I’ve understood it was given as “advice” to women when their husbands wanted sex and they didn’t. Good old Wikipedia confirmed this, and the fact that it theoretically originates in the Victorian era, in the diary of a woman named Lady Alice Hillingdon. It was also given as preparation for brides on their wedding night –  pretty much the only sex education they were going to get.

I know sex education for youth is fraught with parental worry about how much is too much and what’s the best timing, but I surely hope that women and men get comprehensive sex ed long before they’re preparing for their weddings.

For those in our age bracket who are starting out again and might need some refresher info, check our FAQ pages as a start. Pamela Madsen (Shameless) is a great writer celebrating lively and informed sexuality over 50. And I’ve recently discovered Joan Price, author of Naked At Our Age.

It’s a holiday. Relax, and lie back if you so desire. Think about whatever makes you happy.

- Janet

Female puberty isn’t just about menstruation, just as menopause isn’t just about periods ending. Other things are going on, as those in the midst of hot flashes will confirm. The vagina goes through changes as do our bones, skin and hair, but for the purpose of this blog, I’m talking about the vagina. Young women may be menstruating regularly, but their vaginal tissues and cervixes aren’t fully mature for a few years after the onset of periods. Vaginas of women in perimenopause or post menopause have less lubrication than when they were younger, and tissues become thinner as well. As a result, young and older women can be more biologically vulnerable to STI than women in their twenties and thirties.

So what do you do to take care? Obviously, talk to your partner(s) about any recurring STIs you or they may have. Talk to your doctor about STI testing. And when it comes to sex itself, you want to avoid any tearing of tissue and exposure to STIs. Use lots of lube and latex condoms for intercourse – anal or vaginal. For those who are sensitive to latex, polyurethane is a safe barrier (natural materials like lambskin don’t block STIs). You can also use condoms and/or dental dams for oral sex. And even if it feels awkward, ensure the beloved younger generation gets this information too.

- Janet

photo: MorgueFile

Amy’s a nurse and says that her experience and health literacy helped her decision making. She talks about what she wants for her remaining time, and with the knowledge of chemo and radiation effects, decides that’s not the route for her. She wants to live as a person, not just a patient.

Her story echoes what an article from last winter said. In “Why Doctors Die Differently” a physician admits that because doctors know the downside of certain treatments, they opt for quality over quantity. They would rather have whole, shorter lives, than tattered extended ones.  

I think about this as it applies to my work with at Positive Women’s Network, where our organization assists women living with HIV. This includes making health info available as well as providing support workers and peers women can sound out their decisions with if they wish.  

In thinking about HIV treatment, women consider more than their health too. They have to think about how they’ll manage potential side effects and function in their day to day demands. About how they will keep on schedule with their medications when their lives can be so busy- if you mess up or miss doses with HIV drugs, the virus can resurge and be resistant to the medications meant to control it.

They also have to think about sudden disclosure if a guest sees prescription bottles in the bathroom. About lipodystrophy, a potential side effect that changes body shape.(It’s not as common with new drug combinations, but it’s still an issue for some.) If women are moms, they have to get their kids to school or daycare when they feel nauseous or need to be near the toilet. They have to think about taking these medications for the rest of their lives, as there is no cure for HIV. And even if they experience no short term side effects, what might the long term effects be? We’re still finding out.

Where are the Women?

Highlighting the lack of women in all medical research, a recent article in MacLean’s reported that females (even rats) are often excluded from medication studies because hormones get in the way. Pregnancy, the epitome of hormonal worry to researchers, is another problem again. Yet it’s our hormones that make it important that research be specific to us- our bodies function differently from men’s.

Like cancer options, HIV medications can make a huge difference in one’s life expectancy. For many they’re successful, but they’re not simple. For years HIV activists have called for more research specifically on women, and folks at places like Oak Tree Clinic are doing that important work. But treatments are being prescribed to women all the time based on research that doesn’t include enough information on women.

Every drug, even that over the counter no-name one you take for a headache, has benefits and drawbacks That’s a given. But in making decisions about cancer or HIV (or any serious health condition) that can have such profound effects on the lives of so many, it would be best to have women-specific information so women can make whole health decisions.  

- Janet

photo: Istock

My mom died before I had children, before I was even pregnant, actually. I’ve never been able to call her up so she can laugh about the latest parenting milestones I’ve reached. That’s been a huge drag many times; mostly because she deserves a huge fat thank you that I had no idea would be so justified.

Mom had a great piece of wisdom about parents and children that I’ve been thinking about lately. She felt it was important for me to have adults other than her to trust and confide in. She was that person for a friend’s daughter. She had no expectations around homework or house chores. She was the ears and heart her young friend needed.

So Mom had no problem with me confiding in the woman I babysat for, a nurse whose husband rode a motorcycle- far cooler than my parents. They were somewhat younger and totally separate from my life at school and home. They even lived in a different neighbourhood. They were lovely, funny people who treated me like the in-between creature that I was. Not a kid- I was looking after their sweet kid, for goodness sake. But full of worries and questions because I was not yet an adult. They teased me about crushes and didn’t get beefed when I ate all the cookies in the jar.

I have a couple of friends who would be wonderful for my girl that way. They’ve known her since she was a baby, but they have the luxury of arm’s length because they’re not family. And they are waaay hipper than me. We share beliefs around sex education, so if that ever comes up, my girl’s on good ground with them.

We are moving through, my girl and I. I want her to have support and good knowledge of sexual health, confidence in her own sexuality, and joy as her life unfolds. She’s an amazing kid, and I feel grateful she has loving adults besides her parents who are part of her life.

Thanks, Mom.

- Janet

Photo: Kakisky, MorgueFile

But will they be used? Microbicides could change the feel of sex- some formulations could be slick like lube, and others thicker, like contraceptive jelly. How will that play in the moment? Will people be open to the different sensations microbicides (might) offer? How will they feel in varied sex play that could include oral sex?

These are questions that researchers were urged to consider at last week’s conference. We all have our preferences of how we like sex. While it will be great to have new HIV prevention tools, acceptability and adherence are key issues to their success.  

You might say “Of course people would use them!” But think about condoms- they’re effective for preventing HIV and other STIs, yet they’re not always used because people prefer sex without them, even with STI risk (or denial). For those who grew up sexually in the time where the Pill was the answer to safe sex between men and women, adjusting to condoms was a shift (and still needs work, as rising STI rates in older populations show).

Condoms have been part of our sexual culture for thousands of years and they can still prompt complicated feelings. If you carry them, you might feel too forward.  Some people feel awkward about bringing up condoms and safe sex. Others say they just aren’t comfortable. Microbicides will enter this same taut fray of feelings.

I am super excited about the possibility of them – the more safe sex options we have, the better and more confident we can be. How we work them into sexual culture and comfort is as important as the products themselves. What are you willing to try for safe sex?

- Janet

 photo: iStock

It’s not the threat to heart health it might seem to be, despite the racing beat that caffeine often delivers. And it’s not associated with cancer risk over a lifetime. Bonus- although as Joe Jackson once sang, that might change too.

Great things about coffee? It can improve your sexual stamina and alert you for a delightful morning romp. As one coffee lover writes, it’s romantic in that sense- alcohol can’t do the same by a long shot. Not to mention alcohol inhibits one’s ability to make decisions about safer sex. It’s also got its romantic meaning- first dates are often for coffee, instead of higher pressure dinner. And it might enhance our sex drives- it does for rats in lab studies, although they weren’t regular caffeine consumers.  

Coffee does have its down sides. At one point, women didn’t like the effects of coffee on their marriages. When men visited coffee houses (and then the brothels upstairs) women thought it was coffee causing their husbands’ lagging sexual interests, and tried to ban it. And if you’re prone to incontinence at all- not uncommon for us gals- caffeine can irritate a sensitive bladder.

But I’m not giving it up anytime soon. It’s too tasty, too laden with ritual and delight. And at this point in family and work life, I appreciate the jump start it delivers- in many ways.

- Janet 

photo: Morguefile

One researcher who has been studying endocrinology for years is Vancouver’s Dr. Jerilyn Prior. Founder of CEMCOR, the Centre for Menstrual Cycle and Ovulation Research, Prior’s work takes a different turn. Her research thus far indicates that’s it’s a deficit of progesterone, not estrogen, that contributes to challenges of perimenopause and menopause.

Given that standard HRT thinking has tagged a lack of estrogen as “the problem,” Dr Prior’s thesis hasn’t been a popular one. Yet she’s persevered with her research and talking about its results. She’s written a number of books on the topic- and notably, will have a page to herself in the new 40th anniversary edition of Our Bodies Ourselves that highlights her work. This latest research seems to support what she’s saying.

I’ve heard Dr Prior speak and read information on the CEMCOR site- her work makes sense to me. But every woman has to make sense of her own body and make health care decisions with her doctor. I’ll keep looking for info- it’s fascinating how information continues to roll out on these amazing bodies of ours.

- Janet

Facts are, some groups of women do show up more often in the statistics. In the US, it’s Black women. As statistics stand now, 1 in 30 Black women could get HIV in her lifetime- a horrible piece of math to think about in a group of friends.  Here in Canada, it’s Aboriginal women, who account for almost ½ of new diagnoses in Aboriginal populations. That’s akin to infection rates in some African countries.

The US Center for Disease Control recently launched a new campaign called Take Charge, Take the Test. It’s aimed at Black women in the hope of encouraging them to learn their HIV status so they can health care steps as needed.  

I like their tagline, which speaks to all women (substitute “her” as needed):
“You feel as if you’ve known him forever, but that doesn’t mean you know everything.”

And this is the truth of all STIs. So many don’t have obvious symptoms (especially for men), that some people don’t know they have them. HIV may produce a flu-like illness initially, but not always. Then a person can seem well for years before their immune system reaches a dangerous tipping point. Research has shown that the inflammatory impact of HIV starts right away, but it’s not obvious to the person with HIV.  

While this campaign is aimed at Black women, I suggest all women take the hint and get tested for HIV if you haven’t already. If you’re nervous about it, fair enough- there’s support a phone call away at your nearest HIV support organization. It can’t hurt, but it can certainly help.

- Janet

photo: iStock

Sharon’s pick was Brene Brown’s The Power of Vulnerability and mine was Susan Cain’s The Power of Introverts. They’re not about sexual health per se, but stick with me.

These two presentations spoke of individuality and community. Of embracing your own quirky self, along with worries and weaknesses. Of realizing that everyone gets stressed and anxious.

I really appreciated the talk about getting off the standard tracks of perfectionism and “ta da!” extroversion that we’re encouraged to embrace, often at the cost of our individuality. Breaking free from that thinking can change our lives. And here comes the sexual health part- breaking free from prescriptive ways of being can influence all parts of our lives for the better, sex included.

Give them a look/ listen. See what you think. And about how freeing yourself from prescription might be a benefit.

 - Janet

 photo: Morguefile

So.

Not surprising we sometimes forget things. What I appreciated about the article was that it identified that the brain changes aren’t only memory, as in how we recall things. It’s also about how our brain is able to organize tasks. I’m often reminded of how I felt when I was pregnant- the extreme hunger, and words disappearing down a rabbit hole- very frustrating, considering I write for a living! I’ll be having a conversation with a coworker, get interrupted by a phone call I’ve been waiting for and then… dum de dum… what was I saying? *Sigh.*

Other treats of perimenopause can include the roller coaster mood shifts of anger, anxiety and the blues many of you are undoubtedly familiar with. Or maybe you stick to one note. My friend Ann says she’s forever angry, and really tired of it.
 
Take comfort in this- I’m there, you’re there, and there are millions of women around the world going through it. Millions have gone through it. And we’ll make it. Whether we have the words for it or not.

Janet

photo: istock