“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:
Click Here If The Embedded Video Doesn’t Load Automatically!
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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6-Minute Core Strength – by Dr. Jonathan Su
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We don’t normally do author biographies here, but in this case it’s worth noting that Dr. Su is a physiotherapist, military rehab expert, and an IAYT yoga therapist. So, these things together certainly do lend weight to his advice.
About the “6-minute” thing: this is in the style of the famous “7-minute workout” and “5 Minutes’ Physical Fitness” etc, and refers to how long each exercise session should take. The baseline is one such session per day, though of course doing more than one set of 6 minutes each time is a bonus if you wish to do so.
The exercises are focused on core strength, but they also include hip and shoulder exercises, since these are after all attached to the core, and hip and shoulder mobility counts for a lot.
A particular strength of the book is in troubleshooting mistakes of the kind that aren’t necessarily visible from photos; in this case, Dr. Su explains what you need to go for in a certain exercise, and how to know if you are doing it correctly. This alone is worth the cost of the book, in this reviewer’s opinion.
Bottom line: if you want core strength and want it simple yet comprehensive, this book can guide you.
Click here to check out 6-Minute Core Strength, and strengthen yours!
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DBT Made Simple – by Sheri van Dijk
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This book offers very clear explanations of DBT. In fact, a more fitting title might have been “DBT made clear”, because it does it without oversimplification.
This is a way in which van Dijk’s work stands out from that of many writers on the subject! Many authors oversimplify, to the point that a reader may wonder “is that all it is?” when, in reality, there’s rather more to it.
This work is, therefore, refreshingly comprehensive, without sacrificing clarity.
Van Dijk also takes us through the four pillars of DBT:
- Mindfulness
- Distress tolerance
- Emotional regulation
- Interpersonal effectiveness
Each of these can help an individual alone; together, they produce a composite effect with a synergy that makes each more effective. Hence, pillars.
On the topic of “an individual”, you may be wondering “is this book for therapists or the general public?” and the answer is yes, yes it is.
That is to say: it’s written with the assumption that the reader wants to learn DBT in order to practice it as a therapist… and/but is written in such a fashion that it’s very easy to apply the skills to oneself, too. As it’s an introductory guide—a comprehensive one, but without assuming prior knowledge—it’s a perfect resource for anyone to get a good grounding in the subject.
Bottom line: if you’ve been hearing about DBT (possibly from us!) and wondering where you might start, this book is an excellent place to begin.
Click here to check out DBT Made Simple, and start making many parts of life easier!
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How To Reduce Your Alzheimer’s Risk
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Reduce Your Alzheimer’s Risk
Alzheimer’s is just one cause of dementia, but it’s a very notable one, not least of all because it’s
- a) the most common cause of dementia, and
- b) a measurably terminal disease.
For that reason we’re focusing on Alzheimer’s today, although most of the advice will go for avoiding dementia in general.
First, some things not everyone knows about Alzheimer’s:
- Alzheimer’s is a terminal disease.
- People who get a diagnosis at age 60 are typically given 4–8 years to live.
- Some soldier on for as many as 20, but those are rare outliers.
- Alzheimer’s begins 20 years or more before other symptoms start to develop.
- This makes this information very relevant for younger people approaching 40, for example.
- Alzheimer’s accounts for 60–80% of dementia, and affects around 6% of people over 60.
- By the age of 65, that figure is 10%. By the age of 70, however, the percentage is still about the same—this is because of the mortality rate preventing the accumulation of Alzheimer’s patients over time.
Want to know more? Read: 2023 Alzheimer’s Disease Facts And Figures Special Report ← this is a very comprehensive downloadablereference, by the way, including a lot of information about diagnosis, treatmentpathways, and earlyinterventions.
Speaking of diagnosis…
Know what the symptoms are… and aren’t!
Forgetting your car keys can be frustrating. Forgetting them frequently can be worrying.
But: there’s a difference between forgetting your car keys, and forgetting what car keys are used for. The latter is the kind of memory loss that’s more of a red flag for Alzheimer’s.
Similarly: forgetting someone’s name can be embarrassing. Forgetting someone’s name, asking them, forgetting asking them, asking them again, forgetting again (lather rinse repeat) is more of a red flag for Alzheimer’s.
There are other symptoms too, some of them less commonly known:
❝Difficulty remembering recent conversations, names or events; apathy; and depression are often early symptoms. Communication problems, confusion, poor judgment and behavioral changes may occur next. Difficulty walking, speaking, and swallowing are common in the late stages of the disease❞
If you or a loved one are experiencing worrying symptoms: when it comes to diagnosis and intervention, sooner is a lot better than later, so do talk to your doctor.
As for reducing your risk? First, the obvious stuff:
The usual 5 things that go for almost everything:
- Have a good diet—the Mediterranean Diet is once again recommended (we expect this will not be a surprise to regular readers!)
- Get regular exercise—in the case of avoiding Alzheimer’s and other dementias, typically the most important thing here is heart health, so getting regular cardiovascular exercise, such walking, running, or dancing is great. Cycling too. Swimming, not so much. Not that swimming’s bad or anything, it’s just that when your body is horizontal, the heart has less work to do, especially in the upper part of the body, because it’s not defying gravity. Similarly, yoga is great for the health but won’t particularly help with this, nor will weight training.
- Get good sleep—as we get older, we tend to need less sleep, and tend more towards the lower end of the standard “7–9 hours” prescription, but getting at least those 7 hours makes a huge difference.
- Cut down (or eliminate) alcohol consumption—and especially avoid binge-drinking. While “binge-drinking” is typically associated with young people, that Christmas party where that one uncle gets very drunk is also binge-drinking, for example. Plus, heavy drinking in early life has also been correlated with higher risk of Alzheimer’s later.
- Don’t smoke. It’s bad for everything, and Alzheimer’s risk is no exception.
How much do lifestyle changes alone make a difference?
They make a big difference. This 2022 population-based cohort study (so: huge sample size) looked at people who had 4–5 of the healthy lifestyle factors being studied, vs people who had 0–1 of them. They found:
❝A healthy lifestyle was associated with a longer life expectancy among men and women, and they lived a larger proportion of their remaining years without Alzheimer’s dementia.❞
The numbers of years involved by the way ranged between 3 and 20 years, in terms of life expectancy and years without or with Alzheimer’s, with the average increase of healthy life years being approximately the same as the average increase in years. This is important, because:
A lot of people think “well if I’m going to go senile, I might as well [unhealthy choice that shortens lifespan]”, but they misunderstand a critical factor:
The unhealthy choices will reduce their healthy life years, and simply bring the unhealthy ones (and subsequent death) sooner. If you’re going to spend your last few years in ill-health, it’s better to do so at 90 than 50.
The other thing you may already know… And a thing about it that not everyone considers:
Keeping cognitively active is important. This much is broadly known by the general public, and to clinicians, this was the fourth “healthy factor” in the list of five (instead of the sleep that we put there, because we were listing the 5 things that go for most preventable health issues).
Everyone leaps to mention sudoku at this point, so if that’s your thing, great, enjoy it! (This writer personally enjoys chess, which isn’t everyone’s cup of tea; if it yours though, you can come join her on Chess.com and we’ll keep sharp together)
But the more parts of your mental faculties you keep active, the better. Remember, brainpower (as with many things in health and life) is a matter of “use it or lose it” and this is on a “per skill” basis!
What this means: doing sudoku (a number-based puzzle game) or chess (great as it may be) won’t help as much for keeping your language skills intact, for example. Given that language skills are one of the most impactful and key faculties to get lost to Alzheimer’s disease, neglecting such would be quite an oversight!
Some good ways to keep your language skills tip-top:
- Read—but read something challenging, if possible. It doesn’t have to be Thomas Scanlon’s What We Owe To Each Other, but it should be more challenging than a tabloid, for example. In fact, on the topic of examples:
- This newsletter is written to be easy to read, while not shying away from complex ideas or hard science. Our mission is literally to “make [well-sourced, science-based] health and productivity crazy simple”.
- But the academic papers that we link? Those aren’t written to be easy to read. Go read them, or at least the abstracts (in academia, an abstract is essentially an up-front summary, and is usually the first thing you’ll see when you click a link to a study or such). Challenge yourself!
- Write—compared to reading/listening, producing language is a (related, but) somewhat separate skill. Just ask any foreign language learner which is more challenging: reading or writing!
- Journaling is great, but writing for others is better (as then you’ll be forced to think more about it)
- Learn a foreign language—in this case, what matters it that you’re practicing and learning, so in the scale of easy to hard, or doesn’t matter if it’s Esperanto or Arabic. Duolingo is a great free resource that we recommend for this, and they have a wide range of extensive courses these days.
Now for the least obvious things…
Social contact is important.
Especially in older age, it’s easy to find oneself with fewer remaining friends and family, and getting out and about can be harder for everyone. Whatever our personal inclinations (some people being more introverted or less social than others), we are fundamentally a social species, and hundreds of thousands of years of evolution have built us around the idea that we will live our lives alongside others of our kind. And when we don’t, we don’t do as well.
See for example: Associations of Social Isolation and Loneliness With Later Dementia
If you can’t get out and about easily:
- Online socialising is still socializing.
- Online community is still community.
- Online conversations between friends are still conversations between friends.
If you don’t have much (or anyone) in the category of friends and family, join Facebook groups related to your interests, for example.
Berries are surprisingly good
^This may read like a headline from 200,000 BCE, but it’s relevant here!
Particularly recommended are:
- blueberries
- blackberries
- raspberries
- strawberries
- cranberries
We know that many of these berries seem to have a shelf-life of something like 30 minutes from time of purchase, but… Frozen and dried are perfectly good nutritionally, and in many cases, even better nutritionally than fresh.
Read: Effect of berry-based supplements and foods on cognitive function: a systematic review
Turmeric’s health benefits appear to include protecting against Alzheimer’s
Again, this is about risk reduction, and turmeric (also called curcumin, which is not the same as cumin) significantly reduces the build-up of amyloid plaques in the brain. Amyloid plaques are part of the progression of Alzheimer’s.
See for yourself: Protective Effects of Indian Spice Curcumin Against Amyloid Beta in Alzheimer’s Disease
If you don’t like it as a spice (and even if you do, you probably don’t want to put it in your food every day), you can easily get it as a supplement in capsule form.
Lower your homocysteine levels
Lower our what now? Homocysteine is an amino acid used for making certain proteins, and it’s a risk factor for Alzheimer’s.
Foods high in folate (and possible other B-vitamins) seem to lower homocysteine levels. Top choices include:
- Leafy greens
- Cruciferous vegetables
- Tomatoes
Get plenty of lutein
We did a main feature about specifically this a little while ago, so we’ll not repeat our work here, but lutein is found in, well, the same things we just listed above, and lower levels of lutein are associated with Alzheimer’s disease. It’s not a proven causative factor—we don’t know entirely what causes Alzheimer’s, just a lot of factors that have a high enough correlation that it’d be remiss to ignore them.
Catch up on our previous article: Brain Food? The Eyes Have It
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Should Men Over 50 Get PSA?
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
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
❝Loved the information on prostate cancer. Do recommend your readers get a PSA or equivalent test annually for over 50 yr old men.❞
(This is about: Prostate Health: What You Should Know)
Yep, or best yet, the much more accurate PSE test! But if PSA test is what’s available, it’s a lot better than nothing. And, much as it’s rarely the highlight of anyone’s day, a prostate exam by a suitably qualified professional is also a good idea.
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Which Bell Peppers To Pick?
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Bell Peppers: A Spectrum Of Specialties
We were going to do this as part of our ongoing “This Or That?” challenge, but as there are four main types all with many different benefits, we thought this bunch of fruits deserved a main feature.
And yes, they’re botanically fruits, even if culinarily used as vegetables—much like tomatoes, famously!
They’re all the same (but also very much not)
A thing to know is that whether bell peppers be green, yellow, orange, or red, they’re all the same plant, Capiscum anuum. All that differs is how early or late they’re harvested.
Notwithstanding the “Capiscum” genus, they don’t contain capsaicin (as is found in hot peppers). Capsaicin’s a wonderful phytochemical:
Capsaicin For Weight Loss And Against Inflammation
…but today we’re all about the bell peppers.
So, let’s see how they stack up!
💚 Green for lutein
Lutein is especially important for the eyes and [the rest of the] brain, to the point that there’s now an Alzheimer’s test that measures lutein concentration in the eye:
Green peppers have most of this important carotenoid, though the others all have some too. See also:
💛 Yellow for vitamin C
Yellow peppers are technically highest in vitamin C, but all of them contain far more than the daily dose per fruit already, so if there’s any color of pepper that’s nutritionally the most expendable, it’s yellow, since any other color pepper can take its place.
Watch out, though! Cooking destroys vitamin C, so if you want to get your Cs in, you’re going to want to do it raw.
🧡 Orange for zeaxanthin and cryptoxanthins
Similar in their benefits to lutein, these antioxidant carotenoids are found most generously in orange peppers (20x as much as in yellow, 10x as much as in red, and slightly more than in green).
❤️ Red for vitamins A & B6
Red peppers are richest by far in vitamin A, with one fruit giving the daily dose already. The others have about 10% of that, give or take.
Red peppers also have the most vitamin B6, though the others also have nearly as much.
❤️ Red for lycopene
We must do a main feature for lycopene sometime, as unlike a lot of antioxidant carotenoids, lycopene is found in comparatively very few foods (most famously it’s present in tomatoes).
Red is the only color of pepper to have lycopene.
10almonds tip: to get the most out of your lycopene, cook these ones!
Lycopene becomes 4x more bioavailable when cooked:
Lycopene in tomatoes: chemical and physical properties affected by food processing ← this paper is about tomatoes but lycopene is lycopene and this applies to the lycopene in red peppers, too
And the overall winner is…
You! Because you get to eat all four of them
Enjoy!
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New Year, New Health Habits?
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It’s that time of the year, and many of us hope to make this our healthiest year yet—or at least significantly improve it in some particular area that’s important to us! So, what news from the health world?
The rise of GLP-1 agonists continues
GLP-1 agonists have surged in popularity in the past year, and it looks like that trend is set to continue in the new one. The title of the below-linked pop-science article is slightly misleading, it’s not “almost three quarters of UK women”, but rather, “72% of the women using the digital weight loss platform Juniper”, which means the sample is confined to people interested in weight loss. Still, of those interested in weight loss, 72% is a lot, and the sample size was over 1000:
Read in full: New Year, new approach to weight loss: Almost three quarters of UK women are considering using GLP-1s in 2025
Related: 5 ways to naturally boost the “Ozempic Effect” ← these natural methods “hack” the same metabolic pathways as GLP-1 agonists do (it has to do with incretin levels), causing similar results
The lesser of two evils
Smoking is terrible, for everything. Vaping is… Not great, honestly, but as the below-discussed study shows, at the very least it results in much less severe respiratory symptoms than actual smoking. For many, vaping is a halfway-house to actually quitting; for some, it’s just harm reduction, and that too can be worthwhile.
We imagine that probably very few 10almonds readers smoke cigarettes, but we know quite a few use cannabis, which is discussed also:
Read in full: Switching to e-cigarettes may ease respiratory symptoms, offering hope for smokers
Related: Vaping: A Lot Of Hot Air? ← we look at the pros, cons, and popular beliefs that were true a little while ago but now they’re largely not (because of regulatory changes re what’s allowed in vapes)
Sometimes, more is more
The below-linked pop-science article has a potentially confusingly-worded title that makes it sound like increased exercise duration results in decreasing marginal returns (i.e., after a certain point, you’re getting very limited extra benefits), but in fact the study says the opposite.
Rather, increased moderate exercise (so, walking etc) results in a commensurately decreasing weight and a decreasing waistline.
In short: walk more, lose more (pounds and inches). The study examined those who moved their bodies for 150–300 minutes per week:
Read in full: Increased exercise duration linked to decreasing results in weight and waistline
Related: The Doctor Who Wants Us To Exercise Less, & Move More
Take care!
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