I just couldn’t bring myself to do it- buy reading glasses, that is. It’s ridiculous, really. I’ve recently started walking around town in five finger shoes which my daughter calls monkey fashion (she won’t be seen with me when I’m wearing them), and they have attracted some amused snorts. Well, fair enough. I too think they look weird, but stick with them because my feet feel great and I like sensing the ground this way. And as for the look, well- remember when Birkenstocks were ugly and unusual? You may still think they look ugly, but you do see them everywhere.

Walking "barefoot” is a great thing for my aging body: it can improve skeletal alignment, contributing to better positioning for hips, knees, pelvic floor etc. I’m all over that. I can handle my aging bunged up feet that led to physiotherapy, which is what eventually led to the monkey shoes.

I’m intrigued by the shifts in my hormones and cycles that indicate perimenopause is underway. I can even handle the deeper lines in my face that have me wondering when ten years snapped by when I wasn’t looking.

But reading glasses are challenging, because they’re such an indication that I’m middle–aged. After months of stretching my arm to read ingredients on the sides of shampoo bottles (wishing I could take out my contacts in the middle of the store aisle) I have to admit it’s time.

And I tried.

I went to the store and I looked at a couple of pairs. Then I ran back to the shampoo aisle and just bought a brand with ingredients I already trusted.

I will try again. I know it’s a necessary evil, and will probably wonder what all the fuss was about when it’s done. But I have to work up to it.

I laugh at myself often, because I’m as sucked into society’s horror of aging as the next person. I’m dealing with the rigors of age, and enjoying sharing stuff with friends who are in the same stage of life.

It seems I can just view one element of it at a time.

- Janet

Check This Out: Alignment and the Pelvic Floor- You Don’t Know Squat

I remember my first period, but like most women, I won’t know my last period when it arrives. Rather than the face-the-future moment that the first period presented, menopause will be an over-the-shoulder realization, defined when I reach a calendar year without a period.  

Most women will go through years of perimenopause leading up to that unknown finale.  My friend Lisa says she’s almost reached the year point a couple of times and now “wishes it would just damn happen.” Another friend was told she had hit menopause at age 40, after a few confusing years that included dizzy spells and massive headaches that led to some testing. It turned out to be perimenopause in overdrive.

For some women menopause will hit suddenly when medical intervention is advised for health reasons, such as cancer-related treatments, but most of us will meander through changes in cycle length, period heaviness, and other differences that we may not realize are also related.

For example, the lack of memory for words is driving me crazy. “What’s that thing you hold and talk to people on?” I asked my partner after spluttering for the word. Or I find I’ll use a malapropism instead. Thankfully many of my friends are going through it too, and we all have patience and good senses of humour! 

For women who are going through spontaneous perimenopause, Paula Spencer points out that the range of menstrual normal is beyond the “28 day cycle” lots of us were taught in school. Knowing what’s your normal and what isn’t can put you at ease.

And speaking of ease, sex may become a little un-easy if vaginal dryness or flagging libido is an issue. Lube, laughter and leisurely foreplay (particularly before  penetration) can all help with changes. If you think of sex as about connection and not climax, it can take some pressure off you and your partner.

- Janet

Check This Out:
Memory lags as your periods do too? Here’s one theory: Maybe you forget it because you never learned it

Bronwyn and I talked about the sex scenes (no spoiler alert needed) after seeing The Kids are All Right, which we both liked and disliked for various reasons. We work with HIV+ women, so we can’t help but discuss how sexuality is portrayed in movies, and what kind of safe sex messaging does and doesn’t play out. I think that anyone over fourteen can get cynical about messaging around sex when you watch movies, whether you work in the sex education field or not. Meeting women every day who admit they would have benefitted from HIV prevention information, I can’t help but reflect on the general perceptions of women’s risks for HIV.

If you don’t know how HIV is transmitted, get familiar with the “formula” so you can make decisions about what you want to do and how.

Women are vulnerable to HIV infection through unprotected sex for a couple of reasons. HIV (and other STIs) can be transmitted when body fluids come into contact with cells of the vagina, cervix or rectum. When it comes to unprotected sex with a man, semen remains in the body after ejaculation, creating an environment in which HIV has time and opportunity to infect.

For women who have sex with women, sharing body fluids is a risk for sharing STIs. Finger/ hand play from one partner to the other without using gloves can pass vaginal fluids from one to the other. Sharing unprotected sex toys can do the same. Moving from anal to vaginal penetration without using (or changing) gloves and/or condoms can expose the vagina to bacteria from the rectum, which increases the risks of numerous STIs. 

While HIV transmission via oral sex is not as high risk as vaginal/ anal penetration, it’s possible, and other STIS can be easily passed too- no matter who you partner with.

For women who are in perimenopause or post-menopausal, vaginal tissue is not as resilient as it was when we were younger, nor do we have the natural lubrication we once did to prevent slight tears (a.k.a. micro tears that you can’t even detect) during sex. But research has found that even healthy untraumatized tissue is at risk- HIV can penetrate healthy tissue to get into the bloodstream.

Experimenting with different kinds of lube, condoms, dental dams gloves and sex toys can be a lot of fun and create a bond you might not have otherwise enjoyed (“Let’s get the toy chest, honey….”).

Your HIV and STI risk in general is all about what you do, and how you do it. Talk with your partner about being tested for STIs, including HIV. Women are more accustomed to their Pap (although lesbians can skip tests and shouldn’t!), but guys, well, they can be reluctant about STI testing, by their own admission. If you partner with men, you can point out that it may not be comfortable but it’s for his health too.

Your sex scenes may not be as highly edited as the movies (I know mine aren’t!), but they can still yield a lot of, shall we say, viewing pleasure.  

- Janet

Check This Out: Top 10 Lovefilm Picks for Best Sex Scenes in Movies

I get to read a lot on this job, which I love, although it can make me feel like a cartoon character with a spinning head. I’m always on the prowl for interesting items on sexual health, building relationships, safe sex communication, and talking honestly and powerfully about sexuality. I can’t use everything I find, or write about it all in my posts. Here are a few things from the past couple of months that have made me laugh or go hmmmm… 

In the really?? department: if going down on your partner could be improved if he or she tasted better, there’s a pill for that! (In the great quest to create a market for everything). Response is mixed on whether it’s a necessity.

Those who’ve read this blog before know I believe in age-appropriate sex ed for kids, starting young enough to avoid the eeewwwww factor and keeping the conversation going when condoms become currency. I’ve been faced with questions about sex from other people’s kids, but I haven’t written it up as well as Lisa Belkin.

If you’re up for summer sexual fling and haven’t got lucky yet, maybe some advice on the seven types of flings could help?

This one is not related to sexual health at all, but the passion of it still speaks to me. A rant about the crazy discrepancies in how money is spent and how it could be directed at education and health. A lovely kick in the pants for any activist.

Okay, back to reading.

- Janet

Check this Out: Sexual health information for teens, teachers, parents, and health professionals: Sexuality and U

Like many women, I have experienced what I would have called “reduced bladder control” since the birth of my son two years ago.  When it started, I didn’t even think to call it incontinence, let alone pelvic floor dysfunction.  In fact, I think I told the doctor something along the lines of “I’ve been pissing myself”.  For many women, urinary incontinence expresses itself in small leaks when they sneeze or cough or exercise.  I guess this is what I had in mind when I thought about post-partum bladder issues, but it wasn’t like that for me.  I didn’t normally have leaks and I could even go out for a jog without any problems.  Mine was more of a “once-in-a-while-got-some-exciting-news-jump-up-and-down-OMG-I’m-peeing-and-I-can’t-make-it-stop” kind of problem … It turns out that both frequent little leaks and less frequent big leaks are signs that the pelvic floor muscles are not functioning as they should.

In my journey from my family doctor to the urologist and eventually to the pelvic floor physiotherapist, I’ve become a bit more knowledgeable about the subject.  The pelvic floor muscles are a group of muscles that connect the front of the pubic bone to the tailbone at the back.  They support (literally hold in) the bladder and reproductive organs, while the urethra, vagina and rectum pass through them and depend on them for for proper functioning.  To work properly, they also must cooperate with the abdominal muscles (transversus abdominis and multifidis).  Pain, poor alignment and/or movement patterns (wearing high heels all the time, for example), surgery and childbirth can all result in using this group of muscles in an unbalanced way.  It can cause lower back, pelvis or hip pain, as well as urinary or fecal incontinence.  Unfortunately, once the pain or trauma has passed, they don’t “snap back” to healthy function on their own.  Like any other muscle that’s been ignored or misused, they need to be worked and retrained.

About one in four women aged 40 to 59 are living with some kind of pelvic floor disorder.  Wow, like so many women’s health issues, that’s a lot of women experiencing something that many consider taboo to talk about!  What we do hear more and more about is kegel exercises and their importance for women.  These are the exercises that, if done correctly, can help prevent or reverse incontinence.  Unfortunately, 65% of people who think they know how to do kegels are doing them incorrectly.

I’m currently in the middle of the slow, humbling, and sometimes frustrating process of learning to do them correctly, so I’m definitely no expert.  I find the first page of this brochure from White Rock based Diane Lee & associates quite useful for learning to isolate and retrain the pelvic floor.  Venturing off in a completely different direction, I’ve just discovered biomedical scientist Katy Bowman who advocates against kegels.  Instead she recommends working on alignment and retraining ourselves to stop pulling our pelvis forward in the “tummy suck” that make us think we’re using our abdominal muscles …  She also advocates doing lots of squats and strengthening the glutes (butt muscles).  I have to do some more reading and consulting before I commit, but her argument is very compelling.

Wherever you decide to focus your energies, it is all about retraining this group of muscles to function properly.  It takes some research, if possible some professional support, and lots of patient, precise work.  Happy kegelling!

-Miriam
 

I  love the "light summer reading" concept. I took it to heart and just read Judy Blume’s Summer Sisters, an oldie but fluffy goodie. Her readable style kept me entertained and gave me a sweet trip back to age twelve, when I read Forever, my first novel with explicit sex. Apparently Forever was Blume’s book for her teen daughter where the sexually active girl didn’t have to die. On her website, Blume says that writing it in this day and age would include info on STIs.

But I also like to wander through books I’ve already loved. Non-fiction wise, I recently turned to Natalie Angier’s Woman: An Intimate Geography. I read this book not long after it first came out in 1999, and I’m assuming that some of the findings she presented here have changed, but what I love about her writing is the energy. She seems to love this topic, us, our bodies and their amazing capacities and capabilities. The energy reminds me of Owning Pink, a celebratory site that Ob/Gyn Lissa Rankin and other “pinkies’ see as a place where people can explore their whole selves- biology, emotions, spirit, and creativity.

Angier’s writing celebrates the gamut of the formation of a female fetus through puberty, breastmilk and on to menopause without any flag in enthusiasm. A review of the book at the time derided that enthusiasm somewhat, but I was struck by it then and now. I say we need that kind of enthusiasm for our bodies. They really are amazing. 

– Janet

Check This Out: on the "one more time" front: Beach Boys’ I Get Around….

Ah, summer. If warmer weather has you feeling frisky, and you’re considering a discreet romp in the sand, you may end up a little grainy in some unexpected places. Ideally, that’s the only discomfort you’re going to feel. Sex shouldn’t be painful, and if it is, there’s help for that.

Does vaginal penetration hurt? You may have an undiagnosed yeast infection or STI. Many STIs are symptom free, but others can cause painful urination, itching, burning and painful penetration. Talk to your doc about STI testing.

Painful vaginal penetration could also be vaginismus, as one blogger describes in “My Vagina is Broken.” If penetration is okay but ongoing thrusting is painful, vaginal dryness could also be the cause. This can happen if you’re not fully aroused when penetration occurs, or it can also be an issue of hormones- perimenopause and menopause cause a decrease in natural vaginal lubrication. As ever, I sing the praises of lube. Find one you like and use it with condoms or dental dams.

Speaking of dental dams, if oral sex is physically uncomfortable, a dab of lube in between you and the dam can help. If oral sex is outside your comfort zone and that’s what’s making you uncomfortable, talk to your partner- he or she will be better informed about what feels like a good risk and what feels like too much. Despite the overwhelming info in mass media about how women should be sexually, you have a right to be exactly who you want.

If you’re into anal sex, but find it painful, go s-l-o-w. Relaxation is important. Rectal tissue is more delicate than vaginal tissue, so use lube for easier penetration. Use a condom too- there’s more to worry about than pregnancy.

Whatever your approach this season- sandy sex, slow sex, solo sex- make it yours.

- Janet

Check This Out: Celebrate Yourself with 20 Things Every Woman Should Know About Her Vagina

My beloved friend Ann has a birthday coming up, and I’m determined to get her a good card, take her out to lunch and make much of her. We’ve known each other on and off since we were five, through separate classes and schools, then reuniting for good at University. She’s a keeper. We’ve discussed relationships in general, lovers in particular and sex on both fronts. Collectively, we’ve seen each other through big deals: dating, love, marriage, births of children, divorce, dating again and the ensuing safe sex talks, parents’ deaths and remarriage. We cherish each other and each other’s kids.

So how do I honour her with a card when the general themes of birthday cards lean to wetting our pants and lamenting our lost youth?

The implication is that we’re old and undesirable and our bodies are giving out on us. Lamenting youth isn’t something Ann or I do, because we’re glad we’re not there anymore. The mere mention of a name from our twenties will make one of us “Ohmygod” and laugh. Now that our kids are getting older, we’re bracing ourselves for that not so fuzzy future when we’ll see the similar hurdles and corners of young, painful love again, although this time vicariously.

And while it’s true that our bodies are changing, both of us agree that things are better in our forties. We know our bodies. We can ask for what we want sexually. Overall, we’re happy where we are, even if it has its health bumps. We relish life because we’re increasingly touched by its changes.

Maybe I’m taking the card thing too seriously. Wet pants or sagging breasts? Either will probably make her laugh. 

- Janet

Check This Out: Age is Just a Number

My friend Cheryl just completed her first -and potentially last- marathon. She gave me all the gory details post race, and then wearily said, “Now I can cross that off my bucket list.” The bucket list concept has become a touchstone for things we’d like to achieve before we die. Do you have a sexual bucket list? Things you may be curious about and never have shared? 

Whatever your dreams, communicate! Talk to your lover  about what you want and how to get it while taking care of each other. Or if talking isn’t part of the dream, then communicate about safer sex with your body- apply the condom, dental dam, and lube. Make it wordlessly sexy.

Sexuality is a fluid thing throughout our lives. It’s not a direct line from A to B by any means, and can develop until the day we die. It’s influenced by our perceptions, sensibilities, and people. It will be influenced by places, life events, and physical events. On the road there can be changes in physical comfort, disability, sensory perception, physical comfort.

“Good sex” will take on different forms in your life and that’s normal.

If you have a sexual bucket list, or like the idea of developing one, go to. Maybe it will include sex with a same-sex lover or opposite-sex lover, depending on your desire. Perhaps it’s general: improve on orgasms, or specific try anal sex, a blindfold as part of some fantasy play?
Whatever the dream, get your safer sex info and use it. And have a good time. There’s no time like the present.  

- Janet

Check This Out: I often use info from these sources, so here’s an appreciative thanks to Corey Silverberg and Elizabeth Boskey at About.com

Kat Wilder posted a blog last week about dating someone with cancer and I was nodding along with her as I read it. She challenges her friend (and the rest of us) to consider “safety” in relationships.  She asks whether knowing someone has cancer is a reason to avoid getting involved. I got to thinking beyond dating someone with cancer to dating someone with HIV. What would and wouldn’t be “safe” about that? There are the obvious worries about HIV transmission of course, but they can be managed with safer sex. Many serodiscordant couples (one HIV positive, one not) have been together for years, and the uninfected partner has stayed that way. It’s totally possible.

Loving someone with cancer and loving someone with HIV? When I first started working in HIV prevention and support many moons ago, my aunt told me that cancer was once as stigmatized as HIV. No one wanted to talk about it, no one knew much about how people got it, and those who had it were ostracized and died alone. Sound familiar?

Cancer isn’t stigma-free these days, but it has improved, thankfully. We know now that cancer isn’t contagious. And you can’t get it from having sex with someone (although HPV infection can lead to cancer). HIV is preventable through safer sex, which is a wise idea anyway if you’re looking to avoid STIs in general.

So you can manage the physical risks of dating someone with HIV. Would you take the emotional risk?

These days, if people have access to treatment, their lives may stretch as long as those of the uninfected, potentially changing the emotional landscape of loving someone with HIV. Their life may last longer than a partner with cancer. As an HIV doctor once said, “I can’t tell people how long their lives might be [after HIV diagnosis]. You just don’t know.”

There are no guarantees, but there are all kinds of emotional and physical realities to consider when getting into a relationship. As the saying goes, that’s life. 

- Janet  

Check This Out: When Opposites Attract: an Exploration of Serodiscordant Relationships