Who Cares for the Caregivers?

Most of the time when we talk about self-care, we’re focusing on how you can support yourself when you’re going through a rough time. That’s obviously important, but what about when you’re spending a lot of time supporting someone else?

This came up recently when I was talking with some colleagues about the issues around abortion stigma. When we were talking about resources, I mentioned that I’ve taken a number of counseling calls from medical practitioners during my time as a a counselor with Exhale. I know that’s not what most people think of when they think of a support talkline, but I wasn’t expecting the level of surprise and interest that folks had! While we’ve given out those resources for years, the idea of using them for ourselves had never come up.

But in fact, a lot of the people who use these kinds of hotlines are people who are supporting someone else. Exhale’s very first call was from a father who wanted to support his daughter after her abortion, and counselors on all kinds of talklines and support sites have worked to help people be able to support others more effectively. Especially when it comes to issues that involve a lot of stigma, like abortion or sexual assault, having a place to get support anonymously can be particularly important. You often can’t share details with your normal support systems, like your family or mutual friends, but you will often have your own feelings that you want to work through.

Supporting other people can be rough – making sure you’ve got ways to tend to your own needs is crucial, both to make sure that you don’t burn out, and to help you be there in the best ways you can for the people you love. So, if you’re looking for some advice on how to support a friend who’s going through a tough time or want to discuss how it’s affecting you, here are some resources that may be able to help you both:

Exhale – post-abortion talkline
Backline - talkline addressing abortion and making decisions about unplanned pregnancies
Trevor Project – crisis intervention for LGBTQ youth – hotline and online support and community
RAINN – sexual assault hotline and online support
National Domestic Violence Hotline
National Suicide Prevention Hotline and online support

“Lost” Something in Your Vagina? What Now?

If you’re reading this article, you may have come here because you currently have an object stuck in your vagina. From my experience working directly with female patients, this is something people get rather embarrassed about. Whenever someone would come in and get REALLY nervous about telling me what was going on, it was almost always because they had a foreign object stuck in their vagina. What those patients didn’t know was that it happens all the time! So fear not, let the internet and Planned Parenthood be your friend, and let’s see if we can’t figure this conundrum out.

tamponThe first thing I have to say to you is really good news. You can’t actually LOSE something in your vagina. Unlike the anus and rectum, which are ultimately attached to intestine that go on for many, many feet, there is rather short and fixed amount of space in a vagina. The average vagina’s depth isn’t more than a few inches, and the vaginal canal starts at the vaginal opening and ends at the cervix! Knowing that your vagina isn’t a never-ending black hole may help you to feel a little more comfortable!

“WAIT A SECOND,” you might be saying, “I KNOW MY VAGINA ISN’T ENDLESS, BUT GUESS WHAT ELIZA? IT’S STILL STUCK!” Okay, calm down! And I don’t mean “chill out” in a patronizing way; calming down may help you to alleviate the problem. Panic can make the situation worse as you work yourself up into frenzy, and potentially even tighten the muscles of your vagina, making searching for the object harder for you. With clean hands, lie down on your back, or get into a “squatting position” and insert your fingers into your vagina. If you can feel the object, try gently pulling it down. If you cannot feel the object, try bearing down as though you were making a bowel movement, and see if you can feel it after this! Here is a guide that may help you.

If the object will not move without creating fear that you will injure your vagina, or if you still cannot locate it, you may need to involve a doctor. THAT’S OKAY! As I said before, this is something health care providers see a lot. Don’t risk hurting yourself (i.e. if you have inserted an object that you cannot easily remove) or causing infection by leaving something like a tampon in for too long (this can be dangerous!) If the object was a condom, you should also consider purchasing emergency contraceptives, and following up with STD testing during the appropriate time frames.

Would you also like some tips for preventing mishaps like this from happening in the future? Only insert items into the vagina that are meant for the vagina. Items which aren’t meant for the vagina may not only get stuck, but they could cause infection or irritation depending on what they are made of. One example of this is food items that are high in sugar, which can cause yeast infections! Another tip? Don’t cut the strings off your tampons. Some people do this because of worry that a string may slide out of underwear or bikini bottoms, but it’s better to keep your health in check and prevent a rogue tampon incident!

Fun Friday: Trans* Kids and Supportive Families

Today’s Fun Friday post is more of a Heartwarming Friday one. When I saw this article, it just made me want to hug everyone involved.

Image of Rep Mike Honda and his granddaughter - his tweet says When I think of politicians and their families, I don’t tend to get mushy, but this is absolutely an exception. Rep. Mike Honda’s granddaughter Malisa transitioned to presenting as a girl full-time this July, though she’d been living as a girl at home for years. She told her grandfather that she wanted to be able to be a role model for other kids, and that she’s fine with her story being shared.

From the interviews, her family sound like they’ve prepared themselves really well as to how they can best support her while helping to make more people aware of what it’s like for younger children who transition. I’m really happy that Malisa has so much love around her, and that she and her family are helping to make it easier for other kids to have the same.


The Challenges with a Cure for HIV

Today’s post is by “Obi,” a Nigerian doctor conducting his field experience at Planned Parenthood as part of his MPH program. He was a general practitioner in his home country with main interest and expertise in maternal and child health.

Since the discovery of Human immunodeficiency virus (HIV) as the cause of Acquired Immune Deficiency Syndrome (AIDS) in 1983, it continues to pose a huge threat worldwide to the health of millions of people. Data from the World Health Organization (in 2013) revealed that worldwide 35 million people were living with HIV, there were 2.1 million new cases and 1.5 million deaths.

hivThe development of multi-drug combination therapy known as Highly Active Antiretroviral Therapy (HAART) for treatment of HIV/AIDS in 1996 was one of the major successes of modern medicine leading to a dramatic drop in the death rate by 50 to 80% between 1996 and 2006. This period is known as “the decade of HAART.” This changed the view of HIV/AIDS from a fatal and catastrophic disease to what is now a manageable chronic illness.

After this initial success, the next step was to find a cure and/or an effective preventive method. Currently the best way to avoid HIV/AIDS is to take conscious steps to avoid contracting the virus in the first place. This has been the aim of a lot of efforts all around the world teaching safe sexual health practices and healthy lifestyle behaviors. However, changing human behavior is quite difficult.

Due to the rapid and constant mutation of HIV, the human immune system finds it very difficult to defend against it and scientists have found developing an effective vaccine very problematic. Also, HIV is able to create reservoirs in its hosts leading to latency of the disease, which is the main reason HAART can’t eliminate the virus but only reduce its load in the human body to very low levels. For this reason HIV positive patients are unable to stop HAART therapy to avoid dramatic increase in their viral load.

Despite all these issues, promising advances in therapy are being made. Drugs like Prostratin, which are able to reactivate latent HIV and therefore increase the effectiveness of HAART therapy, are being developed. There are also a small group of people who are known to be immune to HIV due to the absence of the cell receptor necessary for HIV to infect cells known CCR5. This knowledge was used in the case of Timothy Ray Brown, the first case of a cured HIV positive patient. Although the therapy used on Timothy is very risky and expensive and therefore can’t be applied on a large scale, it has given researchers ideas on how to modify a patient’s immune system to resist HIV.

Continuing research in this field, including various promising results from numerous clinical trials show that there is hope for an effective cure for HIV. Tests in the lab have shown promise at a cellular level and the aim is to replicate these results at the macro level. This process may take years but with each passing year we get a better understanding of the virus and the disease mechanisms which would bring us closer to developing a cure and possibly a vaccine. Until then, maintaining a healthy lifestyle approach and engaging in healthy sexual behaviors (using condoms) will be the mainstay of HIV prevention.

8 Ways to Protect Your Erection

signs-of-EDMany men are reluctant to address health issues until they affect their sex lives. Most males experience a problem getting or maintaining an erection sometime during their lives. While it may be more impactful to him than his partner, a partner as well as a relationship may also suffer if this becomes a regular occurrence. A recent Men’s Health article suggests several steps a male can take to help eliminate problems related to erectile dysfunction or premature

#1 Check your medicine cabinet. Certain antidepressants, blood pressure medications, even hair growth products all list erection problems as possible side effects. Even allergy or cold medicines may be a cause. Check all labels and especially be wary of meds with Sudafed.

#2 Leave your work at the office. Work-related stress is a common component of sexual dysfunction. Many males who are financially successful work long hours and have a difficult time separating work time from leisure time. Making time for exercise and sleep to help reduce stress.

#3 Get enough sleep. Try and get at least 6 hours a night, but 7 to 8 is even better. Sleep affects testosterone, dopamine, and serotonin levels. Getting 5 hours a night or less can affect testosterone levels even in young males.

#4 Brush your teeth. Studies have shown that many males with erectile dysfunction also have gum disease. As your teeth decay, your immune system attacks pathogens in your mouth. The bacteria then seeps into your bloodstream damaging blood vessels and blood flow. Add flossing and regular visits to the dentist to the list.

#5 Limit alcohol consumption. Having more than 2 daily drinks may affect a male’s ability to get an erection, his ability to sustain an erection, and the firmness of his erection. Even if your sexual functioning is the same for now, heaving drinkers often have sexual problems later in life.

#6 Stay faithful. Being unfaithful to a partner may cause guilt and anxiety to the extent that sexual functioning is affected. Anxiety halts the release of neurotransmitters in charge of stimulating an erection.

#7 Get your laptop off your lap. Laptops generate heat and exposure to extended heat can reduce testosterone and sperm production.

#8 Stop smoking. There is a direct relationship between smoking and erectile dysfunction. Nicotine in any form may damage the lining of blood vessels which affects the smooth muscle in the penis and inhibits blood flow.

Any type of life style change can be extremely difficult, but if most men realize simple changes can make their sex lives better, they will at least think about it!

Check Your Judgments at the Door

define yourselfWe are still doing a lot of work eliminating stigma here in the reproductive health field, and I’ve been thinking a lot about how to get our supporters to examine their own judgments. As I’ve discussed before, shame and judgment are large parts of why people don’t access the reproductive health care they need. As supporters of safe sexuality and reproductive health, some of the biggest steps we can take are working to make sure that we create and promote safe spaces surrounding these issues. While we may be strong advocates of reproductive health, it is also important to remember that we come from a society where we are inundated with negative messages about sex and sexuality every day. Because of this, it is important that we work to examine our own judgments, and how stigma has personally affected us. When you live in a society that expects you to have negative views surrounding sexual health, it is not your fault that you have picked up tendencies to judge people regarding sex, abortions, STDS, and other areas of reproductive health. But it is a problem if you let your judgments hinder or harm people attempting to seek the health care they deserve. Here are some questions you can ask yourself if you find you are judging someone else about sexual or reproductive health care.

1. Why am I feeling judgmental?

The first step you can take in evaluating your own negative feelings towards others is to ask yourself WHY you are feeling judgment. Is this a situation you have been through before that made you feel stigmatized? Something you were raised to have very strong beliefs about? Something you may have seen media representations of that influenced your views? If you can examine where the sources of your judgment is coming from, you can examine whether or not it is actually useful. For example, if you realize that your judgment is coming from somewhere like media representations, you can think critically about whether or not those judgments are accurate and warrant your emotional energy.

2. How is this judgment useful to the person I am interacting with?

If you have examined the root of your judgment, and found that it is comes from a more serious place (i.e. personal experience or belief you grew up with), a great next step would be to examine how useful the judgment you hold is to the person you are interacting with or thinking about. For example, if you are feeling very angry towards someone because they are having a pregnancy scare because they did not use any form of birth control, think about how your anger might affect them. Do you think for their own health it is better to project your anger towards them, or to position yourself as an advocate of reproductive health, and supportively present them with all their options?

3. How does this judgment play in to stigma-free reproductive health?

A final question you can ask yourself is: how does your judgmental attitude impact goals to stigma-free reproductive health as a whole? Does your view contribute to any negative societal outcomes that affect reproductive health access? Have judgments like yours been used to prevent people from getting health care, or to demonize the people who do receive health care? If you realize that your judgment could contribute to stigma, you might find it is best to try and step away from your current thought process, and strive for something more positive!

Microchip Birth Control Technology

microchipBack in 2012, Microchips Biotech Inc., tested out new microchip technology on osteoporosis patients. When it turned out successful, the Bill and Melinda Gates Foundation jumped at the opportunity for using microchip technology to prevent pregnancy. Clinical trials in humans could begin as early at 2016 and microchip birth control could be on the market as early as 2018.

So how does it work? Much like Implanon, the microchip is implanted under the skin, but unlike other contraceptive implants, you don’t have to get it removed when you want to try to conceive… you just TURN IT OFF! With a REMOTE CONTROL! And we should mention that it can release daily hormones for 16 YEARS! No other implant can do that. Early estimates put the cost at $1,000, which is just 17 cents a day!

Luckily, for women in first world countries, there are a myriad of birth control options. So for the squeamish among us, we have the option of bypassing implants, while still maintaining our reproductive freedom. But think for a second about the estimated 80 million women in developing countries who had an unintended pregnancy in 2012; of those women, at least one in four resorted to an unsafe abortion. Think about the barriers for those women: lack of education, cultural taboos, corrupt governments, lack of health care, lack of autonomy, and even logistical barriers like distribution of contraception – it’s not like women who live in isolated areas of Niger (which has added problems like Boko Harem) can just swing by the drug store on their way home from work. 

Giving women and families the power to control their fertility literally changes the world. How? Read this article: 10 Facts About Contraception (And How It Changed the World) That Every Man and Woman Should Know. Think about the impact just for the woman – for 17 cents a day – a marked reduction in unintented pregnancies, birth rates, abortions, maternal deaths, and birth complications such as obstetric fistula.

As with any new scientific and cultural breakthrough, there are hurdles ahead. Stay tuned for developments in this incredible microchip technology because the applications are endless and promising and bring so much hope.