and sometimes may crack or break. In the throat, the Adam's apple, or larynx, gets bigger. Some boys swell a little under their nipples, but this usually goes away.
The testicles start to produce sperm. This will continue for the rest of a man's life. Sperm are released in a white fluid called "semen". Sometimes semen is released from the penis during sleep. This is called a "wet dream", and it is normal and harmless.
Some people think that you can tell the size of a man's penis by other physical characteristics, like the size of his feet or his race. These beliefs are not true. It is also not true that the size of a man's penis affects his partner's sexual satisfaction.
An erection, or "hard-on", may occur at unexpected times. This can be embarrassing, but it is normal. It is not necessary to ejaculate or "come", even for years, in order to be healthy.
Pimples or acne are a common problem. Washing with plain soap, avoiding foods with lots of fat, using lotions with benzoyl peroxide which are available without prescription at drug stores, or a visit to the doctor may help. Body odour is caused by perspiration, and can be helped by washing with plain soap or deodorant soaps and using deodorants.
Most boys grow quickly between ages 12 and 15. By 18, most stop growing, but muscles will continue to develop.
Puberty may be a time of strong sexual feelings and fantasies. These feelings may be confusing, and may cause both concern and pleasure; however, they are normal. If you are worried, find books about puberty, or talk with someone you trust. You can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
A man's most obvious sex organ is his penis. Penis size has nothing to do with how tall or muscular a man is, his race, or any other physical characteristic. The size of a penis when it is soft has little to do with its size when it is erect.
Men with big penises are not more masculine or manly. They do not make more sperm than men with small penises. And, the size of a man's penis has nothing to do with how much he and his partner enjoy sex.
At the tip of the penis is the opening where urine comes out. When the man is sexually excited a clear fluid will come from this opening. This contains sperm and is natural. The opening is also where semen comes out when a man ejaculates or "comes".
Some men have been circumcised. This can be for health or religious reasons. It means that a part of the foreskin has been removed from around the head of the penis. This changes the appearance of the penis and may make it easier to keep the penis clean, but has no other effect.
A penis becomes erect when blood rushes to it, causing it to become hard and stick up or out from the body. This is often called a "hard-on" or a "boner". Some erections happen unexpectedly, often when they aren't wanted. They may happen when a boy or man is thinking sexual thoughts, when he is excited or anxious, or sometimes when he is not thinking about anything in particular. This may be embarrassing but it is normal.
Behind the penis are the testicles or "balls". They are in a sac called the "scrotum". One may be larger and hang lower than the other. Sperm need to be cooler than the body to live -- this is why the testicles are outside the body.
Most lumps or bumps in the scrotum are harmless pouches of fluid, called cysts. Some go away by themselves, others need to be removed by surgery. A lump in the scrotum could also be a sign of cancer. It is important to have any lump checked by a doctor. Your doctor can also show you how to examine your testicles regularly. The best time to do this is after a hot bath or shower. The Canadian and American Cancer Societies have literature on this subject.
If you want more information on men's sexual organs, find books on the topic. Talk with your parents, someone at a clinic or a family planning centre. Or, you can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
There are almost as many ways to think about sex as there are people. Some of these ideas are true and some are not.
Many people think that all guys are only interested in having intercourse. But, boys and men vary in their interest in sex, and their interest changes with other changes in their lives. Men can have and express tender feelings, and appreciate closeness and affection.
Girls and women also have very strong feelings. They often want and enjoy sex, as well as caring, loving relationships.
Both males and females need to express feelings. Good, positive relationships are important to both guys and girls. Sometimes people exaggerate their partner's commitment, to impress their friends, or for their own sense of security. Sometimes feelings get confused.
The first sexual intercourse can be exciting, scary, pleasurable, and even disappointing, for both guys and girls. Many young couples know they're not ready. Maybe it isn't the "right" time or the "right" person; they don't know each other well enough; they want to avoid pregnancy and sexually transmitted diseases. Or, maybe they just feel too confused and need more time to sort out their feelings. Kissing, hugging, touching, mutual masturbation or rubbing genitals to reach orgasm, can be safe, satisfying alternatives to intercourse. These types of sexual activity are called outercourse. Discuss sex, one step at a time, to make sure that both of you are ready for any steps you take.
We get ideas about sex from television, movies, music, ads, jokes, friends and family. You need to sort out your own ideas and values, what it is you want. Sometimes, one partner tries to pressure the other into becoming sexually active. Knowing your values and what you want will help you in this situation.
No means No. Respect your partner and respect yourself. Sexual assault, even in a marriage or dating relationship, is a criminal offense. Only yes means yes.
Neither guys nor girls know all about sex. Take time to communicate your feelings and get to know your partner.
Similar interests and values between partners help make a relationship stronger, more satisfying and longer-lasting. Even happily married couples do not always want sex at the same time, nor do they have orgasms at the same moment.
If a person carries a condom it doesn't mean that he or she is "easy" or expects "action". It means the person is thinking, being prepared, and will have protection if they decide to include intercourse in their sexual relationship.
If you want more information, find books, read other Facts of Life Netline messages, or talk to an adult you respect and trust. You can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
Growing up involves learning to make decisions and living with them. When you begin to care for and be attracted to someone, then it is time to take a good look at yourself, your values and goals. How far do you want to go with that person now? Later?
It's important to talk about your feelings. Becoming sexually active means looking at the relationship and examining why you want to have intercourse. It means taking responsibility for preventing an unplanned pregnancy and the spread of sexually transmitted diseases. Many couples decide not to include sexual intercourse in their activities because of the risks, or because they just don't feel ready.
So, how do you say "no" without hurting the other person, making him or her dislike you and say bad things about you? How do you say "no" so that the other person knows you really mean it? Here are some things to think about:
1. Work out an understanding with your partner. Talk things over before they go further than you both want.
2. Remind yourself that your partner doesn't need to have sexual intercourse; if you can wait, your partner can wait.
3. You don't have to explain, but you can give a reason if you want to, such as "I've made up my mind to wait," or "I'm not ready to get involved."
4. Remember how important birth control and parenthood are.
5. It's easy to get a sexually transmitted disease. These may be painful or uncomfortable, and can cause infertility or sterility. "Infertility" means being unable to have a baby, and "sterility" means being unable to father a child.
6. Respect yourself. Know that the right person will wait for you.
7. Consider your goals for yourself in education, career and other areas of your life.
8. Believe in yourself. Remember your personal values, and do what is right for you.
In some relationships, guys or girls try to talk another person into intercourse. Some lines that people use are:
Remember, no one has the right to pressure you into having intercourse. It's your decision.
Sometimes people feel that having intercourse will solve their problems. Some unhealthy reasons for having intercourse are:
If you are ready to have sexual intercourse, then you need to be ready to take responsibility for birth control and avoiding the spread of sexually transmitted diseases. Relying on luck is not good enough. Find out as much as you can so you can make the best choice. Kissing, hugging, petting, mutual masturbation all can be healthier and safer than intercourse -- and just as sexy.
The more sure you are of yourself, the less likely you are to be flattered or frightened into doing something you're not ready for. Think carefully. Avoid alcohol and drugs, as well as people or situations that keep you from thinking for yourself. Talk things over with someone you trust. You have many choices, make the decisions that seem best for you. You deserve that!
You can read other Facts of Life Netline messages about sexuality. Talk to someone you respect and trust. Or, you can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
Teenagers have many questions about sexuality. One of the most common is "Am I normal?" Most teens are concerned about body changes, fantasies, being sexually attracted to others and having sexual feelings. Teens are also curious about heterosexuality, homosexuality, bisexuality, masturbation, sexual satisfaction and just feeling OK about being curious. You may also have questions about birth control, pregnancy, abortion, sexually transmitted diseases and how to make decisions. It is normal to be interested in all of these. You may find answers to some of your questions in other Facts of Life Netline messages.
Normal sexual body changes for a woman occur between 8 and 18 years of age. Changes in the amount of special chemicals in her body, called "hormones" cause her breasts, usterus, ovaries and vagina to develop. These changes can affect her feelings about her body. Hormones are also connected to menstruation or periods. Menstruation is one sign that a girl is physically changing into a woman.
For a young man, sexual body changes occur between 11 and 20 years of age. They include growth in the size of the testicles and the scrotum, or sac, that holds the testicles. Hormones start to make sperm in the testicles. Many boys have "wet dreams", a release of white fluid from their penis during sleep. The fluid is called "semen" and contains sperm. Wet dreams are a sign that a boy is physically changing into a man. A clear fluid can come out of an aroused penis before ejaculation; it also contains sperm.
Masturbation, or rubbing your own body for sexual pleasure, is normal. It is done by young and old people, men and women. It can also be done with a partner, when the couple isn't ready for intercourse, or to avoid pregnancy or spreading a sexually transmitted disease.
Pregnancy occurs if a woman's egg is fertilized by a man's sperm. Usually, the first sign of a pregnancy is missing a period. At that time, the woman is probably about six weeks pregnant.
Missing a period may be caused by many things other than pregnancy: illness, stress, change in diet, etc. But, if a woman has had intercourse she should get a pregnancy test right away. If a couple has unprotected intercourse or if the condom breaks, and they do not want to start a pregnancy, the woman may go to a doctor or clinic and ask for the "Morning After Pill". But, she has to get the Morning After Pill within 3 days of the intercourse. Or, she might be able to get a "post-coital IUD" within 5 to 7 days, to stop pregnancy.
A woman who is pregnant has three choices: having the baby and keeping it, giving it up for adoption, or having an abortion. You may want to read to the Facts of Life Netline messages about these.
For some young men and women, hormone changes can cause "mood swings". Sexual feelings and fantasies and feelings can also increase because of hormone changes. Some young people have very strong desires and spend a lot of time daydreaming. It is common to be concerned about what others think of them, get confused, rebel and worry about the future.
It's also normal to be curious about heterosexuality -- sexual relationships with someone of the opposite sex, homosexuality -- or sexual relationships with someone of the same sex, and bisexuality -- sexual relationships with people of both sexes. You might find it helpful to talk over your thoughts and feelings with someone you trust, such as your parents, a counsellor, a teacher, a school nurse, your doctor, a clergyperson or a friend. The Facts of Life Netline message on Homosexuality, under Sexuality in the Index, gives more information.
There are many books about teenage questions and concerns. Two books are The Teenage Body Book and Changing Bodies, Changing Lives. You might also read the Facts of Netlife Line message on Making Decisions About Sex, also in the Index under Sexuality, or other topics. Or, you can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
Masturbation is a normal activity that people do alone or with a partner. Masturbation means rubbing or touching your body in a way that arouses sexual feelings and might produce an orgasm. It is called many things, including "jerking off" and "playing with yourself".
Many people used to think that masturbation could seriously affect a person's health. Today, we know that it does not cause physical harm. Most people see it as a normal part of sexuality, a way to fulfil sexual needs. Both men and women masturbate. Children, young people, adults, seniors, single and married people can all masturbate.
Some people do not masturbate. Some do not get pleasure from it and others do not feel comfortable touching their bodies. In some religions, it is not acceptable. Some people never masturbate throughout their lives: all of these choices are normal.
Masturbation can give pleasure, can be relaxing, and is an outlet for sexual tension. It is often used as a way of understanding how your body works. If a woman doesn't have orgasms easily, masturbation can help her learn how.
For many couples, caressing their partners' genitals to bring about orgasm is a very pleasurable way of being intimate without having intercourse. The couple might be trying to avoid pregnancy or practising safer sex. Or, maybe they have decided they are not ready for intercourse.
Masturbation is unacceptable if it is done in front of a person who has not wanted or permitted it.
There are some things to keep in mind. Touching genitals with dirty hands can spread germs. Putting a sharp or unclean object into a vagina or anus is risky. Muscles around the anus are not flexible, and the anus may tear or bleed.
A family doctor or counsellor can talk to you about masturbation. They are there to help. Or, you can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
Outercourse is the word used to describe all of the sexual things you and your partner can do together, everything except sexual intercourse.
Some of these things are holding hands; kissing; hugging; necking; petting; masturbating each other, or mutual masturbation; and oral sex. These activities can all be very satisfying -- and sexy! Remember -- you can get sexually transmitted diseases from oral sex. Also, ejaculating or "coming" near a woman's vagina can start a pregnancy.
Passionate kissing and heavy petting can lead very quickly to intercourse. It is important that you and your partner discuss your limits before you start. Make sure each of you understands just how far you're willing to go physically. This way, you won't have sexual intercourse without planning to. Respect yourself and respect your partner: "No" means No.
Having intercourse if both partners don't really want to can have a negative effect on a relationship. Things may start out well, with long talks and lots of laughs, but intercourse too early may put an end to everything else.
Whether you have intercourse or outercourse, or no sexual activity at all, is a decision that you must make for yourself. So, don't let anyone else talk you into doing anything you don't want to do or don't feel ready for. Your body is your own and you are the only one to decide what you will or will not do with it. Don't be afraid to say "No". If you'd like to talk to somebody you can call your local Planned Parenthood organization or Health Unit -- see References/Resources.
Maturity brings with it different goals and values in all aspects of life including sexuality. Although sexuality is with us throughout life, sexual behaviours and attitudes change as we change over the years.
The media portray young people as glamorous and "sexy', so we associate sexuality with youth. It is difficult, then, and embarrassing, for young people to think of their parents, or any older people, as sexually active. In fact, most older people continue to share sexual relationships all their lives. But, there are gradual differences in our sexuality that occur as we age.
As men get older they may take longer to get an erection and longer to achieve orgasm, or "come". It also takes longer before another erection can happen. Some orgasms are internal, that is, they happen without the ejaculation of semen.
Worrying about changes in sexual response can make the response slower. Nearly every man can't get an erection at times. This is normal, and usually temporary. Men may try other types of sexual activities if they no longer rely on an erection.
A woman's vagina may become somewhat stretched after having children. It becomes less elastic and dryer as she reaches menopause. Water-soluble lubricants, available at drug stores, can help prevent pain or discomfort during intercourse.
Both men and women are usually able to come to climax and have orgasms all their lives, whether or not they choose to include intercourse in their love-making.
Stress, financial and job worries, tragedies, all of life's cares, affect interest in sex. So does feeling angry, depressed, and tired, taking medication, and being offended by a partner's habits. Alcohol slows responses, while increasing desire.
Some older couples find that not having to worry about pregnancy makes sex more enjoyable. After children have left home there is more privacy. More relaxed love-making can mean more imaginative techniques, more creative expressions of intimacy. People like to be touched and hugged no matter what their age. Affection and closeness are important to everyone's health.
People who have health problems may find that a different position is easier and more enjoyable. Mutual masturbation or oral sex may be very satisfying. If a person is alone, masturbation may bring sexual relief and pleasure. Read the message on Masturbation, under Sexuality in the Index.
Books can answer some questions. Or, you can talk with a counsellor or a person who works with older people.
Sex therapy is used to help people accept and increase enjoyment of their sexuality. It is based on the ideas that sex is normal and good, that relationships can be meaningful, and that sexual intimacy is a normal goal. Some of the reasons people go to a sex therapist are:
In some cases, people have problems as a result of illness or physical disability.
During therapy, people learn to accept that it is okay to be sexual, to have sexual feelings, fantasies and needs, and to get sexual pleasure from your own body. A good sex therapist gives accurate, practical information about sex. Some people get help taking responsibility for their own sexual pleasure by learning to communicate and share with their partners what feels good and what they want. Individuals and couples can become more aware of themselves and each other, and gain a deeper understanding of their relationships. They are encouraged to make time in their lives for sexual intimacy. Sometimes therapists give exercises for clients to practise at home. These exercises can help clients learn to enjoy and respond to sexual stimulation without worrying about performance.
A sex therapist may be trained as a sexologist, social worker, psychologist, physician, or counsellor, but should have training in how to help people deal with sexual problems.
In Ontario, sex therapists are not licensed, so anyone can call himself or herself a sex therapist. The Ontario Association of Marriage and Family Therapists has names of therapists who are certified by the Board of Examiners in Sexual Therapy and Counselling in Ontario. The Association's phone number is 1-800- 267-2638.
It's hard to be different in our culture. We have pressure all around us to be like everyone else. Even though it may seem like everyone is sexually attracted to the opposite sex, this is not true. Some people are homosexual: they are attracted to people of the same sex. In Canada and the United States, there are gay men and lesbians in every occupation, leading successful lives.
When most of a person's sexual thoughts and activities are about people of the same sex, this person may be homosexual. Women who are sexually attracted to other women are called lesbians. Some people use the word "gay" to include both male and female homosexuals, but usually it is used for men only. People who are sexually attracted to members of the opposite sex are heterosexual, sometimes called "straight". Some people are attracted to both people of the same sex and the opposite sex; these people are bisexual.
People may feel strongly attracted to a person of the same sex. Someone can think and fantasize about people of the same sex without necessarily being homosexual. Young people, especially, need to explore their feelings.
Just because you are attracted to a person does not mean that you have to have sex with them. You may admire the person and or have a loving, caring, sharing relationship without sex. You do not have to be sexual with anyone until you are ready.
The stereotypes of homosexuals on television or in movies bother many people. Most gays and lesbians do not look or act any different from anyone else.
We do not know why people are heterosexual, homosexual or bisexual. There are many theories but no clear answers. Many people have sexual fantasies about both sexes, and sometimes feel confused about whether they are gay or straight. With time and sometimes help from others, most people can sort out their feelings and sexual orientation.
If you think that you are gay or lesbian, it may be hard to tell others about your sexuality. You may feel afraid of losing friends or family members or your job. However, it may be a huge relief to tell even one person. But don't rush into it. Tell someone you really trust. And remember that it may take time for people to adjust and to deal with the news.
"Coming out" or telling others that you are homosexual is a life-long process; it's never finished. As you become more self- confident it will be easier to tell others. There might be support groups that you can join in your community.
If you are a parent or a friend of someone who has told you they are homosexual, you might feel disappointed, upset or worried. Try to deal with the news in a way which tells the person that you still love them and care for them. As a parent, you may have plans for your child's life, and this wasn't part of your plans. But being gay or lesbian isn't bad. Homosexuals are not sick and they don't need to change or be cured. It is important to support your child or friend now. That person trusts and respects you enough to confide in you. They need you. Your love and understanding will help them accept themselves as they are.
There are books on this subject. It may help to talk to someone you trust. The Kids Help Phone Line, 1-800-668-6868, is a toll-free number that has counsellors 24 hours a day. . You can also call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
Many parents find it hard to talk to their children about sex. Yet children WANT to know, and if they don't get accurate information from their parents, they'll probably get inaccurate information from friends, TV, films and magazines. They are curious about sex, just as they are about everything else. Studies show that young people who talk with their parents about sex tend to wait longer to have intercourse. They are more likely to use birth control and to take precautions against getting sexually transmitted diseases when they do have intercourse.
Here are some general tips that other parents have found helpful for talking to their children.
Be available. Watch for clues that show they want to talk. Remember that your comfort with the subject is important. They need to get a feeling of trust from you.
Answer questions honestly and without showing embarrassment, even if the time and place do not seem appropriate. A short answer may be best for the moment. Then return to the subject later.
Avoid babyish words. Using correct names for body parts and their functions shows that they are normal and OK to talk about.
It's OK to say, "I don't know." Nobody knows everything, and when you can't answer a question, that can be an opportunity to learn with your child. Tell your child that you'll get the information and continue the discussion later, or do the research together. Then be sure to do this soon. Don't duck the question or expect your partner or a professional to handle it, although they can add to your answer.
Some people claim that sex education encourages sexual activity; however, studies show that the earlier you start education the better. If they are old enough to ask questions, they are old enough to get good answers.
Practice talking about sex with your spouse, another family member or a friend. This will help you feel more comfortable when you do talk with your child.
If your child doesn't ask, look for ways to bring up the subject. For example, you may know a pregnant woman, watch the birth of a pet, or see a baby getting a bath. Use a TV program or film to start a discussion. Libraries and schools have good books about sex for all ages.
Talk about sex more than once. Children need to hear things again and again over the years to really understand, because their level of understanding changes as they grow older. Make certain that you talk about feelings, not just actions.
Answer the question that is asked. Respect your child's desire for information. But, don't overload the child with too much information at once. Try to give enough information to answer the question clearly, yet encourage further discussion.
Privacy is important, for both you and your child. If your child doesn't want to talk, say, "OK, let's talk about it later," and do. Don't forget about it. Never search a child's room, drawers or purse for "evidence". Never listen in on a telephone or private conversation.
Listen to your children. They want to know that their questions and concerns are important. The world they're growing up in is different from what yours was. Laughing at or ignoring a child's question may stop them from asking again. They will get information, accurate or inaccurate, from other sources.
Share your values. If your jokes, behaviour or attitudes don't show respect for sexuality, then you cannot expect your child to be sexually healthy. They learn attitudes about love, caring, and responsibility from you, whether you talk about it or not. Tell your child what your values are about sex and about life. Find out what they value in their lives.
Talk about your concern for their health and their future.
There are books which may be helpful, or you can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources
When you were younger you probably asked your parents about your body, about where babies come from, or how they get into their "mommy's tummy". Some adults answer such questions easily, helping the child feel comfortable about asking more. Others are embarrassed, and may laugh, or ignore the question, or give false information.
No matter how your questions were treated when you were younger, you can still talk to your parents about sex. One thing is certain: parents were young once themselves. They have felt afraid and uncertain, and have been through some of the same experiences you're going through.
You already have a good idea of your parents' values and culture. Your own values are formed originally from theirs, but also from your friends, other adults, films, books, religious teaching and others. Some of your values might be different from theirs. Some questions about sex have factual answers. Others are a matter of what is thought to be right and wrong, good or bad.
If possible, choose a time to talk to your parent when you won't be interrupted: in the car or the kitchen, or late at night. But, respect your parents' privacy, just as you want them to respect yours.
If you disagree with them about "rules" or how they want you to behave, ask yourself some questions. Have you shown them you are responsible? Are they worried about your safety, or pregnancy, or sexually transmitted diseases? If you make a promise, stick to it. Can you make a deal that will help you both?
Watching TV or a video together is often a good time to talk about sex. You may state your opinion of what you've just seen. Or, when parents mention friends' or relatives' problems or behaviour, that may be a good chance to talk.
You can open a conversation with a general question, such as "How old were you when you had your first boy (or girl) friend?", or, "Did you ever talk to your parents about dating?" Beginning a conversation with "I feel...", or "Could you tell me more about..." will help. Saying "You're wrong" can make talking more difficult.
Your talk will probably go better if you stay calm. If you are angry or emotional, it may be better to say, "I'll talk to you later," and leave the room. This can show maturity, and give you a chance to think about what you really want to say. It might help to rehearse what you want to say or ask beforehand.
Maybe it's hard to believe, but most couples have sexual relationships most of their lives. Because film and TV stars are young and glamorous, young people often have the idea that their parents no longer have romance or sexual feelings. They probably do, and they also have a lifetime of experiences.
Getting some facts can help you. Find books, or get brochures from clinics. You can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
Most men have sexual concerns at some time. They wonder about why they can't always "get it up", whether they are impotent, or why they "come" so quickly, or why they "come" only through masturbation and not with their partner.
There is a wide range of sexual behaviour and desire. Some people like different positions, different techniques, and others don't. Whatever a man likes is normal for him. He does not have to do what he believes other men do. It is wrong to force another person into any unwanted sexual activity. Force and abuse are criminal acts.
At some time during their lives most men find that they are not able to keep an erection long enough to get satisfaction. It may be a result of being sick, tired, stressed or offended by their partner, or due to alcohol, drugs or medication. But worrying about an erection makes it less likely to happen or, if it does, to keep it long enough. Doctors can help if there is a medical problem. And a sex therapist can help if there is a psychological problem.
The most common sexual concern of young men is premature ejaculation, or "coming" too quickly. This is a learned behaviour, usually from being rushed in the past during sexual activity or masturbation. If a man begins to recognize the feelings that come just before ejaculation, he can learn to slow down and control these feelings. By holding hard onto the penis, by starting and stopping his movements, he can, with practice, overcome this difficulty. Or, he can ejaculate first, either by masturbating with his partner or by himself, then a second ejaculation a few minutes later will be slower and more satisfying. There are books or qualified sex therapists to help.
Sometimes a man has difficulty reaching orgasm with a partner, even though he has no trouble becoming hard and no trouble when he masturbates. There is usually a psychological reason for this. He may feel guilty about sexual activity, or afraid of making a woman pregnant or getting a sexually transmitted disease. Talking to your partner about what you like and what feels good can help a lot. If you need help, this type of difficulty can usually be treated very successfully by a qualified sex therapist.
You can learn more about sexuality by reading books and pamphlets, or talking to a counsellor or doctor. You can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
Many women have concerns about their sexuality. They wonder if they are normal, or why they have trouble having orgasms, or whether they don't enjoy sex as much as other women do, or why intercourse is sometimes painful.
There is a wide range of behaviour and desire. Some people like different positions, different techniques, and others don't. Whatever a woman likes is normal for her. She does not have to do what she believes other women do. It is wrong to force another person into any unwanted sexual activity. Force and abuse are criminal acts.
Common worries are not having an orgasm or not enjoying sex. These can be helped if a woman understands her body and can communicate with her partner. She can learn what feels good, and what she doesn't like. The clitoris, just above the vagina, is the source of most sexual pleasure. During intercourse the clitoris is not usually touched in the way a woman needs. A woman or her partner can stimulate her clitoris during "foreplay" or intercourse, or after the man ejaculates, to help her have an orgasm. She can discover what gives her the most pleasure, either with her partner or alone through masturbation. What a woman likes can change during a lifetime.
When a woman is stimulated, her vagina becomes moist. This natural lubricant makes intercourse easier. Some people use a water-based lubricant to add even more moisture. This can be bought at a drug store, (never use petrolium based lubricants).
A woman can communicate her feelings and desires to her partner through words or body language. Partners will probably find that if they can communicate, they will have more pleasure and satisfaction.
Fear of pregnancy, getting a sexually transmitted disease or being caught can all keep a person from enjoying sex. Feeling tired, stress, illness and alcohol also affect sexual feelings. Negative sexual experiences, such as abuse, rape or just being taught that sex is dirty or wrong all have lasting effects. But sometimes there is a physical problem that a doctor can treat. Psychological problems can nearly always be helped by a qualified sex therapist.
You can learn more about sexuality by reading books and pamphlets, or by talking to a counsellor or doctor if you have questions. You can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
Some people think they will never get a sexually transmitted infection or disease, that is, an S.T.I. You may think that only others get Gonorrhea, Herpes, Chlamydia, AIDS and other infections. If you are having a sexual contact, you may be running a risk. Protect yourself and your partner.
Some S.T.I.s can't be cured. Sometimes there are no signs, or they develop very slowly, without your knowing they are there. If they are not treated, they can cause serious health problems or even death. This is why you need to know how to avoid them.
S.T.I.s can pass from person to person during sexual contact. You can get an S.T.I. from vaginal intercourse, oral sex, anal intercourse, sharing sex toys and mutual masturbation. You cannot get an S.T.I. from toilet seats or dirty clothes. The more people you or your partner have sex with, the greater your chance of coming in contact with an S.T.I. Just like a cold or the flu, if you are exposed to an S.T.I., you can catch it, no matter how clean you are. You can only be sure you will not get an S.T.I. if you or your partner have never had sexual contact except with each other.
If you are sexually active, the best protection is to be with only one person who is only with you. If you have more than one sex partner or if you start a new relationship, use latex condoms and a "barrier method" such as a diaphragm, cap or sponge. When used properly, latex condoms help stop S.T.I.s from spreading. Contraceptive foam, cream, jelly or the sponge give additional protection.
You or your partner may think condoms are unromantic and a bother. Remember, an S.T.I. is a lot more unromantic. So be prepared; use a condom. You can say, "I don't want to take chances, so let's use this condom." Or, "Since we don't have a condom, let's make out some other way besides having intercourse." Don't have contact with sores, rashes, sperm, blood, or vaginal fluids. Talk with your sex partner beforehand so that you don't feel embarrassed about being careful. Washing and urinating before and after sex may also help reduce risk.
There is no way to be sure that someone doesn't have an S.T.I. just by looking at their genitals. However, if you do see a sore or an unusual discharge on the genitals, don't take any chances. Say "NO" to sex until a doctor says your partner is okay. Explain your reasons to your partner and encourage a visit to a doctor. Don't risk getting an S.T.I.
The following might be warning signs of a sexually transmitted illness:
- unusual discharge from the penis or vagina
- pain in the genitals or
lower abdomen
- Itching, sores or bumps on the genitals
- Unusual
bleeding or bleeding after intercourse
- A bad smell
Remember, people often have no sign or symptom. They can pass infections on to someone else without knowing it. So if you are sexually active, being tested at least once a year will help prevent spreading S.T.I.s.
If you do get a sexually transmitted illness, get treatment right away. Your sex partners will also have to be treated. If you want, your doctor or Public Health Unit will tell them without using your name. This is the only way to stop the spread of sexually transmitted diseases and the serious health problems they cause.
You can get more information from the Facts of Life Netline messages on the different types of S.T.I.s. If you want to talk to someone or find out where you can get tested, you can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
A latex condom is one method of birth control and one of the best ways to protect yourself from sexually transmitted diseases. They can be bought at a drug store or clinic without a prescription or a doctor's examination. Some public washrooms have condom machines.
Condoms, also called "rubbers" or "safes", are thin coverings usually made of latex, which fit over a man's erect, hard penis. They may be smooth or textured, lubricated, coloured or even flavoured. Latex condoms prevent pregnancy by keeping semen from getting into the woman's vagina. They also help prevent sexually transmitted diseases during both vaginal and anal intercourse.
Some people think that condoms interfere with sexual pleasure. However, latex ones are very thin so they do transmit body heat. Even if they do interfere, they provide great protection for both yourself and your partner -- a small price to pay to prevent unplanned pregnancy and sexually transmitted disease.
To be most effective, condoms should be used with "contraceptive" or "spermicidal" foam, jelly or cream, and another "barrier method" such as the cap,diaphragm or sponge, every time you have vaginal intercourse. Contraceptive foam, jelly and cream contain Nonoxynol-9 which kills sperm and some of the germs that cause sexually transmitted diseases. Note that the contraceptive foam is different from "feminine hygiene" products like douches and sprays. These other products are useless for birth control or preventing sexually transmitted diseases.
When people use a new condom with contraceptive foam correctly every time and the condom does not break or slip off less than one out of every 100 women will get pregnant.
Condoms are wrapped in individual packages. The condom must be removed and unrolled over the penis as soon as the man has an erection, before there is any contact between the penis and the vagina, anus or mouth. Early semen or fluid contains sperm, and can start a pregnancy even without ejaculation.
It is important to leave a space at the end of the condom with no air in it so that the semen or "come" can collect there. To do this, pinch the tip of the condom and hold it as the condom is rolled down the penis. A condom that is pulled too tightly over the head of the penis is more likely to break. Use a fresh condom every time you have intercourse. Every package should have a date stamped on it; don't use the condom if that date has already passed. Don't leave them in a wallet, car glove compartment or other place that gets hot; heat damages the latex. Condoms that are old or damaged should be thrown away. But don't inflate the condom first to check it, as this can damage the latex also.
After the man ejaculates or "comes" he should withdraw his penis before he loses his erection. Hold onto the condom at the base to keep it from slipping or spilling.
Some people use a "lubricant" to increase moisture and feeling. Use only water-based lubricants such as Astroglide or KY Jelly. You can buy them at a drug store. Do not use vaseline, baby oil or other lotions or oils -- they break down the latex.
For further information, you can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
Chlamydia is the most common sexually transmitted disease, and is especially common in people under age 25. It is caused by bacteria and is spread by having sex with an infected person. Chlamydia can be very serious if it is not treated with antibiotics.
A woman with chlamydia may have a slight discharge from her vagina, or she may have itching and burning in her vagina. She may have a burning feeling when she urinates, or pain in her lower abdomen. A man with chlamydia may have a discharge from his penis or a burning feeling when he urinates. Many men and women don't have any symptoms, and pass the infection without realizing it. If they do not get treatment, their reproductive organs may be permanently damaged.
In women, chlamydia infections that are not treated may lead to ectopic, or tubal, pregnancy, a dangerous condition. Chlamydia may also cause pelvic inflammatory disease, or P.I.D. This serious infection may prevent a woman from becoming pregnant when she wants to. Signs of P.I.D. are fever, a smelly vaginal discharge or severe abdominal pain. If you would like to know more about P.I.D., listen to that message in the Sexually Transmitted Diseases Menu.
In men, the infection can spread to the testicles, or balls, and may cause sterility, that is, being unable to father a child.
If you find out you have chlamydia, you must make sure your sex partner or partners are treated as well. This is the only way to stop them from passing it on to someone else or back to you.
Chlamydia is treated with an antibiotic, such as tetracycline. Be sure you take all the medication, and follow the directions carefully. Then have a follow-up test after the antibiotic is finished to be sure that the treatment has worked.
There are ways to protect yourself against chlamydia. If you don't have intercourse, or have intercourse with only one partner who is not infected or who has intercourse only with you, you will not get chlamydia or any other sexually transmitted disease. However, if you do have more than one sex partner or if you are starting a new relationship, protect yourself. Do not touch sores, rashes or body fluids.
The best protection is to always use a latex condom and another "barrier method" such as the diaphragm, cervical cap or sponge. Contraceptive foam, cream or jelly provide additional protection. Everyone who is having sexual intercourse should be tested for sexually transmitted diseases at least once a year -- especially if they have more than one sexual partner at a time or change partners during the year.
Remember that chlamydia doesn't always have symptoms -- that's why getting tested is so important! So is getting treatment for yourself and your sex partners. If you want, your doctor or Public Health Unit will tell them without using your name.
For further information you can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
Gonorrhea, also called "the clap", is caused by bacteria. It is easily passed from person to person during sex. You can't get gonorrhea from kissing, holding hands or toilet seats. You can get gonorrhea by having vaginal or anal intercourse, or oral sex with someone who has it. It can affect the penis, cervix or opening to the womb, rectum or anus, throat and eyes.
Gonorrhea will not go away by itself. If it is not treated, gonorrhea causes serious health problems. In women it can cause an infection in the uterus, or womb, and tubes. This infection may cause infertility, that is, a woman can't get pregnant. A woman who has gonorrhea when she gives birth may infect the baby; the infection can cause blindness in the child.
Unfortunately, you can have gonorrhea and not know it. You may not see any signs or symptoms. Sometimes the symptoms do not seem serious, so you may ignore them. The symptoms usually start one or two weeks after you come into contact with gonorrhea.
A man may notice a yellowish discharge from his penis or feel pain when he urinates. A woman may notice an unusual vaginal discharge between periods. This discharge may be a different colour or smell, and there may be more of it than usual. A woman may also have pain in her lower abdomen. But many women have no symptoms at all.
The only way to know if you have gonorrhea is to be tested. A Public Health or family planning clinic can provide free, confidential testing and treatment. The test is simple and painless. A doctor or nurse will take a sample of discharge from your penis or vagina. For a woman, this means having an internal examination.
If you have gonorrhea, you will be given an antibiotic medicine. It is very important that you take all of this medication and follow all instructions. You also need to have a follow-up test done after you finish the medicine. This is the only way to make sure you are cured.
If you have gonorrhea, all your recent sex partners also need to be tested. If they have gonorrhea, they need treatment. If they do not get treatment, they can pass gonorrhea on to other people, or back to you. You can get this infection every time you are exposed to it. You can tell your partners yourself, or the Public Health Unit can do it for you without mentioning your name.
There are ways to avoid getting gonorrhea. If you have sex with only one person who only has sex with you, and neither of you has gonorrhea, then you will not be exposed to it. If you have more than one sex partner or if you have a new sex partner, use a condom. Condoms can help stop gonorrhea from spreading. Some professionals think that "contraceptive" foam, cream or jelly give additional protection. Be prepared: have a condom with you. Be safe. If you have more than one sex partner, use condoms. If you think that you or your partner may have gonorrhea, get tested right away. You can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
Genital warts are caused by the Human Papilloma Virus or HPV which can be spread during sexual intercourse.
Warts usually develop 2 to 3 months after you have been in contact with the virus. They may be so tiny that they can't be seen. Or, they can grow inside your body where you can't see them. They might be on or around the penis, vagina, cervix or opening to the womb, mouth or anus. Genital warts look like ordinary skin warts. They may be soft, pink and look like small cauliflowers, or they may be hard, yellow-grey and smooth. You can have just one wart or large groups of them in one area.
If they are not treated, warts can multiply quickly. Warts on the outside of your body are treated by painting them with a special medicine. Warts on the inside can be removed by a doctor.
Your sex partners should be checked to see if they have warts. Children born to mothers with genital warts may develop them.
There is unfortunately no cure for HPV. Once someone has the virus they always carry it with them, and can pass it on, even if there are no visible warts.
Some types of wart viruses seem to be related to cancer of the cervix. Women who have had sexual intercourse should have a test called a "pap smear" at least once a year to test for this type of problem.
Using a latex condom every time you have intercourse may help stop the spread of genital warts. But remember, it only protects the area it covers. Some professionals also think that using contraceptive foam, jelly or cream may help too.
If you think that you may have genital warts, your doctor or a clinic can help you. Or you can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
Herpes is caused by a common virus which spreads from person to person, usually during vaginal or anal intercourse, or oral sex. It is related to the virus which causes cold sores on the mouth.
Genital herpes can cause painful blisters that appear between 2 and 360 days after having sex with an infected person. Blisters develop where the virus entered the body: usually on the penis, testicles, thighs, buttocks, vaginal opening, or inside the vagina or the anus. Other signs can include fever, headaches, swollen glands and trouble urinating. Women may feel pain in the lower abdomen. There is itching or tingling and the blisters swell, then burst. Then they become painful sores that do not heal for a few weeks.
Even after the blisters have healed, the virus is still in the body and may cause a new outbreak of blisters later on. These are usually much milder and do not last as long. Illness, stress or many other things can lead to a new outbreak. Not all people with genital herpes have reported outbreaks, but most do.
Herpes is very contagious from the first sign that blisters are about to appear. Do not let the herpes blisters touch any other part of the body -- yours or your partner's. If you do touch an infected area, wash with soap and water immediately.
Even using latex condoms during intercourse may not be enough to prevent the virus from passing from one sex partner to the other. The only sure way to prevent herpes from spreading is not to have any physical contact with the infected area. You need to talk with your sex partner. Honest and open communication can help you and your partner take steps to prevent herpes from spreading.
If you get pregnant, it is very important to tell your doctor about herpes. Herpes can be transmitted to the baby during delivery. You need special medical attention to avoid these problems.
Although there is no cure for herpes, there are ways to relieve the pain and discomfort. "Sitz baths" and warm or cool compresses often help. There are drugs to speed up the healing of the blisters. If you think that you have genital herpes, here are some tips:
For more information or to find out where to get help, you can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
Syphilis is a sexually transmitted disease caused by bacteria. These bacteria are passed from person to person, usually during vaginal or anal intercourse, or oral sex. Syphilis is spread by contact with sores, rashes, saliva, semen, blood or fluids from the vagina of someone who already has it.
The early signs of syphilis appear 3 or 4 weeks after exposure. A hard, round sore appears on the genitals or sexual organs. This sore, a chancre*, or kankar, appears where the bacteria entered the body. It looks like a small red crater. Men usually get them on the penis. Women get them around the outside or on the inside of the vagina. Therefore, women don't always know it's there. Chancres on the mouth and other parts of the body may be painful, but are not always a sign of syphilis.
The sores do go away on their own in a few weeks. 2 to 5 months later, the syphilis bacteria start to cause problems in other parts of the body. You become tired, feverish and lose your appetite. You usually get a skin rash or notice that patches of hair fall out. In a few weeks these symptoms also go away.
You may never have any other sign of the disease, however it may keep on attacking parts of your body. Syphilis can cause permanent, serious damage to your heart or brain and, eventually, can cause death. It can also pass from a pregnant woman to her fetus, causing birth defects.
Your doctor or Public Health clinic can do a free, confidential test for syphilis by taking a blood sample. It takes a while for syphilis to show up in your blood. If you think you were in contact with syphilis, but your blood test is normal, have another blood test in 6 weeks. All pregnant women are tested for syphilis.
If you do have syphilis, it can be treated with an antibiotic such as penicillin. It is important to complete all of the treatment. You must also have follow-up blood tests to make sure you are cured. All of your sex partners must be tested and treated at the same time. This is the only way to stop them passing syphilis on to someone else or back to you. The Public Health Unit can provide treatment, and can contact your sex partners without using your name if you want. You should not have sex until your follow-up blood test shows that you are cured.
There are ways to protect yourself from getting syphilis in the first place. If you have sex with just one partner who is not infected and who only has sex with you, you will not be exposed to syphilis. If you have more than one sex partner, or if you start a new relationship, use a latex condom for intercourse or oral sex to help stop the bacteria. Some professionals think that using contraceptive foam, jelly or cream may also help. If your partner has a sore or any other sign of infection, or if your partner was exposed to syphilis, do not have sex until a doctor says it's okay.
Syphilis is not a very common disease any more, but it is very serious. You can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
*chancre is pronounced "shang'-kar"
AIDS stands for Acquired Immune Deficiency Syndrome, and HIV stands for Human Immunodeficiency Virus.
A person who has AIDS has one of about 21 AIDS-related illnesses and they have the virus called HIV. Having HIV is also called being HIV-positive.
HIV is carried in blood, semen, fluids from the vagina and other body fluids. You can get AIDS when enough HIV gets into your blood. HIV can enter your body through even the tiniest cut or opening. The virus spreads through your body and attacks your immune system. This means that your body can't fight off illness. There is no known cure.
People usually don't have signs when they get HIV. Some people with the virus live for many years with no visible signs of it. They have the virus but seem healthy. After some time, some people who are HIV positive, develop illnesses like cancer or pneumonia which are AIDS-related and can lead to death. People who have HIV can pass it on to you through sexual activity even if they are healthy!
There are only a few ways to spread HIV. And, there are lots of ways it can't be spread. You cannot get the virus through ordinary, day-to-day contact with someone who has AIDS. You cannot get the virus by touching someone who has AIDS or by sharing cooking utensils. You cannot get the virus by taking care of an infected person. You will not get it by donating blood, as a new needle is used each time. Be sure that your dentist, doctor or hygienist wears gloves.
There are some activities which put you at a high risk of getting HIV from an infected person. The first is having anal or vaginal intercourse without using a latex condom. The second is by sharing needles to inject drugs. There is also a small risk of getting the virus through oral sex on a man, oral sex on a woman if she is having her period, and deep kissing if there are open cuts or sores in the mouth. Otherwise there are no known cases of HIV being spread by kissing.
Many sexual practices cannot spread the virus and are perfectly safe. These include hugging, necking, petting and mutual masturbation. The virus can be passed from an infected pregnant woman to her fetus or by an infected mother who is breastfeeding her baby. In the past, some people got HIV through contaminated blood during blood transfusions. Since 1985, all blood used in transfusions in Canada has been tested for HIV. AIDS is not a "gay" disease. It can attack anyone who absorbs body fluids from an infected person. It does not matter who you are; it only matters what you do. Latex condoms can help stop the spread of HIV and other sexually transmitted diseases, and they also help prevent pregnancy. So, protect yourself and your partner by using them, correctly, every time. There is a blood test to tell if you are infected with HIV: the HIV antibody test. A positive test result means you are infected with HIV, but does not mean you have AIDS. A negative result means that no HIV antibodies were found in your blood. But, since the antibodies can take 14 or more weeks to appear, another test must be done later. Testing may be done anonymously, that is, without giving your name. You can protect yourself from HIV and AIDS by not having sex or by discussing AIDS with your sex partner and having safer sex. Use a latex condom. Some professionals think that contraceptive foam, jelly or cream may provide additional protection. If you use I.V. drugs, try to avoid sharing needles. If you do share needles, make sure they are properly sterilized before each person uses them. Avoid sharing anything that pierces the skin such as a razor or tattoo needle unless you are sure they have been properly sterilized. For more information about AIDS and HIV, you can call the Ontario AIDS Hotline, 1-800-668-AIDS. Or, you can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
"Crabs" are small, crab-like lice that live in pubic hair and occasionally in the hair of the armpits, eyelashes and eyebrows. They crawl onto you during close physical contact with someone who has them. But you can also get them by sharing bedding or clothes with someone who already has them.
The main symptom is intense itching caused when the lice bite you so that they can suck your blood. You may also notice small black spots or bloodstains on your underwear. Although they are tiny, crabs can be seen without a microscope. You can also feel their eggs, little lumps at the base of hair.
To cure crabs, you have to use a non-prescription lotion or shampoo which you can get from your doctor, clinic, or drug store. Follow the instructions carefully. Use a fine toothed comb or your fingernails to scrape the eggs off the hairs. Tell your sexual partner or anyone that you share clothing or a bed with to also get treatment. Avoid close contact until both of you are cured. You may need to repeat the treatment after one week.
After treatment, you must wash all clothing, towels and bedding in hot water. Crabs die within 24 hours after leaving your body, but their eggs will live longer.
Scabies, often called "the Itch", are mites or members of the spider family. You can only see them under a microscope, but they cause intense itching. The female digs into the skin to lay her eggs, usually on a person's hands, wrists or genital area. This leaves marks that look like scratches. The mites are spread through any body contact, and often affect whole families. Using a special lotion on the entire body is usually enough to get rid of the scabies.
If you think you have crabs or scabies, get medical advice. See a doctor or go to a clinic or a drug store. You can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
Trichomoniasis, also called "trich", is a common infection caused by a germ that is usually passed from one person to another during sexual intercourse. This germ can live up to 24 hours on wet clothes or towels, so it may be possible to pass it from one person to another by sharing these items.
Trichomoniasis is usually not dangerous. Women may not see any signs that they have trich, and men usually don't see any signs. If a woman has symptoms, they can include a frothy, bubbly yellow or greenish-white discharge from the vagina, which may be worse after sex. This discharge may have a bad smell. A woman may also have itching around the vagina and a burning feeling when she urinates.
To test for trichomoniasis, a doctor will do a pelvic exam and look at the discharge from the vagina. Since men usually don't have symptoms, they usually find out that they have trich only when their female sex partners are tested. It is important that all sexual partners get treated at the same time or the germs will just pass back and forth between partners.
Trich is easily cured using a drug called Flagyl, taken as pills. There can be side effects: some people feel nauseous, but taking the pills with food often helps. Alcohol reacts with the drug and makes some people feel very ill; doctors suggest that people taking Flagyl not drink alcohol while taking the pills or for 2 days afterwards. Do not take Flagyl if you are pregnant or breast feeding. And do not take Flagyl if you have taken Seldane or Hismanal within the last month.
It is recommended that you have a second test to make sure the infection has gone away. Do not have sexual intercourse until you and your partner have been cured.
Here are some tips to make you more comfortable:
Trichomoniasis is usually not a serious infection but it can be painful and a nuisance. It does not affect a woman's ability to get pregnant later.
For information, testing or treatment of trichomoniasis, see a doctor or go to a clinic. You can also call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
Hepatitis B is a serious infection of the liver, caused by a virus. This virus is found in the blood, semen, fluids from the vagina and saliva of the infected person. The virus can be passed from person to person during sexual contact, or by sharing personal items such as toothbrushes, razors or needles. A pregnant woman can pass hepatitis on to her fetus.
The signs of hepatitis include tiredness, nausea, loss of appetite, abdominal pain, and jaundice. Jaundice means that the skin, whites of the eyes, urine and stools all may become yellow. Sometimes hepatitis has no symptoms.
Doctors and clinics can test for hepatitis by taking a blood sample. There is a safe vaccination to help prevent infection. It is a series of three needles, given over several months. It is wise to become immunized before having sex with anyone who might have hepatitis B.
There is no medical cure for hepatitis. It may take weeks or even months, but most people get better, and are no longer contagious. However, some people become carriers of the virus and must avoid transmitting infection. Following a special diet and avoiding alcohol may help you recover if you get the virus.
If you think you have hepatitis, see a doctor or go to a clinic to be tested. For more information, you can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
Gardnerella is a kind of bacteria which grows in the vagina and anus. It may be passed from one person to another during sex. Too much of this bacteria can cause annoying symptoms, especially in women. These include mild itching or burning, and a fishy smelling discharge. The discharge can be worse after sex. Some women have no symptoms, and men usually have none.
A clinic or doctor can test females for Gardnerella by taking a vaginal swab. Males are not usually tested.
Treatment is recommended only if the infection is annoying. Some doctors prescribe a single dose of Flagyl to be taken with food or milk. Do not drink alcohol for 48 hours before or after the medication, as this can cause nausea and vomiting. Do not take Flagyl if you are pregnant or breast feeding. And do not take Flagyl if you have taken Seldane or Hismanal within the last month. Some women find it helpful to put yogurt capsules, called lactobillus, into the vagina for 5 to 7 nights. These capsules may be purchased at health food stores and stored in the refrigerator.
You may have sex again after you are treated. But use condoms for at least a week until the bacteria are flushed out of your system.
A woman can practice good vaginal hygiene by wiping herself from front to back after using the toilet, not the other way around. Using douches, deodorant pads or tampons can change the normal state of the vagina and allow too much bacteria.
Follow-up testing is not necessary if the symptoms have gone away.
If you want more information, call a doctor or clinic. You can also call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
Pelvic Inflammatory Disease refers to swelling and infection in any of a woman's womb or uterus, fallopian tubes, ovaries, or the covering around them.
If it is not treated, PID has serious, long-lasting effects. It can cause scarring in the infected areas and great pain in the lower abdomen. The scarring can also block the fallopian tubes which lead from the ovaries to the uterus. If this happens, a woman may not be able to get pregnant or, if she gets pregnant, the pregnancy may start in one of the tubes instead of her uterus. The woman might then need to have an emergency operation.
Although most women recover from PID if they are treated quickly, if they don't get treatment PID may be difficult to cure.
PID is related to sexually transmitted diseases. Gonorrhea and chlamydia, for instance, can travel into the uterus and produce PID. Anything that allows germs to get into the uterus might help produce PID. Douching may drive bacteria from the vagina into the uterus. Any time the cervix is opened or a medical instrument is used in the uterus, there is a chance of getting PID.
New types of IUD's, or Intrauterine Devices, are much safer than the old types; however, the string which hangs down from an IUD can allow bacteria to travel up into the uterus. PID is also more likely to occur if a woman has several sex partners.
PID is a serious problem, but there things you can do to lower the chance of getting it, like using condoms and finding other ways to practise safer sex.
If you notice any of these warning signs, get medical attention. Call your doctor or a clinic, or go to a Hospital Emergency Department. Or, you can call your local Public Health Unit -- see References/Resources.
Vaginal infections are common. Most women will experience this at some time in their lives, even if they keep themselves very clean. They can learn to tell the difference between vaginal discharge, which is normal, and vaginal infection which should be treated.
Just as your mouth is always wet with saliva, a vagina is always wet with fluid. This fluid is important, because it cleans out germs and old cells. It is usually clear or white, and has very little smell. There is usually more of it about two weeks before your menstrual period. This is normal, and one sign that a woman can become pregnant.
If is some vaginal discharge which is not normal it should be treated. If it causes itching or irritation, if it is mixed with blood or has a strong or unpleasant smell, if there is so much of it that it becomes annoying, there might be an infection.
Most vaginal infections are not sexually spread, but are caused by a fungus. Yeast is normally found in a vagina, but may for some reason get out of control. The most common vaginal infection in women is caused by yeast, or monilia or candida.
A woman can find out if she has a vaginal infection by going to a doctor or a clinic. During her appointment, she is examined and a sample of the vaginal discharge is taken. If infection is there, treatment may be pills, creams, suppositories, or a special douche. Sometimes sex partners need to be treated at the same time, to stop the infection from being passed on or back to her. She may be told not to have intercourse or to be sure the man wears a condom during intercourse, until the infection is completely gone.
Here are some things you can do to help prevent vaginal infection:
For a test or treatment, you can go to a family planning clinic or your doctor. For more information, you can call your local Public Health Unit -- see References/Resources.
If a couple decides to have sexual intercourse, but doesn't want to start a pregnancy, then they can use birth control or contraception. What is best for one couple may not be suitable for another. There is no contraception that is 100% effective. However, some methods can be very effective if they are used properly.
Making mistakes or "taking chances" by not following instructions carefully makes any method risky.
Pregnancy can start almost any time. A woman can get pregnant,
These are some of the reasons why 85 to 90 of every 100 women who don't use birth control when they have intercourse get pregnant within one year. That's up to 90%! So, the question is, "Which method would we use carefully, every time?"
Do you have sex often? Would it be easier to use a method that's only needed when you have intercourse, like condom and foam, or a diaphragm and jelly? Or would it be easier for you to remember to take a pill at the same time every day? (Remember that the pill doesn't prevent sexually transmitted diseases.)
There are many types of birth control. Some can be bought at the drug store without a prescription, for instance condoms and foam or the sponge. For others, such as the diaphragm, birth control pill, IUD, cervical cap, Depo-Provera or Norplant, you must see a doctor or health care worker. Natural Family Planning requires cooperation and training for both partners. This is not the same as the old rhythm method, counting days on a calendar. Many people, after they are sure they don't want children in the future, consider permanent sterilization.
Another method of preventing pregnancy is not including sexual intercourse in your lovemaking. Many couples find that creative sexual stimulation is as exciting and satisfying as intercourse. You might want to read the message on Outercourse, in the Sexuality Menu.
You may have heard of other methods of birth control. Withdrawing the penis just before ejaculation has a high failure rate. Breast feeding cannot be counted on to prevent pregnancy. Douching can actually speed the sperm on their way.
So, if you don't want to start a pregnancy, you need to choose an effective birth control method that suits you and your partner. Think about the following questions:
The type of birth control you choose now may not be the right method for you in a year, or even next month. As you and your lifestyle change, your birth control needs may change too. Some women have side effects with some types of birth control, and have to change methods. The best method is the one you will use correctly and safely.
If you want to talk with someone about birth control, you can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
There are several birth control or contraceptive methods available today, each with advantages and disadvantages. Many of the methods used to prevent pregnancy may, along with the use of a latex condom, help prevent sexually transmitted diseases.
Each method has been studied to see how effective it is. Researchers find out how many women get pregnant when they use a method for one year. If 100 couples use the same method and 3 women get pregnant, there is a 3% failure rate. Sometimes, you will hear about effectiveness rate. If 3 out of 100 women get pregnant, there is a 97% effectiveness rate. That's 3 subtracted from 100.
The effectiveness of any method of birth control depends greatly on how carefully it is used. If used correctly every time, most methods are very effective. Because we can forget or make mistakes or take chances, it is very difficult to say exactly how effective a method is.
You will notice that none of these is 100% effective. There is no perfect contraception. But, any of these methods can be highly effective if used correctly and regularly.
Some methods are not recommended. One is "withdrawal", when the man pulls his penis out before he "comes" or ejaculates; however, it is better than nothing. The old rhythm or calendar method is about 12 to 20% effective. Breastfeeding is unreliable. Douching may even have a negative effect, by speeding sperm on their way. Using no method is only 10% effective over one year. That is, 9 out of 10 couples using no method for a year will start a pregnancy.
Any type of birth control has to be used carefully every time, to give the best chance forsuccess. That is why it is important to choose the method that is best for you and your partner.
If you would like further information about birth control, you can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
One of the best methods of birth control can be used without seeing a doctor. Condoms and spermicide can be bought at any drug store. Used properly, this method is over 99% effective in preventing pregnancy, and extremely effective against the spread of sexually transmitted diseases. It is therefore highly recommended.
Spermicide comes as foam, cream or jelly. The active ingredient is Nonoxynol-9 which kills sperm and may help stop some sexually transmitted diseases.
Contraceptive foam comes in a small can. The first package you buy should have an applicator. Then you can buy refills. You might want to have a second can with you, since it is difficult to tell when it's getting empty.
Use foam twenty minutes or less before intercourse. Remove the cap of the can. Shake it well. Next, fit the applicator over the top of the can. Insert one applicator full of foam into the vagina.
If you have sex again, use more foam. When buying foam, make sure that the package says "contraceptive" or "spermicidal". It may look like other feminine hygiene products which are not effective as birth control.
Foam is not poisonous. Sometimes it can cause skin irritations or rashes. You can switch to another brand. Remember to check the expiry date on the package.
Contraceptive jelly and cream are sold in tubes. They are used like foam. Buy an applicator with the first package, and then just buy refills. Remove the cap, fill the applicator and insert the jelly or cream into the vagina.
Condoms should be latex. They are available in many forms: smooth or textured, coloured, even flavoured. Some brands are slightly larger or thinner than others. Don't test the condom for holes; you may damage it. Be careful that fingernails don't tear it. Never re-use a condom. If you use a lubricant, make sure that it is water-based. Vaseline and other oil-based lubricants damage latex. Don't store condoms where they'll get hot -- in a wallet or glove compartment -- heat can also damage them. Check the expiry date on the package.
A condom should be used as soon as the man has an erection. There is sperm in early semen, before ejaculation. Remove the condom from its package. Squeeze the tip of the condom, to leave a space for the semen. Then roll the condom down to the base of the penis. After ejaculation, a man should withdraw before he loses his erection. Keep a fingeron the condom while withdrawing to prevent spilling the semen.
Condoms are thin and transmit body heat. Using condoms and spermicide can become part of lovemaking. Even if it reduces the enjoyment of sex slightly for some couples, it also shows that you respect your partner. Respect yourself and make sure that you are respected. You can say, "If we can't use a condom then we can make out some other way besides intercourse". There are other ways to express love and attraction.
In case the condom breaks, there are two methods available to stop pregnancy. Read the message on "The Morning After Pill and Post-Coital IUD", in the Birth Control Index, for more information.
For more information go to a clinic or see a doctor. Or you can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
Birth control pills usually contain 2 female hormones called estrogen and progesterone which stop the ovaries from releasing an egg, or ovum. They also cause other changes in a woman's body which make pregnancy very unlikely. Used correctly, it can be more than 99% effective. "The Pill" does not protect against sexually transmitted diseases.
If a woman wants to go on The Pill, she has to get a prescription. The doctor will first ask questions about her health, her family's health and whether she smokes. If she starts, she will need to know exactly how to take it. She will not be protected from pregnancy for the first month, and should use a back-up method of birth control such as latex condoms with foam.
She needs to know which day to start taking the pills, and when to start the next pack. She will always start a new pack on the same day of the week. If she takes the first pill on a Sunday, she will always take the first pill of every pack on a Sunday.
There are two kinds of pill packages: 21 day and 28 day. Both kinds have 21 pills with active ingredients. A woman who takes the Pill according to the instructions is protected from pregnancy every day, even if she is using a 21-day Pill. In a 28-day package, the last 7 pills contain no hormones; they just help a woman stay in the habit of taking the pills properly every day. With a 21-day Pill, she doesn't take any pills for 7 days after completing a pack. She then starts her next pack.
It is normal for menstrual periods to become lighter, or even for a woman to skip a period while on the Pill.
The Pill is most effective if it is taken properly. Here are some guidelines to follow:
Many women notice some changes in their bodies when they go on the Pill. Tell your doctor or go to a clinic if any of the following changes are upsetting or a problem: nausea, headaches, breast tenderness, weight gain, spotting or bleeding during your cycle, irritability, depression or other mood changes. Some of these changes are no problem, and most of them go away in 2 or 3 months when the body gets used to the Pill. But some women may need to switch to a different type of pill, or use another method of birth control.
The Pill can cause very serious problems for some women, especially women who smoke. There is a slight risk of high blood pressure, blood clots, heart attack and stroke. Some women who have high blood pressure or diabetes may not be able to take the Pill.
The warning signs of serious problems when a woman is taking the Pill are severe abdominal pain or cramps; chest or stomach pain; shortness of breath; coughing up blood; severe headaches; pain, tingling, swelling or numbness in the leg; and blurred or temporary loss of vision. If you notice any of these signs, get to a doctor or clinic right away.
There is no evidence that the Pill causes cervical, uterine or breast cancer. Research on a connection between the Pill and breast cancer has not reached any conclusion yet. There is no evidence that taking the Pill will make it harder for a woman to get pregnant in the future.
Beneficial side effects of the Pill include having clearer skin, having shorter, lighter periods and less menstrual cramping, and a reduced chance of ovarian and endometrial cancers. Many women who get Pre-Menstrual Syndrome find the Pill helpful. There is some protection against breast and ovarian cysts. For many women, not having to worry about pregnancy makes sexual intercourse more enjoyable.
The Pill is a good method of birth control for many women. Remember, it will not protect against sexually transmitted diseases. If you start, be sure to remember to take it at the same time every day, and watch for the warning signs for serious problems! For more information, you can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
The IUD, or intrauterine device, is a small piece of plastic or copper, shaped like a T, which is placed inside a woman's uterus or womb by a doctor. The IUD causes a fertilized egg to leave the uterus during menstruation. It is very reliable: about 99% effective in preventing pregnancy. Once it's in, the IUD is good for 1 to 5 years, depending on the type.
An IUD may not be the best kind of birth control for everyone. Some women with IUDs notice changes in their bodies. These changes can include longer or heavier periods, more cramps, spotting between periods or heavier discharge from their vaginas. These often settle down after their bodies get used to the IUD, but some women decide to have the IUD removed.
For a few women, the IUD can cause serious problems. It is rare, but the IUD can push through the wall of the uterus. Also, if pregnancy occurs with an IUD in place, there is a higher chance of having a tubal pregnancy. But the most serious problem is pelvic infection. You may want to read the message on Pelvic Inflammatory Disease, in the Sexually Transmitted Infections section.
The IUD has a thread on it which hangs down through the cervix. This lets a woman check that the IUD is in place, and makes it easy for a doctor to remove it. The woman should check with her finger every week during the first month after the IUD is inserted, and monthly after that. The IUD doesn't interrupt love-making, isn't messy and doesn't have to be remembered at the same time every day.
The IUD will not prevent sexually transmitted diseases. Sometimes bacteria, such as those causing gonorrhea or chlamydia, will travel up the thread into the uterus. So there is a greater risk of getting a sexually transmitted disease while an IUD is in place. The bacteria can cause a pelvic infection which can leave a woman infertile, that is, unable to get pregnant. However, this happens very rarely if a woman has only one sexual partner or practices safer sex. There is a greater chance of getting a pelvic infection if you have had a pelvic infection or a tubal pregnancy. Some doctors will not insert an IUD in a woman who plans to have children in the future.
If you do try an IUD, remember you might feel abdominal pain and cramps at first. The IUD danger signs include unusual heavy abdominal pain or cramps, heavy bleeding, fever or chills, or unusual vaginal discharge. If you have any of these danger signs, or if you just want more information about the IUD, you can call a local Planned Parenthood organization or a Public Health Unit -- see References/Resources.
Many people wonder if there's a safe time of the month when a woman can have intercourse without getting pregnant. There may be, but you can't know when just by guessing or counting days on a calendar. Pregnancy is possible the very first time a woman has intercourse and at any time during a woman's menstrual cycle, even during her period. Sperm can live inside a woman's body for several days.
Natural Family Planning or Fertility Awareness is not the old "Rhythm Method". It can be used to prevent pregnancy, and combined with other birth control methods for greater effectiveness.
Every month, a woman's body gets ready for pregnancy. An ovum or egg leaves one of her ovaries and travels down her tubes. If the egg meets a sperm, it is fertilized and a pregnancy starts. The egg leaves the ovary about 2 weeks before her period starts; however, this time can depend on things like illness, stress, travel or changes in diet. This means that the egg could leave an ovary a few days earlier or a few days later than usual. For some women this could happen during their period. Once the egg leaves the ovary, it can take a day to travel down the tubes. If it meets a sperm at any time, the woman can get pregnant.
You can see why just guessing or counting days on a calendar can't tell you when the chance of pregnancy is small. The method called Natural Family Planning teaches couples how to tell what days of the month are safest. They learn how a woman's temperature changes during her monthly cycle, how to take it and record it on a graph. They also learn how her vaginal mucus changes during her cycle. People need patience, cooperation and special training to use this method properly. There are courses in some communities for couples to take. You can also get books and pamphlets in libraries and Public Health Units.
If you are interested in learning more about natural family planning or birth control, you can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
Vasectomy is a permanent method of birth control for men. It is a simple 15-30 minute operation which prevents the man's sperm from being released during sexual intercourse.
During a vasectomy, the vas deferens or tubes which carry the sperm are cut and tied. This prevents sperm from getting into semen. When a man has sex, he still releases semen, but the semen doesn't contain sperm. Therefore he can't start a pregnancy.
The operation is done in a doctor's office or the outpatient department of a hospital. A local anesthetic is used, numbing or freezing the genital area.
After giving the man an anesthetic, the doctor makes a small cut on each side of the scrotum, the sac which holds the testicles. The tubes which carry sperm are cut and tied, and small cut is sewn up.
Most men recover from a vasectomy in a day or two. There is pain and bruising, and he will need to take it easy at first. Ordinary pain killers are often helpful.
A vasectomy is not effective right away. There are still sperm in the tubes above the place where they are tied off. After about 6 weeks, the man needs to go back to his doctor to make sure that no sperm are getting into his semen. Until the doctor is sure this isn't happening, the couple should use another kind of birth control, like condom and foam, to prevent pregnancy.
A man's sex drive is affected by a hormone called testosterone which is produced in the testicles. This doesn't change because of a vasectomy. The penis and testicles are not affected. Only two tiny pieces of tubes are removed. Vasectomy is one of the most effective methods of birth control: over 99.9% effective.
You should not have a vasectomy unless you are sure that you will not want children in the future. There is no guarantee that a vasectomy can be reversed, although some men have had this done. The reversal operation is long and difficult and not always successful. Be sure before you decide to have a vasectomy.
For more information about vasectomy, you can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
Sterilization for women, or tubal ligation, is a permanent method of birth control. The fallopian tubes which carry eggs from the ovaries to the uterus are closed off. This operation is often called "having your tubes tied". Some women stay overnight in hospital, while others have the operation done in the hospital's outpatient department.
Tubal ligation is nearly always successful, and very few tubes ever grow back together again. This makes it the most effective method of birth control: over 99.9%. After one menstrual period following the operation, a women can have intercourse without risk of pregnancy.
It "usually" does not affect her menstrual periods, or her sex drive. The uterus or womb is not removed; however, sperm can no longer reach the egg. Some women enjoy sex more when they do not have to worry about pregnancy.
A woman needs a general anaesthetic for this operation and time to recover after she wakes up. Therefore, there is a slightly greater risk with tubal ligation than there is with vasectomy for men. Vasectomies are done under local anesthetic, freezing the genital area, and do not require cutting into the abdomen. You may want to listen to the message on Vasectomies, also in the Birth Control menu.
Some women who have had a tubal ligation try later on to have their tubes reconnected, but it is a long and difficult operation and hardly ever successful. A woman should not have a tubal ligation unless she is sure that she will not want children in the future.
For more information, you can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
What can you do if the condom breaks? What can you do if you had unprotected sexual intercourse, and don't want to become pregnant? What can you do if you have been sexually assaulted? There is something to do if you act quickly.
The Morning After Pill is really four hormone pills. A doctor can prescribe them to a woman who has had intercourse once within the past 72 hours, or 3 days. It will not interrupt a pregnancy from a previous act of intercourse. And it does not protect you from pregnancy for the rest of your cycle. It affects the lining of your uterus or womb so that a fertilized egg can't implant.
A woman is given 4 pills. She takes 2 as soon as possible, and the other 2 pills 12 hours later. Be careful not to sleep through this time!
The pills might cause nausea and vomiting, especially with the second set. Taking a tablet such as Gravol and having something to eat half an hour before she takes the second dose, might help. Then take the second dose with a glass of milk (not water). Some doctors and clinics give a third set of pills in case the second set is vomited. If they are not needed, they should be thrown away.
Other possible side effects can be spotting or bleeding from the vagina, cramps and diarrhea. These are temporary but may last several days. The bleeding is not a menstrual period. The period will probably come when it is due. If it does not, then the woman should have a pregnancy test. The Morning After Pill will not protect you from pregnancy for the rest of your cycle.
The effectiveness rate for the Morning After Pill is very high -- about 98%, especially if taken early; however, a woman should consider what she would do if it doesn't work. Then she may choose to have an abortion or continue the pregnancy.
Many doctors and clinics prescribe the Morning After Pill. You can often get it at the Emergency Ward of a hospital, which is open 24 hours a day. But call before you go to make sure.
The Morning After Pill is simpler than the second option in this situation: a post- coital IUD. Some doctors will insert an IUD in a woman after intercourse to prevent pregnancy. This can be done up to 7 days after unprotected intercourse. You may want to listen to the message on the IUD in the Birth Control Menu.
For more information, you can call a local Planned Parenthood organization or Public Health Unit -- their numbers are listed in the Referrals section of the Facts of Life Line.
Norplant is available in many countries around the world. Since March 1994, Norplant has also been available in Canada.
Women who want a long-term method of birth control but may want to have children in the future might consider Norplant. If you chose Norplant, you would not have to remember to take the Pill every day, or to use contraceptive jelly or foam every time you had intercourse. Norplant costs between $450 and $500 in Canada, which works out to less than $13 a month over five years. Some insurance plans may cover part of the cost.
Norplant is a set of six small capsules or rods, about the size of matchsticks. A specially trained doctor makes a small cut in a woman's upper arm and inserts the rods just under the skin, in a fan shape. This takes 10 to 15 minutes. No stitches are needed, but a bandage will cover the area for a few days.
Once inserted, the capsules become effective within 24 hours, and prevent pregnancy for up to five years. They do not prevent sexually transmitted diseases.
The Norplant capsules release the hormone progestin, also present in many birth control pills. It stops pregnancy in three ways.
First, it helps prevent ovulation, or release of an egg each month. Second, it increases the thickness of the woman's cervical mucus. This makes it harder for sperm to enter the uterus or womb. It also decreases the thickness of the lining of the uterus, also called the endometrium. A fertilized egg needs to attach itself to a thicker lining.
Norplant contains no estrogen. It is therefore an option for women who cannot take birth control pills which have estrogen.
Even though they will work for five years, the capsules can be removed from a woman's arm at any time, for any reason. Removal is also done by a trained doctor. A woman can become pregnant shortly after the capusles are removed.
Norplant is as safe and more effective than the birth control pill. Its effectiveness rate in the first year is more than 99%. This rate gets a little lower in following years, and is slightly lower for women who weight more than 70 kilgrams or 154 pounds.
In the rare instance when a woman using Norplant does become pregnant, there is a slightly higher risk of ectopic or tubal pregnancy. There is no evidence that Norplant causes birth defects.
Many women who use Norplant experience side effects, especially during the first year. The most common side effect is irregular menstrual bleeding. Usually this means longer but often lighter periods, or bleeding between periods. Other side effects can include weight gain, acne, depression, headaches, hair growth and itching around the capsules. Very rarely, there is numbness in the arm around the capsules.
It is very important for a woman considering Norplant to talk to a counsellor. Counsellors can describe Norplant's advantages and disadvantages, possible side effects and suggestions for dealing with them.
Norplant is not a good choice for some women, including women who have liver disease, breast cancer or a history of blood clots. Women who are pregnant or think they might be pregnant should also not use Norplant.
For a woman who is well informed and who protects herself and her partner against sexually transmitted diseases, Norplant may be a good birth control method. For more information, you can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
Some methods of birth control which are available in Canada, might not be that well known. The cervical cap is similar to the diaphragm. It fits tightly over the cervix, partly by suction. A woman must be fitted at a doctor's office or clinic. It should be one third filled with spermicidal jelly or cream six hours or less before intercourse. Then it is left in place for six to 24 hours after the last act of intercourse. The cervical cap, made of latex, needs to be carefully removed, washed and dried after use. Its effectiveness rate is between 82 and 92%, depending on how carefully it is used.
The contraceptive sponge is available at drug stores without a prescription. It can be inserted in a woman's vagina up to 24 hours before intercourse, so many women find it convenient. To use the sponge, first wash your hands, then remove the sponge from its package. Put it under tap water to wet it thoroughly, squeezing it several times until it becomes foamy. This activates the spermicide. Insert the sponge carefully into your vagina as far as it will go, so that it covers the cervix. The sponge provides protection for 24 hours. It should remain in place for 6 to 8 hours after the last act of intercourse. The sponge can't be reused -- throw it away after you remove it. The sponge has a 72 to 91% effectiveness rate, depending on how carefully it is used, and on whether the woman has had a full term pregnancy. Effectiveness is greater for women who have not given birth.
Depo Provera is used as a contraceptive in many countries around the world. In Canada it is approved for other medical purposes, but it is beginning to be used as a method of birth control by some people here as well. It is injected into a muscle every three months to prevent pregnancy. It will not prevent sexually transmitted diseases. "Depo" changes a woman's menstrual bleeding, so that after three or four injections most women will have no bleeding at all.
Great care must be taken to be sure that a woman understands what Depo is, how it works, its effectiveness (which is over 99%), who can use it, advantages and disadvantages. Although some women choose Depo themselves, it has been used in the past to control fertility in other women who did not know what it was or what it might do to them. Many people are still concerned about improper use of Depo.
Some of Depo's benefits may include decreased menstrual cramps, and lower rates of uterine and ovarian cancers. The fact that it is reversible is an advantage. About 80% of women find that they can become pregnant within one year after they stop using Depo. Many women find it extremely satisfactory. But, it doesn't prevent sexually transmitted diseases.
Contraceptive suppositories are available at drug stores. These are inserted into the woman's vagina 10 minutes or more before intercourse so they have time to fully dissolve. Their effectiveness rate is 80 to 85%. When you buy suppositories, make sure that the package says they are for "contraceptive" use.
There is a female condom available in some countries. This gives the woman more control over her own protection. It is a pre-lubricated sheath of latex similar to the condom for men, but has a ring at the bottom end. The top end is closed, and fits over the woman's cervix like a diaphragm. The bottom end is open. It covers the labia, or lips of the pubic area. Like the condom, it is disposable.
Vaginal Contraceptive Film, or VCF, is a semi-transparent square of film which is placed high in a woman's vagina, as close as possible to the cervix. It dissolves into a gel, and remains effective against pregnancy and some sexually transmitted diseases for two hours. It does not need an applicator. It is not yet available in Canada.
RU486, or the "French" or "Abortion" Pill is an alternative to a surgical abortion. It is also being studied as a Morning After Pill. Although it is now being used in some countries, it is not yet available in Canada. In countries where it is available, RU486 can be prescribed by a physician if a woman has decided to abort a pregnancy. The pill is followed by an injection or another pill two days later, and then a check-up. It is a safe and effective method of abortion which does not require surgery.
Scientific research continues, but at the moment, not having intercourse is the only way to be 100% sure a woman will not become pregnant.
At first, a woman may have no signs at all that she is pregnant. The most common early sign of pregnancy is a missed menstrual period. Sometimes a woman has a period, but it is shorter or lighter than usual. If she normally has irregular periods this sign may be hard to notice.
Another sign is having to urinate more often. This is caused by hormone changes and growing pressure on the bladder.
Some women feel sick or nauseous. This may be slight, or may make her throw up. It is called "morning sickness", but can happen at any time of day. Hormone changes cause this also. Eating dry soda crackers before you get out of bed and small, frequent meals may also help.
Breasts may become tender, sore and larger. The area around the nipples may become larger and darker.
Many women feel tired when they are first pregnant and there may be an increase in vaginal secretions.
Another sign is constipation. This is also from hormone changes, and the growing uterus pressing against the bowel. High fibre foods such as prunes, prune juice, bran, or molasses will help.
Having any of these signs does not always mean a woman is pregnant. Stress, illness, a change in diet, doing a lot of heavy exercise and taking the birth control pill can all cause a missed period sometimes. But remember, a woman can get pregnant if she has unprotected vaginal intercourse or misses even one birth control pill in a month.
If you have any of the signs of pregnancy or any other reason to think you might be pregnant, you should have a test done to know for sure. A pregnancy test requires a sample of urine either at a drug store, clinic or doctor's office. Please listen to the message on How to Get a Pregnancy Test, in the Pregnancy Menu for other details.
It is important to know whether or not you are pregnant as soon as possible. You can get the best prenatal care if you plan to continue the pregnancy, or you can get an early abortion if you decide not to continue with it. You can read more about the choices in this situation in the message on Unplanned Pregnancy: Decisions, further down in this document.
In the meantime, look after yourself. Eat well, avoid caffeine, don't smoke, use alcohol, or use any drugs or medication without asking a doctor or pharmacist or clinic if it will affect the fetus. This includes drugs which may be bought without a prescription.
For more information you can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
Even though there are several reasons why a menstrual period might be late, if there is a possibility a woman might be pregnant, she should have a reliable pregnancy test as soon as possible. Other causes of a missed period can be stress, illness, change of diet or routine, or travel.
Most Family Planning Clinics, doctors and drug stores can do a pregnancy test, using a small amount of the woman's urine. The woman may give a sample of urine at a clinic or may take a sample from home. Results are usually ready in a few hours.
At a doctor's office or clinic there is no charge for the test if you have an Ontario Health Card. Some clinics do not charge, even if you don't have the Card. A doctor or clinic will keep all information confidential if you ask. You can also buy a home pregnancy testing kit at a drug store and do the test done at home.
Occasionally, there are false readings. If the test results are negative, or not pregnant, but the woman does not have a menstrual period within two weeks she should have another test done right away.
If the results are negative, or not pregnant, and the woman does not want to have a baby, she can talk to a doctor or counsellor about birth control, to see which method is best for her and her partner.
If the test is positive, or pregnant, the woman has two choices: to continue the pregnancy or to terminate it. The message on Pregnancy Decisions, in the Pregnancy Menu, deals with a woman's choices in this situation. If you are in this situation, you can also talk with someone close to you: your partner, a family member or a friend.
For more information about how and where to get a pregnancy test, you can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
Every year in Canada and the United States, thousands of young women between 10 and 19 become pregnant. Although some teen pregnancies are planned, many are unplanned and therefore mean that difficult decisions must be made.
A high percentage of young women who don't use birth control get pregnant the first month they are sexually active. Some young women don't use birth control because they want to become pregnant. But, many are not trying to become pregnant. Maybe they don't have accurate information to help them choose a good method of birth control, or how to use it properly. Or maybe they don't know where to get it. Others might be afraid or embarrassed to go to their doctor or a clinic, or to buy it in a drug store, especially if they think that they will get a lecture about being sexually active.
Some might not admit to themselves that they are likely to have sexual intercourse and do not prepare for it, or they think, "It can't happen to me." Some feel that planning for sex takes away the romance. Some think that you can't pregnant at certain times of the month, or the first time you have sexual intercourse. Or, they might think the guy will take care of everything.
They may not realize that there are safe and effective methods of birth control. Many methods are actually safer than pregnancy for young women. The chance of problems during pregnancy, such as toxemia and anemia, are higher for a young woman because she hasn't yet completed her own growth period. It takes twenty years to grow!
For many young women, the biggest result of early childbearing may be cutting short their education. Pregnancy is the number one reason that young women drop out of school; it is often difficult to continue or go back. Although most teenage mothers do not marry, those who do face a high chance of divorce within 5 years, often after having a second or third child.
Like women of any age, teenage women who have strong supports around them tend to face fewer problems during and after pregnancy. National studies have shown that teen mothers and their children do much better when they receive economic and emotional support from parents and other relatives. They tend to get better medical care, are more likely to finish school and find work, and are less likely to rely on welfare.
These issues are very complex. There are no easy answers, but there are some ways to help get answers:
You may want to read to other Facts of Life Netline messages on these subjects. Or, you can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
If you had unprotected intercourse less than 72 hours, or three days, ago and you don't want to become pregnant, you can read the message on the Morning After Pill, in the Birth Control section.
If you had a pregnancy test that was positive, that is, it said you are pregnant, but that pregnancy was unplanned, you might be facing one of the most important decisions of your life. This message will talk about the three choices you have:
All three of these choices may have life-long implications. Not one is easy.
But it is the pregnant woman's choice. It must be based on your needs and hopes, on what you decide is right for you now. You must look at what support and help you will have.
Although there may be important people in your life to talk with first, you can't make a decision just to please others. You have to live with your choice, so it must be your decision.
Talking over the possibilities can help sort out your ideas and thoughts. You may want to talk to your partner, your parents, a relative or a friend. Find someone you trust who you think will support you -- whatever decision you make. Or talk confidentially to a counsellor at a family planning clinic.
If you continue the pregnancy, whether you will keep the baby or place it up for adoption, good prenatal care can make the your pregnancy easier, and both you and the baby healthier. Taking care of yourself before the baby's born means eating well, avoiding tobacco, caffeine, drugs and alcohol, getting enough exercise and rest. You can also read the messages about Pregnancy and Childbirth or Teen Pregnancy sections of this document, for more information.
Children can be a great joy. They also need a lot of care for many years. Think about the support and help you will have. Make a budget. Consider your life goals. What will having a child now mean to you, to your education, career, the rest of your family? Is this the right time for you to have a baby?
If you want to place the child for adoption, either with a relative or a friend or someone you don't know, you will need to know your rights and what to expect. More information is given in the message on Adoption on this page.
The third choice, abortion, is legal and safe in Canada. In Ontario, there is no cost to you if you have an Ontario Health Card. If you think you might choose to have an abortion, remember that the procedure is safest and easiest within the first 12 weeks of pregnancy. Very few hospitals or clinics will do abortions if a woman is over 20 weeks pregnant, that is, 20 weeks after the first day of her last menstrual period. Putting off the decision too long can leave no choice but to continue the pregnancy. You may want to read the message on Abortion (see main index).
If you want to talk to someone, you can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
When a man's sperm and a woman's ovum, or egg, meet, the egg is fertilized. The cells begin to divide and grow, and an embryo begins to grow in the woman's womb.
It takes about 266 days or 38 weeks before a baby is ready to be born. The expected delivery date is calculated from the first day of the woman's last menstrual period, even though fertilization probably happened about two weeks later, at ovulation, or when the woman's egg was released. So we often say it takes 40 weeks or nine months of pregnancy before a baby is born. These nine months are divided into three trimesters.
Half of a baby's genes come from the mother and half come from the father. Appearance, some talents and some diseases are hereditary, or passed on through the parents' genes. Each baby is unique, however, full of surprises and potential.
A couple needs to be prepared to have a child of either sex. There is no sure way to choose a baby's sex. The sex can sometimes be found out by an ultrasound, but only long after the pregnancy has started.
Most babies are born in hospitals, with the help of doctors and nurses, as well as special equipment and supplies. Some women choose to have a midwife to help with pregnancy and delivery. There are anesthetics and medications for safety and stopping pain. If there's a medical problem, women can have a cesarean delivery, when the baby is surgically delivered through the abdomen. There is blood for transfusion if this is necessary, for the woman or the baby. Hospitals have monitors to find possible problems before they become serious. Delivery rooms, recovery rooms, nurseries and wards are all designed to make this time as safe and comfortable as possible for the mother and new baby.
Some women prefer to deliver at home, with a midwife's help. They may want to have family around and be in familiar surroundings. A delivery at home can be just as easy and safe as a hospital delivery. Only if there is an emergency, or unusual steps need to be taken for the safety of the mother or baby is it important to be near a hospital.
Occasionally twins, or even more than two babies are born, a few minutes apart. Twins can be identical, if they result from the division of one fertilized egg. Or they can be fraternal if two eggs were fertilized. The doctor can tell by listening to the heartbeats and by ultrasound whether there is more than one fetus.
If you want more information about preparing for childbirth and the actual birth, you can call a local Public Health Unit -- see References/Resources.
If you aren't pregnant yet, but plan to be soon, there are ways to help get your body ready for pregnancy. Being healthy, eating well, getting enough sleep and exercise, and avoiding stress can give the fetus the best start and makes pregnancy easier on you.
While pregnant, a woman's lifestyle -- including any food she eats or medication she takes -- affects the development of the fetus. Early prenatal care is important, as most of the internal organs are developed during the first few weeks of pregnancy.
Prenatal care should begin as soon as possible. Clinics or classes can help with questions about the best foods to eat, ideal weight gain, good exercise, etc.
Alcohol, smoking, caffeine and drugs can all affect the health of a pregnant woman and the fetus. Drinking can cause birth defects, mental retardation, and low birth weight. This includes beer and wine as well as hard liquor such as rum or gin.
Smoking can lead to a higher risk of miscarriage, premature birth and low birth weight, as well as more problems at and after birth. Children who grow up around smokers are sick more often than children of non-smokers.
Health professionals generally advise pregnant women to try to eliminate or cut back on caffeine -- found in coffee, tea, chocolate, colas and coffee liqueurs -- tobacco and liquor during pregnancy.
Most people know that street drugs like cocaine can seriously harm a fetus. But many people don't know that prescription drugs and many non-prescription medications can also affect the fetus. If you are pregnant, or trying to get pregnant, ask a doctor or pharmacist about the possible effects of a drug -- even something as simple as a pain killer or antacid -- before you take it.
For more information, you can call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
Some women who are pregnant know they don't want to have a baby. They may choose not to have an abortion or may be unable to get one. For these women, giving the baby up for adoption may be the best choice.
There are different ways to place a child for adoption:
In some areas, there are special Children's Aid Societies for Catholic, Jewish and Native Canadians, and Americans. There is no cost to the mother or adoptive parents. Adoptive parents might pay for services provided by a private company, but not pay for the child. Counselling and legal services are available to both the birth mother and adoptive parents.
In some cases, an adoption can be arranged between the birth mother and someone she wants to adopt her child, for instance, a relative or friend. Even when strangers adopt the baby, the birth mother may be involved. She can help screen and select adoptive parents.
The relationship between the adoptive and birth parents is usually up to the individuals involved. It can include anything from supplying basic health information for the adoptive parents, to arranging visits by the birth parents after the adoption is complete. The birth mother may also choose to remain totally unknown to the adoptive parents.
Both birth mothers and birth fathers of any age have rights. The birth mother might not want to include the birth father. But, sometimes there are benefits to the child if his thoughts are included in the decision. More accurate background and medical information can be given to the adoptive parents and, later, to the child.
Ontario law* gives the birth mother a chance to think about her decision, even after she's signed a consent form. She has 21 days to change her mind after signing the form. In Ontario, there is an Adoption Disclosure Registry. This can help an adopted child who has reached 18 to contact the birth mother. Reunion counselling and support are also available. *(Laws may vary in different Provinces, and States in the US. You can check with your local Planned Parenthood organization or Public Health Department to find out what the laws are where you live.)
If you are pregnant and considering adoption, you can also listen to the message on Pregnancy, in the Pregnancy menu. The choice to place a child for adoption is not easy. But neither is raising a child, or having an abortion. All may have life-long implications.
There are people who will help, no matter which choice you make. If you want to talk to someone, you can call a Children's Aid Society or ask your doctor about private adoption agencies. You can also call a local Planned Parenthood organization or Public Health Unit -- see References/Resources.
This is some basic, but important information about abortion. Some people say "therapeutic" or "surgical" abortion, but most people just use the word abortion. Abortion means ending a pregnancy. It is a choice that many women consider for an uplanned or unwanted pregnancy.
Abortion is legal in Canada. It doesn't matter why a woman wants to have an abortion; she has a legal right to make this choice.
In Canada, abortions are covered under provincial health plans. In Ontario, OHIP pays for abortions. Any woman with her own Ontario Health Card can have an abortion without having to pay for it. In other provinces or in the United States, check with your local Planned Parenthood Association or Public Health Organization for information about abortion medical coverage --see References/Resources.
Abortions are often done in hospitals. In some areas of the province, women can also get an abortion at a clinic which specializes in doing abortions. It doesn't matter whether you go to a hospital or a clinic -- both are safe places to have an abortion, and both are covered by OHIP in Ontario.
If you would like further information about what an abortion is or how to arrange for an abortion you can read other messages in this section. Phone numbers are listed in the Referrals/Resources section of the Facts of Life Line. Staff at any of these places can help you arrange an abortion. They can also talk to you about your choices and your feelings if you have not made up your mind yet.
There are different kinds of abortions, but this is what usually happens if it is done in the first three months of pregnancy. During an abortion, a woman lies on her back. The doctor gently opens her vagina to see her cervix, or opening to her womb. The doctor uses either a local anesthetic to numb this area or a general anesthetic to make her sleep.
The doctor gradually opens the cervix and inserts a small tube. This tube is attached to a machine which gently removes the contents of the womb. Then the doctor carefully checks the inside of the womb to make sure no tissue remains. This procedure takes about 10 minutes.
Afterwards, the woman usually has some bleeding like a menstrual period. She will probably be able to go to school or work the next day, provided she doesn't have to do any heavy lifting or a lot of standing.
An abortion done after 12 weeks of pregnancy may be different. Ask questions about anything you don't understand. Some common questions about abortions are:
It is best to wait 6 weeks after an abortion to have sex.
You may have heard about an abortion pill called RU-486. This is a safe alternative to surgical abortion; which is not yet legal in Canada or the United States.
A woman might want to talk to her partner before deciding to have an abortion; however, she doesn't need to get his consent or agreement. Hospitals, clinics, family doctors and health insurance plans must keep the names of those having abortions private and confidential.
To have an abortion in a clinic, a parent's consent is not needed, no matter how old you are, as long as the doctor believes that you understand what is going to happen. If you are under 16, you will need to have a parent's consent to have a hospital abortion.
Remember, for both hospital and clinic abortions, there might be different requirements if you're going outside Ontario or Canada. It's important to ask about the requirements ahead of time.
In Ontario, abortions are done in a hospital or in a clinic that specializes in abortions. Not all Ontario hospitals offer abortion services. Abortion clinics are located only in Toronto and Ottawa. This means that, in some places, women have to travel outside their area to get an abortion. Sometime, women who live close to a provincial border end up going outside Ontario. There are also clinics in other Canadian cities, including Montreal and Winnipeg.
To have an abortion in a hospital, you may need to visit a birth control clinic, your family doctor or a women's health centre first. They will help you make the arrangements. A hospital usually requires two or more appointments. The woman may receive a general anesthetic so that she will be asleep during the abortion. She will be at the hospital most of the day.
To have an abortion at an abortion clinic, you can call and make an appointment yourself. At an abortion clinic, women usually have one appointment that lasts about 4 hours. A local anesthetic is used which means she will be awake and kept comfortable. In both the clinic and the hospital, the actual abortion takes about 10 minutes.
An abortion should be done as early as possible. Most abortions are done during the first 12 weeks of pregnancy, and many hospitals will only do abortions up until then. Sometimes, abortions are done as late as 20 weeks. If you are thinking about having an abortion, you should get the information you need as early as possible. Some places you can get this information are:
a Planned Parenthood Association
a birth control centre
a women's
health centre at a hospital
your public health unit, and
the Canadian
Abortion rights Action League.
The more questions you ask, the better informed you'll be.
But be careful! Some doctors, clinics or crisis pregnancy centres will not help arrange for an abortion. Some may try to talk you out of having an abortion. So get all the information you need to make the choice that is right for you. Go to the telephone numbers in the Referral/Resource section for someone to talk to.
An abortion should be done as early as possible. Early abortions are safest and easiest. The earlier you go to a doctor or clinic after you've missed a period, the sooner you'll know whether you're pregnant. Doctors estimate how many weeks pregnant a woman is by counting from the first day of the women's last menstrual period. It's important to know that date when you go for a pregnancy test.
Most abortions in Canada are performed in the first 12 weeks, also called the first trimester, of pregnancy. Sometimes abortions are done after 12 weeks, in the second trimester. Later abortions are more difficult to get.
In Canada, late abortions, after 20 weeks, are usually done to protect the health of the pregnant woman or because of test results showing problems with the fetus. Although they are safe, late abortions can have more complications than early abortions. While there is no time limit for when abortions can be done in Canada, it is very rare for abortions to be done after 20 weeks.
Women have abortions for lots of reasons. Studies find that most women feel relief after an abortion -- they feel the've made the decision that was right for them at that time in their lives.
A woman may feel upset if she did not get support from her partner, friends, family or doctor, of if a women felt pressured into having an abortion. Many women find a good friend or counsellor helpful at this time. There is counselling available at Planned Parenthood organizations, Public Health and abortion clinics.
Perhaps your partner, daughter or friend is considering abortion, or has just had an abortion. Many people in this situation feel confused, upset, concerned or even angry.
Making a decision about an unplanned pregnancy is often hard. All three options -- abortion, keeping the baby or giving the baby up for adoption -- can create a feeling of loss for those involved. The final decision about an abortion or what to do about a pregnancy belongs to the woman.
A lot of women turn to their partners, friends and family for support. Sometimes it's difficult for them to be supportive and comforting because they feel so strongly themselves.
You can encourage the woman to share her thoughts by sharing yours, by being honest about feelings and concerns. You may not agree with her decision, but you can still be supportive and care for her.
Women often talk to a counsellor to help them make a decision; you might find this very helpful also. Remember, there is free counselling available at Planned Parenthood organizations or Public Health Clinics.
Sexual assault happens when a person does something sexual to someone else by force or without the other person's permission. Unwanted sexual intercourse is also called rape. Sexual assault of any kind is a criminal offense, even in marriage and common-law or dating relationships. Statistics show that 1 in 4 females and 1 in 8 males have been sexually assaulted.
Although most sexual assaults are committed by men against women and children, anybody can be assaulted. People who commit these crimes are sometimes strangers, but not usually. They can be sexual partners, parents, relatives, friends, co-workers, bosses, doctors, youth leaders, religious leaders, teachers, neighbors or other acquaintances.
Sometimes, on a date, one person forces the other into some kind of sexual activity. This is called "acquaintance assault", or "date rape". The person who was assaulted, often the woman, may wonder whether she is to blame because she knew the guy and agreed to be with him. She may feel responsible, that she gave the wrong idea or was encouraging him somehow. It is important for a woman to realize that she is not to blame for sexual assault under any circumstances, even if she knew the person, and no matter how far they had gone sexually before she said "No".
A person who commits sexual assault is committing a crime. You don't have to have any kind of sexual contact with anyone unless you want to, even if you have had sex with that person before. People have a right to control their own bodies, and sexual assault violates that right. Sexual assault is a kind of violence. Neither alcohol nor drugs is an excuse for sexual assault.
Under the law, every person has the right to say "No" to any form of sex or sexual touching, even in marriage or when dating. "No" always means "No", even if it is said only once, and whatever the situation. Only "Yes" means "Yes".
Sexual assault may include anything from touching to violent rape. Sometimes sex is demanded in exchange for a promotion or a good report. What may seem like a harmless joke may be a sign of lack of respect for a person. Remember, sexual assault is a criminal act.
If you have been sexually assaulted or abused it is not your fault. It is normal to feel upset, confused and alone. You might feel bad about yourself and about sex. There are people you can talk to. If you are a survivor of sexual assault or abuse, think about telling someone about it. Even if it happened years ago, you might find it helpful to tell someone now. It is possible to bring charges to court even years later.
You can also read the messages on What to Do If You Are Sexually Assaulted and Protecting Yourself From Sexual Assault, both in this section of the Facts of Life Netline.
You can get medical and emotional help by calling a sexual assault centre or a rape crisis centre. The Kids Help Phone Line for those 19 and under is toll-free: 1-800-668-6868. Or you can call your local Public Health Unit -- see References/Resources.
Incest is sex between people who are closely related. It is illegal for a father and daughter, a mother and son, a grandparent and grandchild, or a brother and sister to have sexual intercourse.
Unwanted sexual activity within a family is called sexual assault or abuse. Sexual abuse includes a physical assault such as intercourse, inappropriate touching, making the child touch someone else's body, or making the child watch sexual activity of others. There are laws against incest to protect children.
People who abuse children often threaten them not to tell. They may say, "Something bad will happen to your mother," or "They'll send you away," or "I'll do it to your little sister if you tell." Sometimes, more than one person in the family is assaulted. But, telling someone you trust about the abuse may help stop it.
Often sexual abuse within a family can go on for many years. But there are people who will listen and can help. There are professionals who will understand, believe and support the child. You also can tell a parent, another relative, or a teacher. Or call the Kids Help Phone Line: 1-800-668-6868. This is free, and completely confidential.
People who sexually abuse family members are committing the same crime as those who assault strangers. It is an act of violence, and abusers can be brought to court, even if it happened years ago. It is possible to bring charges even years after the offense.
Adults must report actual or suspected cases of sexual abuse. If you know of incest or family sexual abuse, tell someone you trust about it. Again, for those 19 and under, the Kids Help Phone Line is 1-800-668-6868. There may be a Sexual Assault Centre in your area. Or you can call your local Public Health Unit -- the number is listed in the Referrals section of the Facts of Life Line.
If you have just been sexually assaulted, it's hard to know what to do. You can call a Rape Crisis Centre or a Sexual Assault Centre if there is one near you. These numbers may be listed on the inside cover of the telephone book, or the operator may help. The Kids' Help Phone Line, for those 19 and under, is 1-800-668-6868. If you are in immediate danger, the Emergency number in most areas is 911. There will be other suggestions at the end of this message. Meanwhile, here are some ideas to help you:
First: go to a safe place. If you are in your own home and the attacker has left, you may feel safe remaining there. Or, you may prefer to go to a shelter or a friend's home. In any case, ask yourself, "Where is the best place to be?" If you need it, ask for help in getting there.
Ask for support and help. Most people find that it is important to have support right away to help them cope with their feelings and to help them make decisions. Tell someone you trust what has happened to you --a family member or a friend, or a counsellor on a Distress Line.
The choice to report sexual assault to the police is one that each person must make on her own. The police can get you out of a dangerous situation and they can decide whether or not to lay charges against your attacker. What is important is that you choose the kind of support you want. You need to be able to make decisions regarding the police without pressure and with full understanding of what your decision will mean to you.
Sexual Assault Centres always have a counsellor "on call" to give you this information and support, and help you make the decision that is best for you.
Get the medical attention you need. It is important to take care of any injuries resulting from the assault. Some women do not even realize that they are injured because they are in a state of shock. A hospital's Emergency Department will test you for disease, and can take steps to prevent pregnancy. The decision to report to the police need not be made immediately. However, if you decide to lay charges, the hospital report can be used as evidence in court.
Tell hospital staff that you've been sexually assaulted. They may ask if you'd like a Sexual Assault Centre volunteer to help you through the medical procedures, and the legal procedures if you decide to report the assault. Ask questions about anything you don't understand.
Even if you feel that you want to wash and get clean right away, it is important not to wash or change your clothes before your medical examination. Evidence that could be used in court against your attacker could be destroyed. Do not take any drugs or alcohol, as you need to be able to think as clearly as possible.
If you choose not to go the hospital, a Sexual Assault worker can help you find other medical care. The Morning After Pill, taken within 72 hours of unprotected intercourse, may prevent pregnancy.
Write down everything that happened to you, and mark down the date and time of writing. Writing down everything you can remember is important for three reasons:
Often people who are sexually assaulted are threatened by their attackers and told not to tell anyone. A Sexual Assault worker will understand this because it is common, and will help you make plans to increase your safety.
Again, the emergency number in most places is 911. The Kids' Help Phone Line is 1-800-668-6868. Some communities have Sexual Assault or Rape Crisis Centres, Assaulted Women's Helplines and Distress Centres. Or you can call your Public Health Unit in your area -- see References/Resources.
You have the right to set your own sexual limits. You may have different boundaries with different people, and those boundaries may change. It's a good idea to know what you want or don't want before a difficult situation arises. It's also helpful to communicate those limits to the other person. No one can read your mind!
Trust your feelings. Most sexual assaults are not committed by strangers; they are committed by partners or other acquaintances. It's often difficult to imagine someone you know doing this to you -- that's part of the reason why it's so difficult to prevent sexual assault. But, if you feel you are being pressured into unwanted sex, you're right!
Be alert to behavior that doesn't seem right, for example, inappropriate touching or comments. Beware of someone who sits or stands too close, blocks your way, "power stares", looking through you or down at you, grabs or pushes you, or ignores what you say.
Can you be assertive and speak forcefully when someone does something to you that you don't want? Is there something you can do immediately? In some situations, it might help to say something like, "I don't like that," or "Don't touch me like that," or "NO!". You can practice this by yourself or with a friend.
You have rights. If somebody sexually assaults you, you can tell someone, including the police. Letting the other person know that you know your rights may help stop an attack.
You can take a self-defense course. Stand up for yourself. You don't have to be polite to someone who is sexually pressuring you, even if you are worried about hurting their feelings or getting into trouble. After all, that person doesn't respect your rights or feelings.
Some people might think that the way you dress, talk or behave gives them the right to treat you in a certain way, sexually. No matter what people think, you always have the right to say "no".
Alcohol and drugs can make a person lose control over their own body and mind. If you are tempted to use them, think: Will I be in control? Can I take care of myself?
Avoid situations which may be dangerous or make you feel uncomfortable, such as going into dark or out-of-the-way places. When you leave home, take change with you to make a phone call to arrange a ride home, or have another way to get home (such as with a friend or a group of friends) without depending on a date.
Don't broadcast the fact that you might be walking home alone. Someone might try to follow you. Try to stay on main roads, not back streets, and walk facing traffic. Have your keys ready before you reach your car or door. If you think that someone is following you, go to the nearest phone and call the police. Watch for houses you could run to if you should need help. Carrying a whistle or screamer might help get people's attention if you need help.
Finally, if something happens, don't panic. Your best defense is clear thinking. Unfortunately, there's no sure way out of every situation. You have to do what you believe will keep you safest.
Remember, only people who sexually assault can stop sexual assault. These suggestions are only intended to lower risk. A person does not get raped or attacked because they did something wrong. Whatever happens, if you are sexually assaulted, it's not your fault!
If you want to talk to someone about what has happened to you, or if you want information, you can call a sexual assault centre or rape crisis centre. Or, you can call your local Public Health Unit -- see References/Resources.
The earlier breast cancer is found and treated, the better chance for a successful recovery. Examining your breasts once a month can prevent a small problem from becoming very serious.
It takes just a few minutes. Examining your breasts allows you to become familiar with them, and to recognize the changes that they go through every month.
The best time to do the examination is at the end of your menstrual period. This is the time that breasts will be least tender, and also at their smallest. If you are not having periods, choose a regular day, such as the first day of the month. Also, if you do it just after a doctor has checked and found no lumps, then you can become familiar with the normal glands and muscles. Most lumps are found by self-examination, not by doctors.
This is how to do it:
Part One is the "looking part". Stand in front of a mirror with your arms relaxed at your sides. Look for any changes in the size or shape of your breasts. Look for any rashes or changes in the skin and the nipples, or for discharge from the nipples. Then move your arms up and down, looking to see if either breast doesn't move as easily as the other. Press your hands on your hips. No one has two breasts which are exactly the same. However, if one breast looks quite different from the other, have this checked by a doctor.
Part two is the "feeling part". You will be feeling for hard lumps or a thickening. Do not use your fingertips. Instead, hold your fingers together, and use the flat part of two or three fingers, just below the tips. You need to press your breast against your chest.
Stand up and raise one arm above your head. With the other hand, feel the breast on the side of the raised arm. Move your fingers in little circles, starting at the outside of your breast. Then move your fingers closer to the nipple, and feel all around your breast again. Repeat this until you have covered your whole breast and up to your shoulder. Then lower your arm and carefully feel your armpit. This is a very important part, as many breast cancers start here.
Repeat all of these steps on the other breast. Then do the "feeling part" twice more, once when you are lying down, and again in the shower. Using soap on your skin helps the fingers to be sensitive. If you find anything unusual, ask a doctor to check it right away.
Most lumps are not cancer. If it is cancer, the earlier it is treated the simpler the treatment will be, and the greater chance for complete recovery.
Breast self-examination is a good habit. If there is a history of breast cancer in the family, or if a woman is over 50, you might consider having regular mammogram tests. A mammogram is a special x-ray which can help find cancerous lumps while they are still small.
For more information, contact the Canadian Cancer Society, ask a doctor or go to a clinic. Or, you can call your local Public Health Unit -- see References/Resources.
Menstruation is natural. It is a sign of good health and fertility, or the ability to get pregnant.
Normally, a woman has a menstrual period about once a month, unless she is pregnant. This starts at puberty, between 9 and 14, and ends at menopause, between 45 and 55. The time from one period to the next is called a menstrual cycle.
During a menstrual cycle, the woman's uterus, or womb, builds up a thick lining of blood and nutrients to protect and feed a fetus. At the same time, a few of her eggs begin to ripen. Usually, one egg moves from an ovary into her uterus. This is called ovulation. If the egg is not fertilized by sperm, she doesn't get pregnant. In that case, she doesn't need the thick lining in her uterus. About 2 weeks later, the lining flows out through her vagina. This is called "a menstrual period".
A period usually lasts from 3 to 7 days. The heaviest bleeding is in the first days. You may feel tired during your period. This may be because your body is losing iron. To stop your body from losing too much iron, called "anemia", you can take a vitamin with iron.
To absorb menstrual blood, you can wear sanitary pads outside the body or tampons inside the vagina. If the bleeding is light, you can wear panty liners. These can all be bought at grocery or drug stores.
It is O.K. for both women and girls to wear tampons. They come in different sizes, so if you decide to wear them, you can find a size that is comfortable for your body. If they are inserted correctly, they can't be felt. They also can't get "lost" inside your vagina. A string attached to the bottom of a tampon makes it easy to take it out.
Tampons should be changed every four to six hours. Leaving a tampon in longer than that can allow bacteria to grow, andd lead to an infection called Toxic Shock Syndrome. This is very rare, but is very serious when it does happen.
Some women have a very regular menstrual cycle, every 27 days, for instance, or every 33 days; others have an irregular cycle. The cycle may be longer one month than another. This is also normal. Most cycles are from 21 to 34 days. The average is 28.
It is common for periods to be very irregular for the first year or so. Emotional upsets, illness, stress, gaining or losing a lot of weight, all can cause a woman's period to be late or even missed. A woman just starting the birth control pill may skip a period, or have spotting between periods for the first few months. Periods may change after pregnancy, or just with time.
A woman is as healthy during her period as she is at any time. She can shower or bathe, swim or exercise, have sexual intercourse, or do anything she would normally do. Most women have some cramping or pain the first day or two of a period. This can be relieved by exercise, a heating pad, or taking a pain reliever.
However, some women do need help for problems with their periods. Women may go to a doctor or clinic if they have such serious cramps that they can't go to school or work, or if the period is very heavy, requiring 10 to 12 pads a day for more than 5 days. Bleeding, spotting or cramping when she is not menstruating should also be checked out. And, if she misses a period and there is any possibility of pregnancy she should have a pregnancy test right away.
Remember, once you start having your period, you can get pregnant. So, if you have sexual intercourse and don't want to get pregnant, you'll need to use some form of birth control.
There are books which can tell you more about menstruation. You can talk to your mother, a school nurse or doctor. Or, you can call your local Public Health Unit -- see References/Resources.
Pre-Menstrual Syndrome, or PMS, is what some people call the changes that women may experience during the days before their menstrual period begins.
The most common physical changes are headaches, feeling tired, craving certain foods, being unable to sleep, feeling bloating or heavy, and tender breasts. Some women also find that they might feel more depressed or sad, anxious, or irritable, that their moods just change more easily, or that it's more difficult to concentrate.
Not all women get PMS. Some women find that they have much more energy in the days before their period. They feel well and, sometimes, more creative.
Some women who do get PMS notice only some of these changes. For some, however, the symptoms are so severe that their ability to function is affected. But, there are some ways a woman might be able to make life easier during this time. Learn what brings on the symptoms. Stress and diet can be very important.
Try to avoid stressful activities as much as possible during this time of the month. Let family and co-workers know what PMS is like and you might make them more supportive and understanding. Some women have found yoga, meditation or other relaxation methods helpful. Avoiding foods high in sugar, salt and caffeine as much as possible, especially 10 days before the next period, is also helpful for some women.
Eating several small meals a day rather than three large ones helps keep a steady amount of sugar in your blood. Eating foods high in potassium, such as bananas, nuts, milk and spinach, and plenty of carbohydrates, such as whole grain bread, cereal, pasta, potatoes and fruits, helps replace vitamins and minerals that your body needs.
Regular exercise throughout the month is helpful, and may also release stress and tension. Get plenty of rest.
You can try keeping a record or chart of your menstrual cycle, and physical or emotional changes. This may help you predict how you will feel, and see if doing anything differently affects the PMS. It may help you have more control, and may be useful when you talk to a doctor about your pre-menstrual changes.
Some women have even started support groups. Do you know other women who might be interested in this idea? Is there a women's centre in your area that could help you start up a group?
For more information, you can call your local Public Health Unit -- see References/Resources.
Menopause, or sometimes called the Change of Life, is a normal part of a woman's life. It usually starts between the ages of 45 and 55, and means the end of fertility, or the ability to get pregnant.
Menopause brings a woman new freedom, freedom from menstrual periods, needing to use contraceptives, or fear of pregnancy.
The last periods of a woman's life may be irregular and gradually taper off or just stop. But unusual bleeding or cramps should be reported to a doctor right away. Menopause may take a while to complete. Until it is complete, a woman can still become pregnant. If she is sexually active and doesn't want to start a pregnancy, she should use birth control until at least a year without a period.
Menopause occurs because the ovaries produce less of the female hormones. It may take a while for the body to adjust to this. Most women notice some changes in their bodies, but aren't bothered by them. Some women have physical or emotional changes that seem uncomfortable.
A common discomfort of menopause is having hot flashes or flushes. These are caused by an overreaction of blood vessels in the skin. A short sensation of intense heat travels from the chest to the head. The woman may sweat heavily, and feel cold afterwards. This can occur when she is awake or asleep.
The vagina gradually becomes drier and thinner, and sexual intercourse may therefore become uncomfortable. Lubricating jelly bought at a drug store or a vaginal cream with estrogen, prescribed by a doctor and used before intercourse, can help prevent discomfort.
Some women experience emotional upsets, such as depression, anxiety or sleeplessness. The decrease in estrogen may have some effect on emotions. Many people think that these emotions are also affected by the new lifestyle that many women are adjusting to during menopause. A woman may feel sad because her children are grown and leaving home. Perhaps her husband is also coping with mid-life changes. She may feel unsure of herself in a society that values youth more than experience. Talking to friends, joining a support group or getting professional counselling all might help her understand the changes she is going through and her reactions to the changes.
Experts agree that good nutrition and exercise help the body get used to the decrease in estrogen. Some doctors suggsest that women can benefit from taking small dosages of the female hormones, which the body no longer makes after menopause. This is called Estrogen Replacement Therapy, or ERT. A woman may take hormones orally, or wear a skin patch which delivers them. Like many medications, hormones may have both benefits and risks. A woman should talk with her doctor about the advantages and disadvantages of all her choices before making a decision.
Osteoporosis, when bones become brittle and break more easily, may also become a problem. A woman may shrink a little in height. The best prevention is doing "weight-bearing" exercises, such as walking, to increase bone strength and getting plenty of calcium, at least 1500 milligrams a day. Calcium is found in dairy products, some vegetables, vitamin tablets and regular antacids. Three antacid tablets supply the daily requirement.
Regular medical check-ups are important to a woman's health, whether or not she is being treated for menopause symptoms. Healthy practices include seeing a doctor once a year, and examining her own breasts every month.
If you'd like more information about menopause, you can talk to your doctor or staff at a women's health centre. Or, you can call your local Public Health Unit -- see References/Resources.
Women get bladder infections more frequently than men because the tube that leads from the bladder to the outside is much shorter. Also, the opening from the bladder is very close to the vagina and the anus. This means that it is easy for bacteria or germs to get from the anus to the opening, especially during sex.
A first sign of a bladder infection is needing to urinate more often. Sometimes the woman feels she needs to urinate again, right after she has finished. There may be blood in the urine, or it may have a different smell. Sometimes urination is painful and difficult.
There might be infection in the kidneys, rather than in the bladder. This might cause fever, chills, nausea, throwing up or backache, along with the other symptoms.
A woman may need to see a doctor, whether the infection is in the bladder or in the kidneys. A sample of urine will be sent to a lab for testing. Treatment will probably be with antibiotics. Be sure to follow instructions carefully, and finish all of the pills. Infection can come back easily if the prescription is not finished.
There are some things a woman can do to help prevent bladder infection:
If you think you might have a bladder infection, see your doctor. For more information, you can call your local Public Health Unit -- see References/Resources.
A pelvic or vaginal or internal exam is an important medical check-up. It is recommended for every woman at least once a year. Although it may feel embarrassing or uncomfortable at first, women ususally find it easier as they get used to having it done. Having this exam helps you take responsibilty for your own health. It can stop small problems from becoming large ones.
A woman should go for the appointment when she is not having her menstrual period. Before she goes she might want to shower and change her underwear. But she shouldn't douche for several days beforehand.
The doctor asks a few questions: the date of her last period, if she has had sexual intercourse, and if she has ever been pregnant. Her answers are confidential.
After the woman has undressed she is asked to put on a gown and lie back on an examining table. Her feet are raised and her legs are spread apart. Some women feel more comfortable having this done by a woman doctor, or with another woman in the room.
Relaxing and taking deep breaths can help make this much easier. You can ask questions during the exam and ask for a mirror to see yourself if you wish.
The doctor examines the outer area of the vulva, or genital area, for infections or sores. Then a speculum is inserted into the vagina. The speculum, made of metal or plastic, has two halves which are spread apart inside the vagina so that the cervix can be seen. You may want to listen to the message on Women's Sexual Organs, in the Sexuality Menu, for more information about this area of your body.
The doctor checks for cervical discharge, irritation or injury. Some cells are taken from the cervix. This is called a Pap test. The cervix has few nerve endings, so it doesn't cause much pain. A test for infection can also be done by taking a sample of mucus from the cervix.
After the speculum is removed, the doctor does an exam using both hands, using one hand to feel inside the vagina and the other one to press down on the abdomen. This way, the doctor can feel the inner pelvic organs, the uterus, ovaries and fallopian tubes. Any pain or tenderness can be a sign of infection or another problem, so be sure to tell the person doing the exam if you feel any discomfort or pain.
Getting the results from the tests may take a week or two. You can call the doctor's office to ask about the results.
For more information, you can call your doctor or local Public Health Unit -- see References/Resources.
Having a Pap test, sometimes called a Pap Smear, is one of the easiest, most responsible things a woman can do to protect her health. A doctor who does a pelvic or vaginal exam may do a Pap test at the same time.
Cells at the opening of a woman's womb, the cervix, may change. Some changes, left untreated, may become cancerous. Cancer of the cervix grows very slowly. So, if the cancer is found and removed early enough it will not cause harm.
During the Pap test, the doctor will gently scrape some cells from the cervix. Because there aren't a lot of nerve endings on the cervix, it's not very painful. You can get the test results after a week or two. However, the doctor will contact you if the cells are unusual in any way. Then you will need to have another Pap test.
There can be several causes of unusual cells, such as sexually transmitted diseases or other infections, and exposure to certain chemicals. Most unusual cells do not mean cancer. So, if your doctor wants you to have a repeat test, this does not necessarily mean that you have cancer. However, it is very important to go back and find out more. And remember, if you do have cancer of the cervix, it can nearly always be cured.
If you have an infection, your doctor can treat you for it. If you have unusual cells which need to be removed, this is done in one of three ways: by cutting them out, by freezing them, or by destroying them by laser treatment. None of these procedures is very painful. Unless cancer is widespread, which is rare, you will still be able to have children afterwards.
You should start having yearly Pap tests when you are eighteen or when you start having sexual intercourse, whichever comes first. Some women need Pap tests twice a year. Women who have had cervical cancer, or women who have genital warts or several male partners, should have Pap tests every six months.
You may also want to listen to the message on The Pelvic Exam, in the Miscellaneous Menu.
For more information, you can call a doctor or clinic. Or, you can call your local Public Health Unit -- see References/Resources.
Infertility means having a problem which makes it hard to start a pregnancy. Many couples find that starting a pregnancy is not as easy as they had expected. Although it may be upsetting, most doctors suggest that you should keep trying for at least one year before looking for help. Infertility can happen because of a problem in either a man or a woman.
Here are some things both men and women can do to increase the chances of pregnancy: get healthy and stay healthy. Avoid caffeine, tobacco, drugs and alcohol.
For women, being stressed and tired may make it harder to become pregnant. Maintaining a healthy weight and doing some -- but not too much -- exercise can make it easier.
Men should avoid wearing very tight jeans or underwear, as their testicles need to hang away from the body in order to keep cool to produce sperm. Hot baths can kill sperm.
It may help if the woman lies on her back during intercourse, and remains still for at least 20 minutes afterwards.
There are courses on fertility, books and pamphlets on the subject. A couple can learn to chart the woman's temperature and check her vaginal mucus to figure out when she ovulates. Ovulation is about 14 days before her next menstrual period. Having intercourse a day before ovulation gives the best chance for conception, or starting a pregnancy.
There are doctors and clinics offering treatment for infertility. Both women and men can be checked, and need to provide information about their histories. The man supplies a sample of sperm, and the couple learn how to figure out when the woman ovulates. Tests are done, and treatment may include hormonal therapy or surgery.
Some couples become pregnant, while others don't. Some try to adopt a child, and some will try a process called "in vitro fertilization". For this the woman will be given fertility drugs. Her eggs will be collected and fertilized with her partner's sperm. Eggs that start to develop will be replaced in the woman's uterus. The success rate for this process is about 10%. OHIP may cover some of the costs, depending on what the problem is.
Trying to conceive is often an emotional time, full of frustration and disappointment. There may be support groups in your area. Talk to a doctor or a clinic specializing in infertility treatment. Or, you can call your local Public Health Unit -- see References/Resources.
Eating right is especially important for young people, pregnant women and mothers who are breast-feeding babies. Children who are well-fed are stronger and can learn more easily. Adults who eat well tend to live longer and have fewer health problems. Some illnesses may be complicated by a diet with a lot of sugar or fat, or not enough vitamins, minerals, protein and carbohydrates.
Sometimes people, especially girls and women, become very concerned about their size or shape. Being too worried about fashion and weight can cause very serious health problems. We need some fat in our diet. Thinness does not guarantee happiness or success.
Dieting can mean temporary weight loss, but losing pounds too quickly is dangerous. It is unhealthy to gain, lose, then regain weight. Most people who diet gain the weight back again, and often more weight as well. "Fad" diets don't work!
Sometimes people, particularly girls, develop anorexia. They are so afraid of gaining weight that they don't recognize how underweight they are. They don't eat, or they over-use laxatives, or they exercise so much that they can literally starve themselves unless they get help.
Food can be used as a way of feeling in control or stuffing down emotions: frustration, loneliness, fear, anger or insecurity. Some people "binge" or overeat to try to escape from emotional pain, worries or trouble. It's easier to fall into these patterns if you have low self-esteem, that is, you don't feel good about yourself.
Some people overeat or binge and then throw up, to get rid of the unwanted calories. This is called purging or bulimia. Throwing up is extremely hard on the body, and it rots the teeth.
Although we don't always know why people overeat, we do know that obesity, that is, weighing 20% or more than the normal range, increases the risk of stroke, heart attack and diabetes. Obesity contributes to many health problems and shortens life expectancy.
Poor eating habits are often learned in childhood, and serious eating disorders often result from childhood pain, abuse or fear. Trying to follow Canada's Food Guide can help improve eating habits. This is not easy, and people with a serious eating disorder might find that they need professional help or a support group to help them learn new eating habits. There are doctors and clinics to help. Some hospitals have eating disorder or nutrition programs. Some even have support groups, or might be able to help you start one. For more information, you can call the National Eating Disorder Information Centre at (416) 340-4156, or your local Public Health Unit -- see References/Resources.
You may be calling because you feel desperate, and think that life isn't worth living anymore. Please listen. You are not alone. A lot of people feel that way sometimes.
There may be some terrible things in your life right now. Maybe you just broke up with a friend, failed at school, or lost a job. Maybe your parents, or you and your partner fight a lot or have just separated. Perhaps alcohol or drugs are a problem. Maybe you're not sure why, but you feel hopeless about your future. Is there someone you can talk to, someone you trust, who will listen and believe in you? A good friend, parent, counsellor, teacher or religious leader?
There are places where someone will listen to you. You can always call the Kids Help Phone Line, a distress centre or crisis line, a community health centre or the hospital emergency department, and someone will listen to you and help you.
If you are listening to this message because you are a parent, relative or friend of a person who is talking about suicide, take the person seriously. People often try to let others know how they're feeling and what they're thinking about doing before they actually attempt suicide. Sometimes, they don't come right out and say it, but there are other kinds of signs. Here are some signs to look out for:
These signs of deep depression need attention immediately.