Some may think talking about one’s personal demons so openly is a bad plan, but I think it’s a personal choice and really appreciate her honesty.  One of the things I track for You Should Know is articles on mental health and women. The focus at YSK on midlife and beyond can’t escape the emotional ups and downs of perimenopause, which can bring depression and/or anxiety. Both ends of that spectrum can be isolating and feel so shameful.  

A recent report says that one in five Americans have had mental health problems in the past year, with many youth affected.  In adult populations, women are more likely than men to struggle. If this is so common, we need to start talking.  Which is why I love The Bloggess for going “live.”

A great thing about social networking is the truly social part-it’s informative, it’s fun and it can be supportive, like in this case. It can offer relief when you realize, “Oh, I’m not the only one.”  Especially if you’re feeling, in the words of Anne Lamott,  “My mind is a neighbourhood I try not to go into alone.”

Everyone’s mind can be a lonely neighbourhood, but there really are lots of neighbours in warm homes all  around- we just have to realize that.  Imagery aside, I’m not a doctor, so do see yours if your feelings are interfering with your ability to go about your every day routines.  Some mood swings are part of normal, and others do need assessment and help.

Really, you’re not the only one.

- Janet

PS-  My post on Positive Women’s Network last week discussed the criminalization of  HIV disclosure- is it working?

Image: iStock

The blog introduces the concept that sex won’t be necessary for making babies in the future. It profiles a scientist who suggests that as soon as 50 years from now, the majority of baby-making could be done via In Vitro Fertilization (IVF). Drag for the couples who enjoy the baby-making, I initially thought. I was relieved to read that the pleasures of sex weren’t being abandoned, but enjoying it as a path to a baby might be.

Developments in fertility medicine in my lifetime have been amazing. I remember the birth of Louise Brown, the world’s first “test tube baby” produced via IVF. It was huge international news. Now babies conceived through IVF are born every day. And it’s not just IVF that has become readily available (if you have the money). There are all kinds of options, from donor insemination to surrogacy.   

Age is a factor in fertility, but not necessarily an insurmountable one. Women in the course of perimenopause or even post menopause can carry babies to term with fertility procedures. It’s not always medically achievable, but it works for some.   

IVF is already considered standard procedure in some circles- will it become standard practice for all? Will my grandchildren be conceived in a glass? I have to think about that.  

-  Janet

Photo: digitalart / FreeDigitalPhotos.net

Big Little Wolf did a great piece last week about the delights of being sexy over 50. And it referred to a couple of other pieces on the topic- clearly we’re not giving up on sex midlife. So why wouldn’t safe sex apply?

Perhaps people were shy about talking in public and they get their HIV and STI prevention information elsewhere (please). And that they’re using condoms or dams as needed. What concerns me is if people think it doesn’t apply to them.

Sex doesn’t stop as wrinkles appear. And neither does STI transmission, as illustrated by rising STI rates in older age brackets. Here’s hoping it was a scheduling issue more than anything.

- Janet

P.S.-  I didn’t talk about the new sex education guidelines in the US, because I already posted my thoughts over at Positive Women’s Network on Friday. I will just say, though, I hope they soar!

Photo: scottchan / FreeDigitalPhotos.net

Loved this “Best of re:Cycling Blog” list  from the The Society for Menstrual Cycle research.  DO read the “Menopause isn’t for Dummies” post- good old Roseanne is at it for those of us in perimenopause.  

Best science crud of the year: Celebrities deliver “health” information. Thanks to colleague Robyn Sussel over at Signals for this one. 

Florida’s Sun Sentinel sums up the “Top Ten Sexual Health Events of 2011” Coverage on teens, boomer sexuality, sex education and living longer with HIV.
 
Happy New Year to all!

- Janet

Photo: winnond / FreeDigitalPhotos.net

A wonderful woman is Pamela Madsen. As I’ve said before, we’re not related except in spirit,  so this isn’t a family plug. I love her writing: mid-life, aging, sexuality, honouring  yourself. Excellent thoughtful stuff.

If you’re looking for a few funny reads, do check out The Bloggess.for a view of the world from  Jenny Lawson. She is funny, at times rude, and dependably quirky. She writes on sex, parenting, and then, well, other stuff. Like Big Chickens. She writes for lots of folks, so you’re bound to find something that fits.

If neither of those women fit for the moment, there’s always Facebook.

Until next week, I raise a mint chocolate (no specific brand- I’ll comparison eat them all) and smile.

Janet

According to a recent report in MEDSURG Nursing Journal, rates of HIV and other STIs have increased in people over 40. Syphilis, Chlamydia, and gonorrhea are not at all uncommon. HPV is also on the rise.

Perhaps you’re already living with a viral STI like herpes or HIV. If that’s the case or if you’re trying to avoid STIs, safe sex know-how is important.

What exactly is safe sex? Safe sex is the best you can do to protect yourself and your partner(s) from sharing any STIs either of you might have. It includes behaviour choices and what we sexual health folk call “risk reduction”- handy tools like condoms or dental dams. Safe sex (or safer sex, which is more accurate) isn’t perfect- some STIs can be transmitted through skin to skin contact, like herpes and HPV. Which is why the conversation before sex is important.

Conversation can be the toughest part, as many women living with HIV can attest. But no matter what your STI status, an awkward talk about safe sex is better than none at all. Talking about your desires can include a point about feeling confident with condoms for any penetration (including oral) and dams for oral sex on you. As my nurse-friend Evelyn points out, it’s way better to talk about safe sex than to deal with an unhappy result after the fact, whether with your lover or at the doctor’s.

Risk reduction means doing things differently than you might have before- using condoms for penetration, for one. So what if you no longer can get pregnant? You can still get an STI and more folks our age are, especially with online dating all the rage.

Dating Confidential researcher Cindy Masaro (I’ve sung her praises before) and I recently talked. She’s finding it’s really interesting how women say they’ll have sex with someone they’ve met online soon after meeting them in real life. Even though they’ve shared all kinds of intimate info online, they haven’t talked about safe sex. The assumption that their new love “would have told me” is the general rationale.

Given that lots of people who have HIV don’t know it (here in Canada it’s estimated that 26% of people with HIV don’t know it yet), is this a rationale that seems wise? I’d say no.

If you’re still not convinced, consider this- with perimenopause and post-menopausally, our bodies change. We have less natural lubrication, which can make the tissue more likely to tear during penetration. That puts us at more risk for STI transmission.  

So talk to your guy or gal. It shows confidence and caring.

- Janet

Photo: Free Digital Images/ Markuso

When someone pushes ahead of you in a line up.

When a relationship hits a wall that demands reverse or ending.

In a pressure-cooker sexual situation. What would a nice girl do? Is that what seems right?

Etcetera.

Like so many women, I’ve wrestled with “nice” as I’ve made my way through the world so far. The messages men and women receive about “nice” differ. For women, it can mean “Be quiet, be compliant and don’t question.”  So, it was interesting to read Brian Goldman’s recent piece that suggested being nice might get me better healthcare.  

It makes sense: wouldn’t you care more for someone who communicates positively than for the person who is angry and complaining? Maybe so, but it shouldn’t be that way, as Goldman points out. He talks about the emotions of doctors influencing their work, even though they know it doesn’t jive with the profession.

The doctor-patient relationship is one full of uneven power. Your doctor knows things about health you probably don’t and is the gateway to healthcare beyond the office walls. This can put you in a vulnerable situation if you don’t agree with your doctor on a course of care or treatment. There may be times when you need to speak up, speak out and assert yourself. Which you might find yourself apologizing for if it doesn’t feel nice. 

A relationship with a doctor is like other relationships. It benefits from respectful communication; a clear understanding of what each other is saying and a willingness to see the other person’s side of things. But to get that understanding, you need to understand. So ask about what you don’t get. Research what you can to better assess your situation.

Respect your doctor by telling them the truth about what you know of your health and your feelings about a particular course of care. But remember they’re human too- they have stresses outside of those moments in the exam room, just like you.

So be nice. Or as nice as feels right.

- Janet

photo: iStock

Learning about our health is a lifelong process, as we’re always growing, shifting, aging, dealing with injuries and illness. And looking after our health can be difficult if we don’t have the information we need to make decisions. Being able to get easy-to-use information, interpret it for your circumstances, and make health decisions knowledgeably is health literacy.

Health literacy starts with a fundamental question- do you have the information you need? And this is where communication is so important. This can be part of a conversation but also applies to written information. Health information that supports health literacy is written so you can understand and use it. This isn’t always the case if you’re handed an information sheet on an illness or medication that is written in medical jargon. If you don’t understand your medical information, ask questions.

For instance,  a friend underwent surgery for vaginal prolapse. Her doc said it was “routine” and not a big deal. She assumed she’d be back at work in a couple of weeks, and at the end of those weeks felt something might be wrong because she was still so sore. When she called to clarify with doctor, he said to expect more like six weeks. “Routine” doesn’t mean it’s not a big deal, but both my friend and the doc missed that piece of communication pre-operatively.

Talking to your doctor or health care provider about what you need to know is essential. Telling your health care provider what he or she needs to know about you is essential too.

When it comes to your sexual health, it may feel awkward to admit you don’t know things, but better to ask for information than not have it at all. Have you talked to your doctor about sexual activity, and have you been tested or screened for STIs as needed? They won’t test or screen you for things they can’t imagine you’ll need, and unfortunately, assumptions can be made. I once interviewed a woman with HIV woman who said she had to insist her doctor test her, and when it came back positive, the doc was more surprised than she was.

If by chance a test does come back positive, do you know how the STI will be treated? Do you understand the directions and duration for treatment? You are your own best advocate.

Health literacy will continue our whole lives, whether we’re looking after ourselves or those in our communities. We can all be intimidated by doctors, so remember that you are the most important piece when getting care- your doctor‘s job is to support you. Asking for clarity is your right as you make your way down the road.

- Janet

For example, she suggests we think of condoms as seatbelts- protective but not perfect when it comes to preventing HIV and other STIs. They’re just a part of a safer sex plan that includes other elements.  

She’s not afraid of the politics attached to sexual health either. She recently shared her thoughts on why porn should be better regulated: not out of a judgment on who does or doesn’t watch it, but to protect the performers. I agree.

She writes in easy to understand language in this post about whether a condom with spermicide is better at preventing STIs (in a nutshell: no. But read her for a clear, no-nonsense explanation why).

The funny part? Many of her tweets, but also this post for sure: sex position of the day from Cosmo. Have a look. And do have a look at Gunter’s site for ongoing current sexual health info. She’s great.

- Janet

One of them was a post by Pamela Madsen, one of my faves. She talked about tension between embracing her (large-ish) self as a way of healing and then facing the health implications that a weightier body can pose.

The other item was the outrage over American retailer JC Penney marketing a grossly offensive girl’s t-shirt that reads “I’m too pretty to do homework, so my brother has to do it for me.” I’m thrilled to say that JC Penney has withdrawn the t-shirt; a triumph for body image advocates.  But the fact that it was available is distressing.

Mirror, Mirror

Body image is an issue for women large and small. Big breasted, small-breasted, un-breasted by cancer, surgically enhanced. Big, small, wide, dimply butts. Thighs of proportions that displease us (no matter what they are). I won’t start on noses.

Body image is also an issue for girls. I’m all too aware of it as mine moves towards the teens. It’s something we talk about a lot- how advertisers and magazines promoting for advertisers impress how you must look.

Madsen’s piece is important because it discusses the work that so many of us struggle with: accepting how we look so that we can feel whole and live our lives with respect, rather than separating from our selves because we don’t meet some ideal.

Size no license to bash

I understand obesity is a health concern for an increasing number of people. But obesity isn’t just a lack of willpower that needs a “snap to it” response. There are many reasons people become obese, just as there are many reasons behind anorexia or bulimia. Some are social, some are socioeconomic. And some are scientific. For example, research is finding some are genetic or physical, including our pursuit of “comfort food” in times of stress.

Obesity is a complicated issue that needs more research and understanding. Those who are struggling with it deserve compassionate support rather than a whip snapping retort.

The success of pressuring JC Penney to remove the t-shirt from its stores is a sign that women don’t want the body image pressure to continue. And as we learn more about health in different sized bodies and how we can care for ourselves as we strive for balance, we can’t forget kindness for ourselves and each other. Whatever a girl or woman looks like, she’s way more than a picture.

- Janet

Check This Out: Interestingly, I also came across a piece last week that highlighted when women were pressured to gain weight: “True Beauty” was buxom.