Sexual Disorders

Sexual activity is common in high school students with over 60 percent of males and about 50 percent of females participating in sexual activity. This leads to unwanted pregnancies, sexually transmitted diseases, and HIV infection.

All sexually active teenagers should be considered for regular syphilis screening. There should be yearly Papanicolaou smears to evaluate for human papillomavirus, cervicitis, and malignancy. Cervical cultures for gonorrhea and Chlamydia test should be performed regularly. If there is vaginal discharge, this should be checked for yeast or bacterial vaginitis and trichomonas. If there are multiple sexual partners, testing should be done  more frequently than once a year. If pregnancy is suspected, the beta human chorionic gonadotrophin (BHCG) should be measured. If the over the counter urine pregnancy test is positive, BHCG should be checked if confirmation is required.

Teenage males require urinalysis and the leukocyptesterase test is positive in sexually acquired urethritis. If there  are symptoms with penile discharge or dysuria, gonorrhea culture and Chlamydia test are indicated.

If vaginal of penile lesions are suggestive of herpess infection, a Tzanck test and culture should be performed.

An adolescent who requires treatment for sexually transmitted disease (STD) is entitled to confidential care in the United States. The sexual partner(s) also requires treatment and there should be follow-up after treatment to ensure that there has been resolution. This is important because of the potential for failure to comply with the treatment prescribed.