[Consequences and risks of adolescents]. / Consecuencias y riesgos de los jovenes adolescentes.

PIP: The years of adolescence are a time for loosening ties with the family and strengthening those with peers. Adolescence is a period of physical, emotional, social, and moral transition from childhood toward maturity. Before young people become parents, they should be assured that their children's basic needs for food, housing, education, and health will be met. In order to postpone the arrival of children until conditions are appropriate, they need access to contraceptive information and services. Information about contraception should be imparted to adolescents as part of a correct sex education. Another important reason for avoiding adolescent pregnancy is the elevated risk of maternal mortality and morbidity and the increased risk to the infant of prematurity, low birth weight, and mortality. Information about contraception should not be presented to adolescents in a way that will allow them to feel pressured to become sexually active. The sex education program should reflect the fact that not all contraceptives are universally accepted, for various reasons. Sex education classes should provide information and orientation, allowing each participant to decide whether or not to accept contraception or any particular method. Among available methods, withdrawal requires strong motivation and self-control on the part of the male, and its efficacy is relatively low. Condoms are appropriate for young people with sporadic sexual activity and are easily and inexpensively available. The rhythm method requires a record of the length of the preceding 12 cycles. Oral contraceptives (OCs) are highly effective and do not pose a risk to the health of adult women without risk factors. OCs should be used only by adolescents who have completed their growth and have established a regular menstrual pattern during at least 2 years. OCs are not required for very young adolescents. IUDs are not appropriate for nulliparous adolescents because of their greater likelihood of expulsion. Diaphragms are not as effective as OCs and IUds. Vaginal spermicides are innocuous and acceptable as a temporary method, but they are less effective when used without a diaphragm. They are appropriate to the sporadic sex lives of adolescents. Tubal occlusion and vasectomy are excellent and reliable methods but their irreversible character is not suited to the needs of young people. Lack of information on contraception does not deter adolescents from sexual activity. Girls should be aware that contraception will become an important part of their sexual life until menopause.^ieng

[Relations of the adolescent]. / Las relaciones del adolescente.

PIP: Adolescents often feel like sexual beings because of the physical and psychological changes produced by their hormones. Adolescents are sometimes disturbed by their newly occurring sexual fantasies and by lack of understanding from their parents of the changes they are experiencing. These factors together with social pressures of various kinds occasionally make the adolescent forget that decisions about how to behave sexually should be made by the individual, not by others. Adolescents should be able to evaluate personal relationships for their positive or destructive qualities. Decisions by adolescents about their sexual behavior and about when a personal relationship should become a sexual relationship are made more difficult by the conflicting social, group, and interpersonal pressures they face. In a good sexual relationship as in a good friendship, the 2 persons feel confident and behave honestly with each other. Neither dominates the other, and the relationship is pleasurable rather than negative for both. According to research, the 1st sexual relations of an adolescent often occur with an adult. Sex is usually unpremeditated and unplanned. Many adolescents are disappointed in their 1st sexual experiences, which may have occurred in unfavorable circumstances. The combination of inadequate sex education and knowledge of what to expect and unrealistically high expectations from movies or stories probably are principal causes of disappointment. Adolescents in the process of maturing from childhood into adulthood are not completely prepared psychologically or socioculturally for parenthood. In Mexico, 75% of 1st unions are believed to begin before the woman is 20 years old. Most adolescents who become pregnant do not use contraception. In 1976, only 16% of new family planning acceptors were believed to be 15-19 years old. The proportion of births to mothers under 18 was estimated to have increased from 3.1% in 1968-70 to 10% in 1976. Adolescent pregnancies, especially those in very young mothers, are at high risk of complications. Adolescent parents may suffer psychological complications and may face problems of incomplete education, restricted employment opportunities, and marital instability.^ieng

[Preoccupation of young people with their sexuality].

PIP: Each adolescent in the transition from childhood to adulthood experiences crises, turning points which may be more or less profound and which may affect different individuals in different ways, until the corporal and psychic transition in complete. During the crises there may be modifications in mood, activity, and behavior. The crises are moments for changing direction or viewpoint, reviewing values, and making decisions. For most adolescents it is more helpful to provide company, guidance, and understanding while the crisis is in progress than it is to try to resolve the crisis directly. If the adolescent is not allowed to change, progress, and mature, be will remain fixated as a child in the body of an adult. Adolescents of both sexes are preoccupied by growth and physical changes in their bodies and by comparisons with others. Adolescent males are often concerned about the size of their genitalia and by the appearance of nocturnal emissions and erections, topics on which their fathers can provide reassurance. Adolescent females may be worried about menstruation and tend to be more interested than males in topics such as contraception, pregnancy, and delivery. Females worry more about their physical appearance and less about the development of their sex organs than males. Sexual development of females may be complicated by double standards of sexual behavior. Young females engaging in sexual activity are permanently worried about pregnancy and rejection, which may create insecurity and difficulty in intimate relationships. Adolescent females are concerned about their ability to establish and maintain satisfying marital relationships in the future.^ieng