This article discusses eating disorders and body image, including statistics.

As of 2021, at least 30 million people in the United States will have an eating disorder in their lifetime. This can range from anorexia or bulimia, to restrictive eating, to disordered eating habits. Eating disorders can affect anyone of any age and any gender. According to the National Association of Anorexia Nervosa and Associated Disorders, eating disorders have the highest mortality rate of any mental illness. Obviously, this is a huge and tragic problem. 

What is body image?

Although people affected by eating disorders have their own triggers or reasons the disorder develops, body image plays a large role in these disorders developing. Body image is the way a person feels about their body and the way it looks. It’s essentially the way you see yourself in this world, and how you feel about it. Your body image and sense of self might be totally different than how others actually see you, and most of the time, we are our own worst critics, so we likely judge ourselves more harshly than other people do.

Some bad body image habits could include excessively weighing yourself or obsessing over your weight or body mass index, looking at your body in an extremely critical way and comparing your body to how it “used to look,” or comparing your body to someone else’s body and putting yourself down because of how you look. Excessive dieting or exercise can also be an unhealthy and dangerous way to cope with poor body image. “Punishing” yourself for eating dessert or something unhealthy by working out extra hard the next day is also unhealthy behavior. 

Comparisons in social media and advertising

With social media, it has become far too easy for people to compare themselves solely based on looks. Even before social media became so popular, the media contributed to unhealthy body image for many people. Movie stars look perfect on-screen, while models look completely flawless in magazines. Luckily it has since become widely known and talked about that magazines often photoshop their models excessively. And it’s also important to remember that movie stars are literally paid to exercise and look a certain way for roles. It is literally part of their job. In the past several years, a few brands have done awesome work to contribute to positive body image for their consumers by featuring people of all shapes, sizes, and abilities in their ad campaigns. 

Aerie is one of my favorite brands that does this. Aerie is owned by American Eagle and sells bras, underwear, swimsuits, and loungewear. Aerie has models of all sizes on their website and in ads in their stores, and they don’t retouch any of the models in their photos. They have models with freckles, birthmarks, piercings, body hair, differently-abled models, and feature models varying in age, size, and race. A lot of Aerie stores also have post-it notes available to place positive affirmations on the dressing room mirror, contributing to feeling good while buying a bra and underwear. Not only do I really enjoy the clothing they sell, I like the experience of scrolling through Aerie’s website and seeing models that look like actual people I know. It’s like seeing your friends modeling awesome clothing for you.

Remember that Instagram isn’t real life

Although positive strides have been made to contribute to positive body image through ad campaigns, social media is, unfortunately, the perfect vehicle for comparing yourself to others. Instagram is literally made up of photos, and because of the nature of social media, people post their best bits and happiest moments. Although we all know intellectually that no one’s life is actually as perfect and curated as it seems online, it still hurts seeing other people look “perfect” if you don’t feel that great about yourself. Additionally, being an Instagram model is now a viable career. No shade to any of these models, but they will highly edit their photos so they look sculpted, smooth, and voluptuous. They are hired to sell products, so similarly to photos in a magazine, these photos are curated to perfection. The only difference here is that we scroll past these models while also scrolling past our friends, so it’s easy to forget that they are hired to model and edit themselves and that they actually don’t look like that.

Your body does not need fixing

Bashing your body is so normalized in our culture, especially for women. So many products are marketed towards us, promising to make our bodies look better as if they need fixing in the first place. Spanx, diet pills, neck exercisers (what the heck?), hair vitamins, products to make our eyelashes grow faster, waist trainers … truly I could go on and on. We are bombarded with products and “fitspiration” to make us think our bodies need all this fixing. That is untrue!! If you are taking care of your body and you are healthy, then there is nothing to “fix,” no matter your size. 

When thinking about body image and the way women are socialized to talk and think about our bodies, I often think of a scene from Mean Girls. It’s that scene where Cady first goes to Regina’s house and all of the friends are looking in Regina’s mirror and they go around one by one and say something they don’t like about their bodies. When Cady just stands there saying nothing, all of the girls turn and look at her, waiting for her to complain about her body too. I know Mean Girls is a comedy and it’s supposed to be satirical, but that moment is so true! Women are told we shouldn’t love our bodies the way they are, and we, unfortunately, bond over disliking ourselves. Let’s change that.

Body image extends to mental health too

When we talk about “healthy” bodies, we often just talk about size and weight, and feeling mentally healthy about your body is left out. If you weigh a certain amount, but in order for you to weigh this amount you eat way less than what your body needs, causing you to develop unhealthy eating habits and obsess over your weight, that is not a healthy weight for you! We need to incorporate mental health and positive body image into the conversation of healthy bodies. Negative body image can not only lead to disordered eating, but it can also lead to anxiety or depression

Body image advice from friends

So what are some things you can do to work on developing a healthier body image and feel good in your body? I asked some of my friends for tips for feeling good in their bodies. Here’s what they said…

One friend said they refrain from diet and body talk around friends and politely redirect the conversation when it comes up.

Several friends said they focus less on actual “weight” and more on how they feel. If they are feeling anxious or sluggish, they’ll go for a walk. They’ll eat more vegetables because it makes them feel good. They pay attention to what they body needs and act accordingly.

So many friends said they remind themselves of all of the amazing things their bodies can do. Running, walking, digesting, existing. 

Several friends said they like to wear clothes that make them look good and feel good. One friend said they like to wear things that are bold and out of their comfort zone to prove to themselves they can pull anything off. 

Several friends said they unfollow accounts on social media that make them feel bad or over-edit their pictures and follow people that are body positive instead.

One friend said listen to Lizzo. (Great suggestion)

Another friend said they practice “body neutrality,” which is acknowledging a thought about their body without judging it as positive or negative, but simply recognizing that thought then letting it go, kind of like in meditation. 

Several friends also said they don’t weigh themselves and tell their doctor not to say their weight out loud when they have a check-up.

I personally recommend going for walks, eating vegetables, and spending more time naked: sleeping naked, looking at yourself naked in the mirror at least once a day, and checking yourself out because by golly you look so good!! I also suggest wearing your body hair however you like it.  I also love the idea of health at any size and think this is a great mindset for the body-positive movement. That means being as healthy as you can mentally and physically, no matter your size. This allows for so many people to look good and feel good in their bodies! 

Follow some body-positive social media accounts and remind yourself of all of the amazing things your body can do and does each and every day. Compliment yourself the way you would gas up a friend! 

If you’re struggling with body image or disordered eating, please ask for help. The National Eating Disorders Association Helpline is 1-800-931-2237 and is available to call Monday-Thursday from 9 a.m.-9 p.m., and Friday from 9 a.m.-5 p.m. EST. You deserve to be healthy, care for your body, and love yourself no matter your size. 

Living with frequent migraines can cause many intense symptoms such as light and sound sensitivity, nausea, and even seeing an aura of light around your eyes. If you experience an aura during migraines, you’ll often see flashing lights, zigzags of light, or even blurry lights in your peripheral vision. If you are someone who is prone to migraines, another risk factor can be hormonal birth control pills. 

How do hormones affect migraines?

Hormonal birth control pills use combinations of the hormones estrogen and progesterone to help prevent pregnancy. Changing levels of estrogen that occur naturally in our bodies can often trigger migraines. Have you ever experienced a headache in the days leading up to your period? That’s because your estrogen levels drop during this time, triggering headaches or migraines. Because headaches and migraines can be triggered this way, some doctors prescribe birth control pills to patients to treat headaches. For others, this is just an extra perk of taking the combination pill for other reasons. In some cases though, it can increase the risk of stroke and other serious health complications to take the combination (estrogen and progesterone) pill.

If you get migraines regularly and particularly get migraines accompanied by an aura, ask your doctor about your birth control options. Typically, doctors don’t recommend people taking the pill with estrogen in it if they also get auras with their migraines, or if they have a family history of migraine or blood clots. If you have this history, the estrogen in the pill could increase your risk of stroke, deep vein thrombosis, also known as blood clots, or cardiovascular disease. 

Alternate birth control options

So what do you do if you are someone who wants to take birth control and also has a history of migraine auras? First, speak with your doctor about it. It’s important to be transparent with your doctor about your health history when getting new medication anyway, but especially mention if you have a history of migraines. In addition to the combination pill, there is also a pill with just progesterone that could work for someone with migraines. There are also non-hormonal birth control options like condoms or the copper IUD. If you’re someone with no history of migraines, but you start having migraines after starting hormonal birth control, go chat with your doctor about it immediately. It’s important to mention all of these symptoms and things you notice in your body so you can be as healthy as possible.

Talking to your doctor about migraines

I first learned that migraine auras plus birth control pills can be dangerous over the summer when a co-worker of mine told me she needed to go see her doctor because she was starting to get bad migraines and was on the combination pill. Despite being on the pill myself for many years, I had never heard of this! My doctor never told me about the dangers of migraines and the pill. This just shows the importance of talking about women’s health out loud and without shame! Ask your doctor questions, even if they seem silly. Talk to your friends about what birth control they are taking if you are considering it. Talk to them about other health issues. It’s normal to talk openly about all this stuff because it not only keeps us more informed, but it also keeps us healthier and prevents serious complications in the future.

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

I remember seeing a chart for monthly breast self-exams hanging in the shower in my parent’s bathroom when I was a kid. There were about four or five illustrations of a woman doing a breast self-exam with text explaining what she was doing. Since I couldn’t read when I first saw it, my little kid’s brain thought she was doing a fun dance. I would wave my arms up over my head like the woman in the pictures and dance around in the shower. Now that I’m an adult and have talked with my doctor about doing breast self-exams, I now know the importance of doing this check each month.

What is a breast self-exam?

Breast self-exams are an easy, inexpensive way for people with breasts to check for lumps or irregularities in their breast tissue each month. Self-exams should in no way replace having your primary care doctor or gynecologist check your breast tissue when you visit, and they shouldn’t replace mammograms either. Self-exams are meant to supplement the professional care you get to check your breast tissue. Mammograms typically aren’t necessary until you’re in your 40s anyway, so you want to make sure you’re aware of your breast health from a young age.

Why should I do a self-check?

Self-exams are so important because about forty percent of diagnosed breast cancers are detected by people who notice a lump in their breast. All people with breasts should start doing self-exams once they develop breast tissue or go through puberty. You should do a self-check breast exam once a month. My birth control pack actually has a little note written after my first week of pills that says “Monthly breast self-exam” to remind me to check. You could also put a reminder on your phone or in your calendar, or just do it each month when you get your period. 

When doing a self-exam, you’re looking for any changes in shape or color with your breasts or nipples, and also feeling for any bumps or lumps. In addition to checking for irregularities in your breast tissue, I think breast self-exams are awesome because it prompts you to pay attention to your body and get comfortable with it. 

There are a few steps for a breast self-exam, and it only takes a few minutes

Stand in front of a mirror and have your arms by your side or on your hips. Observe your boobs! What do you see? Do they look the same they always do? Do you notice any discoloration, dimples, or swelling? You should contact your doctor if you notice any dimpling or puckering, bulging, redness or soreness, or nipples that have changed position. Additionally, if your nipples are expelling any liquid or discharge, contact your doctor ASAP!

Next, while still in front of that mirror, lift your arms up. (This is the part on my mom’s chart in the shower I interpreted as a dance, but who can blame me?) With your arms lifted, look for all of the same things you were looking at before. 

You should also check your breast tissue while lying down. Your tissue spreads out all over when you’re lying down, positioning everything a little differently. Lay down and use the tips of your fingers to feel around. Put a pillow under your right shoulder, stretch your right arm up, and feel with your left hand. Use varying amounts of pressure as you feel around. Make sure to feel all the way into your armpit (you’ve got breast tissue in there, baby!), and under your boobs as well. The underboob area is sometimes hard to see in the mirror, so it’s important to feel for it. When you’re feeling around, it’s helpful to go in a pattern. You could start at your nipple and move in small circles going outward, or you could feel in lines across your breast. Just make sure to touch the whole breast. Repeat on the other side.

And finally, do a check standing or sitting up. A lot of people like to do a standing check in the shower (hence my mom’s chart in her shower) because your skin is slippery, making it easier for your fingers to glide over your breast. You’ll basically do the same movements you did to feel your boob when you were lying down. Pay attention to any lumps or bumps you feel.

What if I notice an issue?

If you do find a lump, dimpling, discharge, or change in your nipples, contact your doctor. A lot of women get small bumps or lumps in their breast tissue during their period because of hormonal changes, so if you notice a bump during that time, it might be due to hormones. If that lump persists and doesn’t go away by your next period, it could be something else. Just to be safe, if you notice any irregularities, call your doctor and tell them what’s up. They can guide you through your next steps. 

Staying on top of your health is super important, and your breast health is no exception. Build in your monthly check as part of your self-care or health routine. It doesn’t take long, and if you find a lump or irregularity, it could literally save your life to be on top of your breast health. Remember, self-exams are only meant to supplement exams by your doctor or mammograms. Get comfy with yourself and stay on top of your breast health.

Illustrations depicting a breast self-exam can be found at nationalbreastcancer.org and breastcancer.org.

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.

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!

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.

During a sexual encounter with a new or old partner, you probably learn what they like during sex. A tip I like to use is talking about what each other likes before things start to get sexy to help build a little sexual tension and set each other up for ultimate pleasure once the sex starts. Discussing what someone likes during sex is probably pretty common amongst many partners (I hope!), but knowing what your partner likes after sex is just as important through the practice of sexual aftercare. 

What is sexual aftercare?

Sexual aftercare is a concept made popular by the BDSM and kink community. These types of sexual encounters can involve pain through slapping and biting, or can even involve some more intense toys that combine pain and pleasure. Part of arranging a BDSM “scene” or sexual encounter, is discussing in depth what everyone is and isn’t okay with during sex and also discussing what is needed after sex to help come down from the intense play session and feel safe and comforted. This openness in discussing needs before and after sex should be practiced by everyone, no matter how “vanilla” your sex might be!

What can be included in aftercare?

Aftercare can look like whatever makes you feel best after sex. During sex, feel-good hormones are released, and these hormones are released during orgasm as well. Sometimes people can feel a bit of an emotional comedown after sex once all of these hormones are released, leading to a low mood. Having an aftercare routine that makes you feel comforted and safe can help alleviate some of this. My number one sexual aftercare tip is peeing after sex!!! Especially if you have a vagina. Pee right after sex to avoid a urinary tract infection. Peeing after sex if you have a penis is good for you too, but not as pertinent. 

Maybe after sex, you like to cuddle and talk. Maybe you want to sensually wipe each other down with warm towels. Maybe you are too overheated and need a few minutes to cool off and not touch one another. Maybe you need food. Maybe you need water. Maybe you are energized and want to do an activity together or go for a walk. Stay in bed. Fall asleep. Make a meal. Truly there is no wrong way to do sexual aftercare. Personally, my ideal aftercare routine is 

  1. Pee 
  2. Snuggle in bed 
  3. Ask my partner questions to learn more intimate things about them, whether they are a casual partner or someone I love 
  4. Drink water

Aftercare with any type of partner

Aftercare can be practiced with a casual partner who you only sleep with once or someone you sleep with for the rest of your life. Communicating what you need to feel good after sex, and holding space for someone else to do so will deepen your intimacy no matter the type of encounter. 

I recommend discussing sexual aftercare before you have sex with someone if possible, so that way you know what they need to feel safe ahead of the sexual encounter. If you get caught up in the heat of the moment and can’t discuss first, asking them right after sex is great too! I would also bet that your partner(s) has never been asked about what they need after sex before, which will probably make you a memorable, safe lover. 

Ahh, periods. The monthly bleeding we all know and love. Well, that might be an exaggeration, but plenty of people are familiar with this experience: once a month, if you have a vagina, you’ll release an egg from your fallopian tubes, and if that egg isn’t fertilized, you’ll have your period. This is a regular, routine part of a lot of people’s lives. Sometimes, however, you might experience some light bleeding between your period known as spotting. What’s that all about?

What Exactly is Spotting?

Spotting, also known as breakthrough bleeding or intermenstrual bleeding, is bleeding that occurs outside of your period. Spotting is usually lighter in flow and color than your regular period, even on your lightest days. Spotting is basically your body’s way of getting your attention to tell you something’s up. Spotting can be relatively harmless, but it can also signal some serious stuff is off with your body. If you experience any abnormal bleeding outside of your cycle, contact your doctor. If you call your gynecologist, you can simply ask to speak to a nurse and describe the situation. They can consult you from there and determine if the spotting is serious enough to come in for a check-up. 

What causes Spotting?

Spotting can be caused by a number of issues from hormone changes to stress to sexually transmitted infections. Spotting can be caused by ovulation or changes in your hormone levels. Some people spot a bit during ovulation due to your hormones adjusting. This usually isn’t dangerous, it’s just a reaction to your hormone levels shifting throughout your cycle. 

Speaking of shifting hormones, you might also experience some breakthrough bleeding due to hormonal birth control. If you take the pill, use Nuvaring, the patch, or the implant, or even a hormonal IUD (these all work using varying amounts of estrogen and progestin), you might experience spotting when first starting or stopping any of these birth control methods. Additionally, if you take the birth control pill and usually have a period week if you ever skip your period week and start your next pack of pills a week early, you might also experience some spotting. This is because of those changing hormone levels. 

Your “period” on the pill isn’t actually a period because you’re not ovulating, it’s actually a withdrawal bleed from the steady dose of hormones your body gets from the pill. Your body is at a certain point in its cycle with the pill before your “period” week, so if you start your next pack a week earlier than you usually do, it’s possible you could spot a little. This is also usually harmless, but call your doctor just to confirm. You can also experience breakthrough bleeding as you’re entering menopause. There are a lot of hormonal shifts going on during this time, so spotting can be a common indicator that menopause is approaching.

Extreme stress can cause breakthrough bleeding as well. Whether this stress is mental stress such as anxiety or depression, or stress on your body through exercise, weight loss, or weight gain, this can affect your hormones. Cortisol is a stress hormone, and when this hormone is wacky, it can affect your estrogen and progesterone levels.

Spotting can also occur very early on in pregnancy. Light spotting isn’t a cause for concern, but if you experience heavy bleeding, that could be a sign something is wrong. If you’re pregnant and experience spotting, even if it is light, I’d advise consulting your doctor just to be safe. 

A whole range of infections can also trigger spotting. Sexually transmitted infections, urinary tract infections, polycystic ovary syndrome, and pelvic inflammatory disease are just a few infections that can cause spotting. Because the range of causes is so wide, it’s super important to check with your doctor asap so you can treat the infection before it gets too serious.

Seeing Red After Sex

Some people also experience spotting after sex. It’s common for someone with a vagina to bleed after first-time penis-in-vagina sex, and a lot of people think this is because of the hymen breaking. The hymen is a thin membrane that surrounds the vaginal opening, and the truth is most people break their hymen in childhood riding a bike, or a horse, or doing a toe touch, and some people don’t have a hymen to begin with, so sex has nothing to do with it, but I digress… Bleeding after first-time sex is largely due to the tensing of muscles or lack of lubrication. 

It’s also common for people with vaginas to bleed after sex, even if they regularly have it. This happens when the cervix gets irritated due to particularly rough intercourse of tensing of your muscles. Call your doctor to investigate what might cause this. In general though, a great way to cut down on bleeding after sex is to use lube and make sure you have enough foreplay. The vagina needs time to relax and prepare itself for intercourse. Also, bleeding after sex or painful sex is not normal, so please call your doctor if you experience this because you deserve pain-free, pleasure-filled sex. 

As with any sort of health issue, it’s often hard to tell exactly what the cause of a symptom is. If you experience any sort of spotting, call your doctor. It is likely due to hormones or birth control, or something else that is harmless, but just to be safe, call and check-in. 

“Ingredients: Rayon and/or Cotton Fiber. Polyester or Cotton String, Polysorbate 20.” Those are the ingredients in my tampon of choice, “Playtex Sport’ unscented tampons. My “U by Kotex” menstrual pads don’t list any ingredients anywhere on the box. Even though I use these products every month, and have used them for YEARS, and will use them for years to come, I’ve never considered what ingredients I’m putting inside of my body.

Organic Ingredients?

If you’ve ever listened to literally any podcast with women on it, you’ve probably heard an ad for Lola. Lola is a subscription-based period product company that uses 100% organic tampons. With Lola and other organic cotton period products becoming popular, there’s been a lot of talk about what ingredients are in menstrual products and whether or not they are safe for us.

Several years ago the Menstrual Products Right to Know Act of 2017 was created. This act proposed that manufacturers had to list all of the ingredients of period products on the box so consumers could be one hundred percent informed. I didn’t realize this wasn’t already enforced, and because the pads I use don’t list ingredients, it seems this act didn’t get passed, so it’s hard to know what you are putting in or close to your body each month.

Finding Research on these Ingredients

From all of the research that I’ve done, it seems people are very unclear about which chemicals in period products are actually bad for us. I found numerous conflicting reports about similar ingredients, so honestly, I’m still not sure which ingredients are truly “good” or “bad.” It is important to note, however, that most of the articles I found talking about how toxic tampon and pad ingredients are were written five or more years ago. This shows that more research needs to be done on this topic so we can have more conclusive and definitive answers. I think part of the reason extensive research on this topic hasn’t been done is that there is such a stigma surrounding menstruation and so much shame in talking about it. We need to talk about periods, and we need to get that research done! But I digress…

Toxic Shock Syndrome

If you use 100% organic period products, obviously you don’t need to worry about any chemicals in your body. Although organic cotton period products don’t have chemicals in them, it is still possible to get Toxic Shock Syndrome from leaving a tampon in for too long. Don’t get lulled into a false sense of security and leave your tampon in for more than eight hours. You’ll still be at risk for TSS, even if your products are organic. Menstrual cups are also recommended as alternatives for tampons and pads that are full of chemicals. Most menstrual cups are made of body-safe silicone or rubber, last for up to 12 hours, and don’t have the same chemicals in them that tampons do.

From what I’ve found, it seems chlorine, dioxin, BPA, rayon, and “fragrance” are the most harmful chemicals overall. Although there are some misconceptions about chlorine and rayon used in tampons.

Chlorine 

This was used for bleaching tampons in the 1990s, but actual chlorine is no longer used. All brands use chlorine-free bleaching agents to clean their products, and according to the FDA, this is safe. When it comes to tampon production, “bleaching” is used to clean and purify the fibers of cotton or rayon used in the product. The tampon being “bleached” white isn’t the goal or reason for using chlorine in this part of the process.

Bleaching is done to reduce the levels of dioxins in these products. Dioxins are “chemically-related compounds that are persistent environmental pollutants.” What does that mean? Dioxins are a grouping of dangerous chemicals present in our environment that can be very damaging if high levels of exposure persist. Through these chlorine-free bleaching methods, the levels of dioxins in tampons are severely lessened to a supposedly safe level, and the levels of dioxins in our environment pose a much greater threat than those in our tampons.

BPA 

Bisphenol A (BPA) is a chemical found in plastic. You probably see refillable water bottles advertised as “BPA-free”— this is that same thing. BPA has been linked to disrupt hormones and cause other health issues. BPA would only be present in your applicators and not in the actual tampon itself, so look for BPA-free applicators, or use cardboard applicators or applicator-free tampons instead if this is a concern.

Rayon 

This showed up as a “bad” chemical in a lot of my research, but I also found just as many sources saying it’s okay. According to Tampax’s website and the FDA, the rayon used in menstrual products is completely safe. Rayon has been called unsafe because it’s a synthetic material, so people fear that it could increase the likelihood of toxic shock syndrome if any rayon fibers are left behind in the body. This is hasn’t been proven, and just as I said before, even organic tampons can still cause TSS.

Fragrance

You should never use ANY vagina products that list “fragrance” as an ingredient. Fragrances will not only disrupt your vaginal pH, which can lead to infections but products are not required to list what exactly goes into that “fragrance.” Always get unscented tampons, pads, or toilet paper, and stay away from vaginal hygiene products.

Oh and that polysorbate 20 that was one of the ingredients in my tampons? It’s apparently used in a lot of skincare/makeup/hygiene products to help with odor and is “supposedly” not harmful for your body.

Like I said before, it’s hard to know what levels of which chemicals are actually safe for our bodies because of the lack of scientific research done to regulate these products and all of the conflicting information out there. It seems that cotton and rayon tampons are okay, but if knowing completely what ingredients are in your menstrual products is important to you, using 100% organic cotton tampons or a menstrual cup would be the safest. These products don’t use chemicals found in other tampons, and they are fragrance-free.

As I mentioned before, the conflicting reports on ingredients I found while doing research just further show that menstrual hygiene and women’s health needs to be a priority so we can be fully informed on what we’re putting into our bodies.