Come Together – by Dr. Emily Nagoski
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From Dr. Emily Nagoski, author of the bestseller “Come As You Are” (which we reviewed very favorably before) we now present: Come Together.
What it is not about: simultaneous orgasms. The title is just a play on words.
What it is about: improving sexual wellbeing, particularly in long-term relationships where one or more partner(s) may be experiencing low desire.
Hence: come together, in the closeness sense.
A lot of books (or advice articles) out there take the Cosmo approach of “spicing things up”, and that can help for a night perhaps, but relying on novelty is not a sustainable approach.
Instead, what Dr. Nagoski outlines here is a method for focusing on shared comfort and pleasure over desire, creating the right state of mind that’s more conducive to sexuality, and reducing things that put the brakes on sexuality.
She also covers things whereby sexuality can often be obliged to change (for example, with age and/or disability), but that with the right attitude, change can sometimes just be growth in a different way, as you explore the new circumstances together, and continue to find shared pleasure in the ways that best suit your changing circumstances,
Bottom line: if you and/or your partner(s) would like to foster and maintain intimacy and pleasure, then this is a top-tier book for you.
Click here to check out Come Together, and, well, come together!
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The Hormone Therapy That Reduces Breast Cancer Risk & More
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The Hormone Balancing Act
We’ve written before about menopausal HRT:
What You Should Have Been Told About Menopause Beforehand
…and even specifically about the considerations when it comes to breast cancer risk:
Menopausal Hormone Replacement Therapy
this really does bear reading, by the way—scroll down to the bit about breast cancer risk, because it’s not a simple increased/decreased risk; it can go either way, and which way it goes will depend on various factors including your medical history and what HRT, if any, you are taking.
Hormone Modulating Therapy
Hormone modulating therapy, henceforth HMT, is something a little different.
Instead of replacing hormones, as hormone replacement therapy does, guess what hormone modulating therapy does instead? That’s right…
MHT can modulate hormones by various means, but the one we’re going to talk about today does it by blocking estrogen receptors,
Isn’t that the opposite of what we want?
You would think so, but since for many people with an increased breast cancer risk, the presence of estrogen increases that risk, which leaves menopausal (peri- or post) people in an unfortunate situation, having to choose between increased breast cancer risk (with estrogen), or osteoporosis and increased dementia risk, amongst other problems (without).
However, the key here (in fact, that’s a very good analogy) is in how the blocker works. Hormones and their receptors are like keys and locks, meaning that the wrong-shaped hormone won’t accidentally trigger it. And when the right-shaped hormone comes along, it gets activated and the message (in this case, “do estrogenic stuff here!” gets conveyed). A blocker is sufficiently similar to fit into the receptor, without being so similar as to otherwise act as the hormone.
In this case, it has been found that HMT blocking estrogen receptors was sufficient to alleviate the breast cancer risk, while also being associated with a 7% lower risk of developing Alzheimer’s disease or related dementias, with that risk reduction being even greater for some demographics depending on race and age. Black women in the 65–74 age bracket enjoyed a 24% relative risk reduction, with white women of the same age getting an 11% relative risk reduction. Black women enjoyed the same benefits after that age, whereas white women starting it at that age did not get the same benefits. The conclusion drawn from this is that it’s good to start this at 65 if relevant and practicable, especially if white, because the protective effect is strongest when gained aged 65–69.
Here’s a pop-science article that goes into the details more deeply than we have room for here:
Hormone therapy for breast cancer linked with lower dementia risk
And here’s the paper itself; we highly recommend reading at least the abstract, because it goes into the numbers in much more detail than we reasonably can here. It’s a huge cohort study of 18,808 women aged 65 years or older, so this is highly relevant data:
Want to learn more?
If you’d like a much deeper understanding of breast cancer risk management, including in the context of hormone therapy, you might like this excellent book that we reviewed recently:
The Smart Woman’s Guide to Breast Cancer – by Dr. Jenn Simmons
Take care!
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Better Sex Through Mindfulness – by Dr. Lori Brotto
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Female sexuality is such a taboo topic that, if one searches for (ob/gyn professor, women’s health research director, and psychologist) Dr. Brotto’s book on Google or Amazon, it suggests only “lori brotto mindfulness book”. So, for those brave enough to read a book that would have shocked Victorians, what does this one contain?
The focus is on, as the title suggests, better sex, by and for women. That said, it’s mostly because typically women are more likely to experience the problems described in the book; it’s nothing actually intrinsic to womanhood. A man with the same problems could read this book and benefit just the same.
While the book covers many possible problems between the sheets, the overarching theme is problems of the mind, such as:
- Not getting into the mood in the first place
- Losing the mood quickly and easily, such as by becoming distracted
- Difficulty achieving orgasm even when mechanically everything’s delightful
- Physical discomfort creating a barrier to enjoyment
…and yes, that last one is in part mind-stuff too! Though Dr. Brotto isn’t arguing that mindfulness is a panacea, just an incredibly useful tool. And, it’s one she not only explains very well, but also explains from the position of a wealth of scientific evidence… Enough so, that we see a one-star Amazon reviewer from Canada complained that it was too well-referenced! For us, though, it’s what we like to see.
Good science, presented clearly and usefully, giving practical tips that improve people’s lives.
Bottom line: if you’ve ever lost the mood because you got distracted into thinking about taxes or that meeting on Tuesday, this is the book for you.
Click here to check out Better Sex Through Mindfulness—you can thank us later!
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Lacking Motivation? Science Has The Answer
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The Science Of Motivation (And How To Use It To Your Advantage)
When we do something rewarding, our brain gets a little (or big!) spike of dopamine. Dopamine is popularly associated with pleasure—which is fair— but there’s more to it than this.
Dopamine is also responsible for motivation itself, as a prime mover before we do the thing that we find rewarding. If we eat a banana, and enjoy it, perhaps because our body needed the nutrients from it, our brain gets a hit of dopamine.
(and not because bananas contain dopamine; that dopamine is useful for the body, but can’t pass the blood-brain barrier to have an effect on the brain)
So where does the dopamine in our brain come from? That dopamine is made in the brain itself.
Key Important Fact: the brain produces dopamine when it expects an activity to be rewarding.
If you take nothing else away from today’s newsletter, let it be this!
It makes no difference if the activity is then not rewarding. And, it will keep on motivating you to do something it anticipated being rewarding, no matter how many times the activity disappoints, because it’ll remember the very dopamine that it created, as having been the reward.
To put this into an example:
- How often have you spent time aimlessly scrolling social media, flitting between the same three apps, or sifting through TV channels when “there’s nothing good on to watch”?
- And how often did you think afterwards “that was a good and rewarding use of my time; I’m glad I did that”?
In reality, whatever you felt like you were in search of, you were really in search of dopamine. And you didn’t find it, but your brain did make some, just enough to keep you going.
Don’t try to “dopamine detox”, though.
While taking a break from social media / doomscrolling the news / mindless TV-watching can be a great and healthful idea, you can’t actually “detox” from a substance your body makes inside itself.
Which is fortunate, because if you could, you’d die, horribly and miserably.
If you could “detox” completely from dopamine, you’d lose all motivation, and also other things that dopamine is responsible for, including motor control, language faculties, and critical task analysis (i.e. planning).
This doesn’t just mean that you’d not be able to plan a wedding; it also means:
- you wouldn’t be able to plan how to get a drink of water
- you wouldn’t have any motivation to get water even if you were literally dying of thirst
- you wouldn’t have the motor control to be able to physically drink it anyway
Read: Dopamine and Reward: The Anhedonia Hypothesis 30 years on
(this article is deep and covers a lot of ground, but is a fascinating read if you have time)
Note: if you’re wondering why that article mentions schizophrenia so much, it’s because schizophrenia is in large part a disease of having too much dopamine.
Consequently, antipsychotic drugs (and similar) used in the treatment of schizophrenia are generally dopamine antagonists, and scientists have been working on how to treat schizophrenia without also crippling the patient’s ability to function.
Do be clever about how you get your dopamine fix
Since we are hardwired to crave dopamine, and the only way to outright quash that craving is by inducing anhedonic depression, we have to leverage what we can’t change.
The trick is: question how much your motivation aligns with your goals (or doesn’t).
So if you feel like checking Facebook for the eleventieth time today, ask yourself: “am I really looking for new exciting events that surely happened in the past 60 seconds since I last checked, or am I just looking for dopamine?”
You might then realize: “Hmm, I’m actually just looking for dopamine, and I’m not going to find it there”
Then, pick something else to do that will actually be more rewarding. It helps if you make a sort of dopa-menu in advance, of things to pick from. You can keep this as a list on your phone, or printed and pinned up near your computer.
Examples might be: Working on that passion project of yours, or engaging in your preferred hobby. Or spending quality time with a loved one. Or doing housework (surprisingly not something we’re commonly motivated-by-default to do, but actually is rewarding when done). Or exercising (same deal). Or learning that language on Duolingo (all those bells and whistles the app has are very much intentional dopamine-triggers to make it addictive, but it’s not a terrible outcome to be addicted to learning!).
Basically… Let your brain’s tendency to get led astray work in your favor, by putting things in front of it that will lead you in good directions.
Things for your health and/or education are almost always great things to allow yourself the “ooh, shiny” reaction and pick them up, try something new, etc.
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Frozen/Thawed/Refrozen Meat: How Much Is Safety, And How Much Is Taste?
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What You Can (And Can’t) Safely Do With Frozen Meat
Yesterday, we asked you:
❝You have meat in the freezer. How long is it really safe to keep it?❞
…and got a range of answers, mostly indicating to a) follow the instructions (a very safe general policy) and b) do not refreeze if thawed because that would be unsafe. Fewer respondents indicated that meat could be kept for much longer than guidelines say, or conversely, that it should only be kept for weeks or less.
So, what does the science say?
Meat can be kept indefinitely (for all intents and purposes) in a freezer; it just might get tougher: True or False?
False, assuming we are talking about a normal household electrical freezer that bottoms out at about -18℃ / 0℉.
Fun fact: cryobiologists cryopreserve tissue samples (so basically, meat) at -196℃ / -320℉, and down at those temperatures, the tissues will last a lot longer than you will (and, for all practical purposes: indefinitely). There are other complications with doing so (such as getting the sample through the glass transition point without cracking it during the vitrification process) but those are beyond the scope of this article.
If you remember back to your physics or perhaps chemistry classes at school, you’ll know that molecules move more quickly at higher temperatures, and more slowly at lower ones, only approaching true stillness as they near absolute zero (-273℃ / -459℉ / 0K ← we’re not saying it’s ok, although it is; rather, that is zero kelvin; no degree sign is used with kelvins)
That means that when food is frozen, the internal processes aren’t truly paused; it’s just slowed to a point of near imperceptibility.
So, all the way up at the relatively warm temperatures of a household freezer, a lot of processes are still going on.
What this means in practical terms: those guidelines saying “keep in the freezer for up to 4 months”, “keep in the freezer for up to 9 months”, “keep in the freezer for up to 12 months” etc are being honest with you.
More or less, anyway! They’ll usually underestimate a little to be on the safe side—but so should you.
Bad things start happening within weeks at most: True or False?
False, for all practical purposes. Again, assuming a normal and properly-working household freezer as described above.
(True, technically but misleadingly: the bad things never stopped; they just slowed down to a near imperceptible pace—again, as described above)
By “bad” here we should clarify we mean “dangerous”. One subscriber wrote:
❝Meat starts losing color and flavor after being in the freezer for too long. I keep meat in the freezer for about 2 months at the most❞
…and as a matter of taste, that’s fair enough!
It is unsafe to refreeze meat that has been thawed: True or False?
False! Assuming it has otherwise been kept chilled, just the same as for fresh meat.
Food poisoning comes from bacteria, and there is nothing about the meat previously having been frozen that will make it now have more bacteria.
That means, for example…
- if it was thawed (but chilled) for a period of time, treat it like you would any other meat that has been chilled for that period of time (so probably: use it or freeze it, unless it’s been more than a few days)
- if it was thawed (and at room temperature) for a period of time, treat it like you would any other meat that has been at room temperature for that period of time (so probably: throw it out, unless the period of time is very small indeed)
The USDA gives for 2 hours max at room temperature before considering it unsalvageable, by the way.
However! Whenever you freeze meat (or almost anything with cells, really), ice crystals will form in and between cells. How much ice crystallization occurs depends on several variables, with how much water there is present in the food is usually the biggest factor (remember that animal cells are—just like us—mostly water).
Those ice crystals will damage the cell walls, causing the food to lose structural integrity. When you thaw it out, the ice crystals will disappear but the damage will be left behind (this is what “freezer burn” is).
So if your food seems a little “squishy” after having been frozen and thawed, that’s why. It’s not rotten; it’s just been stabbed countless times on a microscopic level.
The more times you freeze and thaw and refreeze food, the more this will happen. Your food will degrade in structural integrity each time, but the safety of it won’t have changed meaningfully.
Want to know more?
Further reading:
You can thaw and refreeze meat: five food safety myths busted
Take care!
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Tilapia vs Cod – Which is Healthier?
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Our Verdict
When comparing tilapia to cod, we picked the tilapia.
Why?
Another case of “that which is more expensive is not necessarily the healthier”!
In terms of macros, tilapia has more protein and fats, as well as more omega-3 (and omega-6). On the downside, tilapia does have relatively more saturated fat, but at 0.94g/100g, it’s not exactly butter.
The vitamins category sees that tilapia has more of vitamins B1, B3, B5, B12, D, and K, while cod has more of vitamins B6, B9, and choline. A moderate win for tilapia.
When it comes to minerals, things are most divided; tilapia has more copper, iron, phosphorus, potassium, manganese, and selenium, while cod has more magnesium and zinc. An easy win for tilapia.
One other thing to note is that both of these fish contain mercury these days (and it’s worth noting: cod has nearly 10x more mercury). Mercury is, of course, not exactly a health food.
So, excessive consumption of either is not recommended, but out of the two, tilapia is definitely the one to pick.
Want to learn more?
You might like to read:
Farmed Fish vs Wild Caught: Know The Health Differences
Take care!
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What does it mean to be immunocompromised?
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Our immune systems help us fight off disease, but certain health conditions and medications can weaken our immune systems. People whose immune systems don’t work as well as they should are considered immunocompromised.
Read on to learn more about how the immune system works, what causes people to be immunocompromised, and how we can protect ourselves and the immunocompromised people around us from illness.
What is the immune system?
The immune system is a network of cells, organs, and chemicals that helps our bodies fight off infections caused by invaders, such as bacteria, viruses, fungi, and parasites.
Some important parts of the immune system include:
- White blood cells, which attack and kill germs that don’t belong inside our bodies.
- Lymph nodes, which help our bodies filter out germs.
- Antibodies, which help our bodies recognize invaders.
- Cytokines, which tell our immune cells what to do.
What causes people to be immunocompromised?
Some health conditions and medications can prevent our immune systems from functioning optimally, which makes us more vulnerable to infection. Health conditions that compromise the immune system fall into two categories: primary immunodeficiency and secondary immunodeficiency.
Primary immunodeficiency
People with primary immunodeficiency are born with genetic mutations that prevent their immune systems from functioning as they should. There are hundreds of types of primary immunodeficiencies. Since these mutations affect the immune system to varying degrees, some people may experience symptoms and get diagnosed early in life, while others may not know they’re immunocompromised until adulthood.
Secondary immunodeficiency
Secondary immunodeficiency happens later in life due to an infection like HIV, which weakens the immune system over time, or certain types of cancer, which prevent the body from producing enough white blood cells to adequately fight off infection. Studies have also shown that getting infected with COVID-19 may cause immunodeficiency by reducing our production of “killer T-cells,” which help fight off infections.
Sometimes necessary treatments for certain medical conditions can also cause secondary immunodeficiency. For example, people with autoimmune disorders—which cause the immune system to become overactive and attack healthy cells—may need to take immunosuppressant drugs to manage their symptoms. However, the drugs can make them more vulnerable to infection.
People who receive organ transplants may also need to take immunosuppressant medications for life to prevent their body from rejecting the new organ. (Given the risk of infection, scientists continue to research alternative ways for the immune system to tolerate transplantation.)
Chemotherapy for cancer patients can also cause secondary immunodeficiency because it kills the immune system’s white blood cells as it’s trying to kill cancer cells.
What are the symptoms of a compromised immune system?
People who are immunocompromised may become sick more frequently than others or may experience more severe or longer-term symptoms than others who contract the same disease.
Other symptoms of a compromised immune system may include fatigue; digestive problems like cramping, nausea, and diarrhea; and slow wound healing.
How can I find out if I’m immunocompromised?
If you think you may be immunocompromised, talk to your health care provider about your medical history, your symptoms, and any medications you take. Blood tests can determine whether your immune system is producing adequate proteins and cells to fight off infection.
I’m immunocompromised—how can I protect myself from infection?
If you’re immunocompromised, take precautions to protect yourself from illness.
Wash your hands regularly, wear a well-fitting mask around others to protect against respiratory viruses, and ensure that you’re up to date on recommended vaccines.
Immunocompromised people may need more doses of vaccines than people who are not immunocompromised—including COVID-19 vaccines. Talk to your health care provider about which vaccines you need.
How can I protect the immunocompromised people around me?
You never know who may be immunocompromised. The best way to protect immunocompromised people around you is to avoid spreading illnesses.
If you know you’re sick, isolate whenever possible. Wear a well-fitting mask around others—especially if you know that you’re sick or that you’ve been exposed to germs. Make sure you’re up to date on recommended vaccines, and practice regular hand-washing.
If you’re planning to spend time with someone who is immunocompromised, ask them what steps you can take to keep them safe.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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