HIIT, But Make It HIRT

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This May HIRT A Bit

This is Ingrid Clay. She’s a professional athlete, personal trainer, chef*, and science writer.

*A vegan bodybuilding chef, no less:

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For those who prefer reading…

This writer does too 😉

We’ve previously reviewed her book, “Science of HIIT”, and we’re going to be talking a bit about High Intensity Interval Training today.

If you’d like to know a little more about the woman herself first, then…

Centr | Meet Ingrid: Your HIIT HIRT trainer

Yes, that is Centr, as in Chris Hemsworth’s personal training app, where Clay is the resident HIIT & HIRT expert & trainer.

What’s this HIIT & HIRT?

HIIT” is High Intensity Interval Training, which we’ve written about before:

How To Do HIIT (Without Wrecking Your Body)

Basically, it’s a super-efficient way of working out, that gets better results than working out for longer with other methods, especially because of how it raises the metabolism for a couple of hours after training (this effect is called EPOC, by the way—Excessive Post-exercise Oxygen Consumption), and is a good thing.

You can read more about the science of it, in the above-linked main feature.

And HIRT?

HIRT” is High Intensity Resistance Training, and is resistance training performed with HIIT principles.

See also: Chris Hemsworth’s Trainer Ingrid Clay Explains HIRT

An example is doing 10 reps of a resistance exercise (e.g., a dumbbell press) every minute on odd-numbered minutes, and 10 reps of a different resistance exercise (e.g. dumbbell squats) on even-numbered minutes.

If dumbbells aren’t your thing, it could be resistance bands, or even the floor (press-ups are a resistance exercise!)

For HIRT that’s not also a cardio exercise, gaps between different exercises can be quite minimal, as we only need to confuse the muscles, not the heart. So, effectively, it becomes a specially focused kind of circuit training!

If doing planks though, you might want to check out Clay’s troubleshooting guide:

Expert trainer Ingrid Clay identifies the mistakes many people make when doing the plank, and how to correct them.

Want more from Clay?

Here she gives a full 20-minute full-body HIIT HIRT workout:

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Enjoy!

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  • 11 Things That Can Change Your Eye Color

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Eye color is generally considered so static that iris scans are considered a reasonable security method. However, it can indeed change—mostly for reasons you won’t want, though:

    Ringing the changes

    Putting aside any wishes of being a manga protagonist with violet eyes, here are the self-changing options:

    • Aging in babies: babies are often born with lighter eyes, which can darken as melanocytes develop during the first few months of life. This is similar to how a small child’s blonde hair can often be much darker by the time puberty hits!
    • Aging in adults: eyes may continue to darken until adulthood, while aging into the elderly years can cause them to lighten due to conditions like arcus senilis
    • Horner’s syndrome: a nerve disorder that can cause the eyes to become lighter due to loss of pigment
    • Fuchs heterochromic iridocyclitis: an inflammation of the iris that leads to lighter eyes over time
    • Pigment dispersion syndrome: the iris rubs against eye fibers, leading to pigment loss and lighter eyes
    • Kayser-Fleischer rings: excess copper deposits on the cornea, often due to Wilson’s disease, causing larger-than-usual brown or grayish rings around the iris
    • Iris melanoma: a rare cancer that can darken the iris, often presenting as brown spots
    • Cancer treatments: chemotherapy for retinoblastoma in children can result in lighter eye color and heterochromia
    • Medications: prostaglandin-based glaucoma treatments can darken the iris, with up to 23% of patients seeing this effect
    • Vitiligo: an autoimmune disorder that destroys melanocytes, mostly noticed in the skin, but also causing patchy loss of pigment in the iris
    • Emotional and pupil size changes: emotions and trauma can affect pupil size, making eyes appear darker or lighter temporarily by altering how much of the iris is visible

    For more about all these, and some notes about more voluntary changes (if you have certain kinds of eye surgery), enjoy:

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    Want to learn more?

    You might also like to read:

    Understanding And Slowing The Progression Of Cataracts

    Take care!

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  • Water’s Counterintuitive Properties

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝Why are we told to drink more water for everything, even if sometimes it seems like the last thing we need? Bloated? Drink water. Diarrhea? Drink water. Nose running like a tap? Drink water❞

    While water will not fix every ill, it can fix a lot, or at least stop it from being worse!

    Our bodies are famously over 60% water (exact figure will depend on how well-hydrated you are, obviously, as well as your body composition in terms of muscle and fat). Our cells (which are mostly full of mostly water) need replacing all the time, and almost everything that needs transporting almost anywhere is taken there by blood (which is also mostly water). And if we need something moving out of the body? Water is usually going to be a large part of how it gets ejected.

    In the cases of the examples you gave…

    • Bloating: bloating is often a matter of water retention, which often happens as a result of having too much salt, and/or sometimes too much fat. So the body’s homeostatic system (the system that tries to maintain all kinds of equilibrium, keeping salt balance, temperature, pH, and many other things in their respective “Goldilocks zones”) tries to add more water to where it’s needed to balance out the salt etc.
      • Consequently, drinking more water means the body will note “ok, balance restored, no need to keep retaining water there, excess salts being safely removed using all this lovely water”.
    • Diarrhea: this is usually a case of a bacterial infection, though there can be other causes. Whether for that reason or another, the body has decided that it needs to give your gut an absolute wash-out, and it can only do that from the inside—so it uses as much of the body’s water as it needs to do that.
      • Consequently, drinking more water means that you are replenishing the water that the body has already 100% committed to using. If you don’t drink water, you’ll still have diarrhea, you’ll just start to get dangerously dehydrated.
    • Runny nose: this is usually a case of either fighting a genuine infection, or else fighting something mistaken for a pathogen (e.g. pollen, or some other allergen). The mucus is an important part of the body’s defense: it traps the microbes (be they bacteria, virus, whatever) and water-slides them out of the body.
      • Consequently, drinking more water means the body can keep the water-slide going. Otherwise, you’ll just get gradually more dehydrated (because as with diarrhea, your body will prioritize this function over maintaining water reserves—water reserves are there to be used if necessary, is the body’s philosophy) and if the well runs dry, you’ll just be dehydrated and have a higher pathogen-count still in your body.

    Some previous 10almonds articles that might interest you:

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  • How influencers and content creators discuss birth control on social media: What research shows

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    News articles in recent weeks have documented the spread of misinformation about hormonal birth control methods on popular social media platforms like TikTok, YouTube and X, formerly called Twitter. Influencers with large and small followings are sharing unsubstantiated claims about the side effects of contraceptives, while directly or indirectly encouraging others to stop using them.

    This trend has not escaped researchers, who for several years have been investigating what people who can get pregnant are posting on social media platforms about hormonal and non-hormonal birth control methods. Understanding the drivers of these trends is important because they have implications for policy and patient care, according to researchers. Some worry that during the post-Dobbs era, when there are continued strikes against reproductive rights in the U.S., misinformation about birth control on social media could have a negative influence on contraceptive preferences — potentially leading to more unwanted pregnancies.

    More than 90% of women of reproductive age have used at least one contraceptive method, according to a 2023 report by the U.S. National Center for Health Statistics. However, the report also finds that the use of male condoms and withdrawal methods increased between 2006 and 2019, while the use of the birth control pill decreased. Non-hormonal contraception methods, including condoms, spermicides, withdrawal and menstrual cycle tracking, are 10% or less effective than hormonal contraceptives. The only exceptions are surgical sterilization and the copper intrauterine device.

    To be sure, not all birth control-related content posted on social media platforms is negative, studies show. Health care professionals are sharing educational material with a high rate of engagement and non-health care professional users share their positive experiences with the birth control methods they use.

    But as you will see in the studies curated below, researchers also find that social media users, including influencers, share inaccurate information about hormonal contraceptives on various social media platforms, discuss their discontinuation of birth control in favor of non-hormonal methods and engage in unsubstantiated fear-mongering of hormonal contraceptives.

    Researchers also have learned that the content posted on social media platforms has changed in tone over time, mirroring the shift in the national political discourse.

    In a 2021 study published in the American Journal of Obstetrics & Gynecology, researchers analyzed more than 800,000 English-language tweets mentioning at least one contraceptive method between March 2006, when Twitter was founded, and December 2019. They coded the sentiment of tweets as positive, neutral or negative.

    “What we found over time was that the number of neutral tweets went down for each and every one of the birth control methods, and people became more polarized with regards to how they talk on these social media platforms over those 13 years,” says study co-author Dr. Deborah Bartz, an OB-GYN at Brigham and Women’s Hospital with expertise in complex family planning and an associate professor at Harvard Medical School.

    In a February 2024 commentary in the Journal of Women’s Health, University of Delaware researchers Emily Pfender and Leah Fowler argue that ongoing dialogue about contraception on social media provides “a glimpse into public sentiment about available options” to people who can get pregnant.

    The authors also note that misinformation and disinformation about hormonal contraception may have a larger effect on health disparities, especially among historically marginalized groups who may already mistrust the medical establishment.

    “This may contribute to unintended pregnancy and delayed care, further widening health disparities and hindering progress toward equitable reproductive health outcomes,” Pfender and Fowler write.

    Side effects

    There are known side effects to hormonal birth control methods, including headaches, nausea, sore breasts and spotting. Most are mild and disappear with continued use or with switching to another method. Among hormonal contraceptives, only the Depo-Provera injection has been linked with weight gain, studies show.  

    But some social media influencers have spread false claims about the potential side effects of hormonal birth control methods, ranging from infertility to abortion to unattractiveness. Despite these false claims, physicians and professional organizations such as the American College of Obstetricians and Gynecologists find today’s contraceptive options safe and very effective.

    “They’re about the most low-risk prescription that I give,” says Dr. Megana Dwarakanath, an adolescent medicine physician in Pittsburgh. “I always joke that if something goes wrong in someone’s life, they’re within the reproductive years, it always gets blamed on birth control.”

    Dwarakanath says her young patients are most worried about two side effects: weight gain and mood. “Those are the things that they will almost always attribute to their birth control at a time that their bodies are also changing very rapidly,” she says. “Things like mental health diagnoses or personality disorders also tend to crop up during the time young people have started or have been on birth control.”

    Most research on the link between oral contraceptives and cancer risk comes from observational studies, according to the National Cancer Institute. Overall, the studies have consistently shown that the risks of breast and cervical cancer are slightly increased for women who use oral contraceptives, whereas the risk of endometrial, ovarian and colorectal cancers are reduced.

    The use of hormonal birth control has also been associated with an increase in the risk of developing blood clots, studies show. But that risk is not universal for everyone who takes hormonal birth control. This risk is higher for women 35 and older, those who smoke, are very overweight or have a history of cardiovascular disease. Overall, 3 to 9 out of 10,000 women who take the pill are at risk of developing blood clots within a given year. The risk for women who don’t take the pill is 1 to 5 out of 10,000.

    There is no association between the pill and mood disorders, according to a large body of research, including a 2021 cohort study of nearly 740,000 young women. 

    It’s worth noting the dearth of research into women’s reproductive health due to chronic underfunding of women’s health research. An analysis of funding by the U.S. National Institutes of Health finds that in nearly three-quarters of the cases where a disease affects mainly one gender, the institute’s funding pattern favored males. Either the disease affected more women and was underfunded, or the disease affected more men and was overfunded, according to the 2021 study published in the Journal of Women’s Health.

    Aside from underfunding, conducting robust research into the long-term effects of birth control is complex.

    “Historically, people haven’t felt that it’s ethically OK to randomize people to birth control methods in large part because the outcome of unintended pregnancy is greater,” for people who are given the placebo, Bartz says.

    Research on birth control misinformation on social media

    Social media use is widespread among young adults. More than 90% of Americans between 18 and 29 reported ever using YouTube, while 78% said they had used Instagram, 62% used TikTok and 42% used Twitter, according to a 2023 survey of 5,733 U.S. adults by Pew Research Center.

    These years overlap with the demographic of people who are most likely to use birth control. And because the use of contraceptives is less stigmatized today, people are more likely to talk with one another about their questions and concerns or share that information online.

    In addition to investigating the general landscape of social media posts about birth control, researchers are also interested in the type of content influencers, who typically have 20,000 or more followers, post, because of their persuasive power over their audiences.

    “When influencers disclose personal experiences and beliefs about various topics, audience members tend to form similar attitudes especially when they feel connected to the influencer,” Pfender and M. Marie Devlin write in a 2023 study published in the journal Health Communication.

    Below we have curated several studies published in recent years documenting the spread of birth control misinformation on social media. The roundup is followed by a quick reference guide on female contraceptives and their actual potential side effects.

    Contraceptive Content Shared on Social Media: An Analysis of Twitter
    Melody Huang, et al. Contraception and Reproductive Medicine, February 2024.

    The study: The authors explore how contraceptive information is shared on X and understand how those posts affect women’s decisions. They analyze a random 1% of publicly available English-language tweets about reversible prescription contraceptive methods, from January 2014 and December 2019. The 4,434 analyzed tweets included at least 200 tweets per birth control method — IUDs, implants, the pill, patch and ring.

    The findings: 26.7% of tweets about contraceptive methods discussed decision-making and 20.5% discussed side effects, especially the side effects of IUDs and the depot medroxyprogesterone acetate (DMPA or Depo-Provera) shot. Discussions about the pill, patch or ring prompted more discussions on logistics and adherence. About 6% of tweets explicitly requested information. Tweets about IUDs were most popular in terms of likes.

    More importantly, 50.6% of the tweets were posted by contraceptive users, while only 6% came from official health or news sources. Tweets from news or journalistic sources were more frequent than tweets from a health care professional or organization.

    Some tweets contained misinformation represented as facts, such as the unsubstantiated claim that IUDs can cause fertility issues. Others were outwardly misogynistic, shaming women and claiming that they wouldn’t be able to have kids because of using hormonal birth control.

    One takeaway: “While Twitter may provide valuable insight, with more tweets being created by personal contraceptive users than official healthcare sources, the available information may vary in reliability. Asking patients about information from social media can help reaffirm to patients the importance of social networks in contraceptive decision-making while also addressing misconceptions to improve contraceptive counseling,” the authors write.

    What Do Social Media Influencers Say About Birth Control? A Content Analysis of YouTube Vlogs About Birth Control
    Emily J. Pfender and M. Marie Devlin. Health Communication, January 2023.

    The study: To explore what social media influencers shared on YouTube about their experiences with hormonal and non-hormonal methods of birth control, the researchers analyzed 50 vlogs posted between December 2019 and December 2021. Most of the 50 influencers were categorized on YouTube as Lifestyle (72%) and Fitness (16%). They had between 20,000 and 2.2 million subscribers each.

    The findings: In total, 74% of the influencers talked about discontinuing hormonal birth control. About 44% said the main reason they were discontinuing birth control was to be more natural, while 32% said they wanted to improve their mental health and 20% were concerned about weight gain.

    Forty percent of influencers mentioned using non-hormonal birth control methods such as menstrual cycle tracking, condoms, non-hormonal IUDs and the pull-out method. Twenty percent reported switching from hormonal to non-hormonal methods.

    One takeaway: “Our content analysis revealed that discontinuation of hormonal birth control is commonly discussed among [social media influencers] on YouTube and sexual health information from influencers might not provide accurate educational information and tools… this is especially concerning given that social media is young adults’ primary tool for sexual health information. Future research is needed to understand the effects of SMI birth control content on sexual health behaviors,” the authors write.

    Hormonal Contraceptive Side Effects and Nonhormonal Alternatives on TikTok: A Content Analysis
    Emily J. Pfender, Kate Tsiandoulas, Stephanie R. Morain and Leah R. Fowler. Health Promotion Practice, January 2024.

    The study: The authors analyzed the content of 100 TikTok videos that used the hashtags #birthcontrolsideeffects and #nonhormonalcontraception. Their goal was to understand the types of content about side effects of hormonal and non-hormonal contraceptives on TikTok.

    The findings: The videos averaged about 1 minute and garnered an average of 27,795 likes, 251 comments and 623 shares. For #birthcontrolsideeffects, 80% of the audience was 18 to 24 years old and videos with that hashtag had 43 million views worldwide as of July 7, 2023.

    Thirty-two percent of the videos were by regular users (non-influencers), 26 by clinicians, 13% by health coaches and 2% by companies. Only 3% had a sponsorship disclosure and 6% included a medical disclaimer, that the person was not a doctor or was not providing medical advice.

    Most of the 100 videos (71%) mentioned hormonal contraception. Among them 51% discussed unspecific hormonal contraceptives, 31% talked about the pill and 11% about hormonal IUDs. Four of the 71 creators explicitly recommended against using hormonal contraceptives.

    Claims about hormonal contraceptives were mostly based on personal experience. About 25% of the creators cited no basis for their claims, 23% included outside evidence, including unspecified studies or information from the FDA insert, and 11% used a combination of personal and outside evidence.

    Almost half (49%) mentioned discontinuing their hormonal contraception, with negative side effects cited as the most common reason.

    The creators talked about mental health issues, weight gain, headaches, and less common risks of various cancers or chronic illness, change in personality and blood clots. They were less likely to mention the positive aspects of birth control.

    About 52% of videos mentioned non-hormonal contraception, including copper IUDs and cycle tracking.

    Nine of the 100 creators expressed feeling dismissed, pressured, gaslit or insufficiently informed about contraception by medical providers.

    One takeaway: “Our findings support earlier work suggesting social media may fuel ‘hormonophobia,’ or negative framing and scaremongering about hormonal contraception and that this phobia is largely driven by claims of personal experience rather than scientific evidence,” the authors write. “Within these hashtag categories, TikTok creators frame their provider interactions negatively. Many indicate feeling ignored or upset after medical appointments, not sufficiently informed about contraceptive options, and pressured to use hormonal contraceptives. This finding aligns with previous social media research and among the general population, suggesting opportunities for improvements in contraceptive counseling.”

    Popular Contraception Videos on TikTok: An Assessment of Content Topics
    Rachel E. Stoddard, et al. Contraception, January 2024.

    The study: Researchers analyzed 700 English-language TikTok videos related to hormonal contraception, with a total of 1.2 billion views and 1.5 million comments, posted between October 2019 and December 2021. Their aim was to explore the types of contraception content on TikTok and to understand how the platform influences the information patients take into birth control counseling visits.

    The findings: More than half of the videos (52%) were about patient experiences and how to use contraceptives. Other common topics included side effects (35%) and pregnancy (39%).

    Only 19% of the videos were created by health care professionals, including midwives, physician assistants and medical doctors, although those videos garnered 41% of the total views, indicating higher engagement. While 93% of health care providers shared educational content, 23% of non-health care providers shared educational content.

    One takeaway: “Our findings show an exceptional opportunity for education around contraception for young reproductive-aged individuals, given the accessibility and popularity of these videos. This may also extend to other topics around sex education and family planning, including sexually transmitted infection prevention and treatment and procuring abortion care,” the authors write.

    TikTok, #IUD, and User Experience With Intrauterine Devices Reported on Social Media
    Jenny Wu, Esmé Trahair, Megan Happ and Jonas Swartz. Obstetrics & Gynecology, January 2023.

    The study: Researchers used a web-scraping application to collect the top 100 TikTok videos tagged #IUD on April 6, 2022, based on views, comments, likes and shares. Their aim was to understand the perspectives and experiences of people with IUDs shared on TikTok. The videos had a total of 471 million views, 32 million likes and 1 million shares. Their average length was 33 seconds.

    The findings: Some 89% of the creators identified as female and nearly 90% were from the United States; 37% were health care professionals; and 78% were 21 years or older.

    Video types included patients’ own experiences with IUD removal (32%), educational (30%) and humorous (25%). More videos (38%) had a negative tone compared with 19% with a positive tone. The videos that portrayed negative user experiences emphasized pain and distrust of health care professionals.

    Half of the videos were very accurate, while nearly a quarter were inaccurate (the authors did not use the term misinformation).

    One takeaway: “The most liked #IUD videos on TikTok portray negative experiences related to pain and informed consent. Awareness of this content can help health care professionals shape education given the high prevalence of TikTok use among patients,” the authors write. “TikTok differs from other platforms because users primarily engage with an algorithmically curated feed individualized to the user’s interests and demographics.”

    Types of female birth control

    Most female hormonal contraceptives contain the synthetic version of natural female hormones estrogen and progesterone. They affect women’s hormone levels, preventing mature eggs from being released by the ovaries, a process that’s known as ovulation, hence, preventing a possible pregnancy.

    Of the two hormones, progesterone (called progestin in synthetic form) is primarily responsible for preventing pregnancy. In addition to playing a role in preventing ovulation, progesterone inhibits sperm from penetrating through the cervix. Estrogen inhibits the development of follicles in the ovaries.

    The information below is sourced from the CDC, the National Library of Medicine, the Cleveland Clinic and the Mayo Clinic.

    Intrauterine contraception

    Also called Long-Acting Reversible Contraception, or LARC, this method works by thickening the cervical mucus so the sperm can’t reach an egg. There are two types of IUDs: hormonal and non-hormonal.

    • Levonorgestrel intrauterine system is a T-shaped device that’s placed inside the uterus by a doctor. It releases a small amount of progestin daily to prevent pregnancy. It can stay in place for 3 to 8 years. Its failure rate is 0.1% to 0.4%.
    • Copper T intrauterine device is also T-shaped and is placed inside the uterus by a doctor. It does not contain hormones and can stay in place for up to 10 years. Its failure rate is 0.8%.
    • Side effects: Copper IUDs may cause more painful and heavy periods, while progestin IUDs may cause irregular bleeding. In the very rare cases of pregnancy while having an IUD, there’s a greater chance of an ectopic pregnancy, which is when a fertilized egg grows outside of the uterus.

    Hormonal methods

    • The implant is a single, thin rod that’s inserted under the skin of the upper arm. It releases progestin over 3 years. Its failure rate is 0.1%, making it the most effective form of contraception available.
    • Side effects: The most common side effect of an implant is irregular bleeding.
    • The injection Depo-Provera or “shot” or “Depo” delivers progestin in the buttocks or arms every three months at the doctor’s office. Its failure rate is 4%.
    • Side effects: The shot may cause irregular bleeding. The shot is also the only contraceptive that may cause weight gain. It may also be more difficult to predict when fertility returns once the shot is stopped.
    • Combined oral contraceptives or “the pill” contain estrogen and progestin. They’re prescribed by a doctor. The pill has to be taken at the same time daily. The pill is not recommended for people who are older than 35 and smoke, have a history of blood clots or breast cancer. Its failure rate is 7%. Among women aged 15 to 44 who use contraception, about 25% use the pill.
    • The skin patch is worn on the lower abdomen, buttocks or upper body, releasing progestin and estrogen. It is prescribed by a doctor. A new patch is used once a week for three weeks. No patch is worn for the fourth week. Its failure rate is 7%.
    • Hormonal vaginal contraceptive ring releases progestin and estrogen. It’s placed inside the vagina. It is worn for three weeks and taken out on the fourth week. Its typical failure rate is 7%.
    • Side effects: Contraceptives with estrogen, including the pill, the patch and the ring, increase the risk of developing blood clots.
    • Progestin-only pill or “mini-pill” only has progestin and is prescribed by a doctor. It has to be taken daily at the same time. It may be a good option for women who can’t take estrogen. Its typical failure rate is 7%.
    • Opill is the first over-the-counter daily oral contraceptive in the U.S., approved by the Food and Drug Administration in 2023. Opill only has progestin and like other birth control pills, it has to be taken at the same time every day. It should not be used by those who have or have had breast cancer. Its failure rate is 7%.
    • Side effects: The most common side effect of progestin-only pills is irregular bleeding, although the bleeding tends to be light.

    Non-hormonal birth control methods include using barriers such as a diaphragm or sponge, condoms and spermicides, withdrawal, and menstrual cycle tracking. Emergency contraception, including emergency contraception pills (the morning-after pill), is not a regular method of birth control.

    Additional research studies to consider

    Population Attitudes Toward Contraceptive Methods Over Time on a Social Media Platform
    Allison A. Merz, et al. American Journal of Obstetrics & Gynecology, December 2020.

    Social Media and the Intrauterine Device: A YouTube Content Analysis
    Brian T. Nguyen and Allison J. Allen. BMJ Sexual and Reproductive Health, November 2017.

    This article first appeared on The Journalist’s Resource and is republished here under a Creative Commons license.

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  • Brain Food – by Dr. Lisa Mosconi

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    We know that we should eat for brain health, but often that knowledge doesn’t go a lot further than “we should eat some nuts… but also not the wrong nuts, which would be bad”.

    However, as Dr. Lisa Mosconi lays out for us, there’s a lot more than that!

    This book is as much a treatise of brain health in the context of nutrition, as it is a “eat this and avoid that” guide.

    Which is good, because our brains don’t exist in isolation, and nor do the nutrients that we consume. Put it this way:

    We have a tendecy to think of our diets as a set of slider-bars, “ok, that’s 104% of my daily intake of fiber, I need another 10g protein and that’ll be at 100%, I’ve had 80% of the vitamin C that I need, and…”

    Whereas in reality: much of what we eat interacts positively or negatively with other things, and thus needs to be kept in balance. And not only that, but other peri-nutritional factors play a big part too! From obvious things like hydration, to less obvious things like maintaining good gut microbiota, our brains rely on us to do a lot of things for them.

    This book is very easy-reading, though a weakness is it doesn’t tend to summarise key ideas much, give cheat-sheets, that sort of thing. We recommend reading this book with a notebook to the side, to jot down things you want to attend to in your own dietary habits.

    Bottom line: this is an excellent overview of brain health in the context of nutrition, and is more comprehensive than most “eat this for good brain health and avoid that” books.

    Click here to check out “Brain Food” on Amazon and treat your brain like it deserves!

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  • South Indian-Style Chickpea & Mango Salad

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    We have a double-dose of chickpeas today, but with all the other ingredients, this dish is anything but boring. Fun fact about chickpeas though: they’re rich in sitosterol, a plant sterol that, true to its name, sits on cholesterol absorption sites, reducing the amount of dietary cholesterol absorbed. If you are vegan, this will make no difference to you because your diet does not contain cholesterol, but for everyone else, this is a nice extra bonus!

    You will need

    • 1 can white chickpeas, drained and rinsed
    • 1 can black chickpeas (kala chana), drained and rinsed
    • 9 oz fresh mango, diced (or canned is fine if that’s what’s available)
    • 1½ oz ginger, peeled and grated
    • 2 green chilis, finely chopped (adjust per heat preferences)
    • 2 tbsp desiccated coconut (or 3 oz grated coconut, if you have it fresh)
    • 8 curry leaves (dried is fine if that’s what’s available)
    • 1 tsp mustard seeds
    • 1 tsp cumin seeds
    • 1 tsp black pepper, coarse ground
    • ½ tsp MSG or 1 tsp low-sodium salt
    • Juice of 1 lime
    • Extra virgin olive oil

    Method

    (we suggest you read everything at least once before doing anything)

    1) Heat some oil in a skillet over a medium heat. When it’s hot but not smoking, add the ginger, chilis, curry leaves, mustard seeds, and cumin seeds, stirring well to combine, keep going until the mustard seeds start popping.

    2) Add the chickpeas (both kinds), as well as the black pepper and the MSG/salt. Once they’re warm through, take it off the heat.

    3) Add the mango, coconut, and lime juice, mixing thoroughly.

    4) Serve warm, at room temperature, or cold:

    Enjoy!

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    For those interested in some of the science of what we have going on today:

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  • People with dementia aren’t currently eligible for voluntary assisted dying. Should they be?

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    Dementia is the second leading cause of death for Australians aged over 65. More than 421,000 Australians currently live with dementia and this figure is expected to almost double in the next 30 years.

    There is ongoing public discussion about whether dementia should be a qualifying illness under Australian voluntary assisted dying laws. Voluntary assisted dying is now lawful in all six states, but is not available for a person living with dementia.

    The Australian Capital Territory has begun debating its voluntary assisted dying bill in parliament but the government has ruled out access for dementia. Its view is that a person should retain decision-making capacity throughout the process. But the bill includes a requirement to revisit the issue in three years.

    The Northern Territory is also considering reform and has invited views on access to voluntary assisted dying for dementia.

    Several public figures have also entered the debate. Most recently, former Australian Chief Scientist, Ian Chubb, called for the law to be widened to allow access.

    Others argue permitting voluntary assisted dying for dementia would present unacceptable risks to this vulnerable group.

    Inside Creative House/Shutterstock

    Australian laws exclude access for dementia

    Current Australian voluntary assisted dying laws exclude access for people who seek to qualify because they have dementia.

    In New South Wales, the law specifically states this.

    In the other states, this occurs through a combination of the eligibility criteria: a person whose dementia is so advanced that they are likely to die within the 12 month timeframe would be highly unlikely to retain the necessary decision-making capacity to request voluntary assisted dying.

    This does not mean people who have dementia cannot access voluntary assisted dying if they also have a terminal illness. For example, a person who retains decision-making capacity in the early stages of Alzheimer’s disease with terminal cancer may access voluntary assisted dying.

    What happens internationally?

    Voluntary assisted dying laws in some other countries allow access for people living with dementia.

    One mechanism, used in the Netherlands, is through advance directives or advance requests. This means a person can specify in advance the conditions under which they would want to have voluntary assisted dying when they no longer have decision-making capacity. This approach depends on the person’s family identifying when those conditions have been satisfied, generally in consultation with the person’s doctor.

    Another approach to accessing voluntary assisted dying is to allow a person with dementia to choose to access it while they still have capacity. This involves regularly assessing capacity so that just before the person is predicted to lose the ability to make a decision about voluntary assisted dying, they can seek assistance to die. In Canada, this has been referred to as the “ten minutes to midnight” approach.

    But these approaches have challenges

    International experience reveals these approaches have limitations. For advance directives, it can be difficult to specify the conditions for activating the advance directive accurately. It also requires a family member to initiate this with the doctor. Evidence also shows doctors are reluctant to act on advance directives.

    Particularly challenging are scenarios where a person with dementia who requested voluntary assisted dying in an advance directive later appears happy and content, or no longer expresses a desire to access voluntary assisted dying.

    Older man looks confused
    What if the person changes their mind? Jokiewalker/Shutterstock

    Allowing access for people with dementia who retain decision-making capacity also has practical problems. Despite regular assessments, a person may lose capacity in between them, meaning they miss the window before midnight to choose voluntary assisted dying. These capacity assessments can also be very complex.

    Also, under this approach, a person is required to make such a decision at an early stage in their illness and may lose years of otherwise enjoyable life.

    Some also argue that regardless of the approach taken, allowing access to voluntary assisted dying would involve unacceptable risks to a vulnerable group.

    More thought is needed before changing our laws

    There is public demand to allow access to voluntary assisted dying for dementia in Australia. The mandatory reviews of voluntary assisted dying legislation present an opportunity to consider such reform. These reviews generally happen after three to five years, and in some states they will occur regularly.

    The scope of these reviews can vary and sometimes governments may not wish to consider changes to the legislation. But the Queensland review “must include a review of the eligibility criteria”. And the ACT bill requires the review to consider “advanced care planning”.

    Both reviews would require consideration of who is able to access voluntary assisted dying, which opens the door for people living with dementia. This is particularly so for the ACT review, as advance care planning means allowing people to request voluntary assisted dying in the future when they have lost capacity.

    Holding hands
    The legislation undergoes a mandatory review. Jenny Sturm/Shutterstock

    This is a complex issue, and more thinking is needed about whether this public desire for voluntary assisted dying for dementia should be implemented. And, if so, how the practice could occur safely, and in a way that is acceptable to the health professionals who will be asked to provide it.

    This will require a careful review of existing international models and their practical implementation as well as what would be feasible and appropriate in Australia.

    Any future law reform should be evidence-based and draw on the views of people living with dementia, their family caregivers, and the health professionals who would be relied on to support these decisions.

    Ben White, Professor of End-of-Life Law and Regulation, Australian Centre for Health Law Research, Queensland University of Technology; Casey Haining, Research Fellow, Australian Centre for Health Law Research, Queensland University of Technology; Lindy Willmott, Professor of Law, Australian Centre for Health Law Research, Queensland University of Technology, Queensland University of Technology, and Rachel Feeney, Postdoctoral research fellow, Queensland University of Technology

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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