During this time sex hormones begin acting up, this will increase your awareness of your sexuality whether you are a boy or a girl. Interest in the opposite sex starts to develop. Questions about relationships and friendships start imposing themselves. Thinking about someone you fancy might get your heart racing and cause you to flush. This is very normal.

Your sexual feelings will grow stronger during this time but it is very important to understand what you are going through and not to feel pressured whether by your own urges or by friends and peers to go into something you may not be fully convinced of and prepared for. Relationships between friends (of the opposite sex) built on mutual respect, understanding sharing, caring and laughing together are more important than sexual relationships and the complexities associated with them. It is better to enjoy your young adulthood without having to worry about sex until you have reached a certain age and maturity that will help you make the right decisions with regard to your relationships.

This can be a confusing decision to make, while the media, through TV, internet, cheap magazines, commercials, movies, billboards keep promoting sex in a very casual way, you keep hearing about the various health issues (See section on STI’S, HIV/AIDS) related to being sexually active. These infections and their consequences should be given very serious consideration.

Your friends could also be showing off about their sexual experiences, you should understand that you should not feel pressured to follow suit. This is a purely individual decision that you have to make; possibly by talking to an older family member you trust and feel comfortable enough with to discuss these issues. It is important to respect the social and cultural values of your family and that of your partner. And to know that love can exist without sex.

If your decision is to engage in sexual activity with the mutual consent of your partner; you should both take into consideration the importance of your decision and do everything you can to protect yourself and your partner, speaking of which it is very important that you be faithful to your partner. We hope that your decision will be taken after discussion with a trusted adult and after carefully looking into means to have safe and protected sex. (See section on Pregnancy & Contraception).

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• Sexual Intercourse

When you look at the sexual organs (see figures: boys & girls) of both men and women you will notice that they are formed in a way to fit together. This makes it possible for a man and a woman to have sexual intercourse. When a man and a woman are in a mature love relationship they feel a physical attraction towards each other. This attraction makes them want to be physically close, this gives them a good feeling and this feeling translates itself in changes that happen in their sexual organs. And they feel they want to be even closer.

If they decide to have sexual intercourse they put their bodies closer together so that the man’s penis slides into the woman’s vagina. This is pleasurable to both of them and usually one or both reach an orgasm. The man ejaculates and sperm is released in the woman’s vagina and move toward her fallopian tubes. If an egg is present there at the time it will be fertilized with the man’s sperm and a pregnancy could start.

As we have said earlier there are many ways to express your love to someone other than engaging in sexual relations. Caring for someone you love could be expressed through being there for them, holding their hand, giving them flowers being a good listener etc….
Engaging in sexual relations can result in pregnancy even during puberty and even if it is the first time. Our advice to you is to postpone sexual relations until a later period in your life when you are more mature to deal with the consequences. Yes sex is a very important feeling to experience but it can also carry with it many problems when you are not ready for it. After all having a mature body is not reason enough to engage in sexual relations.

 

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• Pregnancy
The possibility of getting pregnant after having sexual intercourse is very high. In case you didn’t know how it happens you will now after reading the first part of this section. You might have heard many stories told about how you can avoid getting pregnant but you should know that the best way is to abstain from sexual relations. If this is not your choice, then you need to get informed about contraception.

Methods of Contraception or Birth Control:
- Abstinence
- Condoms (male and female)
- Contraceptive creams or spermicidal creams
- Contraceptive sponge
- Depo-provera (Hormonal Injections) - A monthly hormonal injection
- Diaphragm
- The pill
- Emergency Contraception or Day After pill
- Lunelle a once a month hormonal injection

For recent info that is being requested, I would recommend the MEC of WHO as
available ectronically at the following URL:

http://www.who.int/reproductive-health/publications/RHR_00_2_medical_eligibi
lity_criteria_3rd/index.htm

The Overview section of the above document has statistics and a section on
adolescents.

For more detailed description of methods, you may want to use the following
document:

http://www.infoforhealth.org/pubs/ect/

Contraception Myths:
- It is not true that a woman will not get pregnant 3 days before her period and 3 days after her period.
- It is not true that a woman cannot get pregnant during her period.
- It is not true that pregnancy can be avoided by a certain position taken during sexual intercourse, whether it's done standing up, sitting down or lying down when ejaculation takes place inside the vagina, pregnancy will most certainly happen.
- It is not true that urinating after intercourse can stop pregnancy. You cannot wash out sperm after intercourse.
- It is not true that a woman doesn’t get pregnant if she doesn’t have an orgasm.
- It is not true that toothpaste can be used as contraception.
- We know some of these stories might sound strange but some people believe and live by these mythical precautions. It is important to get informed and educated about these matters and know that you should only rely on medically proven methods of contraception.

You Should:
- Never Use a condom more than once.
- Always check the expiry date on the condom package.
- It is preferable to use latex condoms; their high efficiency has been tested and proven.
- For double protection against pregnancy and STIs use the pill for girls and condoms for boys.

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• Sexually Transmitted Infections:
Sexually Transmitted Infections or STI’s for short, as they are commonly known, are infections that spread from one person to another through intimate sexual contact.
Sexual activity involves serious health risks for all people regardless of their age or gender. As teenagers you may be more prone because you are more likely to embark on sexual activity without serious consideration to the consequences associated with it. Very often young people are more vulnerable than adults to engage in risky behavior such as unprotected sex because of external factors such as peer pressure, imposing ones image etc..) or internal factors or by simply assuming ‘it will not happen to me’. Teenagers may not be exposed enough to the importance of having safe sex and the importance of using condoms to achieve this purpose.

Another reason for being vulnerable is that you may feel pressured (by your partner or by your peers who may be boasting about their sexual experiences) to engage in sex when you are not really ready yet to do so. Sexually transmitted infections are serious infections that can have long-term negative effects on your general health and well-being, some of them can be even deadly. They should be dealt with seriously and knowing about them can help you protect yourself and the person you care for. Getting informed is very important. In this section we will discuss different types of STI’s, their symptoms and what you can do if you think you might have any of these infections.

We are lucky because there are treatments for most STI’s but we should not rely on this fact, prevention is the most essential thing to do. As some of these diseases may not show any symptoms until a great deal of damage has been done to your body.

There are things you can do to avoid getting infected by any of these viruses or germs. The most important thing is to abstain from entering into sexual relations during adolescence, first of all because as we have mentioned in a previous section, relations during adolescence have many success factors that do not include sex. It is important if you have someone in your life to work on building trust, sharing and caring with this person. There are many ways to enjoy a relationship with someone you care for.
It is important not to feel pressured ‘to go with the flow’ believing that everyone is doing it.

List of most common STI’s:
- Chlamydia: One of the most common infections, it is spread by sexual intercourse. If you are sexually active and have had sex without using a condom, you have to get tested for chlamydia. It’s important to know that Chlamydia is one of those STI’s that does not show symptoms early on. You can be healthy and have it. The good news is it can be treated easily with antibiotics. The bad news is if left untreated it can cause serious damage to both boys’ and girls’ reproductive organs, this means that chlamydia can easily destroy your chances of having children in the future. A condition we refer to as infertility. If you are diagnosed positively your partner should be informed and treated as well.(Check table below for early symptoms.)

- Gonorrhea: Is also another common and well known STI, it also spreads through sexual relations. It is also dangerous, as it does not show symptoms early on like chlamydia. It can travel through the body and attack other internal organs. It can cause great damage to the reproductive organs in both males and females. It is treatable by antibiotics. If you are diagnosed positively your partner should be informed and treated as well. (Check table below for early symptoms.)

- Genital warts: Genital warts are highly contagious. They can spread through skin-to-skin contact. Sometimes even condoms don’t offer proper protection in the case of warts. They should be treated immediately, though they may sometimes disappear on their own. They are caused by the Human Papillomavirus or HPV, which if remains untreated can lead to cervical cancer and other types of genital cancers. You can have this infection without it appearing physically anywhere and without symptoms. As it progresses it becomes easily detectable as warts appear on and around the genital area, for both boys and girls. The warts may be either flat or raised. (Check table below for early symptoms.)

- Genital Herpes: These are tough to treat, some medications are available but they only shorten the period of time when they are contagious. Genital herpes can remain in the body for a long time. There are initial symptoms but sometimes they may not be so apparent. You should abstain from any sexual activity if you have genital herpes and should seek medical advice immediately. (Check table below for early symptoms.)

- Syphilis: The oldest known of STI’s but it is still around. It can only be detected by a blood test. It spreads through bodily fluids and blood. The treatment requires a long course of antibiotics and it is curable. If you are sexually active your partner should be tested as well even if they show no symptoms. (Check table below for early symptoms)

- Scabies & Pubic lice: Scabies can be confused with other skin irritations; therefore a professional medical examination is necessary as with other infections. They can spread through sexual contact and close non-sexual contact. Treatment is fairly easy and within twenty- four hours it can ensure that the person afflicted cannot spread the disease. Pubic lice are tiny insects they can be easily visible and they feed on blood from their host. They can spread through sexual and non-sexual contact. Special care should taken and cleaning and washing sheets and clothing of an infected person. (Check table below for early symptoms)


- Candidiasis: Can be sexually transmitted, but it can also happen for other reasons, like taking antibiotics. It infects the vagina and can be transmitted to males though it does not grow in male genitals. It is easy to treat but might recur. (Check table below for early symptoms)

- Trichomonas: Another common STI it can happen to both males and females. Although males can have it with no symptoms. It lives in the vagina and the urethra. It is easily diagnosed through microscopic testing of discharge. It is easily curable but you should follow the treatment well and until the end. Your partner should be tested as well. (Check table below for early symptoms)

- Pelvic Inflammatory Disease (PID): This yet another serious infection that afflicts the reproductive organs of women. PID is the result of two other STI’s Chlamydia and gonorrhea. It happens when an infection in the genital tract spreads either because it wasn’t treated properly or not treated at all. It can cause permanent health damage, although most of the time it is totally painless. It can cause infertility in women. If you suspect you might have PID (check symptoms in chart below) get checked for it immediately, if it is detected early it can be treated with antibiotics. The best way to prevent PID is to prevent STIs. That is to not engage in sexual intercourse, to use condoms always and to remain faithful if you are sexually active, the more people you have sexual relations with the higher the risk of getting STIs or PID. Also very important is get tested at least once a year for the common STIs especially chlamydia and gonorrhea.

- HIV & AIDS: You have probably heard a lot about this HIV stands for Human Immunodefiency Virus and causes AIDS or Acquired Immunodefiency Syndrome. AIDS is basically the breakdown of the immune system in the human body that means the body would not be able to fight any more even simple viruses and infections. People with AIDS could die from simple illnesses such as the common flu. It is by far the most dangerous STI and it has had a devastating toll on humanity. There is no cure or vaccine yet for it. Though there has been some scientific advance in researching medications that could delay the deadly effects. People who carry HIV now live longer but they are never cured, so once you have the virus you will carry it forever. It was first believed that AIDS only hit a certain group of people, homosexuals; but anybody is at risk of getting it. HIV will definitely develop into AIDS even though this could take up to 10 years or more sometimes. A blood test can detect HIV & AIDS. Since the onset of this disease there has been numerous campaigns world wide to make people understand more about it, its causes and its effects. It is very important to know and get informed about AIDS and how it is spread. HIV is passed only through bodily fluids and blood: Through semen, blood and vaginal secretions, also through breast milk.
Infection can happen:
- Through sexual intercourse with an infected person, Sharing needles for injecting drugs with an infected person,
- Through transfusion of infected blood,
- Mother to child transmission
- You cannot get AIDS from kissing, hugging or holding hands. You cannot get AIDS from sneezing, coughing or through toilet seats. You cannot get AIDS from being friends with someone who has it or by sitting next to them or talking to them. Insects and other bugs don’t carry the Aids virus. AIDS is a fatal disease you should do everything you can not to contract it. Always use a condom if you are sexually active.

Testing for STIs can be performed both by a doctor's examination and by a blood test which is available at any laboratory. If you think you might be infected you can visit the doctor at any of the centers listed in the "contact us" section of the website.

- HIV is tested for using a blood test. This blood test is also available at any laboratory, as well as the testing centers listed below. It is confidential, if you think you might be infected you should get tested. If you turn out negative (meaning you don't have the virus), you should be happy and do everything you can to stay that way. If you turn out positive, you will be referred by the testing center to a doctor.

Government University Hospital - Baabda: 05920755 (testing free of charge)
Lebanese family Planning Association - Ashrafieh: 01586731 and Saida: 07751077
SIDC Association - Sin el fil: 01428428

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• Early symptoms of sexually transmitted infections

Disease First symptoms AIDS (Acquired Immune Deficiency Syndrome) Headache, night sweats, unexplained weight loss, fatigue, swollen lymph nodes, persistent fever, persistent diarrhea, oral thrush (a heavy, whitish coating on the tongue and on the inside of the mouth). Candidiasis Itching in the genital area, pain when urinating, a thick odorless vaginal discharge. Chlamydia Often no symptoms at all for males or females For females: pain during intercourse. For males: a clear, watery, urethral discharge THE #1 STI because it is often "silent". Genital Herpes Itching, tingling sensation, burning in the genital area, fluid filled blisters on the genitals in males & females, usually painful or inflamed. Genital Warts Soft, cauliflower-like growths appearing in clusters or alone around the vagina, penis, anus, groin, and/or scrotum. Gonorrhea For females: a cloudy vaginal discharge, painful urination, vaginal itching. Often no early symptoms for women For males: a yellowish, pus-filled discharge from the penis, burning with urination. Hepatitis B Fever, fatigue, nausea or no symptoms at all in either partner for 2 - 6 months. Pelvic Inflammatory Disease (PID) Fever, lower abdominal pain, often a pus-filled discharge vaginal discharge. Pubic Lice (Crabs) Intense itching in both sexes. Crabs are tiny but visible in pubic hair and on thighs. Scabies Intense itching in both sexes. Crabs are tiny but visible in pubic hair and on thighs. Syphilis A sore on the genitals of both sexes. (Chancre), rash, fever, sore throat, sores in the mouth or anus. Trichomoniasis For females: vaginal itching and pain, a foamy, greenish or yellow foul-smelling discharge. For males: a clear discharge from the penis.

• Prevention Protecting yourself and the person you care for is the most important thing, getting properly informed about STIs, being free of them and knowing how to avoid getting them is your responsibility as a maturing person and can make your relations worry free and much more enjoyable. - It is important to know that you can get a STI from sexual relations with one person only, if they happen to be infected. - It is important to know that some STIs do not show immediate symptoms. - It is important to know that prevention of STIs is possible if you are properly informed. - It is important to seek medical advice immediately if you suspect you might be infected. Talk to your partner and abstain from sexual relations until you are tested and treated. You can also talk to an adult you trust. If you are sexually active, it is important to BE FAITHFUL TO YOUR PARTNER. To practice SAFE SEX always and every time. Use condoms ALWAYS. Never use the same condom twice. This will prevent the spread of infections of most STI and HIV.