Teen Sexual Health- Talk the Talk Before They Walk the Walk with Kimberly Fallon, MD
From the Show: Valley Health System - NJ
Summary:
Air Date: 11/16/22
Duration: 10 Minutes
Research shows that many teens are sexually active by the time they are in high school. Sexual health includes how sex affects a person's physical and emotional health. Whether your teen practices abstinence or is engaging in sexual activities, talking with them about safe sex not only encourages responsible behavior but helps you guide your teen to make the healthiest choices for their sexual health.
Transcription:
Maggie McKay (Host): The conversation explaining sex between parents and their kids used to be called the birds and bees. But now, information is so accessible at such a younger age. When is the right time to broach this delicate topic with your teen? It can be awkward for both sides. So, our guest today is obstetrician and gynecologist, Dr. Kimberly Fallon, who will tell us all about teen sexual health. Talk the talk before they walk the walk. She'll guide us through the best ways to cover topics like birth control options, STIs, protection, kinds of sex, and much more.
Welcome to Conversations Like No Other, presented by Valley Health System in Ridgewood, New Jersey. Our podcast goes beyond broad everyday health topics to discuss very real and very specific subjects impacting men, women, and children. We think you'll enjoy our fresh take. Thanks for listening. I'm Maggie McKay.
Dr. Kimberly Fallon: Oh, thank you for having me.
Maggie McKay (Host): Thank you so much for being here, Dr. Fallon. I have so many questions. So, let's jump right in with, at what age should I start talking to my kids about sex?
Dr. Kimberly Fallon: So, I really don't think there's a specific age because really every kid matures at different rates. I think to me when they start asking specific questions about sex or you think that they've been exposed to something that they're curious about or not sure about is a good time. I think starting early, just questions about health and their bodies is extremely important. And that sort of is a segue for younger children to be able to feel comfortable talking to you about anything so that you can have the talk later when you feel that they're mature enough and ready.
Maggie McKay (Host): I think my mom could have benefited from your advice. Because I remember way back in the day, most of our moms, my friends, they said, "Do you have any questions about sex?" And we'd say, "No." And they'd go, "Okay," and that was it. That was it. So today, it's a lot different, right?
Dr. Kimberly Fallon: It is, yes.
Maggie McKay (Host): What suggestions do you have for parents on how to broach the subject? Like how do you get it rolling?
Dr. Kimberly Fallon: Yeah. So, you can seize an opportunity if they see something kind of sexual on TV or a song, bring it up in a really casual way, maybe when you're one-on-one with your kid. I mean, I probably totally embarrassed my three teenagers years ago when we started talking. But yeah, I don't call it the birds and the bees, but I think I jokingly said something like, "Hey, want to talk about sex, drugs, and rock and roll? Ask me anything" and, you know, make them totally blush, but it does kind of open up the conversation and just be super open and honest, which is not that easy for a lot of parents, because it can be a touchy subject. But I've always just advised people to answer questions sort of matter of factly and your child will usually guide you with their questions or embarrassment or both as to what they're ready to hear.
Maggie McKay (Host): Yeah. And like you said, I think timing is everything. Like you said, you can bring it up more casually if it ties into what you're watching or hearing on the radio. So, that's a good start right there.
Dr. Kimberly Fallon: Yep, absolutely.
Maggie McKay (Host): Is it necessary to talk to my kids about different kinds of sex, or is less is more the way to go?
Dr. Kimberly Fallon: So again, I think if they start asking questions, you can certainly answer them honestly. You know, I really think there's just an unfortunate wealth of information that kids have access to now between smartphones and the internet, and not every parent is monitoring everything that they're seeing. But, you know, I think for younger children, kind of matter of fact information about how babies are made and loving relationships between couples and things like that is a starting place. And I think, as they start to get older, you have to be more clear that sex does not only mean intercourse, that there's a lot of different types of things that involve closeness between two people.
Maggie McKay (Host): Right. I remember driving carpool and kids were talking about it and they forget you're there when you're driving, if you're quiet enough. And they were talking about oral sex and how, "Oh, that's not sex. That's not sex. Oral doesn't count." And I thought, "Oh, boy." Anyway, what is the average age people have sex for the first time? Is there one?
Dr. Kimberly Fallon: So, there are some ages listed. They've sort of changed over time. It's very variable based on geography and different cultures. I think the average age now is between 16 and 17. And by senior year of high school, which is 17 to 18-year-olds, it is the majority of kids that are actually having sexual intercourse and an even larger then have experimented with other types of sexual contact by that age.
Maggie McKay (Host): How old should a girl be before she goes for her first appointment with a gynecologist?
Dr. Kimberly Fallon: So, it's very variable. Again, I think it depends on how emotionally ready she is. If the parent thinks that she's sexually active, certainly that's a good time to bring them in whatever age that may be. I have an extra certification in pediatric and adolescent gynecology, so I'll see young girls of all ages with any issues that are beyond the scope of their general pediatrician. We don't start Pap testing, which is cervical cancer screening, until age 21 now, mainly because cervical cancer is very, very rare younger than that age. However, any young woman who's sexually active does need to be screened for gonorrhea and chlamydia, which can be silent. And also, sometimes parents will bring me their daughter who is not yet sexually active, but they want me to help with this talk that we're having now. So, I can open up with them and ask them if they have any questions and talk to them about the importance of condoms, discuss different birth control options, even though it may not be quite the time yet.
Maggie McKay (Host): And what's involved in the appointment? What should you tell your daughter to expect when they go to the gynecologist for the first time?
Dr. Kimberly Fallon: So when I see young girls, I first do interview them fully dressed. I ask them questions about their medical history. And then, I do ask about sexual activity, whether it's something they've already done or are planning on. I actually ask whether they prefer boys, girls, or both, so I can be clear on that because if it's a girl who's interested in another girl, you're not going to talk to them about pregnancy prevention. And once I have that information, we'll do a brief exam. If the young woman is not sexually active, I do not do a pelvic exam. That's kind of scary. I think that's every young girl's fear when they come in, especially if they're not having sexual intercourse yet. If they are sexually active and having sex with male partners, I will talk to them about birth control and I will do screening for gonorrhea and chlamydia, which is just a Q-tip if they are under 21. If they're over 21, I'll do a Pap test as well as gonorrhea and chlamydia screening.
Maggie McKay (Host): And you mentioned birth control. If you talk to your child about birth control, does that make them think it's acceptable and they have permission?
Dr. Kimberly Fallon: Absolutely not. Knowledge is power and the more educated your child is about their bodies, about contraceptive options, about protecting themselves from getting any type of infection, I think the more equipped they're going to be to enter the world and make good and wise decisions.
Maggie McKay (Host): And if your child is gay, what do parents need to tell them to be safe?
Dr. Kimberly Fallon: So, the most important thing, if your child comes to you and says that they're gay or transgender, is acceptance. And I would hope nowadays our generation of parents of teenagers now are becoming much more open to differences. But the most important thing is, "I love you no matter what. You're still my child no matter how you identify."
LGBTQ+ teenagers do have higher rates of substance abuse. They have higher rates of anxiety and depression and suicide. So, being completely accepting is the best way to prevent some of these issues. And then, it depends, of course, what type of sexual activity you think they're engaging in as far as safety, but still condoms and protecting themselves, protecting their bodies, making sure that everything they're doing is consensual and that they feel safe is extremely important as well.
Maggie McKay (Host): And what are STIs? Are they common and are they permanent or can they go away?
Dr. Kimberly Fallon: So, STIs are very common. Condoms are the only way to prevent certain STIs. The most common STI right now is human papillomavirus. At this point, lifetime risk of exposure is upwards of 80%. So, it's basically if you're having sex, any type of sex, even just close contact, it doesn't have to be intercourse, your body is going to come across HPV at some point. Gonorrhea and chlamydia are still prevalent. Syphilis made a little bit of a comeback. HIV is still around, but there are good treatments now and it's not as common. So, you know, the treatment depends on what the infection is. Viral infections are treatable but not curable. Although with HPV, your immune system usually does clear it within a couple of years. And bacterial and parasitic infections are completely treatable and curable, but they need to be picked up as early as possible.
Maggie McKay (Host): So, a child needs to know they can get an STI even if they're not having sex per se.
Dr. Kimberly Fallon: Yeah, absolutely. And this is something that I don't think is clearly taught necessarily in school or talked about enough, which is that, you know, both HPV, which is human papillomavirus and HSV, which is herpes simplex virus, can be transmitted just with close skin to skin contact. It doesn't have to be intercourse. Even while wearing a condom, if the genital skin is still exposed, then there's genital to genital contact or oral-genital contact, it's pretty contagious and transmissible.
Maggie McKay (Host): And why is it important for a teenager to have the HPV vaccination?
Dr. Kimberly Fallon: Well, we've already mentioned just how common HPV is. It's just kind of everywhere. So, HPV can cause several different cancers, most commonly cancer of the cervix in women, but also vaginal, penile cancers, some anal cancers, throat cancers. And the HPV vaccine, which the current one now is called Gardasil 9, recommended for ages nine to 45. It prevents infection, if you haven't already been exposed, with nine different strains of HPV, although there are about 30 of them that can infect the genitals. So, you know, we're not only helping prevent cancers, but also additional testing that's uncomfortable. Especially for young women, we see a lot of abnormal Pap tests and they need office procedures and biopsies and a whole bunch of things that can be avoided hopefully by vaccination.
Maggie McKay (Host): So, if a parent doesn't like the idea of their teen taking birth control pills, say, are there other types of birth control to tell them about?
Dr. Kimberly Fallon: Yes. First and foremost, condoms, condoms, and also condoms. I tell every single patient that condoms are the only form of birth control that protect you from STDs and infections, not only from pregnancy. So even while using other forms of contraception, I still recommend condom use with all new partners.
As far as other birth control options, there is an intrauterine device. There's a couple on the market, but the one I usually recommend for younger women is called Kyleena. It's a little plastic device that gets inserted into the uterus as an office procedure, and it provides five years of birth control that is over 99% effective. It's a good option because there's no user failure. You know, even people on pills just forget them and miss pills and then they're not as protected. You know, condoms can break. They can roll up. There's mishaps with other forms of birth control, but the IUDs are very, very protective. So, that's a good option. There are both hormonal and non-hormonal IUDs available.
There's also contraceptive rings. There's a newer one where you reuse the whole ring for a full year. It's called Annovera. It also delivers hormones. So if you're looking for a totally non-hormonal contraception, that would not be it. There are also female condoms. There are contraceptive sponges. There are a bunch of options. But mainly for teenagers, I think the most common are birth control pills. Although the intrauterine devices are definitely gaining popularity and, of course, condoms, condoms and condoms.
Maggie McKay (Host): Speaking of condoms, let's say a boy has condoms in his car for months. And you know, it gets hot in there. It's the summer. Don't you have to have kind of new ones and look at the expiration date?
Dr. Kimberly Fallon: Yes, absolutely. And thank you for asking because, I think, sometimes boys thinks they're being responsible by carrying a condom, leaving them in their car or carrying a condom in their pocket, in their wallet, and it's exposed to body heat and sunlight and heat and melting, and that can damage the latex for sure. Condoms always need to be checked for expiration date.
The other common reason for them breaking is putting them on improperly. Sometimes putting it on inside out, and then realizing and turning it the other way. Or not squeezing the air out of the tip, there's a reservoir tip at the end. And sometimes if you put it on too snugly, there's a little bit of an air bubble in there that can just snap and you don't even feel anything. And another huge one is using any extra lubricant that's oil-based rather than water-based, so Vaseline, coconut oil. A lot of young women don't know there are over-the-counter yeast medicines that they may be experiencing yeast infection and they buy some yeast cream without a prescription, and the yeast medicine can actually damage a condom. So, there's a lot of things you have to be mindful of with condom use.
Maggie McKay (Host): So, do you need a prescription for birth control?
Dr. Kimberly Fallon: Yes, you do need a prescription for contraceptive pills, an intrauterine device. Condoms are available without a prescription. But if you're talking about hormonal forms of contraception, they do require a prescription from a physician or healthcare provider.
Maggie McKay (Host): At what age can a child get birth control without a parent's knowledge or consent?
Dr. Kimberly Fallon: So, it depends a little bit on the state. There are state laws on minors under the age of 18. I believe in New Jersey, minors, unless they are married, which is another issue or they have been previously pregnant, they cannot get prescription for birth control without parental consent. In New York, you can and, again, it varies by state. However, there are so-called Title X clinics. So if you're not going through your parents' insurance and you do want to have some form of birth control prescribed, you can go this route and be seen and obtain birth control without going through your parents' insurance.
Maggie McKay (Host): And will birth control or Plan B affect my teen's ability to have children in the future?
Dr. Kimberly Fallon: No, not at all. They're both completely reversible hormones that don't stay in your system. Plan B is just a single dose and it can slightly alter the periods and have some side effects, some nausea and other side effects, but there are no long-term health issues. That's said, I don't propose that Plan B be used for contraception. It should be used only if your contraceptive method has failed or, say, a condom broke or you've had a mishap, but not something that should be used regularly. But no, they do not cause infertility.
With birth control pills or oral contraceptives or contraceptive rings, we use contraceptives for a lot more reasons than just to prevent pregnancy. We also use them for girls and women who have heavy periods or severe cramping, mood swings. You know, there are a whole bunch of reasons that we use them. And I think the misconception, no pun intended, that they cause issues with infertility, is that there are a lot of young women who take them because they're already experiencing period issues, irregular periods, and they have some underlying condition that can affect fertility. So, it's not caused by the contraceptives, it's just that the birth control pill is covering it up while you're taking it. And when you stop it, the issue that you had underlying comes right back.
Maggie McKay (Host): Okay. And if a parent is concerned about their teen's relationship, what can they do to get them to see that their relationship is unsafe? How would you talk to them about that?
Dr. Kimberly Fallon: Yeah, that's a tricky one and very scary. I mean, I think the first thing you would do is look for sort of obvious signs of physical abuse if they're there, bruises, scratches. But also ,if your child is in a relationship and you see changes in their social behavior, they seem more withdrawn than usual, they're retreating to their room, you really need to find out what's going on to keep them safe. I would tell my children just your body is your own to protect and I want to make sure that you are mentally and physically healthy because I see some of those signs that I just mentioned.
Maggie McKay (Host): And this kind of goes hand in hand with that question, but how would you broach the topic of consent with your child?
Dr. Kimberly Fallon: Yeah. Most importantly, and I have teen boys, but certainly I tell my teen girl patients the same, is that no means no. And it doesn't matter if you've been drinking, if you've used drugs and, you know, it's no means no. So, consent is a tricky one. But in general, the legal definition of consent is a little different from what I would think is the emotional definition of consent. You know, in New Jersey, the legal age of consent for sexual intercourse is 16. But that doesn't mean that it's always non-consensual, because it could be two 16-year-olds, however, the 16-year-old boy could still actually be charged with things even if they're the same age. But in general, consent means you feel ready and you are okay with the touching or the sexual activity that's going on. It's important I think to speak to your child, to ask questions to their partner. You know, is this okay? Is this still okay? And if the answer is yes, you can proceed. If the answer is no, you need to stop immediately and get out of that situation if it's getting uncomfortable.
Maggie McKay (Host): Dr. Fallon, wrapping it up, is there anything else you'd like to tell parents who have to eventually have this talk with their children or their teenagers?
Dr. Kimberly Fallon: So, yeah, I would say don't be afraid because you know it's better for kids to get accurate information from you than whatever sources they may be looking at. Parental education is so important. There are actually studies questioning teenagers and they say that actually their parents influence their decisions about sex more than their peers, which is really, really powerful. And I know, culturally or based on different upbringings, not everyone is comfortable talking so openly about sex. I mean, it probably came easier for me because I'm a gynecologist and I talk about it all week. But it's really important. Because by being open, you're going to be able to keep your kid safe and responsible and, hopefully, set them up in the world to make good decisions.
Not all information that's out there on the internet that they have access to is healthy stuff. So, I think it's extremely important to be as open as you feel comfortable being and start at a young age. Start telling your kid they can tell you anything from a very young age, and it's going to make it a lot easier as they get into the difficult adolescent years.
Maggie McKay (Host): That's so true. You're so right, because then it's not a big deal, you know? Whereas if you wait until they're 16 and you bring it up out of the blue, it's like, "Ah, I don't want to talk to you about it." Well, thank you, Dr. Fallon, for helping us navigate this topic, all these topics, with our teens. Your expertise has been so informative and useful. We appreciate you and all you do.
Dr. Kimberly Fallon: Thank you so much for having me.
Maggie McKay (Host): For more information about obstetrics and gynecology at Valley, please visit valleyhealth.com/obgyn or call 1-800-VALLEY, 1-800-825-5391 to schedule an appointment. If you found this podcast helpful, please share it on your social channels. And for more topics of interest to you, check out our entire library of podcasts..
Thank you for listening to Conversations Like No Other, presented by Valley Health System in Ridgewood, New Jersey. For more information on today's topic or to be connected with today's guest, please call 201-291-6090 or email This email address is being protected from spambots. You need JavaScript enabled to view it. . I'm Maggie McKay. Be well.
Maggie McKay (Host): The conversation explaining sex between parents and their kids used to be called the birds and bees. But now, information is so accessible at such a younger age. When is the right time to broach this delicate topic with your teen? It can be awkward for both sides. So, our guest today is obstetrician and gynecologist, Dr. Kimberly Fallon, who will tell us all about teen sexual health. Talk the talk before they walk the walk. She'll guide us through the best ways to cover topics like birth control options, STIs, protection, kinds of sex, and much more.
Welcome to Conversations Like No Other, presented by Valley Health System in Ridgewood, New Jersey. Our podcast goes beyond broad everyday health topics to discuss very real and very specific subjects impacting men, women, and children. We think you'll enjoy our fresh take. Thanks for listening. I'm Maggie McKay.
Dr. Kimberly Fallon: Oh, thank you for having me.
Maggie McKay (Host): Thank you so much for being here, Dr. Fallon. I have so many questions. So, let's jump right in with, at what age should I start talking to my kids about sex?
Dr. Kimberly Fallon: So, I really don't think there's a specific age because really every kid matures at different rates. I think to me when they start asking specific questions about sex or you think that they've been exposed to something that they're curious about or not sure about is a good time. I think starting early, just questions about health and their bodies is extremely important. And that sort of is a segue for younger children to be able to feel comfortable talking to you about anything so that you can have the talk later when you feel that they're mature enough and ready.
Maggie McKay (Host): I think my mom could have benefited from your advice. Because I remember way back in the day, most of our moms, my friends, they said, "Do you have any questions about sex?" And we'd say, "No." And they'd go, "Okay," and that was it. That was it. So today, it's a lot different, right?
Dr. Kimberly Fallon: It is, yes.
Maggie McKay (Host): What suggestions do you have for parents on how to broach the subject? Like how do you get it rolling?
Dr. Kimberly Fallon: Yeah. So, you can seize an opportunity if they see something kind of sexual on TV or a song, bring it up in a really casual way, maybe when you're one-on-one with your kid. I mean, I probably totally embarrassed my three teenagers years ago when we started talking. But yeah, I don't call it the birds and the bees, but I think I jokingly said something like, "Hey, want to talk about sex, drugs, and rock and roll? Ask me anything" and, you know, make them totally blush, but it does kind of open up the conversation and just be super open and honest, which is not that easy for a lot of parents, because it can be a touchy subject. But I've always just advised people to answer questions sort of matter of factly and your child will usually guide you with their questions or embarrassment or both as to what they're ready to hear.
Maggie McKay (Host): Yeah. And like you said, I think timing is everything. Like you said, you can bring it up more casually if it ties into what you're watching or hearing on the radio. So, that's a good start right there.
Dr. Kimberly Fallon: Yep, absolutely.
Maggie McKay (Host): Is it necessary to talk to my kids about different kinds of sex, or is less is more the way to go?
Dr. Kimberly Fallon: So again, I think if they start asking questions, you can certainly answer them honestly. You know, I really think there's just an unfortunate wealth of information that kids have access to now between smartphones and the internet, and not every parent is monitoring everything that they're seeing. But, you know, I think for younger children, kind of matter of fact information about how babies are made and loving relationships between couples and things like that is a starting place. And I think, as they start to get older, you have to be more clear that sex does not only mean intercourse, that there's a lot of different types of things that involve closeness between two people.
Maggie McKay (Host): Right. I remember driving carpool and kids were talking about it and they forget you're there when you're driving, if you're quiet enough. And they were talking about oral sex and how, "Oh, that's not sex. That's not sex. Oral doesn't count." And I thought, "Oh, boy." Anyway, what is the average age people have sex for the first time? Is there one?
Dr. Kimberly Fallon: So, there are some ages listed. They've sort of changed over time. It's very variable based on geography and different cultures. I think the average age now is between 16 and 17. And by senior year of high school, which is 17 to 18-year-olds, it is the majority of kids that are actually having sexual intercourse and an even larger then have experimented with other types of sexual contact by that age.
Maggie McKay (Host): How old should a girl be before she goes for her first appointment with a gynecologist?
Dr. Kimberly Fallon: So, it's very variable. Again, I think it depends on how emotionally ready she is. If the parent thinks that she's sexually active, certainly that's a good time to bring them in whatever age that may be. I have an extra certification in pediatric and adolescent gynecology, so I'll see young girls of all ages with any issues that are beyond the scope of their general pediatrician. We don't start Pap testing, which is cervical cancer screening, until age 21 now, mainly because cervical cancer is very, very rare younger than that age. However, any young woman who's sexually active does need to be screened for gonorrhea and chlamydia, which can be silent. And also, sometimes parents will bring me their daughter who is not yet sexually active, but they want me to help with this talk that we're having now. So, I can open up with them and ask them if they have any questions and talk to them about the importance of condoms, discuss different birth control options, even though it may not be quite the time yet.
Maggie McKay (Host): And what's involved in the appointment? What should you tell your daughter to expect when they go to the gynecologist for the first time?
Dr. Kimberly Fallon: So when I see young girls, I first do interview them fully dressed. I ask them questions about their medical history. And then, I do ask about sexual activity, whether it's something they've already done or are planning on. I actually ask whether they prefer boys, girls, or both, so I can be clear on that because if it's a girl who's interested in another girl, you're not going to talk to them about pregnancy prevention. And once I have that information, we'll do a brief exam. If the young woman is not sexually active, I do not do a pelvic exam. That's kind of scary. I think that's every young girl's fear when they come in, especially if they're not having sexual intercourse yet. If they are sexually active and having sex with male partners, I will talk to them about birth control and I will do screening for gonorrhea and chlamydia, which is just a Q-tip if they are under 21. If they're over 21, I'll do a Pap test as well as gonorrhea and chlamydia screening.
Maggie McKay (Host): And you mentioned birth control. If you talk to your child about birth control, does that make them think it's acceptable and they have permission?
Dr. Kimberly Fallon: Absolutely not. Knowledge is power and the more educated your child is about their bodies, about contraceptive options, about protecting themselves from getting any type of infection, I think the more equipped they're going to be to enter the world and make good and wise decisions.
Maggie McKay (Host): And if your child is gay, what do parents need to tell them to be safe?
Dr. Kimberly Fallon: So, the most important thing, if your child comes to you and says that they're gay or transgender, is acceptance. And I would hope nowadays our generation of parents of teenagers now are becoming much more open to differences. But the most important thing is, "I love you no matter what. You're still my child no matter how you identify."
LGBTQ+ teenagers do have higher rates of substance abuse. They have higher rates of anxiety and depression and suicide. So, being completely accepting is the best way to prevent some of these issues. And then, it depends, of course, what type of sexual activity you think they're engaging in as far as safety, but still condoms and protecting themselves, protecting their bodies, making sure that everything they're doing is consensual and that they feel safe is extremely important as well.
Maggie McKay (Host): And what are STIs? Are they common and are they permanent or can they go away?
Dr. Kimberly Fallon: So, STIs are very common. Condoms are the only way to prevent certain STIs. The most common STI right now is human papillomavirus. At this point, lifetime risk of exposure is upwards of 80%. So, it's basically if you're having sex, any type of sex, even just close contact, it doesn't have to be intercourse, your body is going to come across HPV at some point. Gonorrhea and chlamydia are still prevalent. Syphilis made a little bit of a comeback. HIV is still around, but there are good treatments now and it's not as common. So, you know, the treatment depends on what the infection is. Viral infections are treatable but not curable. Although with HPV, your immune system usually does clear it within a couple of years. And bacterial and parasitic infections are completely treatable and curable, but they need to be picked up as early as possible.
Maggie McKay (Host): So, a child needs to know they can get an STI even if they're not having sex per se.
Dr. Kimberly Fallon: Yeah, absolutely. And this is something that I don't think is clearly taught necessarily in school or talked about enough, which is that, you know, both HPV, which is human papillomavirus and HSV, which is herpes simplex virus, can be transmitted just with close skin to skin contact. It doesn't have to be intercourse. Even while wearing a condom, if the genital skin is still exposed, then there's genital to genital contact or oral-genital contact, it's pretty contagious and transmissible.
Maggie McKay (Host): And why is it important for a teenager to have the HPV vaccination?
Dr. Kimberly Fallon: Well, we've already mentioned just how common HPV is. It's just kind of everywhere. So, HPV can cause several different cancers, most commonly cancer of the cervix in women, but also vaginal, penile cancers, some anal cancers, throat cancers. And the HPV vaccine, which the current one now is called Gardasil 9, recommended for ages nine to 45. It prevents infection, if you haven't already been exposed, with nine different strains of HPV, although there are about 30 of them that can infect the genitals. So, you know, we're not only helping prevent cancers, but also additional testing that's uncomfortable. Especially for young women, we see a lot of abnormal Pap tests and they need office procedures and biopsies and a whole bunch of things that can be avoided hopefully by vaccination.
Maggie McKay (Host): So, if a parent doesn't like the idea of their teen taking birth control pills, say, are there other types of birth control to tell them about?
Dr. Kimberly Fallon: Yes. First and foremost, condoms, condoms, and also condoms. I tell every single patient that condoms are the only form of birth control that protect you from STDs and infections, not only from pregnancy. So even while using other forms of contraception, I still recommend condom use with all new partners.
As far as other birth control options, there is an intrauterine device. There's a couple on the market, but the one I usually recommend for younger women is called Kyleena. It's a little plastic device that gets inserted into the uterus as an office procedure, and it provides five years of birth control that is over 99% effective. It's a good option because there's no user failure. You know, even people on pills just forget them and miss pills and then they're not as protected. You know, condoms can break. They can roll up. There's mishaps with other forms of birth control, but the IUDs are very, very protective. So, that's a good option. There are both hormonal and non-hormonal IUDs available.
There's also contraceptive rings. There's a newer one where you reuse the whole ring for a full year. It's called Annovera. It also delivers hormones. So if you're looking for a totally non-hormonal contraception, that would not be it. There are also female condoms. There are contraceptive sponges. There are a bunch of options. But mainly for teenagers, I think the most common are birth control pills. Although the intrauterine devices are definitely gaining popularity and, of course, condoms, condoms and condoms.
Maggie McKay (Host): Speaking of condoms, let's say a boy has condoms in his car for months. And you know, it gets hot in there. It's the summer. Don't you have to have kind of new ones and look at the expiration date?
Dr. Kimberly Fallon: Yes, absolutely. And thank you for asking because, I think, sometimes boys thinks they're being responsible by carrying a condom, leaving them in their car or carrying a condom in their pocket, in their wallet, and it's exposed to body heat and sunlight and heat and melting, and that can damage the latex for sure. Condoms always need to be checked for expiration date.
The other common reason for them breaking is putting them on improperly. Sometimes putting it on inside out, and then realizing and turning it the other way. Or not squeezing the air out of the tip, there's a reservoir tip at the end. And sometimes if you put it on too snugly, there's a little bit of an air bubble in there that can just snap and you don't even feel anything. And another huge one is using any extra lubricant that's oil-based rather than water-based, so Vaseline, coconut oil. A lot of young women don't know there are over-the-counter yeast medicines that they may be experiencing yeast infection and they buy some yeast cream without a prescription, and the yeast medicine can actually damage a condom. So, there's a lot of things you have to be mindful of with condom use.
Maggie McKay (Host): So, do you need a prescription for birth control?
Dr. Kimberly Fallon: Yes, you do need a prescription for contraceptive pills, an intrauterine device. Condoms are available without a prescription. But if you're talking about hormonal forms of contraception, they do require a prescription from a physician or healthcare provider.
Maggie McKay (Host): At what age can a child get birth control without a parent's knowledge or consent?
Dr. Kimberly Fallon: So, it depends a little bit on the state. There are state laws on minors under the age of 18. I believe in New Jersey, minors, unless they are married, which is another issue or they have been previously pregnant, they cannot get prescription for birth control without parental consent. In New York, you can and, again, it varies by state. However, there are so-called Title X clinics. So if you're not going through your parents' insurance and you do want to have some form of birth control prescribed, you can go this route and be seen and obtain birth control without going through your parents' insurance.
Maggie McKay (Host): And will birth control or Plan B affect my teen's ability to have children in the future?
Dr. Kimberly Fallon: No, not at all. They're both completely reversible hormones that don't stay in your system. Plan B is just a single dose and it can slightly alter the periods and have some side effects, some nausea and other side effects, but there are no long-term health issues. That's said, I don't propose that Plan B be used for contraception. It should be used only if your contraceptive method has failed or, say, a condom broke or you've had a mishap, but not something that should be used regularly. But no, they do not cause infertility.
With birth control pills or oral contraceptives or contraceptive rings, we use contraceptives for a lot more reasons than just to prevent pregnancy. We also use them for girls and women who have heavy periods or severe cramping, mood swings. You know, there are a whole bunch of reasons that we use them. And I think the misconception, no pun intended, that they cause issues with infertility, is that there are a lot of young women who take them because they're already experiencing period issues, irregular periods, and they have some underlying condition that can affect fertility. So, it's not caused by the contraceptives, it's just that the birth control pill is covering it up while you're taking it. And when you stop it, the issue that you had underlying comes right back.
Maggie McKay (Host): Okay. And if a parent is concerned about their teen's relationship, what can they do to get them to see that their relationship is unsafe? How would you talk to them about that?
Dr. Kimberly Fallon: Yeah, that's a tricky one and very scary. I mean, I think the first thing you would do is look for sort of obvious signs of physical abuse if they're there, bruises, scratches. But also ,if your child is in a relationship and you see changes in their social behavior, they seem more withdrawn than usual, they're retreating to their room, you really need to find out what's going on to keep them safe. I would tell my children just your body is your own to protect and I want to make sure that you are mentally and physically healthy because I see some of those signs that I just mentioned.
Maggie McKay (Host): And this kind of goes hand in hand with that question, but how would you broach the topic of consent with your child?
Dr. Kimberly Fallon: Yeah. Most importantly, and I have teen boys, but certainly I tell my teen girl patients the same, is that no means no. And it doesn't matter if you've been drinking, if you've used drugs and, you know, it's no means no. So, consent is a tricky one. But in general, the legal definition of consent is a little different from what I would think is the emotional definition of consent. You know, in New Jersey, the legal age of consent for sexual intercourse is 16. But that doesn't mean that it's always non-consensual, because it could be two 16-year-olds, however, the 16-year-old boy could still actually be charged with things even if they're the same age. But in general, consent means you feel ready and you are okay with the touching or the sexual activity that's going on. It's important I think to speak to your child, to ask questions to their partner. You know, is this okay? Is this still okay? And if the answer is yes, you can proceed. If the answer is no, you need to stop immediately and get out of that situation if it's getting uncomfortable.
Maggie McKay (Host): Dr. Fallon, wrapping it up, is there anything else you'd like to tell parents who have to eventually have this talk with their children or their teenagers?
Dr. Kimberly Fallon: So, yeah, I would say don't be afraid because you know it's better for kids to get accurate information from you than whatever sources they may be looking at. Parental education is so important. There are actually studies questioning teenagers and they say that actually their parents influence their decisions about sex more than their peers, which is really, really powerful. And I know, culturally or based on different upbringings, not everyone is comfortable talking so openly about sex. I mean, it probably came easier for me because I'm a gynecologist and I talk about it all week. But it's really important. Because by being open, you're going to be able to keep your kid safe and responsible and, hopefully, set them up in the world to make good decisions.
Not all information that's out there on the internet that they have access to is healthy stuff. So, I think it's extremely important to be as open as you feel comfortable being and start at a young age. Start telling your kid they can tell you anything from a very young age, and it's going to make it a lot easier as they get into the difficult adolescent years.
Maggie McKay (Host): That's so true. You're so right, because then it's not a big deal, you know? Whereas if you wait until they're 16 and you bring it up out of the blue, it's like, "Ah, I don't want to talk to you about it." Well, thank you, Dr. Fallon, for helping us navigate this topic, all these topics, with our teens. Your expertise has been so informative and useful. We appreciate you and all you do.
Dr. Kimberly Fallon: Thank you so much for having me.
Maggie McKay (Host): For more information about obstetrics and gynecology at Valley, please visit valleyhealth.com/obgyn or call 1-800-VALLEY, 1-800-825-5391 to schedule an appointment. If you found this podcast helpful, please share it on your social channels. And for more topics of interest to you, check out our entire library of podcasts..
Thank you for listening to Conversations Like No Other, presented by Valley Health System in Ridgewood, New Jersey. For more information on today's topic or to be connected with today's guest, please call 201-291-6090 or email This email address is being protected from spambots. You need JavaScript enabled to view it. . I'm Maggie McKay. Be well.