Who says what, when and to whom?

The above discussion has focused on aspects of fertility and reproductive health, although as briefly discussed in the introduction, a wide range of sexual health Viagra pharmacy issues are relevant to adolescents with CF. Given the risks of pregnancy, it is especially of concern that sexually active young women with CF are less likely to use contraception than otherwise healthy young women, and have erroneous beliefs about infertility and pregnancy risk. It is equally of concern that approximately one in three young men with CF report confusing not needing to use contraception with not needing to protect themselves from sexually trans-mitted infections, making statements like:

  • I don’t need to use condoms because I don’t have to worry about contraceptives.

These examples highlight the importance of ensuring that young people as well as parents have an appropriate level of knowledge and skills to protect themselves from unnecessary sexual health risks. As approximately two-thirds of adolescents and young adults want more information about sexual and reproductive health, it looks like this information is not being provided. This raises the need to consider why these issues appear difficult to discuss, when these issues should be discussed and by whom.

In contrast to acquired medical conditions where an ‘event’ such as the diagnosis of cancer or the commencement of chemotherapy may act as a catalyst for a discussion of reproductive complications such as infertility, CF is a congenital condition that is generally diagnosed in infancy. In contrast to infertility as a complication of chemotherapy where actions can sometimes be taken to improve later reproductive health (e.g. egg or sperm retrieval), this is not the case in CF. Thus, while it is expected that brief discussion of likely male infertility will take place at the time of diagnosis, the priority of most ongoing clinic discussions with parents of children with CF is on more immediate or day-to-day CF-focused management issues.

Mothers of girls with CF report that they would like to discuss a range of sexual and reproductive health topics with their daughters’ CF doctor before their daughters reach puberty. However, this occurs uncommonly in practice and mothers still overwhelmingly call for more CF-specific sexual and reproductive health information to be provided. It is likely that parents of boys would be similarly interested in discussing these issues with their sons’ CF doctor. However, the perspective of parents of boys with CF (both mothers and fathers) has been infrequently studied.