Girls Experiencing Sexual Intercourse Early: Could It Play a Part in Reproductive Health in Middle Adulthood?

Girls Experiencing Sexual Intercourse Early: Could it Play a Part in Reproductive Health in Middle Adulthood?

December 2, 2010 M/W/F, 8am Psychology 103 Dr. Harris

Introduction The article, “Girls experiencing sexual intercourse early: Could it play a part in reproductive health in middle adulthood?” is a study that examined a possible relationship between experience of early intercourse and reproductive health characteristics for women in middle adulthood. The study consisted of interviewing 522 females up to the age of 14 regarding the timing of their first sexual intercourse experience. Of the initial 522 interviewees that provided information, 369 were interviewed again 29 years later at age of 43. The questions consisted of a series of psychological and medical questions. The goal of the study was to examine whether being an early starter could have long-term implications for women’s reproductive health characteristics. The article discussed various factors, including socioeconomic status, demographic backgrounds, household income, education levels of the female and her parents, and any correlations with problematic behavioral problems. The article also provided methodology, data and results, a discussion section, and future outlook on the topic. At the time of the article’s publication in December, 2006, there was minimal research on this topic. However, a few additional studies and research have been published on this topic since this publication. Based on the findings presented in the combined research, I support the general position that there is a correlation between girls who experience sexual intercourse early and their reproductive health in middle adulthood.

Rationale There have been many studies on early sexual activity, however there was no attempt to correlate it to reproductive health in middle adulthood. Instead, prior research focused on various problem behaviors such as delinquency, violation, alcohol and drug use. Only one study focused on the consequences of the co-occurrence and separateness of early sexual intercourse and problem behaviors over time. The result showed that early onset of sexual intercourse, and early onset of intercourse and problem behavior in adolescence, produced long-term consequences relating to alcohol use and criminal activity in young adulthood. The majority of prior research on long-term consequences of early intercourse focused on early pregnancy. And while numerous studies have focused on the link between early pregnancy and early sexual activity, less is known about the link between early sexual activity and long-term reproductive health issues. There are, however, a few studies that indicate that early onset of intercourse could be a risk factor for poor reproductive health in adolescence. Studies have shown that girls with early onset of sexual intercourse are more exposed to sex-related reproductive ill-health, unintended pregnancies, STDs, and cervical atypias than girls with later onset [1]. While these are attempts at trying to understand physical and psychological well-being during adolescence, there was little empirical and theoretical research done on the long-term consequences of being an early starter.

Method The participants in the study were part of an Individual Development and Adaption (IDA) project. IDA is a longitudinal program for three complete school-grade Swedish children aged 10, 13, and 15 from a population of 100,000. The girls from the main group, age 10, have been followed into adulthood and by the age of 14, 522 girls were studied. And when the women turned 43, 379 of those participated in an intensive psychological-medical investigation. Additional testing measurement tools incorporated included an “Adjustment Screening Test,” gaining demographic variables, and gathering information by asking them the question, “Have you ever been pregnant?” The “Adjustment Screening Test” was used to identify criteria for an early starter and any problem behavior. Background information was obtained from personal interviews and data was obtained regarding socioeconomic status based on household income and education information based on age 13. Other information gathered included their parents’ education, age of leaving home, number of children, education, family income, and individual income. Asking the question, “Have you ever been pregnant?” was instrumental in gathering additional reproductive health characteristics dat.. They also asked questions regarding fertility, menstrual symptoms, contraception, and health check-ups.

Results The first part of the study examined if there were any significant differences between early and normal/late starters based on various demographic characteristics including reproductive health and health related behavior. It was found that generally early starters left home earlier than normal/late starters. Typically early starters left home approximately one year prior to normal-late starters and had a lower level of education. Additionally, early starters’ parents also had a lower education level in comparison with parents of later starters. There was no difference in household income. Nearly every woman by the age of 43 had been pregnant at some time and nearly all were married or cohabiting. However, there were several differences between the two groups of girls based on reproductive health markers. Fifty-one (73.9%) early starters terminated their pregnancies by a miscarriage or abortion, in comparison with 104 (47.7%) later starters. Regarding fertility, 24 (32%) of the early starters had tried to get pregnant for more than a year in comparison with 51 (21%) of later starters. Early starters consistently reported more menstrual symptoms than later starters and fewer had used contraception than later starters. No differences were found in routine health check-ups. Since household income during childhood did not differ between the groups, this was not studied further. However, parents’ education at age 13 did differ and was examined further as an early predictor to sexual intercourse. Girls who have a parent with a lower education were represented more frequently than those who have a higher educated parent. It was also found that being an early intercourse starter was a strong predictor of having menstrual symptoms at age 43. Being an early starter, independent of problem behaviors, did have a predictive association with being a teenage mother, pregnancies less than six months, abortion as a teenager, and no use of contraception. It was however, not linked with medical fertility treatment. Problem behaviors and early intercourse, together, was not linked to some reproductive health characteristics. It was also determined that low parental education consistently did not predict reproductive health. Early intercourse, however, was a strong predictor of early aged abortions than any of the other predictors.

Discussion Given there was minimal prior research done on this topic at the time, quite a bit of experimental evidence was added to the existing knowledge. The results help suggest that those who experience early intercourse early are likely different than their counterparts on various characteristics. Early starters and their parents tend to be less formally educated and leave home earlier than earlier counterpart who experience sexual intercourse later. The results also show that early intercourse plays a role in later reproductive health for women. Women with a history of early sexual intercourse reported less contraception use as well as more menstrual symptoms at age 43 than their counterparts without such a history. Strong correlations were also found for early intercourse being a strong predictor of reproductive health markers, both as a teenager and as an adult. The authors critiqued their work fairly in a variety of ways including offering explanations and citing related research in an attempt to propose possibilities and likelihoods. For example, no explanations are made for why early starters use less contraception in midlife. The authors then site another source explaining how perhaps fertility management requires a certain amount of ability to act rationally and plan for the future, as well a certain level of cognitive and emotional maturity. The authors also address some methodological limitations including using a varied group sizes in the final analysis and also how studying linear relations between variables will deny them gaining knowledge on possible interactions and patterns of reproductive health.

Critical Thinking The findings of the study correspond in many ways with what I have learned in Human Growth and Development class, particularly in the early adolescence stage. This is the age when young females begin puberty and develop sex characteristics. And with the arrival of puberty, hormonal changes will lead to an increased sex drive. This is when libido levels are increased and that 75% of females are sexually active prior to the age of 16 (in the U.S.) and that 50% of abortions occur in females under the age of 18. As stated in the study, I also learned in class that a substantial percentage of young females under the age of 18 are sexually active quite early, by the age of 15. Taking the Human Growth and Development class also identified how characteristics of sexually active adolescents are similar to what the study proposed. For example, I also learned that early and frequent teenage sexual activity is linked to personal, family, peer, and educational characteristics. These include early pubertal timing, parental divorce, single-parent and stepfamily homes, large family size, little or no religious involvement, weak parental monitoring, disrupted parent-child communication, sexually active friends and older siblings, poor school performance, lower educational aspirations, and tendency to engage in norm-violating acts, including alcohol and drug use and delinquency [2]. And as the study produced, we also learned how there is a correlation between early pregnancy and negative effects on educational attainment, martial patterns, and economic circumstances. This evidence could impact individual’s lives positively if there were more education and prevention strategies in place. Too often sex education classes and counseling sessions are provided too late (after sexual activity has begun) and are limited in time and generally stick just to the basic facts, such as reproduction and anatomy. While sex education does not encourage sex, it does improve awareness. And if this evidence was presented in sex education classes at an early life stage, it may prevent the negative impacts of early starters. However, given the life stage of the subjects, it may be difficult and challenging to get them interested as they generally do not consider themselves to be at risk. To have an impact, the sex education and counseling sessions must be relevant and related to their lifestyles to gain their interest so they can understand the impact it may have on their long-term reproductive health. The study’s findings could easily be an addendum to any contraceptive and birth control education. This study focused on 14 year old Swedish females and while the Sweden population takes a more liberal approach toward adolescent sexuality and associated behaviors (as long as it is monogamous), exposure to sex, education about it, and effort to limit the sexual curiosity of children and adolescents vary widely around the world. The study did not evaluate factors such as religion or race. However, as prior research has documented, earlier ages of initiation of sexual activity among African American compared with European American girls [3]. Based on the evidence presented in this study, and other supporting research on sexual activity, I support that there is a clear correlation between girls who experience sexual intercourse early and their reproductive health in middle adulthood.

References 1. Magnusson, C., Trost, K. (2006). Girls experiencing sexual intercourse early: Could it play a part in reproductive health in middle adulthood? Journal of Psychosomatic Obstetrics and Gynecology. Vol. 27, Iss. 4, p. 237-44 (8pp.) 2. Anaya, H.D., Cantwell, S.M., & Rothman-Borus, M.J. (2003). Sexual risk behaviors among adolescents. In A. Biglan & M.C. Wang, Preventing youth problems (pp.113-143). New York: Kluwer Academic. 3. Schofield, Hannah-Lise T. (2008). Predicting early sexual activity with behavior problems exhibited at school entry and in early adolescence. Journal of Abnormal Child Psychology. New York: Nov 2008. Vol. 36, Iss. 8, p. 1175-88 (14 pp.)

References: 1. Magnusson, C., Trost, K. (2006). Girls experiencing sexual intercourse early: Could it play a part in reproductive health in middle adulthood? Journal of Psychosomatic Obstetrics and Gynecology. Vol. 27, Iss. 4, p. 237-44 (8pp.) 2. Anaya, H.D., Cantwell, S.M., & Rothman-Borus, M.J. (2003). Sexual risk behaviors among adolescents. In A. Biglan & M.C. Wang, Preventing youth problems (pp.113-143). New York: Kluwer Academic. 3. Schofield, Hannah-Lise T. (2008). Predicting early sexual activity with behavior problems exhibited at school entry and in early adolescence. Journal of Abnormal Child Psychology. New York: Nov 2008. Vol. 36, Iss. 8, p. 1175-88 (14 pp.)