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Doctors need to have more conversations about sex with their teenage patients.

New research reveals that less than two thirds of doctors and teenage patients talk about sex, sexuality or dating during annual visits. Researchers also found that these conversations last less than a minute on average.

"It's hard for physicians to treat adolescents and help them make healthy choices about sex if they don't have these conversations," said lead author Stewart Alexander, Ph.D., associate professor of medicine at Duke. "For teens who are trying to understand sex and sexuality, not talking about sex could have huge implications."

Researchers said that doctors can promote many health behaviors to teens by discussing issues like smoking, drinking and sex. While these conversations may be uncomfortable, experts at the American Academy of Pediatrics said that they are opportunities to talk about sexual development, sexually transmitted infections and pregnancy prevention.

Researchers analyzed audio recordings of annual visits for 253 adolescents. The teens, ages 12 to 17, visited pediatricians and family medicine physicians at 11 clinics in North Carolina.

The findings revealed that doctors brought up sex in 65 percent of visits, which conversations lasting an average of 36 seconds. Researchers found that 35 percent of visits included no mention of sex and none of the teens initiated discussions on sex.

"We saw that physicians spent an average of 22.4 minutes in the exam room with their patients. Even when discussions about sex occurred, less than 3 percent of the visit was devoted to topics related to sex," Alexander said. "This limited exchange is likely inadequate to meet the sexual health prevention needs of teens."

The study revealed that teen patients responded to yes or no questions with limited discussion and only 4 percent of teens had prolonged conversations with their doctors.

They found that female adolescents were more than twice as likely to spend more time talking about sex than their male counterparts. Researchers said that the finding suggests that boys could be missing out on benefits of annual visits.

"The implication for males is troublesome because as they get older, they become less likely to routinely see physicians outside of checkups or sports physicals," said Alexander. "Thus, the annual visits become essential and are perhaps the only opportunity for physicians to address the sexual behaviors of adolescent boys."

Unsurprisingly, older teens were more likely to talk about sex in their visits than younger teens. However, experts recommend that these conversations start in early adolescents before teens are sexually active.

"There's a saying that it's always better to have the conversation two years too soon than one day too late," Alexander said. "If you're one day too late, the teens may already be engaging in sexual behaviors that have consequences for them."

"Although adolescents have access to information on sex from a variety of sources, physicians could do more in support of teens' healthy sexual development," said Alexander. "Initiating conversations demonstrates to adolescents that talking about sex is a normal part of a checkup, and may open the door for more extensive discussions."

The findings are published in the journal JAMA Pediatrics.