Teen girls often don't use condoms during their monthly menstrual cycles, according to a study that suggests this might increase their risk for HIV and other sexually transmitted infections.
Adolescent women are disproportionately impacted by sexually transmitted infections (STIs), and changes in the bacteria and other microflora in the vagina during menstruation can increase this risk, researchers note in the journal Sexually Transmitted Infections.
But adolescent girls used condoms for vaginal sex during menstruation just 26 percent of the time, the study found.
They were much more likely to use condoms during their periods if they had already had protected sex at least once during the past week while they were bleeding.
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The study findings "support the idea that young women's day to day decisions about condom use are linked to how they feel about their partners on that day, and especially how recently they've used a condom with that partner," lead study author Devon Hensel, of the Indiana University School of Medicine in Indianapolis, said by email.
The researchers recruited 387 girls aged 14 to 17 from primary care clinics in Indianapolis and asked them to keep daily diaries recording details about their sexual partners and contraceptive use.
At the start, nearly all of the teens reported experience with hand holding, kissing and breast touching. Many of them also had engaged in oral sex, but fewer had experienced vaginal or anal sex, about 34 percent and 12 percent, respectively.
The 'ick' factor
The young women reported vaginal sex in just 6.8 percent of the diary entries, and only 3.2 percent of the encounters happened when the teens were menstruating.
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The youngest women in the study were less likely to use condoms, as were teens that felt the highest levels of both positive and negative emotions toward their partners.
Shortcomings of the study include the lack of data on the women's relationships with sexual partners prior to the start of the study, the authors acknowledge.
In addition, condom use was low even when the teens weren't menstruating. The girls reported using condoms only 28 percent of the time when they weren't bleeding, a difference that isn't statistically different from the condom use rates reported during menstruation.
Honest, ongoing communication
"Condom use is slightly lower, but not notably different from other non-bleeding days," said Lucia O'Sullivan, a researcher in adolescent sexual health at the University of New Brunswick in Canada who wasn't involved in the study.
"There is nothing special about those days, although perhaps a higher 'ick' factor for some, but that does not appear to be influencing their condom use significantly," O'Sullivan said by email.
It's unlikely that teens would respond to warnings that unprotected sex is even more unsafe during menstruation, O'Sullivan added.
Instead, the best course of action for parents is to encourage honest, ongoing communication with their teen children, and urge teens to speak frankly with their sexual partners, Hensel advised.
"Young people have to learn to make independent decisions about their sexuality, balancing information about risk and protection with their own beliefs and needs," Hensel said.
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Image: Girl standing with a condom from iStock