Overcoming Tendonitis – by Dr. Steven Low & Dr. Frank Skretch

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.

If you assumed tendonitis to be an inflammatory condition, you’re not alone. However, it’s not; the “-itis” nomenclature is a misnomer, and while one can rarely go wrong with reducing chronic/systemic inflammation, it’s not the cure for tendonitis.

What, then, is tendonitis and what does cure it? It’s a non-inflammatory proliferation disorder, meaning, something is growing (or in this case, simply being replaced) in a way it shouldn’t. As to fixing it, that’s more complex.

This book does cover 20 interventions (sorted into “major” and “minor”), ranging from exercise therapies to surgery, with many things between. It also examines popular myths that do not help, such as rest, ice, heat, and analgesics.

The style of this book is hard science, but don’t worry, it explains everything along the way. It does however mean that if you’re not very accustomed to wading through scientific material, you can’t just dip into the middle of the book and be guaranteed to understand what’s going on. Indeed, before even getting to discussing tendonitis/tendinopathy, the first chapter is very reassuringly dedicated to “understanding the levels and classification of evidence in studies”, along with the assorted scales and guidelines of the Center for Evidence-Based Medicine.

The rest, however, is about the etiology, diagnosis, and treatment of tendonitis and tendinopathy more generally. One interesting thing is that, according to the abundant high-quality evidence presented in this book, what works for one body part’s tendonitis does not necessarily work for another body part, so we get quite a part-by-part rundown.

Bottom line: this book has a wealth of useful, applicable information about management of tendonitis, making it indispensable if you or a loved one suffer from such—but settle in, because it’s not a light read.

Click here to check out Overcoming Tendonitis, and overcome tendonitis!

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Recommended

  • Forks Over Knives: Flavor! – by Darshana Thacker
  • Why is cancer called cancer? We need to go back to Greco-Roman times for the answer
    Tracing cancer’s roots: From ancient descriptions and treatments to the origins of the word itself, the fight against this persistent disease continues after millennia.

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  • Our blood-brain barrier stops bugs and toxins getting to our brain. Here’s how it works

    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.

    Our brain is an extremely complex and delicate organ. Our body fiercely protects it by holding onto things that help it and keeping harmful things out, such as bugs that can cause infection and toxins.

    It does that though a protective layer called the blood-brain barrier. Here’s how it works, and what it means for drug design.

    The Conversation, Rattiya Thongdumhyu/Shutterstock, Petr Ganaj/Pexels

    First, let’s look at the circulatory system

    Adults have roughly 30 trillion cells in their body. Every cell needs a variety of nutrients and oxygen, and they produce waste, which needs to be taken away.

    Our circulatory system provides this service, delivering nutrients and removing waste.

    A fenestrated capillary
    Fenestrated capillaries let nutrients and waste pass through. Vectormine/Shutterstock

    Where the circulatory system meets your cells, it branches down to tiny tubes called capillaries. These tiny tubes, about one-tenth the width of a human hair, are also made of cells.

    But in most capillaries, there are some special features (known as fenestrations) that allow relatively free exchange of nutrients and waste between the blood and the cells of your tissues.

    It’s kind of like pizza delivery

    One way to think about the way the circulation works is like a pizza delivery person in a big city. On the really big roads (vessels) there are walls and you can’t walk up to the door of the house and pass someone the pizza.

    But once you get down to the little suburban streets (capillaries), the design of the streets means you can stop, get off your scooter and walk up to the door to deliver the pizza (nutrients).

    We often think of the brain as a spongy mass without much blood in it. In reality, the average brain has about 600 kilometres of blood vessels.

    The difference between the capillaries in most of the brain and those elsewhere is that these capillaries are made of specialised cells that are very tightly joined together and limit the free exchange of anything dissolved in your blood. These are sometimes called continuous capillaries.

    Continuous capillary
    Continuous capillaries limit the free exchange of anything dissolved in your blood. Vectormine/Shutterstock

    This is the blood brain barrier. It’s not so much a bag around your brain stopping things from getting in and out but more like walls on all the streets, even the very small ones.

    The only way pizza can get in is through special slots and these are just the right shape for the pizza box.

    The blood brain barrier is set up so there are specialised transporters (like pizza box slots) for all the required nutrients. So mostly, the only things that can get in are things that there are transporters for or things that look very similar (on a molecular scale).

    The analogy does fall down a little bit because the pizza box slot applies to nutrients that dissolve in water. Things that are highly soluble in fat can often bypass the slots in the wall.

    Why do we have a blood-brain barrier?

    The blood brain barrier is thought to exist for a few reasons.

    First, it protects the brain from toxins you might eat (think chemicals that plants make) and viruses that often can infect the rest of your body but usually don’t make it to your brain.

    It also provides protection by tightly regulating the movement of nutrients and waste in and out, providing a more stable environment than in the rest of the body.

    Lastly, it serves to regulate passage of immune cells, preventing unnecessary inflammation which could damage cells in the brain.

    What it means for medicines

    One consequence of this tight regulation across the blood brain barrier is that if you want a medicine that gets to the brain, you need to consider how it will get in.

    There are a few approaches. Highly fat-soluble molecules can often pass into the brain, so you might design your drug so it is a bit greasy.

    Person holds tablet and glass
    The blood-brain barrier stops many medicines getting into the brain. Ron Lach/Pexels

    Another option is to link your medicine to another molecule that is normally taken up into the brain so it can hitch a ride, or a “pro-drug”, which looks like a molecule that is normally transported.

    Using it to our advantage

    You can also take advantage of the blood brain barrier.

    Opioids used for pain relief often cause constipation. They do this because their target (opioid receptors) are also present in the nervous system of the intestines, where they act to slow movement of the intestinal contents.

    Imodium (Loperamide), which is used to treat diarrhoea, is actually an opioid, but it has been specifically designed so it can’t cross the blood brain barrier.

    This design means it can act on opioid receptors in the gastrointestinal tract, slowing down the movement of contents, but does not act on brain opioid receptors.

    In contrast to Imodium, Ozempic and Victoza (originally designed for type 2 diabetes, but now popular for weight-loss) both have a long fat attached, to improve the length of time they stay in the body.

    A consequence of having this long fat attached is that they can cross the blood-brain barrier, where they act to suppress appetite. This is part of the reason they are so effective as weight-loss drugs.

    So while the blood brain barrier is important for protecting the brain it presents both a challenge and an opportunity for development of new medicines.

    Sebastian Furness, ARC Future Fellow, School of Biomedical Sciences, The University of Queensland

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

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  • Dates vs Raisins – Which is Healthier?

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    Our Verdict

    When comparing dates to raisins, we picked the dates.

    Why?

    There are benefits for each fruit, but we say dates come out on top. See what you think:

    In terms of macros, while they’re both dried fruits, dates contain more water (unless you leave them sitting open for a while), which will tend to mathematically lower the relative percentages of other components because they’re being held against water weight too. However, even though this is the case (i.e. dates are being mathematically disadvantaged), dates contain more than twice the fiber that raisins do (8g/100g compared to raisins’ 3.7g/100g).

    While we’re talking macros, dates are also lower in total carbs, as well as obviously net carbs, and have a much lower glycemic index than raisins (dates have a glycemic index of 42, considered low, while raisins have a glycemic index of 64, considered medium; their respective glycemic loads are even more telling: 13 for raisins and just 2 for dates!).

    About those carbs… For dates, it’s an approximately equal mix of sucrose, glucose, and fructose, while for raisins it’s 49% glucose and 49% fructose. Because sucrose is the only disaccharide here, this (as well as the fiber difference) is one of the reasons for the different glycemic indices and glycemic loads, since glucose and fructose are more quickly absorbed.

    That’s more than we usually write about macros, but in this case, both fruits are ones especially often hit with the “aren’t they full of sugar though?” question, so it was important to cover the critical distinctions between the two, because they really are very different.

    Summary of macros: dates win easily in every aspect we looked at

    In the category of vitamins, raisins get a tally in their favor. Raisins are higher in vitamins B1, B2, C, E, K, and choline, while dates are higher in vitamins A, B3, B5, and B9, giving raisins a 6:4 lead here. In dates’ defense, the difference in vitamin K is marginal, and it’d make it a 5:4 lead if we considered that within the margin of error (because all these figures are of course based on averages), and the vitamins that dates are higher in, the margins are much wider indeed, meaning that both fruits have approximately the same overall levels of vitamins when looked at in total, but still, we’ll call this category a nominal win for raisins.

    When it comes to minerals, dates have more magnesium, selenium, and zinc, while raisins have more copper, iron, phosphorus, and potassium. Nominally that’s a 4:3 lead for raisins, but if we consider that raisins also contain more sodium, it’s more like a tie here. If we have to pick one though, this is a very slight win for raisins.

    Adding up the sections, we have one huge win for dates (macros) with two very marginal wins for raisins—hence, we say that dates win out.

    Still, of course enjoy both; diversity is good for the health.

    Want to learn more?

    You might like to read:

    Which Sugars Are Healthier, And Which Are Just The Same?

    Take care!

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  • Kidney Beans vs Pinto Beans – Which is Healthier?

    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.

    Our Verdict

    When comparing kidney beans to pinto beans, we picked the pinto.

    Why?

    Looking at the macros first, pinto beans have slightly more protein and carbs, and a lot more fiber, making them the all-round “more food per food” choice.

    In the vitamins category, kidney beans have more of vitamins B3, C, and K, while pinto beans have more of vitamins B1, B2, B6, B9, E, and choline; another win for pinto beans. In kidney beans’ defense though, with the exception of vitamin E (31x more in pinto beans) the margins of difference are small for the rest of these vitamins, making kidney beans a close runner-up. Still, at least a nominal win for pinto beans here, by the numbers.

    When it comes to minerals, kidney beans are not higher in any minerals, while pinto beans have more calcium, copper, magnesium, manganese, phosphorus, potassium, and selenium. In kidney beans’ defense, though, with the exception of selenium (5–6x more in pinto beans) the margins of difference are small for the rest of these minerals, making kidney beans a fine choice here too. Once again though, a winner is declarable here by the numbers, and it’s pinto beans.

    Adding up the three wins makes for one big win for pinto beans. Still, enjoy either or both, because kidney beans are great too, and so is diversity!

    Want to learn more?

    You might like to read:

    What’s Your Plant Diversity Score?

    Take care!

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Related Posts

  • Forks Over Knives: Flavor! – by Darshana Thacker
  • Why You’re Tired & How To Fix It

    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.

    This is Sadia Badiei. A dietician by academic and professional background, she’s nowadays hung up her lab coat for a chef’s jacket, and is best known for her “Pick Up Limes” brand. Today, we’ll be taking her advice on managing energy levels with what’s on our plates!

    Quick note: our usual medical/legal disclaimer applies, and this article cannot diagnose you from afar, and thus neither can it make any certain prescription; this is for educational purposes, and aimed at being applicable to most of our readers.

    There are many possible things that can cause chronic fatigue, and not all of them can be fixed by diet. Your doctor will have access to tests and such that we, being a humble health science publication, do not.

    You may recognize her; we’ve featured her videos occasionally, mostly recently:

    Pick Up A Zest For Life: 10 Lessons For A Healthy Mind & Body

    But, what does she want us to know about living life with more energy?

    It starts with balance

    Badiei makes the case that we should strive for a nutritionally-balanced diet; that may not come as much of a revelation, but what does that look like for a vegan (Badiei advocates for plant-based eating)?

    She recommends that our diet consist of:

    • About 50% fruits and vegetables
    • About 25% grains and starches
    • About 25% proteins
    • Modest amounts of fats
    • A little of well-chosen dairy substitutions
    • Finally, a few judicious supplements to top it off

    That does add up to more than 100%, but 1) we did say “About n%” and 2) this is not a bad thing to note, actually, since Badiei advocates (as we do) for focussing more on what we add into our diet, rather than what we take out.

    Breaking it down a little further, she recommends making sure to get “the foundational seven”, which is a little like “Dr. Greger’s Daily Dozen”, but in this case it’s counted on a per-food-type basis.

    Thus, she recommends:

    1. Dark green leafy vegetables
    2. Assorted other non-starchy vegetables (your choice what kind)
    3. Fruit, of any kinds (unlike Dr. Greger separating berries)
    4. Grains and starches (so for example, potatoes are lumped in with rice here, botanically very different, but often fulfil a similar culinary role)
    5. Nuts and seeds
    6. Legumes
    7. Fortified dairy alternatives

    For full details including how much of each, and “what counts”, etc, see:

    Pick Up Limes | The Nourish Method

    Time your carbs

    Slow-release carbohydrates, those with the most fiber, are best most of the time, giving us more sustained fuel, keeping us energized for longer after meals—even if we would rather sleep:

    She cites: Fiber and Saturated Fat Are Associated with Sleep Arousals and Slow Wave Sleep

    Quick-release carbohydrates, those with what’s generally considered a less favorable carb:fiber ratio, are best if we’re going to eat nearer to bedtime. We know, eating before bed is often considered a bit of a no-no, but Badiei bids us indulge if we so desire, as the quicker-absorbed carbohydrates support tryptophan reaching our brain more efficiently, and thus promote sleep onset.

    See also: Should You Go Light Or Heavy On Carbs?

    About that fat

    We mentioned (or rather, Badiei’s citation mentioned) saturated fat. It is indeed linked with difficulty falling asleep, and/but omega-3 fatty acids, on the other hand, promote better sleep.

    She cites: The relationship between sleep duration, sleep quality and dietary intake in adults

    While you’re enjoying those nuts and seeds (for the omega-3 fatty acids), you might also note that several also star in Badiei’s list of plant-based foods that are rich in tryptophan, such as soy, cashews, pumpkin seeds, sunflower seeds, beans, green vegetables, and mushrooms.

    Micronutrients

    Badiei’s focus here is on B-vitamins, iron, magnesium, selenium, and zinc. We imagine most of our readers here are taking steps to ensure to get a full daily coverage of vitamins and minerals anyway, but you might want to read what she has to say about iron on a plant-based diet, because the numbers may be different than you think.

    The reason for this is that while animal products contain mostly heme iron, which is easier to absorb but associated with a risk increase in some diseases, plant-based foods usually* contain only non-heme iron, which is healthier but not as bioavailable, so if eating only plants, we need more of it:

    Pick Up Limes | Iron on a Plant-Based Diet

    *If you eat a carnivorous plant, guess what, it’ll have heme iron in it, tangling that food web.

    “What if I know I have chronic fatigue for non-dietary reasons?”

    Well, that sucks, and we’re not going to pretend the above will magically fix it. However, there are still things that can at least relatively improve your experience:

    Eat To Beat Chronic Fatigue! Yes, Even When Fatigued Chronically

    (it’s a good guide to being able to consistently eat healthily when your energy levels are consistently at minimal, meaning that a lot of common advice becomes unusable)

    Take care!

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  • Do we need animal products to be healthy?

    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.

    Do we need animal products to be healthy?

    We asked you for your (health-related) perspective on plant-based vs anima-based foods, and got the above-pictured spread of answers.

    “Some or all of us may need small amounts of animal products” came out on top with more votes than the two more meat-eatery options combined, and the second most popular option was the hard-line “We can all live healthily and happily on just plants”.

    Based on these answers, it seems our readership has quite a lot of vegans, vegetarians, and perhaps “flexitarians” who just have a little of animal products here and there.

    Perhaps we should have seen this coming; the newsletter is “10almonds”, not “10 rashers of bacon”, after all.

    But what does the science say?

    We are carnivores and are best eating plenty of meat: True or False?

    False. Let’s just rip the band-aid off for this one.

    In terms of our anatomy and physiology, we are neither carnivores nor herbivores:

    • We have a mid-length digestive tract (unlike carnivores and herbivores who have short and long ones, respectively)
    • We have a mouthful of an assortment of teeth; molars and premolars for getting through plants from hard nuts to tough fibrous tubers, and we have incisors for cutting into flesh and (vestigial, but they’re there) canines that really serve us no purpose now but would have been a vicious bite when they were bigger, like some other modern-day primates.
    • If we look at our closest living relatives, the other great apes, they are mostly frugivores (fruit-eaters) who supplement their fruity diet with a small quantity of insects and sometimes other small animals—of which they’ll often eat only the fatty organ meat and discard the rest.

    And then, there’s the health risks associated with meat. We’ll not linger on this as we’ve talked about it before, but for example:

    If we avoid processed and/or red meat, that’s good enough: True or False?

    True… Ish.

    Really this one depends on one’s criteria for “good enough”. The above-linked studies, and plenty more like them, give the following broad picture:

    • Red and/or processed meats are unequivocally terrible for the health in general
    • Other mammalian meats, such as from pigs, are really not much better
    • Poultry, on the other hand, the science is less clear on; the results are mixed, and thus so are the conclusions. The results are often barely statistically significant. In other words, when it comes to poultry, in the matter of health, the general consensus is that you can take it or leave it and will be fine. Some studies have found firmly for or against it, but the consensus is a collective scientific shrug.
    • Fish, meanwhile, has almost universally been found to be healthful in moderation. You may have other reasons for wanting to avoid it (ethics, environmentalism, personal taste) but those things are beyond the scope of this article.

    Some or all of us may need small amounts of animal products: True or False?

    True! With nuances.

    Let’s divide this into “some” and “all”. Firstly, some people may have health conditions and/or other mitigating circumstances that make an entirely plant-based diet untenable.

    We’re going light on quotations from subscriber comments today because otherwise this article will get a bit long, but here’s a great example that’s worth quoting, from a subscriber who voted for this option:

    ❝I have a rare genetic disease called hereditary fructose intolerance. It means I lack the enzyme, Aldolase B, to process fructose. Eating fruits and veggies thus gives me severe hypoglycemia. I also have anemia caused by two autoimmune diseases, so I have to eat meat for the iron it supplies. I also supplement with iron pills but the pills alone can’t fix the problem entirely.❞

    And, there’s the thing. Popular vegan talking-points are very good at saying “if you have this problem, this will address it; if you have that problem, that will address it”, etc. For every health-related objection to a fully plant-based diet there’s a refutation… Individually.

    But actual real-world health doesn’t work like that; co-morbidities are very common, and in some cases, like our subscriber above, one problem undermines the solution to another. Add a third problem and by now you really just have to do what you need to do to survive.

    For this reason, even the Vegan Society’s definition of veganism includes the clause “so far as is possible and practicable”.

    Now, as for the rest of us “all”.

    What if we’re really healthy and are living in optimal circumstances (easy access to a wide variety of choice of food), can we live healthily and happily just on plants?

    No—on a technicality.

    Vegans famously need to supplement vitamin B12, which is not found in plants. Ironically, much of the B12 in animal products comes from the animals themselves being given supplements, but that’s another matter. However, B12 can also be enjoyed from yeast. Popular options include the use of yeast extract (e.g. Marmite) and/or nutritional yeast in cooking.

    Yeast is a single-celled microorganism that’s taxonomically classified as a fungus, even though in many ways it behaves like an animal (which series of words may conjure an amusing image, but we mean, biologically speaking).

    However, it’s also not technically a plant, hence the “No—on a technicality”

    Bottom line:

    By nature, humans are quite versatile generalists when it comes to diet:

    • Most of us can live healthily and happily on just plants if we so choose.
    • Some people cannot, and will require varying kinds (and quantities) of animal products.
    • As for red and/or processed meats, we’re not the boss of you, but from a health perspective, the science is clear: unless you have a circumstance that really necessitates it, just don’t.
      • Same goes for pork, which isn’t red and may not be processed, but metabolically it’s associated with the same problems.
    • The jury is out on poultry, but it strongly appears to be optional, healthwise, without making much of a difference either way
    • Fish is roundly considered healthful in moderation. Enjoy it if you want, don’t if you don’t.

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  • Why STIs Are On The Rise In Older Adults

    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.

    Three Little Words

    Sexually Transmitted Infections (STIs) are often thought of as something that predominantly plagues younger people… The truth, however, is different:

    ❝Rising divorce rates, forgoing condoms as there is no risk of pregnancy, the availability of drugs for sexual dysfunction, the large number of older adults living together in retirement communities, and the increased use of dating apps are likely to have contributed to the growing incidence of STIs in the over-50s.

    These data likely underestimate the true extent of the problem as limited access to sexual health services for the over 50s, and trying to avoid the stigma and embarrassment both on the part of older people and healthcare professionals, is leading to this age group not seeking help for STIs.❞

    ~ Dr. Justyna Kowalska

    Read more: Managing The Rise In STIs Among Older Adults

    That said, there is a gender gap when it comes to the increased risk, for example:

    ❝A retrospective study from the USA involving 420,790 couples aged 67 to 99 years, found that widowhood was associated with an increased risk of STIs in older men, but not women❞

    ~ US Dept of Health & Human Services

    Source: CDC: | Sexually Transmitted Disease Surveillance

    Is abstinence the best preventative, then?

    It is inarguably the most effective, but not necessarily the best for everyone.

    This is because for most adults, a healthy sex life is an important part of overall wellbeing.

    See also: Mythbusting The Big O

    Even in this case there is a gender gap in:

    • the level of importance placed on frequency of sexual interactions
    • what act(s) of sexuality are held to be most important:

    ❝Among sexually active men, frequent (≥2 times a month) sexual intercourse (P < .001) and frequent kissing, petting, or fondling (P < .001) were associated with greater enjoyment of life.

    Among sexually active women, frequent kissing, petting, or fondling was also associated with greater enjoyment of life (P < .001), but there was no significant association with frequent intercourse (P = .101).

    Concerns about one’s sex life and problems with sexual function were strongly associated with lower levels of enjoyment of life in men and to a lesser extent in women.❞

    ~ Dr. Lee Smith et al.

    Source: Sexual Activity is Associated with Greater Enjoyment of Life in Older Adults

    If you have the time to go into it much more deeply, this paper from the Journal of Gerontology is much more comprehensive, looking also at related lifestyle factors, religious/political backgrounds, views on monogamy or non-monogamy (of various kinds), hormonal considerations, the impact of dementia or other long-term disabilities that may affect things, widowhood, and many other elements:

    The National Social Life, Health, and Aging Project: An Introduction

    What’s the best preventative, then?

    Regular health screening for yourself and your partner(s) is an important key to preventative health when it comes to STIs.

    You can Google search for a local STI clinic, and worry not, they are invariably discreet and are well-used to everybody coming in. They’re just glad you’re being responsible about things. It’s also not their job to judge your sexual activities, even if it’s something you might have reason to wish to be secretive about, try to be honest there.

    Secondly, most of the usual advice about safe sex still goes, even when there’s no risk of pregnancy. For example, if there’s at least one penis involved, then condoms remain the #1 barrier to all manner of potential infections (we know, almost nobody likes condoms, but sometimes the truth isn’t what we want to hear).

    Lastly, if there’s at least one vagina involved, then please for the love of all that is holey, do not put anything there that could cause a yeast infection.

    What can cause a yeast infection? Pretty much anything with sugar, which includes but is not limited to:

    • Most kinds of food that Cosmo-style “liven things up in the bedroom” advice columns might suggest using (including fruit, honey, chocolate sauce, whipped cream, etc)
    • Hands that are not clean (watch out for bacteria too)
    • A mouth that has recently been eating or drinking anything with sugar in it, and that includes many kinds of alcohol, as well as milk or hot drinks that had milk in

    Yeast infections are not nearly so serious as the STIs the other measures are there to avoid, but they’re not fun either, so some sensible policies in that regard are always good!

    On a related note, see also: How To Avoid UTIs

    Recap on the single most important part of this article:

    At all ages, it remains a good health practice—unless one is absolutely celibate—to regularly get oneself and one’s partner(s) checked for STIs.

    Take care!

    Don’t Forget…

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