We know that parents communicating with kids about sexuality can have powerful effects: on average it delays the age of first intercourse, increases the chance of contraception if they do have intercourse, and decreases the number of sexual partners – even if the talk doesn’t go as well as parents hoped. The National Institute of Mental Health and the CDC funded a study into “The Big Talk” to see what is most important about this talk for having the biggest positive impact. They especially considered which is more important, the breadth of topics covered or the number of times the conversation is revisited. The results were published online in Pediatrics in March 2008. Because sexuality is a sensitive subject to discuss with one’s children, parents often focus on limit conversations to “safe” topics, such as changes in the body during puberty, how babies are conceived, and possible negative consequences of sex, such as sexually transmitted diseases. Many parents avoid or rush through more delicate topics, such as masturbation, orgasm, sexual decision-making, and how to use condoms. Many teenagers feel a gap between the topics that their parents cover during sexual discussions and the more personal topics they really want to learn about. Many parents and teens feel a bit let down by the talk.

In this study, researchers analyzed the conversations for completeness by comparing them to a list of 22 topics, such as “how you will make decisions about whether to have sex,” “consequences of getting pregnant or getting someone pregnant,” “how to choose a method of birth control,” “what it feels like to have sex,” “how well condoms can prevent sexually transmitted diseases,” and “how to say no if someone wants to have sex and you don’t want to”). Teens whose parents covered more topics felt that their sexual discussions occurred with greater openness than did those who discussed fewer topics.

Repetition – discussing sexuality multiple times – was far more important than the breadth or depth of the discussions. Teens who had more sexual conversations with their parents felt closer to their parents, felt more able to communicate with their parents in general, felt more able to communicate honestly about sex in specific, and perceived that discussions occurred with greater openness than did teens who had fewer talks, or worse yet, just one Big Talk.

This is good news, taking the pressure off parents. The key isn’t getting one moment right, but at least once kids are in middle school, checking in with them early and often about sexual matters, answering whatever questions they may have.

Martino SC, Elliott MN, Corona R, Kanouse DE, Schuster MA. Beyond the “Big Talk”: The Roles of Breadth and Repetition in Parent-Adolescent Communication About Sexual Topics Pediatrics 2008;121;e612-e618.

When people think of peer pressure, they usually think of someone being pressured to go against their conscience to engage in unhealthy behavior. That does happen, but peer pressure is far stronger than that: peers’ attitudes powerfully shape your child’s conscience, changing what they think is right or wrong.

A study in the September 2001 issue of the Journal of Adolescent Health found that among children aged 13-15, those who had engaged in sex had friends who approved of sex at that age, and those who refrained from sex had friends who disapproved. Likewise, those who used condoms had friends who used condoms.

Going out of your way to foster healthy friendships is an increasingly important part of parenting as your children grow.

Dr. Greene’s Answer:

Let me go out on a limb here: you started dating a guy you really liked. He was wonderful. He made you feel special. He told you he loved you, he gave you gifts, and he was very affectionate. You did really fun things together and you felt wonderful. The two of you became physically involved. It seemed really right at the time. Now he seems distant, and you feel used, insecure, lonely, and confused. This is a very common scenario.

The high school and college years are an incredible time of exploration. Life is filled with options. You have new freedoms and opportunities, limitless energy, and raging hormones. This combination is exhilarating and dangerous. The exhilaration is obvious; the danger is not.

Of course there are all the dangers everyone talks about: drug addiction, HIV, unwanted pregnancy, etc. But there is another danger that most people miss: the danger of getting stuck in the wrong relationship.

I’m not saying that your relationship with your boyfriend is wrong. But I am saying that you need to be clear about what you want out of a relationship. From your question, I can tell you want a boyfriend who likes to spend time with you. You want someone who puts you ahead of other things in his life. If you’ve talked with your boyfriend about what you want, and he isn’t responding, then perhaps this is not the right relationship for you. Or at least this is not the right relationship for you at this time. Don’t spend your energy trying to change someone else. You can’t control him, but you can take control of your own life. Above all, stay true to yourself and what you want out of a partner. A relationship is about both parties staying true to themselves while caring for each other. One of the reasons that divorce is so common among adults is that both people in the marriage didn’t learn these lessons as teenagers. All too often, one of the individuals in the relationship attempts to give up things that are important in order to gain the other’s love. As time goes by, this loss is greater than can be tolerated, and divorce seems to be the only way back to finding one’ s true self.

As painful as a breakup is, it is still far better to face what you really have and to deal with it, than to keep trying to make something work out of a situation that just doesn’t feel right. The longer you wait, the more painful it is likely to be. Next time around, look for a guy who wants the same thing out of a relationship that you want. In the long run, you will be much happier.

Dr. Greene’s Answer:

Sex hurts? How unsettling! And much more common than you might imagine. Doctors have a name for this; we call it dyspareunia (pronounced dis-pah-ROO-ne-ah). Most women have gone through a stage in which intercourse is painful; in up to a third of women, this has lasted a long time. ¹ There are many reasons why having sex can hurt.

Before we look at some of the more common reasons, I’d like to say a word about communication. Sometimes sex is hard to talk about. I’ m very glad you asked your question here. Dyspareunia can be solved, one way or another, for people who are willing to ask about it.

One of the key things to learn during your current difficulties is that it’s important to talk with your partner about what is going on. Tell your boyfriend why you like him and what feels good when you are together. But also tell him when something hurts. Learning to work together is an important part of sex.

What might be causing the pain depends on whether sex has always hurt or if this is a recent development; whether it hurts every time or only sometimes; and (perhaps most importantly) whether you feel the greatest pain when the penis first enters or once it is in deeply.

If you hurt as the penis first enters, the most common problem is not enough lubrication. Friction in this sensitive area can hurt! Your organs normally get wet and slippery as part of sexual arousal. Taking more time for sexual play before intercourse is often all that is needed to turn a painful experience into a pleasant one. Too fast is usually too dry.

Fear, too, can decrease lubrication. Fear of infection, fear of pregnancy, and fear about the relationship are all common. Abuse or incest can leave you dry until the real hurt is healed.

A water-based lubricant (do not use lotion, baby oil, or Vaseline) you pick up at the drugstore can work wonders, but don’t ignore the reason for decreased lubrication, if you know what it is.

Pain on insertion might also come from inflamed external genitals. The tissue might be inflamed from a yeast infection, warts, herpes, or some other infection. Sometimes the area is tender from a benign cyst called a Bartholin’s gland cyst. All of these conditions require medical treatment.

Intercourse can also remain painful as long as the hymen is partly intact. If you can insert a tampon comfortably, a mechanical obstruction is not likely.

Pain with deep penetration usually comes from the deeper organs being tender. This includes the ovaries, uterus, bladder, and even the intestines. At your age, the most common reasons for deep pain are ovarian cysts, a retroverted uterus (positioned so it gets bumped during intercourse), abdominal adhesions (in people who have had abdominal surgery), and an infection called pelvic inflammatory disease. Many other, less common conditions (such as inflammatory bowel disease) can also make you hurt. In some positions (such as lying on the side), penetration is not as deep, and sex might be more comfortable.

But if the hurting doesn’t improve quickly, you’ll also need to talk to your doctor about the pain. Be sure to tell them whether the pain has always been there or is new. Describe what hurts most and when. Work together to identify the cause. Don’ t stop asking about this until you understand why sex hurts and until you’ve gotten relief from the pain. Having sex shouldn’t have to hurt.
Footnote References:
^{1 Glatt, AE, Zinner SH, McCormack WM. The prevalence of dysparenia. Obstet Gynecol 1990;75:433.}