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Thursday, August 25,2011

Kids' sexual health

By Dr. Jenni Skyler


Dear Dr. Jenni,

My daughter is 12 years old, and my gynecologist suggested I give her the HPV vaccine. I know that this is probably the right thing to do, yet I’m not sure if it’s really needed. I don’t want to give her an extraneous vaccine if she doesn’t need it, especially if it might make her sexually active.

—Worried Mom

Dear Worried,

Many parents worry that getting the HPV vaccine gives permission for their child to be sexually active. While HPV is the most prevalent sexually transmitted infection, with an estimated 79 percent infection rate, a vaccine is not about sexual activity; it’s about preventive medicine for optimum health.

It’s like exercising on a daily basis to prevent potential health consequences like Type 2 diabetes or cardiovascular disease.

The idea of this vaccine is that if HPV infections can be prevented, then so can many cases of cervical cancer.

However, you mention another issue here, and that is about relevancy and efficacy. The Journal of the American Medical Association ( JAMA) states that the issues surrounding the HPV vaccine are quite complex. While the vaccine targets the dominant four types of HPV, there are still 100 different types to consider. Furthermore, of the 15 most potentially cancerous strains, the vaccine only targets two.

In addition, long-term efficacy and safety are still in question. The vaccine is relatively young, and decade-long studies have yet to be conducted. Thus, how this vaccine works in the human body in 20 to 40 years is still unknown.

Many opt out of the vaccine because the human immune system is often able to clear the virus on its own. Others choose it for the potential protection of cancer. Rather than make your choice based on an implication of your daughter’s sexual activity, evaluate the potential risks against the potential benefits, and see what feels right for her health.

Dear Dr. Jenni,

My wife and I are having a baby next month. Her obstetrician has informed her that she cannot have sex for six weeks. I’m very worried what this will do for our intimacy. And I’m very worried that after giving birth, down there will be less pleasurable. I don’t know what to do or how to have this conversation with her.

—Pleasure After Pregnancy?

Dear Pleasure,

Your concerns are very normal for new fathers. While intercourse is off limits for the first six weeks, this doesn’t mean you cannot engage in sexual intimacy. While I warn you that you will be quite sleep-deprived, this can be an opportunity to expand your typical routine and incorporate other activities, such as sensual showers.

As for physical pleasure, the vaginal canal is quite elastic, allowing a small, tight space to easily expand in order to birth a baby. The opening of the vagina might tear a little, or be cut by a doctor, but she is sewn up after. Once she is healed, she can also do kegels to increase strength in the pelvic floor.

More importantly, though, is that you will have new roles, and it can be tricky to transition from parent to lover. While it’s always easier to have sex than talk about it, I encourage you to invite her to a conversation to discuss what you’d like your intimate lives to look like. You will have to be more conscious about maintaining sexual intimacy. Some parents do a mandatory date night or arrange Flirtatious Fridays to assure the fires of seduction stay ablaze.

Whatever you decide, just chatting about this will give you the chance to deepen emotional intimacy and, as a result, sexual intimacy.

Send questions for Jenni Skyler, PhD, to drjenni@theintimacyinstitute.org. Skyler is a sex therapist and board-certified sexologist who runs The Intimacy Institute in Boulder, www.theintimacyinstitute.org.

Respond: letters@boulderweekly.com

[ Questions Send questions for Jenni Skyler to drjenni@ theintimacyinstitute.org.]
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