“Why Does It Hurt When I Have Sex?” (And What To Do About It)
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This is one that affects mostly women, with 43% of American women reporting such issues at some point. There’s a distribution curve to this, with higher incidence in younger and older women; younger while first figuring things out, and older with menopause-related body changes. But, it can happen at any time (and often not for obvious reasons!), so here’s what OB/GYN Dr. Jennifer Lincoln advises:
Many possibilities, but easily narrowed down
Common causes include:
- vaginal dryness, which itself can have many causes (half of which are “low estrogen levels” for various different reasons)
- muscular issues, which can be in response to anxiety, pain, and occur as a result of pelvic floor muscle tightening
- vulvar issues, ranging from skin disorders (e.g. lichen sclerosis or lichen planus) to nerve disorders (e.g. vestibulitis or vestibulodynia)
- uterine issues, including endometriosis, fibroids, or scar tissue if you had a surgery
- infections, of the STI variety, but bear in mind that some STIs such as herpes do not necessarily require direct sexual contact per se, and yeast infections definitely don’t. Some STIs are more serious than others, so getting things checked out is a good idea (don’t worry, clinics are discreet about this sort of thing)
- bowel issues, notwithstanding that we have been talking about vaginal sex here, it can’t be happy if its anatomical neighbors aren’t happy—so things like IBS, Crohn’s, or even just constipation, aren’t irrelevant
- trauma, of various kinds, affecting sexual experiences
That’s a lot of possibilities, so if there’s not something standing out as “yes, now that you mention it, it’s obviously that”, Dr. Lincoln recommends a full health evaluation and examination of medical history, as well as a targeted physical exam. That may not be fun, but at least, once it’s done, it’s done.
Treatments vary depending on the cause, of course, and there are many kinds of physical and psychological therapies, as well as surgeries for the uterine issues we mentioned.
Happily, many of the above things can be addressed with simpler and less invasive methods, including learning more about the relevant anatomy and physiology and how to use it (be not ashamed; most people never got meaningful education about this!)*, vulvar skin care (“gentle” is the watchword here), the difference a good lube can make, and estrogen supplementation—which if you’re not up for general HRT, can be a topical estrogen cream that alleviates sexual function issues without raising blood serum estradiol levels.
*10almonds tip: check out the recommended book “Come As You Are” in our links below; it has 400 pages of stuff most people never knew about anatomy and physiology down there; you can thank us later!
Meanwhile, for more on each of these, enjoy:
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Want to learn more?
You might also like to read:
- Water-based Lubricant vs Silicon-based Lubricant – Which is Healthier? (counterintuitively, it’s the silicon! But do give it a quick read, because here be science)
- How To Avoid Urinary Tract Infections (may be relevant; always good to know)
- Come As You Are – by Dr. Emily Nagoski (book; if we could only recommend one book on responsible vagina ownership, this would be the one)
Take care!
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How worried should I be about cryptosporidiosis? Am I safe at the pool?
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You might have heard of something called “cryptosporidiosis” recently, closely followed by warnings to stay away from your local swimming pool if you’ve had diarrhoea.
More than 700 cases of this gastrointestinal disease were reported in Queensland in January, which is 13 times more than in January last year. Just under 500 cases have been recorded in New South Wales this year to-date, while other states have similarly reported an increase in the number of cryptosporidiosis infections in recent months.
Cryptosporidiosis has been listed as a national notifiable disease in Australia since 2001.
But what exactly is it, and should we be worried?What causes cryptosporidiosis, and who is affected?
Cryptosporidiosis is the disease caused by the parasite Cryptosporidium, of which there are two types that can make us sick. Cryptosporidum hominis only affects humans and is the major cause of recent outbreaks in Australia, while Cryptosporidium parvum can also affect animals.
The infection is spread by spores called oocysts in the stools of humans and animals. When ingested, these oocysts migrate and mature in the small bowel. They damage the small bowel lining and can lead to diarrhoea, nausea, vomiting, fever and abdominal discomfort.
Most people develop symptoms anywhere from one to 12 days after becoming infected. Usually these symptoms resolve within two weeks, but the illness may last longer and can be severe in those with a weakened immune system.
Children and the elderly tend to be the most commonly affected. Cryptosporidiosis is more prevalent in young children, particularly those under five, but the disease can affect people of any age.
So how do we catch it?
Most major outbreaks of cryptosporidiosis have been due to people drinking contaminated water. The largest recorded outbreak occurred in Milwaukee in 1993 where 403,000 people were believed to have been infected.
Cryptosporidium oocysts are very small in size and in Milwaukee they passed through the filtration system of one of the water treatment plants undetected, infecting the city’s water supply. As few as ten oocysts can cause infection, making it possible for contaminated drinking water to affect a very large number of people.
Four days after infection a person with cryptosporidiosis can shed up to ten billion oocysts into their stool a day, with the shedding persisting for about two weeks. This is why one infected person in a swimming pool can infect the entire pool in a single visit.
Cryptosporidium oocysts excreted in the faeces of infected humans and animals can also reach natural bodies of water such as beaches, rivers and lakes directly through sewer pipes or indirectly such as in manure transported with surface runoff after heavy rain.
One study which modelled Cryptosporidium concentrations in rivers around the world estimated there are anywhere from 100 to one million oocysts in a litre of river water.
In Australia, cryptosporidiosis outbreaks tend to occur during the late spring and early summer periods when there’s an increase in recreational water activities such as swimming in natural water holes, water catchments and public pools. We don’t know exactly why cases have seen such a surge this summer compared to other years, but we know Cryptosporidium is very infectious.
Oocysts have been found in foods such as fresh vegetables and seafood but these are not common sources of infection in Australia.
What about chlorine?
Contrary to popular belief, chlorine doesn’t kill off all infectious microbes in a swimming pool. Cryptosporidium oocysts are hardy, thick-walled and resistant to chlorine and acid. They are not destroyed by chlorine at the normal concentrations found in swimming pools.
We also know oocysts can be significantly protected from the effects of chlorine in swimming pools by faecal material, so the presence of even small amounts of faecal matter contaminated with Cryptosporidium in a swimming pool would necessitate closure and a thorough decontamination.
Young children and in particular children in nappies are known to increase the potential for disease transmission in recreational water. Proper nappy changing, frequent bathroom breaks and showering before swimming to remove faecal residue are helpful ways to reduce the risk.
Some sensible precautions
Other measures you can take to reduce yours and others’ risk of cryptosporidiosis include:
- avoid swimming in natural waters such as rivers and creeks during and for at least three days after heavy rain
- avoid swimming in beaches for at least one day after heavy rain
- avoid drinking untreated water such as water from rivers or springs. If you need to drink untreated water, boiling it first will kill the Cryptosporidium
- avoid swallowing water when swimming if you can
- if you’ve had diarrhoea, avoid swimming for at least two weeks after it has resolved
- avoid sharing towels or linen for at least two weeks after diarrhoea has resolved
- avoid sharing, touching or preparing food that other people may eat for at least 48 hours after diarrhoea has resolved
- wash your hands with soap and water after going to the bathroom or before preparing food (Cryptosporidium is not killed by alcohol gels and sanitisers).
Not all cases of diarrhoea are due to cryptosporidiosis. There are many other causes of infectious gastroenteritis and because the vast majority of the time recovery is uneventful you don’t need to see a doctor unless very unwell. If you do suspect you may have cryptosporidiosis you can ask your doctor to refer you for a stool test.
Vincent Ho, Associate Professor and clinical academic gastroenterologist, Western Sydney University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Couple’s Guide to Thriving with ADHD – by Melissa Orlov and Nancie Kohlenberger
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.
ADHD (what a misleadingly-named condition) is most often undiagnosed in adults, especially older adults, and has far-reaching effects. This book explores those!
Oftentimes ADHD is not a deficit of attention, it’s just a lack of choice about where one’s attention goes. And the H? It’s mostly not what people think it is. The diagnostic criteria have moved far beyond the original name.
But in a marriage, ADHD symptoms such as wandering attention, forgetfulness, impulsiveness, and a focus on the “now” to the point of losing sight of the big picture (the forgotten past and the unplanned future), can cause conflict.
The authors write in a way that is intended for the ADHD and/or non-ADHD partner to read, and ideally, for both to read.
They shine light on why people with or without ADHD tend towards (or away from) certain behaviours, what miscommunications can arise, and how to smooth them over.
Best of all, an integrated plan for getting you both on the same page, so that you can tackle anything that arises, as the diverse team (with quite different individual strengths) that you are.
Bottom line: if you or a loved one has ADHD symptoms, this book can help you navigate and untangle what can otherwise sometimes get a little messy.
Click here to check out The Couple’s Guide to Thriving with ADHD, and learn how to do just that!
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How to Use Topical Estrogen Cream For Aging Skin
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Dr. Sam Ellis, dermatologist, explains:
Tackling the cause
Estrogen is important for very many aspects of health beyond the sexual aspects. When it comes to skin, a drop in estrogen (usually because of menopause) leads to changes like collagen loss, dryness, reduced elasticity, and slower wound healing. Applying estrogen creams to the skin can reverse these changes.
If your estrogen levels are already within normal pre-menopausal female ranges, by the way, there isn’t so much science to indicate its benefit when used topically. If you are already on systemic HRT (i.e., you take estrogen already to raise your blood estrogen levels and affect your body in its entirety), you may or may not gain extra benefits from the topical cream, depending on factors such as your estrogen dose, your route of administration, your cardiovascular health, and other factors.
For those with lower estrogen and not currently on HRT, you may be wondering: can topical estrogen cream affect systemic estrogen levels? And the answer is that it mostly depends on the dose. In other words: it’s definitely possible, but for most people it’s unlikely.
As ever, if thinking of taking up any hormonal treatment, do consult an endocrinologist and/or gynecologist, and if you have an increased breast cancer risk (for example genetically or prior history), then an oncologist too, just to be safe.
That sounds like a lot of scary things, but mostly it’s just to be on the safe side. The dose of estrogen is very low in topical creams, and even then, only a tiny amount is used per day.
For more on all of this, enjoy:
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Want to learn more?
You might also like to read:
- “Why Does It Hurt When I Have Sex?” (And What To Do About It) ← because topical estrogen is not just for your face! Yes, you can use it down there too and it’s commonly prescribed for exactly this use.
- Hormones & Health, Beyond The Obvious
- The Hormone Therapy That Reduces Breast Cancer Risk & More
Take care!
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Can I Eat That? – by Jenefer Roberts
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.
The answer to the question in the title is: you can eat pretty much anything, if you’re prepared for the consequences!
This book looks to give you the information to make your own decisions in that regard. There’s a large section on the science of glucose metabolism in the context of food (other aspects of glucose metabolism aren’t covered), so you will not simply be told “raw carrots are good; mashed potatoes are bad”, you’ll understand many factors that affect it, e.g:
- Macronutrient profiles of food and resultant base glycemic indices
- How the glycemic index changes if you cut something, crush it, mash it, juice it, etc
- How the glycemic index changes if you chill something, heat it, fry it, boil it, etc
- The many “this food works differently in the presence of this other food” factors
- How your relative level of insulin resistance affects things itself
…and much more.
The style is simple and explanatory, without deep science, but with good science and comprehensive advice.
There are also the promised recipes; they’re in an appendix at the back and aren’t the main meat of the book, though.
Bottom line: if you’ve ever found it confusing working out what works how in the mysterious world of diabetes nutrition, this book is a top tier demystifier.
Click here to check out Can I Eat That?, and gain confidence in your food choices!
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Endure – by Alex Hutchinson
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.
Life is a marathon, not a sprint. For most of us, at least. But how do we pace ourselves to go the distance, without falling into complacency along the way?
According to our author Alex Hutchinson, there’s a lot more to it than goal-setting and strategy.
Hutchinson set out to write a running manual, and ended up writing a manual for life. To be clear, this is still mostly centered around the science of athletic endurance, but covers the psychological factors as much as the physical… and notes how the capacity to endure is the key trait that underlies great performance in every field.
The writing style is both personal and personable, and parts read like a memoir (Hutchinson himself being a runner and sports journalist), while others are scientific in nature.
As for the science, the kind of science examined runs the gamut from case studies to clinical studies. We examine not just the science of physical endurance, but the science of psychological endurance too. We learn about such things as:
- How perception of ease/difficulty plays its part
- What factors make a difference to pain tolerance
- How mental exhaustion affects physical performance
- What environmental factors increase or lessen our endurance
- …and many other elements that most people don’t consider
Bottom line: whether you want to run a marathon in under two hours, or just not quit after one minute forty seconds on the exercise bike, or to get through a full day’s activities while managing chronic pain, this book can help.
Click here to check out Endure, and find out what you are capable of when you move your limits!
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What does it mean to be immunocompromised?
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 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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