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First Injectable HIV Treatment Approved

As of January 21, 2022, the first-ever injectable HIV treatment has been approved. This injectable drug called Cabenuva is a revolutionary breakthrough for HIV treatment. 

What is HIV?

Human Immunodeficiency Virus (HIV) is a virus that takes over cells in the body of an infected person and weakens the immune system, making it impossible for the virus to get cleared out. HIV can be spread through certain bodily fluids such as blood, semen, pre-seminal fluid or pre-cum, rectal fluids, vaginal fluids and breast milk. People can become infected with HIV by sharing a needle or having unprotected sex with someone who is infected with HIV. Although HIV is a virus that will stay in your body indefinitely, there have been great strides made for the treatment of HIV over the last several decades. 

What is the traditional HIV treatment?

People who are HIV positive typically take a daily pill to keep the level of HIV in their blood low enough that it can no longer be detected on a lab test. Once the blood levels are this low and stay that way for at least six months, the person can no longer spread HIV. This phase of HIV is typically called “U=U,” meaning undetectable=untransmittable. If the virus is untransmittable, that means you can’t spread it to someone else. Yay! Although you can get to a point in treatment where the virus is U=U, you still have to take meds for HIV every day if you have the virus. 

How does the injectable HIV treatment work?

This new injection works similarly to the daily pills, but it is a once-a-month injectable treatment administered by a doctor, rather than something taken every day. Patients who are eligible for the injection should consult with their doctor first, of course, then will take once-a-day “starter pills” for the first month of treatment and can start getting the shot shortly after. 

Patients will schedule what Cabenuva calls a “Target Treatment Date,” which is the same date each month to come into the office and receive the shot. If something comes up and that Target Treatment Day has to be missed, patients are still covered within their “Flexible Treatment Window,” which is seven days before the treatment date, and up to seven days after. This once-a-month injection is just as effective as the daily pills patients are used to taking, as long as it’s taken within this treatment window.

Why is an injectable HIV treatment a big deal?

The daily pill first came onto the scene in 2006 and has been a great option to keep patients undetectable, but now with this monthly injection, there are more options. A once-a-month injection is a great option for someone who doesn’t want to have to worry about taking a pill every day or someone who doesn’t have a schedule or lifestyle that allows that to be accessible. Since the injection has to be administered by a doctor, this is also a great option for someone who would enjoy having a monthly check-in with their provider each time they get their shot. 

Are there any side effects?

Similar to the daily pill, the injection does come with some possible side effects: fever, tiredness, muscle aches, trouble breathing, blisters or sores in the mouth, swelling of eyes, swelling of the mouth, face, lips, or tongue. The Cabenuva website also notes that you should contact your doctor immediately if you develop a rash after the shot.

This is a wonderful development for HIV treatment and helps make living with HIV easier and more manageable. I also want to be clear that people living with HIV have healthy, fulfilling lives. They have great sex lives, loved ones and careers. Treatment options like the daily pill and now this injection help make living U=U easier than ever. Visit Cabenuva’s website for more info, and contact your doctor if you think the once-a-month shot is for you.

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Weight-Bearing Exercise and Menopause

From the beginning of time, people with uteruses have experienced menopause. Menopause occurs when a person’s estrogen and progesterone levels decrease and their period permanently stops. This decrease in hormone levels typically starts between the ages of 45 and 55 in people with uteruses, but it can sometimes start earlier or later. Once you have gone without a period for a whole year, you are officially menopausal. Congrats! If you want to start preventing symptoms now, you may be able to thanks to the connection between exercise and menopause. 

What to expect in menopause

The time leading up to menopause where you experience symptoms like hot flashes, mood swings, and decreased muscle mass is called perimenopause. This begins during the ages of 45-55 (sometimes sooner, as I mentioned), and symptoms from this period can last for up to 14 years after menopause is done. That seems unfair to me!! During this time, your baby-making hormones are decreasing, and your body is no longer able to make a baby. That’s why it causes someone’s period to stop. Similar to puberty when all of your sex hormones are gearing up, menopause can come with a lot of symptoms. In addition to hot flashes and mood swings which we are typically aware of, menopause can also cause a decrease in bone density and a decrease in muscle mass. 

Estrogen levels are linked to healthy bones and muscles in women and people with uteruses, so when these levels decrease, bone mass and muscles decrease as well. Many studies have shown that people who practice some form of exercise, particularly weight-bearing exercise, experience some milder symptoms related to this decrease during menopause. 

How exercise can help symptoms

Lifting weights and doing strength training helps increase bone density. It’s recommended that women in the early 40s start exercising intentionally to lessen the symptoms of menopause even before they begin. If you lift weights, even light ones, and build up that bone density and muscle mass for years before your menopausal symptoms even begin, your body will be in an even healthier state to make up for some of those losses once those hormones start to fluctuate. 

Cardio exercise is also recommended for menopausal women. Dancing, going for walks, light jogging, and yoga are all great for relieving stress and mood swings that accompany changing hormones, but they also ensure the body is fit and healthy, creating as pleasant of a menopausal experience as possible.

Start to exercise and menopause may be milder

If you begin weight training now, when perimenopause beings, hopefully, some of the physical changes in the body will be less noticeable or less painful. Although a great stress reliever, unfortunately, weight training won’t stop hot flashes from happening. Some women will treat this with hormone replacement therapy, or HRT. During this treatment, patients take either estrogen, progesterone, or both to help alleviate menopause symptoms. By adding in some hormones through treatment, the decline in these hormones in the body will hopefully be milder. 

Although I am decades away from experiencing menopause myself, it’s something I’ve become increasingly fascinated with. Despite learning about my period and birth control very thoroughly, no one has ever talked to me about what to expect in menopause. It seems like a scary adventure no one is talking about. 

Resources such as The Menopause Manifesto by Dr. Jen Gunter talk in-depth about this time of life and ways to handle the changes and live a wonderful life after menopause. This, in addition to exercising and talking with your doctor can make menopause a less scary thing to navigate.

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Locked-up condoms to prevent easy purchase?

Condoms are one of the most popular forms of birth control. They are relatively inexpensive, easy to find (they’re available in nearly every grocery store and drug store), non-invasive, can be used as needed, and are effective at preventing pregnancy and preventing the spread of sexually transmitted infections. What’s not to love?! A lot of college campuses and health centers will even give them out for free. However, I have noticed in the last year or so, more and more stores are selling locked-up condoms behind glass or putting them inside of a clear plastic box that needs to be unlocked.

Have you noticed locked-up condoms?

Typically, items that are expensive or often stolen are locked away like this. I’ve seen some stores that will lock razors or even expensive skincare at a drug store behind glass that needs a key to open. I’ve noticed at my local grocery store, ALL of the condoms are inside individual plastic boxes that a clerk needs to unlock to release, similar to how some alcohol has a lock on the top that you need help opening. Although I understand that stores don’t want condoms to be stolen, I think this is a harmful solution. 

How locked-up condoms stigmatize sex

People can feel awkward buying condoms at the store, especially young people who are coming into their sexuality and have just begun having partnered sex. If the store you’re buying condoms at doesn’t have a self check out, the idea of looking a stranger in the eyes as they ring up your condoms can be intimidating for some people. Having safe sex is a normal part of life, and buying condoms to do so shouldn’t be intimidating. 

We live in a sex-negative culture where we typically don’t comfortably talk about these topics. Now imagine going to the store to buy condoms only to find they are locked up behind a glass case or need to be specifically unlocked at check out by a clerk. I worry that this extra step of intentionally asking a stranger to unlock the birth control at the store will deter people from buying condoms as frequently, resulting in more instances of unprotected sex. We don’t want that! We don’t want more exposure to STIs! We don’t want young people exploring their sexuality to put themselves at risk of an unwanted pregnancy. We don’t want anyone of any age to be at risk for that either. 

Other options for purchasing condoms?

I understand that perhaps stores don’t want these items to be stolen, but in the grand scheme of things, someone stealing a $5 pack of condoms is worth it to me. This is also coming from someone who believes birth control should be free everywhere for anyone. 

Condoms can be bought discreetly online, but it’s fast and easy to purchase them at a drug store as well. Not all stores have started locking up their contraceptives, but I’ve noticed enough that it worries me. My grocery store for example locks up all of their condoms but doesn’t lock up their razors or razor blades. In terms of items being stolen, I believe stolen razor blades are more hazardous than stolen condoms! And also way more expensive. 

I’m not sure what the solution is, but my hope is that this extra step of unlocking affordable birth control doesn’t deter people from purchasing condoms. If you need a little boost in confidence, I did write about how to confidently buy condoms. You’re welcome.  

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Flex Disc Menstrual Cups Empty Themselves!

I recently saw a commercial that stopped me in my tracks! This doesn’t happen often, or ever, really. I heard the woman on my television say, “Flex Disc even empties itself out while you pee.” Excuse me?! Sure, I’ve heard of menstrual discs before. Even contemplated trying them. But a menstrual disc that empties itself out while I go to the bathroom? That was a novel concept to me! I had to learn more. And then of course share that knowledge with you all. [Photo Credit: Amazon/Hello Giggles]

What is the flex disc?

Flex Disc is a single-use menstrual disc meant to be worn for up to 12 hours. Flex Disc is made from a body-safe material, although the website doesn’t specify what that is. This disc is inserted into the vaginal canal and sits at the base of the cervix in the vaginal fornix. The disc collects your period blood here and leaves your vaginal canal open. 

The website mentions several times and even encourages Flex users to enjoy mess-free period sex while the disk is inserted. I love that! Since the disc sits at the opening of the cervix, the vaginal canal is wide open for business. Flex Disc users have also reported they’ve experienced less cramping since switching to the disc, and the disc produces 60% less waste than other disposable menstrual products. 

How does the flex disc work?

To insert, you pinch the disc between your fingers so it is as long and thin as possible. You insert the disc into the vagina, and when you can no longer keep pinching, release the pinch and push it into place using either a thumb or pointer finger. They also suggest doing some Kegels or squats once it’s in place to make sure the disc is situated. 

You can keep the disc in for up to 12 hours, and at the end of the day, or whenever you’re ready to change it, you insert a pointer finger to take it out. With clean hands, grab onto the edge of the disc, and pull it out of the vagina, keeping it as flat as possible to avoid spilling blood. You empty the blood into the toilet, then throw the disc away. Don’t reuse the disc once you take it out! If you have a particularly heavy period, Flex suggests emptying the disc out throughout the day, then inserting a new one. And here comes the good part! The disc can empty itself while you use the bathroom. 

How does it empty itself?

Essentially, the natural muscle tension of our body helps hold the disc in place as we’re living our life throughout the day. When you sit on the toilet, the muscles relax a bit. If you “bear down” slightly, the disc can somewhat pop out of place, emptying a bit of blood while you empty your bladder. With clean hands, use your thumb or pointer finger to situate the disc back into place just as you did when you first inserted it, then carry on with your day. 

This company stands out

The fact can the disc can naturally empty itself BLEW MY MIND! Our bodies are so cool. If disposable period products aren’t your jam, Flex does have a menstrual cup available as well. I’ve seen other menstrual discs on the market, but the period and sex-positivity that Flex has really stood out to me. They mention period sex several times on their website and use inclusive language to make it clear that this product is for anyone who has a vagina and menstruates. Check them out at flexfits.com

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California Outlaws Stealthing

Content warning: This article discusses stealthing, a form of sexual assault in which a condom is removed during a sex act without consent. 

Stealthing is the nonconsensual removal of a condom during a sex act. This is sexual assault. Despite being sexual assault, this topic is rarely discussed, even though it happens too often. Thirty-two percent of women who sleep with men, and 19% of men that have sex with men have reported this happening to them. California just became the first state to outlaw this specific act, which I think is great progress in the right direction. 

Is stealthing assault?

Many people don’t discuss stealthing because I think many people don’t realize it is assault. If you consent to having sex with someone under the condition that they use a condom, then in the middle of sex, they remove the condom without you knowing, you are not continuing to consent to what’s happening. That is assault. This is a problem because it is sex without consent, even though it began consensually, but it can also put someone at risk for an STI or an unwanted pregnancy when the sex they agreed to with a condom would not expose that risk at all. Consent is essential for all sex acts. It’s essential in many of our interpersonal interactions in fact. Consent says that everyone involved in whatever is happening says “yes” to all that is happening. If someone removes a condom without the other person’s knowledge, it is impossible for them to consent to that.

How are stealthing cases handled?

California just outlawed stealthing earlier this year, and I hope this brings much-needed attention and discussion to this topic. Many sexual assault cases do not end in favor of the survivor, and the way investigating sexual assault cases in this country is handled is not great. This is a step in the right direction though, allowing survivors of stealthing in California to sue the perpetrators. 

I first heard about stealthing several years ago through an article I saw online, but I had never heard of it discussed amongst people I knew or in any discussions of consent. It was also a topic of discussion on the most recent season of “I May Destroy You,” where the main character is raped after being drugged, then several weeks later is assaulted again when her partner removes the condom during sex when she turns around to switch positions. She asks him about it afterward and he says he “assumed” she could feel that he took it off, blaming her for being upset. 

How can I talk about consent?

Hopefully, other states will follow in California’s footsteps and outlaw stealthing as well, furthering this conversation of assault and consent. Sexual consent is ongoing throughout a sex act. If someone agrees to sex with a condom, then that condom needs to stay on the whole time, unless there is consent for it to be removed. This act being outlawed can also act as an opportunity for people to further discuss consent. As I mentioned, consent is ongoing, and it can be changed at any time. It is a discussion. Sex without consent is an assault. Hopefully, this being outlawed can help acts of stealthing to decline, and other states will follow California’s example.

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The LEEP Procedure for HPV

You’ve probably seen commercials for the HPV vaccine. Hopefully, you’ve gotten the series of three shots to help prevent certain types of human papillomavirus that could lead to cancer. But if you do get HPV, you may have the common LEEP procedure completed with your doctor to remove unhealthy cervical cells.

What is HPV?

HPV is the most common sexually transmitted infection, and if you are sexually active, you will most likely get HPV at some point in your life. GASP! That sounds bad, right? It’s not bad in most cases. HPV is so common because it’s spread through skin-to-skin contact, and most of the time it doesn’t show symptoms. Most strains of HPV are no big deal and go away on their own, but some strains are harmful because they can turn into cancer.

Think of it like the common cold. Most people will get many colds throughout their lifetime. That’s not shameful or “dirty” or scary. No big deal. It will go away on its own, but in some cases, that cold could turn into something more serious like pneumonia or a sinus infection. That’s when you need to seek medical attention.

Types 16 and 18 of the human papillomavirus can lead to cervical cancer. If you have a vagina and are age 21 or over, or sexually active, you should be getting regular Pap smears to test for unhealthy cells on your cervix. If your doctor detects abnormal cervical cells, they will likely do an HPV test to see if that is the cause. Although HPV can cause unhealthy cells, HPV tests and Pap smears usually aren’t done together unless there is an abnormality. 

How does HPV relate to cancer?

You might be wondering, what even is my cervix? Where is it? Your cervix is a small area of tissue that connects your vagina to your uterus. Your vagina is the internal part of your genitalia and your uterus is also known as your womb. The cervix is kind of like a little cap at the top of the vagina. This is what prevents tampons or other things from getting lost in your body forever. The cervix is an important part of your body, so that’s why checking for healthy cells is so essential. 

If you have unhealthy cells on your cervix and have a positive HPV test, you’ll likely undergo something called LEEP. You and your doctor will of course discuss the best course of action to treat your unhealthy cells, but LEEP is a very common procedure to remove unhealthy cervical cells.

LEEP, or Loop Electrosurgical Excision Procedure, is done by your gynecologist in their office and removes unhealthy cells from your cervix. LEEP uses a wire heated by electrical current to scrape away the unhealthy cells. Sounds high-tech, right?! You don’t need to do anything to prepare for the LEEP procedure, although it is usually done when you’re not on your period, so if you have LEEP done, schedule it so it doesn’t happen while you’re menstruating. LEEP might hurt a little, so you could also take some Tylenol or Advil prior to the procedure. 

What can I expect from the LEEP procedure?

When you arrive at your doctor’s office, you’ll go into an exam room and undress from the waist down, similar to your Pap smear visit to the gynecologist. You’ll wear a gown and put your legs in stirrups so your doctor can see into your cervix. Your doctor will insert a speculum into your vagina to hold the vaginal walls open to have a clear view of your cervix. A speculum is made of metal or plastic and it honestly looks like a little beak that props open your vagina. Speculums are also used during Pap smears, so if you’ve had a Pap before, it’s the same thing. Once the vagina is open and the cervix is in view, your doctor might spray your cervix with a vinegar solution. This isn’t done with every LEEP procedure, but this solution turns the unhealthy tissue white, making it easier for your doctor to locate and remove it. After the solution is put into your cervix, you will be numbed. Your doctor will inject a numbing medicine into your cervix, then begin with the LEEP wire.

While holding very still, your doctor will put the wire through the speculum and into your cervix. Some doctors will also use a magnifying tool in your cervix to help see the unhealthy tissue clearer. The wire will take off the unhealthy tissue, your doctor will collect it, and send it to a lab for more testing. Because the wire uses electrical currents, it seals your blood vessels as it removes the unhealthy tissue, so you won’t bleed a lot during the procedure. The whole procedure takes about ten minutes and isn’t too painful. Since numbing medicine is used, most people only experience slight discomfort during the procedure. 

What happens after the LEEP procedure?

It takes about three or four weeks for your cervix to heal after the procedure, so don’t have vaginal sex, use tampons, or douche during this time. You should never douche ever, so don’t even worry about that one! Additionally, you’ll probably have some cramping for a day or so after the procedure, and you will probably bleed a little and have some watery discharge. The discharge can last for the whole healing process, and it might smell a little. This is normal! It’s also recommended to take it easy in general during the three to four weeks following the procedure. Don’t do any super intense physical activity. You need to allow your body some rest so it can heal. 

Are there any possible risks?

LEEP is a safe procedure, however, some serious complications could happen, although they are rare. Some people have pelvic infections, heavy bleeding, intense cramps or belly pain, fever, discharge that smells very bad, or bleeding that’s heavier than ever the heaviest day of your period. Additionally, LEEP may increase the risk of preterm birth in pregnancy. If you are currently pregnant and find abnormal cells, your doctor will wait until the pregnancy is over to do the procedure. 

If these possible side effects seem too severe or risky, talk to your doctor about other methods to remove unhealthy cells. LEEP isn’t the only method, although it is very common. Because HPV is so common and these unhealthy cells can turn into cancer, it is imperative that you get regular Pap smears! Encourage other people with vaginas in your life to go as well. Our vaginal and sexual health is super important, and although it might be uncomfortable or intimidating to think about, you need to stay on top of it.

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HIV Vaccine Trials

A very promising vaccine trial to treat HIV took place earlier this year. A report published in February by IAVI and Scripps Research reported a very successful initial trial for an HIV vaccine. This is a huge discovery not only for HIV research and treatment but for vaccine research in general. 

What are HIV and AIDS?

HIV, or Human Immunodeficiency Virus, is a virus that takes over cells in the body of an infected person and weakens the immune system, making it impossible for the virus to get cleared out of the infected person. HIV can be spread through certain bodily fluids such as blood, semen, pre-seminal fluid or pre-cum, rectal fluids, vaginal fluids, and breast milk. People can become infected with HIV by sharing a needle or having unprotected sex with someone who is infected with HIV. AIDS is the final stage of HIV. A person is diagnosed with AIDS if or when their immune system is no longer working the way it should. HIV turns into AIDS if the virus is untreated and weakens the immune system over time. Thanks to modern medicine, someone with HIV can live a full and healthy life and never progress to AIDS. This promising vaccine trial is another great step in the right direction for HIV treatment. 

How does the HIV vaccine work?

The vaccine is designed to target B cells, which then will trigger the body to produce “broadly neutralizing antibodies.” The vaccine is designed to be an “immune primer” and produces several different types of bnAbs. Using bnAbs has been a method for HIV treatment for many years, and this vaccine is targeting these antibodies as part of a multi-step vaccine treatment plan. The theory is that these antibodies will attach to HIVs surface proteins, disabling them once they enter the human body.

HIV has been a notoriously difficult virus to develop a vaccine for because of how quickly it mutates. This initial trial was 97% successful, which seems extremely promising.  This trial used 48 participants, giving some a placebo and some the actual vaccine. The trial had success in producing the bnAbs the scientist created it to produce. Many scientists involved are excited about this vaccine working for HIV, but also using a similar method to develop vaccines for other viruses that are quickly mutating as well.

The stigma of HIV/AIDS

During the 1980s when the HIV and AIDS epidemic hit, there was so much prejudice and misinformation going around. People with the virus did not get the treatment they needed, and because the virus was so new, very little was known about it. Since the epidemic, so much research has been done to make living with HIV totally possible and nontransmittable to others. Many medications have been developed over the years to treat HIV, and this vaccine showing promise in the early stages is exciting as well. With each new development, the stigma of living with HIV will shrink, and those who do have the virus will be able to live a totally healthy life and keep the virus under control. 

For more information on the initial vaccine trials, check out this article from europeanpharmaceuticalreview.com. 

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Premenstrual Dysphoric Disorder: More than Just PMS

It’s no secret that people who get periods can experience a range of symptoms leading up to and during their menstrual cycle. Premenstrual syndrome, or PMS, affects the majority of women who get their period. Symptoms of PMS include headaches, bloating, breast tenderness, fatigue, and mood swings, just to name a few. Culturally we seem to have a pretty good understanding of PMS and what that looks like, although people often mock women or discredit their mood because of PMS, which is another issue worth discussing another time. But I digress… Some women, however, experience even more severe symptoms during the week or two leading up to their period. Premenstrual dysphoric disorder, or PMDD, is a mood disorder that accompanies the more typical pre-period symptoms in a more serious way. 

According to Mayo Clinic, mood disorders are present when your “emotional state or mood is distorted or inconsistent with your circumstances and interferes with your ability to function.” People with PMDD experience common PMS symptoms, but oftentimes the emotional symptoms are so intense they are debilitating and affect those around them. 

What are the symptoms of PMDD?

Symptoms of PMDD include regular physical pre-period symptoms such as breast tenderness, bloating, cramps, fatigue, headache, and mood swings. Emotional symptoms include extreme sadness or hopelessness, extreme anxiety or tension, extreme moodiness, and extreme irritability or anger. Other possible symptoms include difficulty concentrating, extreme fatigue, binge eating or extreme change in appetite, change in sleep patterns, feeling out of control or panic attacks, and heightened physical symptoms mentioned above. 

To be diagnosed with PMDD you must have at least five of these symptoms, only during the week or two leading up to your period, and for a few days after your period starts. If you experience these symptoms randomly throughout the month not leading up to your period, it’s possible you have a different mood disorder or something else might be going on. The symptoms of PMDD only are present leading up to your period. Symptoms of PMDD begin about one or two weeks before your period starts and quickly disappear about two or three days after your period begins. It’s also important to note that most, if not all, of the symptoms are classified as being “extreme.” 

Misdiagnosing premenstrual dysphoric disorder

About five percent of women who are of reproductive age are diagnosed with PMDD, but that’s not to say more women don’t actually have it. Unfortunately, women’s pain is not taken seriously all the time, and women who seek medical help to figure out what is going on are often told they are just overreacting and being too hormonal, so their symptoms get blamed on PMS, when in fact it’s much more serious. Some women are also misdiagnosed with bipolar disorder when seeking help for premenstrual dysphoric disorder. There aren’t any tests for PMDD, so if you experience these extreme symptoms, you should keep track of when you experience them to help your doctor accurately diagnose you.

Tracking fluctuating hormones

People with premenstrual dysphoric disorder experience these symptoms because of their fluctuating hormones during menstruation, but the cause for this sensitivity to the changing hormones is unclear. As of 2017, the National Institutes of Health did a study that discovered women with PMDD actually have an altered gene complex for the part of the body that processes hormones and stress. This is a huge discovery and not only helps validate the women experiencing PMDD each month, but also opens the door for more research. Some studies have also suggested a link between people with PMDD and low serotonin levels. Serotonin is a chemical in your brain that helps control mood, sleep, and pain.

Treatments to help PMDD

When you experience PMS symptoms, taking some pain medicine and getting some extra rest can usually help a little. Treating PMDD is a little more complex. Antidepressants that are serotonin reuptake inhibitors are used to treat symptoms of PMDD. Birth control pills containing certain hormones can also be used to treat PMDD and hopefully regulate some of the changing hormones. Natural remedies such as exercise, meditation, and other stress management techniques can also help, although sometimes these practices aren’t strong enough to treat PMDD without medication as well. 

Some people have also found that taking calcium, vitamin B-6, magnesium, and L-tryptophan can also help treat PMDD, and some have found that chaste berry can also help control some of the symptoms. Doing other things that generally help manage anxiety like cutting down on caffeine can also help. These “natural” remedies aren’t approved by the FDA, while the medicine to treat PMDD is, so check with your doctor before exploring the natural route. 

Taking PMDD seriously

Premenstrual dysphoric disorder is a big deal, and we should start talking about it. Until I wrote this article I didn’t know much about the difference between typical PMS and this disorder. PMDD is a serious medical issue, and women’s pain should be taken seriously. If you think you might have premenstrual dysphoric disorder, start tracking your symptoms and see if they align with your cycle. You can also talk with your doctor about your symptoms and possible treatment if you suspect you have it.

Menstrual health is so important and deserves to be talked about. Your pain surrounding your period is valid and you’re not “crazy” for feeling emotional or not like yourself leading up to your period. It is a serious medical issue! If you suspect you have PMDD or even severe PMS, talk to your doctor. These symptoms can come on two weeks before your period even begins. Living two weeks of your month feel depressed or out of control is a long time to live that way. 

Talk with your doctor about ways to manage it. Your pain is valid. You’re not “too emotional.” You’re not overreacting. Sure, we can experience pain and discomfort leading up to and during our period, (our uterine lining is shedding after all), but it does not need to be debilitating. It should not be debilitating. Track your symptoms, talk to your doctor, and find out if there is a diagnosis that can help you treat your symptoms.

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Sex Positivity

If you know me and have spent more than an hour of your life around me, you know I love talking about sex. If we’re good friends that share parts of our lives with each other, I probably have asked you “How’s your sex life?” or “What’s your relationship with sex and your sexuality right now?” as casually as I’ve asked you how your job is going. That’s because practicing sex positivity is super important to me!

I don’t necessarily mean I love talking about sex in a graphic, “give me every detail of your sex life and I’ll give you mine,” kind of way, but also, if you feel inclined to share, I’ll probably listen. I am incredibly passionate about sex education and normalizing talking about sex so we can take away the cultural shame and stigma surrounding it. I am sex-positive, baby!

What is sex positivity?

Since people’s relationship to sex is so diverse and personal, it’s hard to pin down one, all-encompassing definition for sex-positivity. In general, though, sex positivity is having a positive, open attitude around sex. People who are sex-positive view consensual sex as a healthy part of life that can be openly discussed without shame or awkwardness. It’s also important to point out that you don’t have to have sex to be sex-positive. You can have a positive, open attitude around sex without it being a part of your life.

Stigmas around sex

We live in a sex-negative culture, meaning we receive all sorts of negative messaging surrounding sex that creates shame and stigma. How often have you heard a woman or even teenage girl referred to as a slut for being sexually active? Sex negativity! The idea that “normal” sex only exists within heterosexual marriage and all other sex is taboo or wrong? Sex negativity! Masturbation is dirty and sad? Sex negativity!!! Despite being bombarded with oversexualized women in magazines and on television, and despite seeing graphic sex scenes in movies, we still have a bunch of shame around sex as a culture. Sex positivity is all about breaking up that shame and learning that sex is a natural part of life that can be discussed openly without judgment.

When was the term created?

The term sex-positive has actually been around since the 1920s when Austrian psychoanalyst William Reich coined the term. If this word and idea have been around since the 1920s, then why is there still so much shame around sexuality in our culture?! One large contributing factor is not having comprehensive sexual education in all schools. Some schools teach abstinence-only sexual education or even require a parent’s signature to allow children to receive sex ed, so some kids are either told don’t have sex until they’re married, while some children don’t get any information at all. 

Sex positivity in education

Comprehensive sex education teaches things like consent, as well as LGBTQ+ sex, information about STDs, sexual desire, and the biology behind sex. Having sex education be open and inclusive in the information it is giving will create healthier attitudes towards sex in children and teenagers when they are first learning about it. Studies have also shown that students who receive comprehensive sex education have their first sexual experience at a later age, have fewer instances of STDs, and have a lower rate of teen pregnancy. 

Now that you know what it means to be sex-positive, what are some ways you can practice this? For me, being sex-positive means knowing that sex and sexuality is an essential part of life. Sexuality should be celebrated. I feel free to explore my body and my sexuality without judgment or limitations. I accept other people’s sexual preferences and want to learn more about how people feel good, even if they are not my own preferences. I do not tolerate slut-shaming or the concept of “losing your virginity,” because these ideas perpetuate restrictions and shame put on people, especially young women when it comes to sexual expression. I also know that not everyone wants to have sex, and that is also part of being sex-positive! 

A really important part of sex positivity to me is wanting to learn more about sex and sexual expression. I also strive to never “yuck” somebody’s “yum,” meaning just because someone is into something you wouldn’t find pleasurable, don’t shame them for it! It’s good for them, but not for you, and that’s okay. 

If you’re interested in becoming more sex-positive, but don’t know where to start, look online. There are so many amazing sex educators online who help normalize talking about sexuality. Three of my favorite educators are Esther Perel, Shan Boodram, and Hannah Witton. Start with some education, and eventually, you’ll feel open to discussing sexuality as well. Let’s leave sex-negativity BEHIND in 2021. Sex positivity only going forward!

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What to Expect in Menopause

The first time I heard about menopause was when I was in grade school. My family was visiting my great aunt who is always theatrical and fun, and I remember seeing her have a hot flash. She got up and walked around fanning herself vigorously and all of the adult women in my family giggled together. Since my aunt is already so theatrical, I thought she was just being silly. I didn’t understand what a hot flash was or how intense it could be.

Menopause is something I suppose I have always known I would experience one day, but other than knowing my baby-making hormones will slow down, I’ll stop getting my period, and I’ll have horrible hot flashes, this period of time seems almost like a caricature or something scary and unknown. So other than feeling uncomfortable and having intense hot flashes, what really happens to our bodies during menopause, and what are all of the side effects?

What is menopause?

First thing’s first: menopause is when your period stops permanently and your estrogen and progesterone levels go down. You are officially in menopause when you haven’t had your period for one year. The time leading up to the last menstrual cycle that we typically think of having hot flashes and other side effects are actually called perimenopause or the menopausal transition. This transition into menopause can happen anywhere from four to seven years before your last period, and after you’re in menopause, many symptoms can last for up to 14 years!!! That’s crazy to me! That means that even after your body has gone through these hormonal changes and you’re officially not producing reproductive hormones, you can still experience these pesky symptoms for up to over a decade. How did no one ever tell me this?!

People typically enter into perimenopause between ages 45 and 55, although it could be a little earlier or a little later. This transition begins when your body naturally starts producing less estrogen and progesterone, which are your reproductive hormones. During this transition, you’ll still get a period and can still become pregnant, although your periods might be irregular due to the hormonal shifts. Other side effects during this transition period include hot flashes, migraines, anxiety or depression, vaginal dryness which can lead to pain during sex, memory loss, and trouble sleeping. 

All about hot flashes

Hot flashes are due to these dropping hormone levels and can come and go at any time. Many women will experience really bad hot flashes at night, waking them up from their sleep. These can be treated with hormones, so you can see your doctor and get help managing those. The fluctuating hormones can also cause mood changes and anxiety or depression. Similarly, you can see your doctor about this and find a treatment plan.

Because your reproductive hormones are significantly decreasing, your vagina no longer produces natural lubrication. This can lead to pain during penetrative sex for many women, and can even lead to a lower desire for sex because of how uncomfortable it is. This can be treated by using a water-based lubricant during sex, and can even be treated with vaginal moisturizers, which are put into the vagina and can be used daily or every other day to treat dryness—not just for sex-related purposes. You can also use estrogen cream or talk with your doctor about taking hormones as well. Your sex life doesn’t have to end just because you’re hormones are shifting!

Some women experience memory loss during perimenopause or feel foggy-headed and confused. Getting enough sleep, staying active, and staying social can help with this, but if memory loss is a big problem for you, talk with your doctor. These symptoms slowly start happening as you approach your last period, and like I said they can start four to seven years before that even happens. Once you do have your last period and are officially in menopause after a year of no periods, these symptoms persist. Just like any other hormonal-related thing, some people are affected more than others. Some women experience minor menopause symptoms and are generally unaffected, while other women experience hot flashes so intense they have to eat dinner outside on a cold November day to cool off (a true story my mom told me).

Talking more about menopause

Regarding menopause, I’m most struck by how no one has ever really talked to me about perimenopause and menopause, and what exactly these symptoms look like. I had no idea these symptoms lasted so long and could carry on way past your last period. From the time I was a kid, I remember hearing all about when I would get my first period and what that would be like, but no one talked with me about this transition as well. I spend a lot of time reading and writing about women’s sexual health, yet I somehow still knew very little on this topic. 

I’m honestly quite overwhelmed thinking about all of these symptoms and anticipating this time in my own life, and I think talking about menopause openly with young women could help make this time seem less scary. Women already have to work to manage their periods and period symptoms as well as their fertility during their whole reproductive life, and then after that time winds down, we then have to manage a whole new set of symptoms. We should talk more openly about our reproductive hormones and what all menopause entails. This not only will empower women as they enter menopause themselves, but will also offer support for those women who are already experiencing it.

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