Category Archives: Women’s Health

The End of the Yearly Pelvic Exam?


Posted on May 6, 2013 by

Doctors question need for yearly pelvic examsFor the past three generations, bimanual pelvic exams have traditionally been considered a vital part of well-woman visits. But new research is suggesting that they may not always be necessary on a yearly basis.

Pelvic exams are important for screening for cervical cancer, STIs, and a variety of other health issues, and can make life-saving discoveries. But for healthy women, without a family history of cancer and using protection against STIs, is it a yearly necessity? Ask Your Doctor.

A recent study has been released by the Columbia University Medical Center that suggests annual pelvic exams of women without any symptoms could be an overuse of cancer screenings. (http://www.ncbi.nlm.nih.gov/pubmed/21194307) As a young woman, without a family history of cancer, with a low risk of STIs, do I still need a pelvic exam? For me, the answer is yes – at least until my doctor tells me otherwise. But that may soon be changing, as new guidelines are released about the necessity of annual exams.

Planned Parenthood suggests more frequent pelvic exams if you have any of the following:

  • a history of abnormal Pap test results
  • a history of sexual health problems
  • a family history of certain kinds of cancer
  • a sexually transmitted infection or a sex partner with an infection
  • recurrent vaginitis

In some cases, a pelvic exam is needed in order to prescribe hormonal birth control — the pill, the patch, the ring, or the shot. A pelvic exam is always needed for inserting an IUD or fitting a diaphragm.

For some women, a bimanual pelvic exam can be a stressful and anxious experience. In the five years I have been prescribed birth control (and consequently, five bimanual pelvic exams) I have always dreaded my annual visit, even with my wonderful gynecologist. (We have tips on how to make it less scary, though!) Maybe in the future – with further research of course – I will be able to get my prescription without an annual pelvic exam! Until then, I will just keep on making the appointments and keeping this body healthy.

No One Told Me It Would Be This Hard: Part II


Posted on May 1, 2013 by

The follow up to No One Told Me It Would Be This Hard: Part I . . .

The day of the induction and delivery of my baby was not at all what I thought it would be like. I had Pitocin administered through an IV at 6:00am the next day and by 11:00am my water broke and all hell broke loose in my body. I went from feeling like I could handle labor and the level of pain I was experiencing to having my husband and Doula take turns jamming their fists into my back. I was one of the unfortunate women who have posterior babies (the baby’s skull is in the back of the pelvis). It was the most incredible back pain I have ever experienced and I needed the counter pressure of their fists to get through each contraction. Once I reached 8 centimeters I asked for something to slow the contractions down and give me a break! They gave me a small amount of pain medication but it didn’t do much to help me. I eventually got to 10 centimeters and started pushing. Everyone kept telling me to grab my legs and thought to myself, they want ME to grab my legs?

CSectionRepeats_main_0314I am normally very modest and well-mannered but at this point I didn’t care what was showing or coming out of me, and I was swearing like a sailor. I always hear women say that they are nervous they might poop. When you reach the point of no return, you don’t care what is going on, you just want that baby out of you. I was placed in all kinds of squatting positions and nothing worked. Two hours later, my bladder was swelling and there was no head in sight. I was in a lot of pain and the decision was made to have a C-section before it turned into an emergency C-section. It was the worst case scenario for me, but I knew I didn’t have a choice. I had a spinal block/epidural and by 6:41pm, I had a baby. It wasn’t what I envisioned but I had a healthy baby and eventually came to terms with the outcome. Many women experience a range of emotions and go through a grieving process when they have an undesirable birth experience. Information and resources for women who have had cesareans can be found at the International Cesarean Awareness Network.

I work with abortion. I will not apologize.


Posted on April 30, 2013 by

abortion-law-sizeLast week I attended an incredible workshop with my colleagues, where we talked about the emotional side of abortion work. About ten of us, all working in different roles within our affiliate, shared with each other how we cope with the stigmatized nature of our work, and how we deal with protesters both in our communities and in our personal lives (friends, family, etc.). I learned so much about the strength, courage, and absolute commitment to helping women that my colleagues and I share. It was really emotional and absolutely inspiring to recognize the commitment we have to this work. I am so proud to be a part of in the struggle of women; in the herstory of women.

Having said that, it was ironic that a few days later I became involved in a confrontation about my work with a distant relative through, of all places, Facebook. While I honor and love this family member, and have incredibly fond memories of our time together in my childhood, we just don’t agree politically or socially now that I’m an adult. Specifically, when it comes to social issues and the issue of a woman’s right to decide. So, I posted something about an interview with anti-choice protesters, and was issued a moral citation via comment box.

A few days later he sent me an email about the better choice being adoption. I now felt like I needed to explain myself without apologizing or igniting personal defenses. I do not want to fight with family about the work I do. And I will not apologize. Having spent time discussing such awkward and uncomfortable interactions with family a few days before at the workshop, I felt like I was prepared to respond. Awkward? Yes. Impossible? No. In summary:

…I’ve been working one-on-one with women who choose abortion for the past 5 years. I’ve met with hundreds and hundreds, perhaps thousands of women in my office, and my beliefs about choice stem from listening to them and learning their stories. For many, adoption is an excellent choice, and I whole-heartedly support women who choose that route. I am most excited when I meet with a woman who has planned her pregnancy, and is ecstatic when the pregnancy test comes back positive. There is so much joy to share in life.

Though the organization I work for only sees about 10% of clients for abortion services, I travel to our different locations and work predominantly with those clients. I do family planning education and give emotional support to women who are choosing abortion. I feel I am an angel for so many of the women I see, who are ashamed, afraid, stigmatized, guilt-ridden and desperate. I accept them, I accept their choice, and I honor them as human beings trying to do the best they can for themselves, their families, and their futures.

Having said that, I speak with each and every single woman who is considering abortion about adoption. That is a requirement; we talk with women about adoption and how to continue their pregnancies for parenthood, along with abortion education. Over and over and over again, when I talk with women about adoption, many give the same response: there is no way they could spend 9 months becoming emotionally attached to their pregnancy and give it away. The guilt and resentment they would feel knowing they had a child in the world that they had “abandoned” is a worse choice for them than to prevent the pregnancy from continuing. These are their words, not mine. For others, adoption is an opportunity to give their child to a family who is ready and able to provide a quality life for their child. Every woman’s view is valid.

In many cases over the years, I have helped women choose to continue their pregnancies. I support their choice, regardless of the outcome. It is their body, their life, not mine…. Having said that, our perspectives on this issue are different, but I respect your opinion, as your beliefs are just as valid as mine.

This line of work is both incredibly challenging and incredibly rewarding. Our greatest hope and mission is for all children to be wanted children, and for the need for abortion to no longer exist. However, we do not currently live in a world where this is possible, and abortion is a safe option that 1/3 of U.S. women make in their lifetime. I emphasize education and prevention. I will not apologize.

 

The Lighter Side of Breastfeeding


Posted on April 29, 2013 by

The following images pretty much sum up the lighter side of breastfeeding. WARNING: laughing too hard post-babies may make you tinkle a little. Sneezing too. And coughing. Hell, just expect to pee your pants a lot after you have a baby. Enjoy!

Seriously.

breastfeeding

 

Just admit it, you’ve totally caught your own face in the crossfire.

abundance

 

Work it, girl!

bf7

 

So true.

bf6

 

Chopped liver. Dads.

bf5

 

Love it when celebrity moms normalize breastfeeding.

bf pink

 

Breastfeedicus.

bf8

 

HA!

Udder Feeding in Public

 

Take that, sucka!

bs11

 

True ‘dat.

Breastfeeding-85-ppi1

 

Not funny, but awesome nonetheless. 

bf establishment

 

Do you have a funny breastfeeding story to share? Leave it in our comments section.

 

April is Sexual Assault Awareness Month


Posted on April 10, 2013 by

Photo via The Dawn Center.

Photo via The Dawn Center.

Feronians, it’s April once again, which means it’s Sexual Assault Awareness Month. A big part of why SAAM exists is because we don’t often talk about sexual assault – for every Steubenville or Delhi case that involves a prosecution and spurs widespread discussion, there are thousands of assaults that pass by without comment, and without legal consequence.

On the one hand, this year seems like it’s had a lot of good conversations about this topic – and thinking back to 2001, when the national campaign officially began, I think that there’s a ton of progress that we can see. Watching commentators like Melissa Harris-Perry proclaim their support for rape survivors on air and hearing Australia’s Prime Minister Julia Gillard tell survivors ‘we hear you, you’re valued and you’re believed’ as Australia begins an inquiry into child sexual abuse is amazing, and isn’t something that I think we would have seen 12 years ago.

We’ve also seen new approaches in assault prevention that are moving away from the old framing – how potential victims of assault can protect themselves – to how to prevent assaults more broadly. These range from videos about how you should treat people who’ve passed out (don’t assault them, do get them a blanket) to broader campaigns on what bystanders can do. (Trigger warning – that video focuses on an evening leading up to an assault, and various ways that bystanders could have made a difference).

But I also know that these still aren’t the norm when it comes to talking about assault. When multiple CNN commentators spoke to how difficult life will be for two young men convicted of rape, without expressing any similar concern for their victim, many people got upset, but CNN never responded. Judges, educators and journalists still focus on how to change what women wear as a way to control men.

So, in honor of the strides we’ve made, and with an eye towards the work that still needs to be done, here’s some more information on activism opportunities this month, locally and nationally:

Activism / SAAM Events

Local
New College of Florida events (Sarasota)
Tampa events, and events throughout Florida

National
One Student – based out of the Tampa area, this group focuses on campus strategies for preventing sexual violence
Project Unbreakable (trigger warning – this project involves survivors reclaiming words that were used against them through art. It can be very powerful, but is a very emotionally charged space.)

Resources for survivors

National
RAINN
Survivor Project

Local
CARE (Charlotte)
Peace River Center (Hardee, Highlands & Polk)
The Dawn Center (Hernando)
Crisis Center of Tampa Bay (Hillsborough)
ACT (Lee)
Sunrise of Pasco County, Inc. (Pasco)
Suncoast Center (Pinellas)
Manatee Glens (Manatee)
SPARCC (Sarasota & DeSoto)

Happy Endometriosis Awareness Month!


Posted on March 26, 2013 by

endoMarch is Endometriosis Awareness Month, and as such, we’re sharing some information about the disease and what you can do to manage it if you find yourself symptomatic or diagnosed. Endometriosis is a common disease that can lead to infertility. It can be managed with hormonal birth control – but only if women are aware of the disease and have access to good health care.

Endometriosis affects 5.5 million women in North America and is most diagnosed in women in their 30s or 40s. It is a leading cause of infertility in women. Hormonal birth control is a treatment for the pelvic pain that accompanies endometriosis and may help prevent long-term damage to the reproductive system.

Other symptoms can include intestinal pain, spotting or bleeding between periods, pain during sex, and in some cases, infertility.

Find out more about this disease by reading an excellent post about it by E.G. Hannah!

And as always, we care. No matter what.

 

Women’s Health & the ACA: The Benefits for Women


Posted on March 21, 2013 by

womens-health

We’re so lucky to have two public policy interns here at PPSWCF. She’s writing today on the benefits to women in the Affordable Care Act.

Although we’ve all heard of the Affordable Care Act, it can definitely be challenging to keep up with all of the pieces of President Obama’s expansive health care reform bill. I know that I was overwhelmed by the sheer size of just the first section of the Act. Because of the vast amount of discussion, debate, and misinformation clouding the benefits of the Affordable Care Act I want to take a minute to point out and celebrate some of the huge gains in women’s health care ushered in by this law.

To put the significance of this bill into context, it’s important to first recognize that one of the largest challenges for women in this country is finding affordable health care. In fact, according to Health and Human Services Secretary Kathleen Sebelius “more than half the women in this country [have] delayed or avoided preventive care because of its cost”. To combat this state of affairs the Health Resources and Services Administration commissioned the Institute of Medicine to investigate what services are most necessary for ensuring women’s health. In response the IOM identified eight preventive services that are of particular importance to female health. (What are they? Check out Monday’s post for the list.)

Based on the results of this study, the Affordable Care Act has mandated that all insurance companies fully cover the eight identified health services without cost sharing. In essence this means that all insured women will have access to a spectrum of free services, from FDA-approved contraception methods to domestic violence screenings. Since this portion of the law took effect in August of 2012, healthcare has been expanded for an estimated forty-seven million women, many of whom might not have been able to afford the premiums associated with these vital services before now. Additionally, the Affordable Care Act includes a provision requiring insurance plans to end sex-based discrimination by 2014. This means that companies will no longer be allowed to charge women more for coverage than men.

Unfortunately, these new advances are hardly set in stone. Lawmakers have struggled to create legislation that adequately protects both the health needs of women and the rights of religious employers. Currently, explicitly religious employers (such as churches) are not required to pay for services that conflict with their theology, and religiously affiliated organizations (such as some universities) do not have to pay or arrange for contraceptive coverage. Instead, women who are insured through such employers receive contraceptive coverage from separate insurance policies.

Despite these accommodations, this conflict has resulted in a national controversy. So far more than 45 lawsuits have been filed in federal district courts which directly challenge the contraceptive coverage section of the Affordable Care Act. It is believed that at least one of these cases will eventually make its way to the Supreme Court. Furthermore, legislators in the House of Representatives have attempted to overturn the entirety of the Affordable Care Act on more than thirty separate occasions.

There is a great deal for women and all people who value quality healthcare to celebrate in the Affordable Care Act. It is also important for us to be vigilant in defending the new gains associated with this piece of legislation. To learn more about how you can benefit from the Affordable Care Act, and to see a list of free preventive services you may now be eligible for, check out: http://www.healthcare.gov/prevention.

Surrogacy: Traditional vs. Gestational


Posted on March 12, 2013 by

surrogateSurrogacy is the process of carrying a child for someone else. Surrogates typically carry for couples who struggle with infertility, same-sex couples, and single people. There are two types of surrogacy: traditional and gestational.

A traditional surrogate (TS) is a woman who donates her eggs and carries the baby. This method is typically used when the intended mother (IM) can not use her own eggs. Many times, the intended father’s (IF) sperm is used and therefore, the child will have the genetic material of the surrogate and the intended father. The TS may become pregnant using IUI or IVF. If they choose to use the IVF process, they may extract more eggs to be fertilized than they can put back into her body and in that case, the embryos are usually frozen for later use. Typically, 1-3 embryos are transfered during IVF.

A gestational surrogate (GS) only carries the baby. The embryos transfered to her body might be fresh or frozen and have either 100%, 50%, or 0% of the intended parent’s (IP) genetic material. If the IM is not using her own eggs, an egg donor will be needed. Likewise, if the IF is not using his sperm, a sperm donor will be needed.

A surrogate must be a healthy woman, typically in her 20′s or early 30′s, who is willing to forgo all parental rights once the baby is born. Many surrogates already have children. Surrogates must undergo a battery of tests, both physical and psychological. She will have to inject herself with hormones, potentially endure invasive medical procedures, and of course, will have to be pregnant and deliver a baby or three. Once “matched” the surrogate and IP’s must draw up a contract, usually covering a litany of “what if” circumstances. There are attorneys who specialize in surrogacy. Having an iron clad contract drawn up by a skilled attorney and both parties should protect everyone involved. Some states like New York outlaw surrogacy, while others, like California, a “surro-friendly.” The process can be done privately or through an agency. Surrogates are usually compensated by the IPs, unless they are doing an altruistic surrogacy (usually family members). If you are interested in surrogacy, here are a few resources:

SurrogateMother.com is an online community for surrogates. The forum allows people to share their experiences, get educated about laws, health insurance, and processes, and may even help someone find their “match.” ALERT: be wary of scammers!

Resolve, The National Infertility Association covers various ways of building a family.

The Human Rights Campaign highlights state laws and legislation.

Even celebrities are not immune to the need for surrogacy. Nicole Kidman, Elton John, Elizabeth Banks, Sarah Jessica Parker, Giuliana Rancic, Ricky Martin, Michael Jackson, Neil Patrick Harris, and Dennis Quaid all had the help of a surrogate to build their family! You can also see a modern family being built with the help of a surrogate in the tv sitcom The New Normal.

The Self-Cleaning Vagina – Discharging the Myths of Discharge


Posted on March 11, 2013 by

Today we are recycling one of our most popular posts. Read on and see why . . . 

botticelli-venus-400x400Recently, I asked the staff at one of our health centers for a story that highlighted a myth about vaginas. They cited a recent story in which a patient came in complaining of vaginal discharge and, once diagnosed with a yeast infection, was convinced it was because she worked in a bakery. Yeast … around you … yes, we get the idea. But no, unless one places a baked good into the vagina, the chances the infection came from a yeasty treat are null and void.

We might chuckle a little at the sticker shock of such seemingly silly logic, but we realize the societal truth that vaginal discharge, along with many other reproductive health issues, is not usually a hot topic in people’s everyday lives. There is a lot of shame and embarrassment surrounding vaginal care, so let me clear a few things up.

Having worked for Planned Parenthood for close to four years, here are a few things I wish I could scream from the rooftops for every vagina-carrying human to hear:

1. Douching is bad for you and can cause the symptoms you’re trying to avoid!

We’ve all seen the boxes of Summer’s Eve tucked between the maxi-pads and pregnancy tests on our local pharmacy shelves. I’ve even seen advertisements that suggest vaginal douching will give a woman the confidence she needs to ask for a raise at work (what the hell?) I’ve heard women say their mothers douched, so they do it themselves. They’ve heard it makes them clean, or that it makes them smell good (with blatant implication that the natural odor is foul). Some do it every so often, while others integrate it into their sexual health routine more frequently. Regardless of the frequency of douching, please do yourself a favor and STOP! Douching, specifically with any agents that contain a fragrance, can drastically alter the natural balance of vaginal flora and acidity needed to self-regulate. Women who douche frequently are more susceptible to vaginal irritation, bacterial vaginosis, STIs, yeast infection or Pelvic Inflammatory Disease (PID). Same can be true for scented soaps and tampons … your temple smells fine the way it is, keep the perfumes outta there!

(**In some rare instances a medical professional may advise douching with water or other banal substance, in which case err on the side of your trusted health care advisor).

2. Healthy vaginas do not smell like fish or any other aquatic sea life!

There is a cultural myth that vaginas smell bad, specifically “fishy.” This myth has been further circulated within our society by some pretty off-color jokes (a blind man and a fish market…) which, while funny to those telling it, can often lead to reinforcing insecurities within women about their bodies. In a culture as dually sexually repressed and exploited as ours, it’s no wonder that this notion reigns “true” in the public arena. I can’t think of anyone else beside my P.P. family who would go toe to toe to argue the damaging ramifications of such a sexist joke as the punch line is delivered, so how else do we stop these dangerous lies from spreading? My thought is: education.

3. Vaginas are independent: When left alone they can clean and manage themselves just fine! 

The Vagina, as stated, is a self-sustaining organ that naturally produces bacteria and acids that cleans itself. It also produces a clear or whitish, generally odorless (sometimes acidic), itchless discharge that can increase and decrease in quantity as the menstrual cycle (28 days) changes. If you’re on a hormonal birth control method, your discharge may differ when on it from your non-hormonal cycles, as ovulation (releasing of the egg from the ovary) may increase discharge for a few days. Sexual arousal can also increase vaginal discharge, as your vagina naturally lubricates (though adding a fragrance-free water-based lubricant can help prevent tearing of condoms).

4. At the end of 6-8 hours, take out your tampon!

Too often a woman will come into our health centers complaining about a terrible vaginal odor, only to have the clinician remove days, weeks, or even months old tampon remnants. We call these “impacted tampons,” and they have the potential for some serious consequences, such as incredible odor (we sometimes have to close down the exam room for the day afterward), infection (bacterial vaginosis or pelvic inflammatory disease), toxic shock, or even death! It is so critical to take your tampons out within the time suggested for use on the package label, but also easy to ignore. Here’s a tip: confirm all tampons are out at the end of your period by placing your finger inside your canal and checking!

5. If your vagina smells abnormal, has colored or thick discharge, itches, or is generally out of the norm, head into Planned Parenthood!

So many times we see clients who incorrectly self-diagnose vaginal symptoms, and end up further irritating their condition, or wasting time and money on incorrect treatments. If I had a dollar for every time over-the-counter yeast medication was used on bacterial vaginosis, I’d create a P.S.A. about this topic and launch it during the Super Bowl. Delaying proper treatment of vaginal infections or sexually transmitted infections does not improve your health or save you money. Contrary, it can worsen temporary symptoms or cause irreversible damage to reproductive organs. Often clinicians can write a prescription that has multiple refills, if you are a person with chronic susceptibility to a specific infection, so you don’t have to pay for every visit to the health center (this rule is very specific to your condition, your health history, and the medical discretion of the clinician).

Here are some helpful links to some info about common vaginal infections, and as always, WE’RE HERE FOR YOU!

Self Love is Safe Love: A History of Masturbation


Posted on March 5, 2013 by

Masturbation Doesn't Screw With Your Eyes, Really

Today we are re-running an oldie, but so very goodie: Fosgood’s history of masturbation post. Enjoy!

Masturbation has a long and colorful history.  According to some ancient Egyptian myths, the god Apsu created the Milky Way when he copulated with his fist. (This certainly gives star gazing a new twist!) Greek men and women both were known to masturbate and saw it as a gift from the gods. They believed the god Hermes taught his son Pan how to masturbate to help heal his broken heart when he was rejected by the nymph, Echo.

Some took it a bit too far: the philosopher Diogenes masturbated in public stating that no human activity should be seen so shameful that it must be done in private; his fellow citizens disagreed. The physician Galen felt that the retention of semen is dangerous and leads to sickness while Hippocrates cautioned that loss of excessive amounts of semen could result in physical damage, such as spinal cord deterioration.

Women in ancient Athens commonly purchased dildos known as olisbos, made of padded leather or wood. Greek men saw masturbation as a sign of poverty and if you had the money, you would pay someone to do it for you. A few centuries later, Roman boys were encouraged to deplete their sexual energies through philosophy and gymnastics, the Roman equivalent of a cold shower.

Many of the negative attitudes about masturbation are attributed to the Bible, but no mention of masturbation is found; actually, what is referred to is the story of Onan, who  protested God’s commandment to impregnate his brother’s widow, whom he did have sex with but pulled out and “spilled his seed.”  From here, things went way downhill. An early Christian bishop taught that masturbation was a worse sin than adultery, rape and incest because it was “unnatural” and a form of contraception. On and on the debate went for many centuries. By 1729 the “post-masturbation disease” came with a long list of serious and debilitating symptoms and charlatans made a killing selling cures for this dreaded affliction.

Things became so extreme that be the turn of the 20th century parents were encouraged to have their sons circumcised so as not to be aroused when cleaning their foreskins and daughters to have clitoridectomies (removal of the clitoris).  Parents were encouraged to place their children in straightjackets, or wrap the child in cold wet sheets and apply leeches to remove blood and congestion, or burn genital tissue with hot irons to make sure their child had no access to their genitals at night where the evil deed was likely to happen.

There has been much improvement in the attitudes about masturbation, but there is still a long way to go. On a regular basis, health educators today still hear very negative responses about masturbation. (Female masturbation, in particular, is often greeted with something like, “Eww, that’s nasty!”) I’ve frequently asked parent groups concerned about masturbation if they would prefer their child masturbate or be out having sex, possibly causing a pregnancy or contracting a STI. That gets them thinking – though many would just prefer their child have no sexual feelings at all.

We know masturbation is an important way for people to discover their own sexuality, prevent infection (as long as their hands are clean), and prevent a pregnancy – and we would sincerely hope it’s sex with someone you love!

Edit: Historical facts come from the Planned Parenthood Federation of America’s white paper publication, Masturbation, From Stigma to Sexual Health.