During adolescence there are rapid changes in body shape and hormonal levels. Girls are exposed to a wide variety of influences with sex being aired so much by the media. Magazines for teenagers are explicit, as are films and television. Peer pressure and pressure from boyfriends also play a part in the timing of a teenage girl’s first sexual experiences. The National Survey of Sexual Attitudes and Lifestyles interviewed men and women in 5-year age cohorts from ages 16 to 59. The reported median age of first intercourse decreased with age of responder. Thus the median age at which the youngest women in the sample experienced first sexual intercourse was 4 years earlier at 17, than that for those born 40 years earlier, when it was 21. The median ages for men were 17 and 20, respectively. There was also an increase in the numbers of both males and females who lost their virginity below the age of 16. The decline in the age of first sexual experience was greater than the decline in the age of menarche. The numbers confessing to first intercourse below the age of 16, particularly in the female group, were much lower in the groups from the Indian subcontinent than in any other ethnic minority. This may reflect religious and cultural influences.

Most people surveyed could easily remember the timing of their first intercourse. A survey of 7395 Scottish teenagers from a wide range of social groups with a mean age of 14 years 2 months found that 18% of boys and 15.4% of girls reported having had heterosexual intercourse. Many of the responders experienced regret. Thirty-two per cent of the girls and 27% of the boys thought that it had happened too early, whilst 13% and 5%, respectively, thought that it should not have happened at all. If there was any pressure surrounding the event, both sexes were more likely to report regret.

For girls, lack of prior planning with their partner was also significant.

The provision of contraception and advice regarding sexually transmitted infections is crucial in this age group. Confidentiality is a real issue for young people; teenagers living in rural areas may feel that a visit to the doctor’s surgery for contraception will not go unnoticed. It is important that young people can get advice regarding sexual matters from other sources such as youth centres and schools. First sexual experiences can be traumatic and events surrounding them can leave indelible memories. Early fears and fantasies can often be expelled if nipped in the bud and it is important that medical professionals are aware that young people may be sexually active and may have problems. As with older age groups, there may be difficulty disclosing the problem directly. A non-questioning technique, noting the atmosphere in the room, may be helpful.

Particularly in the under 16s, there is the possibility that sexual activity may be abusive and gentle enquiry regarding the age of the partner and the enjoyment and willingness to partake in the activities described may be propitious.

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