Mothers First, Women Second: Childfree Women’s Fight for Sterilization
Lisa Samy April 2024
For a woman to decide to be childfree—meaning to not have children—they are chained to a never-ending struggle for bodily autonomy. In particular, when it comes to the fight for permanent sterilization. Sue, a childfree woman living in Queensland, Australia, had long suffered uncomfortable side effects from hormonal contraception.[1] Yet, her doctor refused to consider her request for permanent sterilization, and “treated [her] very condescendingly,” leaving her with “long-lasting trauma.”[1]
Surely if women are old enough to have children, then they are old enough to choose not to have them as well. As of now, many people believe this isn’t the case.
Rising inflation, living costs, climate change, and stricter anti-abortion legislations ( the reversal of Roe v. Wade) have solidified an increasing number of young women’s choice to be childfree.[4] Still, there are women who don’t wish to have children simply because they don’t feel “that calling” to be a mother.[4] Any and all reasons should be treated as enough, but society’s overwhelmingly pronatalist views and enforced gender roles bar its validation.
Therefore, childfree women are lambasted with negative and presumptuous comments about their decision, even from friends and family. One of the largest online childfree communities—the r/childfree subreddit on the platform Reddit—has labeled these remarks as “bingos.”[2] Some notable bingos are “you’ll change your mind,” “don’t worry, you’ll find the one someday” or “so, you just sleep around then?”[2] In short, their choices aren’t taken seriously and reduced to a phase.
The Hard-fought Battle for Sterilization
The main reason doctors deny sterilization requests to child-free women are their potential regret for their decision.[3] However, studies show that post sterilization regret for women is merely “20.3 percent of those 30 or younger and 5.9 percent of those over 30.”[3] Regardless, the world constantly equates motherhood to womanhood, forcing childfree women into a status of perceived inferiority. They are stereotyped as selfish and immature, shirking from their duty to reproduce, and regarded with a less rewarding life compared to women with children.[3]
On the other hand, childfree men don’t deal with nearly as much backlash. Fatherhood is associated as a learned skill rather than an intrinsic one—as in, separate to a man’s biological makeup.[3] Furthermore, studies indicating the sterilization regret for childfree men are sparse, cementing that men aren’t held up to the same level of scrutiny.[3] As such, sexism creates a division between childfree men and childfree women’s experiences.
In fact, childfree women with partners have attested to this disparity. Jess Lawry, a military spouse, says her husband was able to receive a vasectomy with little to no pushback from doctors.[4] It’s a stark contrast compared to her journey for a tubal ligation: one of countless attempts, ending with no approval for sterilization.[4]
Opening the Doors to Communication
Women are slowly realizing that having children isn’t an obligation—it’s a choice. Those who do opt to be childfree hope to have candid discussions with their friends and family one day, but fear the derisive remarks they may receive.[1] When people let go of gendered prejudices, it opens a much needed path for childfree women to find support from loved ones, and access birth control that caters to their needs.
References:
[1] Davey, Melissa. (2021). ‘Why is it such a scandalous thing?’: the women who have to fight for their right to be child-free. The Guardian. https://www.theguardian.com/society/2021/jan/08/why-is-it-such-a-scandalous-thing-the-women -who-have-to-fight-for-their-right-to-be-child-free
[2] Hintz A., Elizabeth & Brown L., Clinton. (2019). Childfree and “bingoed”: A relational dialectics theory analysis of meaning creation in online narratives about voluntary childlessness. Communication Monographs. (2019). https://www.marshall.edu/commstu/files/Monographs_Childfree-and-bingoed_-A-relational-dial ectics-theory-analysis-of-meaning-creation-in-online-narratives-about-voluntary-childlessness.pdf
[3] Lalonde, Dianne. (2018). Sexist barriers block women’s choice to be sterilized. The Conversation. https://theconversation.com/sexist-barriers-block-womens-choice-to-be-sterilized-99754
[4] Sweeney, Britney. (2022). The rise of childfree Gen-Z: As demand for female STERILIZATION for under-30s soars, ‘childless-by-choice’ women speak out about their decision and the bitter struggles they’ve faced – from doctors REFUSING surgeries to shock $28K bill. Daily Mail. https://www.dailymail.co.uk/news/article-11051355/Gen-Z-women-sterilized-speak-decision.htm
For many young women, the thought of labor and delivery has always been daunting…but the journey is truly astounding, and is separated into multiple stages till birth. The technical term for childbirth is “Parturition”, which is calculated to be 280 days from a woman’s last menstrual period. Now, we are going to walk through each stage and dive deeper into this interesting topic. The definition of labor is the series of events that expel the infant from the birth giver. The whole experience is extremely terrifying, especially if the woman experiences Braxton- Hicks contractions, which are false uterine contractions caused by the peaking of estrogen. The peak of estrogen increases the amount of oxytocin receptors, which inhibits progesterone from calming the uterine muscle during the birth process.
The first stage is the dilation stage. During this time, the cervix is 8-10 cm and is fully dilated in 8 to 18 hours. In subsequent pregnancies, the time to full dilation decreases to 5-12 hours. At the end of this stage, the mother will feel the urge to push.[1] This stage creates true contractions, but only until the cervix is fully dilated. At this time, the baby’s head will be pushed against the cervix, and water breaks as the amnion ruptures. Amnion is the inner membrane that surrounds the embryo [2] During pregnancy, the amniotic fluid, which fills the amniotic sac, protects the fetus from injury and temperature changes such as maintaining heat. Since it is soft, it allows the fetus to move freely and assists with musculoskeletal development, lung development, and pressure on the umbilical cord[.4] There are many hormones and chemicals working behind the scenes to make this happen. For example, atural and synthetic prostaglandins help relax cervical muscles to soften the cervix, which makes it easier to dilate.[3]
Stage 2: Expulsion
By the second stage, the cervix will have been fully dilated and prepared for childbirth. Now, it is time for the woman to start pushing her baby out. Although the amount of time this takes will vary with every birth, it typically lasts from 20 minutes to a few hours. This time period will decrease with the second child, and so on.[5] This time is also ideal to get an epidural, because it cannot be given right before the mother gives birth, but must be fully dilated. However, an epidural can be given any time the mother can remain relatively still.[6] The purpose of an epidural is to relieve any intense pain the mother feels while pushing. An epidural can be a steroid or an anesthetic, injected into your spinal nerves. [7] A catheter is the tube that injects the medicine into the spine, as a small tube.[8]
Stage 3: Placental stage
The uterine contractions will continue for about 15 minutes after birth, the placenta detaches from the uterine wall. After it detaches, the doctor will pull the umbilical cord which removes the placenta. During birth, the placenta, a temporary organ, attaches to the uterus, and helps pass oxygen, nutrients, and antibodies from the mother to the baby, while getting rid of wastes from the baby. In the case of twins, identical twins may share a placenta, but fraternal twins have their own placentas. [9]
Understanding PCOS: Risks and Changes Over the Ages
Emily Bergin
April 2024
Background
Polycystic ovary syndrome (PCOS) impacts approximately 10% of females and is a lifelong condition.[1] It can be diagnosed in adolescence but often goes unrecognized for some time with the mean age of cases around 27 years of age.[2] Despite being an endocrine condition, it is associated with a host of other risks and comorbidities.
Correlated Conditions
Patients with PCOS often struggle with additional conditions such as obesity, metabolic syndrome, and diabetes.[2] All these conditions can increase individuals’ risk of developing PCOS. Therefore it is important to target preventing excessive weight gain and insulin resistance early in life to reduce the risk.[2]Insulin resistance in particular is highly prevalent and experienced by 50-95% of general and obese PCOS women.[3]
Due to the correlation with weight gain and metabolic conditions, there is a need to better understand how disordered eating may be related to PCOS. In a study of 46 PCOS patients and 56 controls, binge eating symptoms were found to be more prevalent in the PCOS group.[4] Symptoms including uncontrolled, emotional, and binge eating were observed as positively correlated, highlighting the need to further investigate this association to reduce PCOS risk and associated comorbidities.
Changes Over the Years
In addition to the concerns highlighted above, PCOS is also associated with other eating disorders and body image concerns. PCOS is associated with risks of infertility and sleep issues as well.[1] Since this is a lifelong condition, concerns tend to change over the course of time depending on the individual’s age. Younger patients tend to be more concerned over increased risks of dermatological issues like acne, irregular periods, and body image. As they age into the family planning stage of life, fertility troubles and the development of cardiac diseases become more relevant and important.[1]
It is important to not only be aware of the symptoms of PCOS to help with early diagnosis but also to better understand how this chronic condition affects all aspects of life. With the right approach, including healthier lifestyle changes and seeking medical help where need be, PCOS can be a well-managed disease that does not have to negatively impact women’s overall health and well-being.
References
[1] Simon, S. L., Phimphasone-Brady, P., McKenney, K. M., Gulley, L. D., Bonny, A. E., Moore, J. M., Torres-Zegarra, C., & Cree, M. G. (2024). Comprehensive transition of care for polycystic ovary syndrome from adolescence to adulthood. The Lancet. Child & adolescent health, S2352-4642(24)00019-1. Advance online publication. https://doi.org/10.1016/S2352-4642(24)00019-1
[2] Christ, J. P., Yu, O., Barton, B., Schulze-Rath, R., Grafton, J., Cronkite, D., Covey, J., Kelley, A., Holden, E., Hilpert, J., Sacher, F., Micks, E., & Reed, S. D. (2024). Risk Factors for Incident Polycystic Ovary Syndrome Diagnosis. Journal of women’s health (2002), 10.1089/jwh.2023.0741. Advance online publication. https://doi.org/10.1089/jwh.2023.0741
[3] Dubey, P., Reddy, S., Sharma, K., Johnson, S., Hardy, G., & Dwivedi, A. K. (2024). Polycystic Ovary Syndrome, Insulin Resistance, and Cardiovascular Disease. Current cardiology reports, 10.1007/s11886-024-02050-5. Advance online publication. https://doi.org/10.1007/s11886-024-02050-5
[4] Pehlivanturk-Kizilkan, M., Akgül, S., Güven, A. G., Düzçeker, Y., Derman, O., & Kanbur, N. (2024). Binge eating symptomatology in adolescents with polycystic ovary syndrome. Physiology & behavior, 279, 114532. Advance online publication. https://doi.org/10.1016/j.physbeh.2024.114532
The Loneliness Epidemic and What the World is Doing to Fight It
Paz Etcheverry, MS, PhD
April 2024
The loneliness epidemic has been touted as an epidemic of modern societies. According to Dr. Vivek Murthy, the current Surgeon General of the United States, more than half of American adults are lonely.[9] Globally, it has been estimated that 1 in 4 older people experience social isolation and between 5 and 15 percent of adolescents experience loneliness.[20]
Loneliness is a feeling that may arise at certain moments in life and affects anyone, regardless of gender, age, or socio-demographic characteristics.[22] Loneliness is synonymous with perceived social isolation, not with objective social isolation. In other words, people can live relatively solitary lives and not feel lonely. Conversely, people can lead a seemingly rich social life and feel lonely.[10] Loneliness is a distressing feeling that accompanies the perception that one’s social needs are not being met by the quantity or quality of one’s social relationships.[10]
There are numerous root causes of loneliness such as lack of social skills, disagreeableness, and antisocial behavioral tendencies. For example, less agreeable adolescents are more likely to report a chronically high level of loneliness.[6] Social media might also be to blame.[6] A study found that the more time spent on social media, the greater the risk of loneliness overall, especially for people who used social media as a means for maintaining relationships.[3] We have become less trustworthy of others, which contributes to social isolation and loneliness.[2] [18] [21] Living alone, the loss of family or friends, chronic illnesses, long-term disabilities, going through changes such as the loss of a job or divorce, sensory impairments, and psychiatric or depressive disorders might cause or exacerbate social isolation or loneliness.[4] [16]
Effects of Loneliness on Health
Loneliness can impact both physical and mental well-being. Higher risk of heart disease, lung disease, cardiovascular disease, hypertension, atherosclerosis, stroke, and metabolic disorders, such as obesity and metabolic disease, have all been associated with loneliness.[22] In fact, loneliness increases the likelihood of early death by 26 percent—an increase roughly equivalent to smoking 15 cigarettes a day. Loneliness has been associated with an increased risk of depression, psychosis, mental disorders, anxiety, stress, and suicide.[12] [14] [22]
What the World is Doing to Fight Loneliness
In light of this epidemic and its insidious effects, governments and companies alike are attempting to tackle loneliness. Here are a few examples.
In 2018, the UK appointed its first Loneliness Ministry to develop and support innovative anti-loneliness programs.[11]
The National Health Service of the UK has funded social prescribing, an approach where doctors can refer their patients to activities, groups, and services in their community,[9] such as pottery classes, language courses, dance, and cooking lessons to name a few.
The Know Your Neighbourhood Fund, launched by the UK government in January 2023, is a £30-million funding initiative aimed at increasing community participation and addressing loneliness in 27 disadvantaged areas across England. The fund focuses on supporting individuals in these areas to connect through volunteering, enhancing their well-being.[5]
Japan’s Prime Minister appointed a Minister of Loneliness in 2021 to address the rising issues of loneliness, social isolation, and increased suicide rates exacerbated by COVID-19 restrictions, which have mainly affected women and the elderly.[17]
In 2023, New York Governor Kathy Hochul appointed 95-year-old media personality and sex therapist Dr. Ruth, also known as Ruth Westheimer, as the state’s Loneliness Ambassador to address the growing issue of loneliness.[19]
That same year, Australia launched its first ever Loneliness Awareness Week (7 through 11 August), which aims to raise awareness about loneliness and its impact on mental and physical health and to encourage individuals and communities to take action to reduce loneliness and increase social connections.[13]
In response to reports of over a million people in South Korea living as recluses due to the coronavirus scare, the government has introduced a monthly living allowance of US $490 for lonely youths to encourage them to leave their homes.[1]
It is not only governments that take action when it comes to fighting loneliness. The Dutch grocery store chain Jumbo has created slow “chat checkout” lanes where cashiers take time to talk with people. Additionally, Jumbo has created “chat corners” where people can enjoy coffee and small talk.[15]
In Ireland, Friends of the Elderly, established in 1980 as a volunteer-based charity, is dedicated to combating loneliness among older individuals living alone. With a small staff and committed volunteers, the organization provides emotional and social support to improve the lives of older members, promoting independence and a sense of community connection.[8]
Ventilen, which translates to “friend to one” in Danish, is a two-decade-old initiative designed to unite individuals aged 15 to 25 in Denmark. Organized twice a week, the program pairs 2 or 3 volunteers with the participants. Within the group, activities such as playing games, preparing meals, attending cinema outings, and fostering essential human connections take place, addressing the sense of connection that many in this age group may be seeking.[7]
In conclusion, the global battle against the loneliness epidemic is gaining momentum, with various nations implementing strategies to address this pervasive issue. From government to community-based initiatives fostering social connections, the world is actively seeking solutions to combat loneliness.
References
[1] Awasthi, A. (2023). ‘Hikikomori’: South Korea paying its ‘lonely’ youth to go out and socialise. https://www.firstpost.com/world/hikikomori-south-korea-paying-its-lonely-youth-to-go-out-a nd-socialise-12449452.html
[2] Barjaková, M., Garnero, A., & d’Hombres, B. (2023). Risk factors for loneliness: A literature review. Social science & medicine (1982), 334, 116163. https://doi.org/10.1016/j.socscimed.2023.116163
[3] Bonsaksen, T., Ruffolo, M., Price, D., Leung, J., Thygesen, H., Lamph, G., Kabelenga, I., & Geirdal, A. Ø. (2023). Associations between social media use and loneliness in a cross-national population: do motives for social media use matter? Health Psychology and Behavioral Medicine,11(1), 2158089. https://doi.org/10.1080/21642850.2022.2158089
[4] Center for Disease Control and Prevention (2023). Health Risks of Social Isolation and Loneliness. https://www.cdc.gov/emotional-wellbeing/social-connectedness/loneliness.htm
[5] Department of Culture, Media and Sport (2023). About the Know Your Neighbourhood Fund. https://www.gov.uk/guidance/about-the-know-your-neighbourhood-fund
[7] Dr. Happy (2023). A simple way to combat loneliness; lessons from the Danes. https://drhappy.com.au/2019/04/23/a-simple-way-to-combat-loneliness-lessons-from-the-dan es/
[8] Friends of the Elderly Ireland (n.d.). Bringing Friendship and Companionship. https://friendsoftheelderly.ie/about/
[9] Global Wellness Summit (2023). Governments Ramp Up the War on Loneliness. https://www.globalwellnesssummit.com/blog/governments-ramp-up-the-war-on-loneliness/
[10] Hawkley, L. C., & Cacioppo, J. T. (2010). Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine, 40(2), 218–227. https://doi.org/10.1007/s12160-010-9210-8
[11] John, T. (2018). How the World’s First Loneliness Minister Will Tackle ‘the Sad Reality of Modern Life’.https://time.com/5248016/tracey-crouch-uk-loneliness-minister/
[12] King, M. (2018). Working to address the loneliness epidemic: perspective-taking, presence, and self-disclosure. American Journal of Health Promotion, 32(5),1315–1317. doi:10.1177/0890117118776735c
[13] Loneliness Awareness Week (2023). Lonely, not Alone. https://lonelinessawarenessweek.com.au/
[14] Mann, F., Wang, J., Pearce, E., Ma, R., Schlief, M., Lloyd-Evans, B., Ikhtabi, S., & Johnson, S. (2022). Loneliness and the onset of new mental health problems in the general population. Social Psychiatry and Psychiatric Epidemiology, 57(11), 2161–2178. https://doi.org/10.1007/s00127-022-02261-7
[16] National Academies of Sciences, Engineering, and Medicine; Division of Behavioral and Social Sciences and Education; Health and Medicine Division; Board on Behavioral, Cognitive, and Sensory Sciences; Board on Health Sciences Policy; Committee on the Health and Medical Dimensions of Social Isolation and Loneliness in Older Adults. (2020). Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System. National Academies Press (US).
[17] OMF (2021). Japan Appoints Minister of Loneliness, Can He Solve the Loneliness Problem? https://omf.org/us/japan-appoints-minister-of-loneliness-can-he-solve-the-loneliness-problem/
[18] Rapolienė, G., & Aartsen, M. (2021). Lonely societies: low trust societies? Further explanations for national variations in loneliness among older Europeans. European Journal of Ageing, 19(3), 485–494. https://doi.org/10.1007/s10433-021-00649-z
[19] The New York Times (2023). Dr. Ruth Saved People’s Sex Lives. Now She Wants to Cure Loneliness. https://www.nytimes.com/2023/11/09/nyregion/dr-ruth-loneliness-ambassador.html
[20] World Health Organization (2024). Social Isolation and Loneliness. https://www.who.int/teams/social-determinants-of-health/demographic-change-and-healthy-a geing/social-isolation-and-loneliness
[21] Yang, J., & Moorman, S. M. (2021). Beyond the Individual: Evidence Linking Neighborhood Trust and Social Isolation Among Community-Dwelling Older Adults. International Journal of Aging & Human Development, 92(1), 22–39. https://doi.org/10.1177/0091415019871201
[22] Yanguas, J., Pinazo-Henandis, S., & Tarazona-Santabalbina, F. J. (2018). The complexity of loneliness. Acta bio-medica: Atenei Parmensis, 89(2), 302–314. https://doi.org/10.23750/abm.v89i2.7404
Women of all ages feel the effects of the menstrual cycle. At a young age, females experience their first periods with cramps, mood swings, and even PMS (Premenstrual Syndrome) that stick with them until they hit menopause. However, even when women feel their menstruation cycle coming to an end, the body can experience vast fluctuations due to changes in hormones during the menstruation cycle. Many women, experiencing periods for years, feel perplexed and anxious due to the changes in their bodies and find it hard to reach out and get the right support.
By definition, menopause is the time after which the menstrual cycle has stopped. Usually, it is diagnosed once 12 months have gone by without a menstrual period.[1] Generally speaking, most women experience the transition period of menopause in their 40s and menopause in their 50s; however, factors such as stress, lifestyles, and diets can result in menopause occurring at varying times for different women.
Similar to the initial experience of menstruation, menopause is a natural biological process that signifies the end of a woman’s menstruation cycle. Generally speaking, the cycle for menopause is gradual and slow – periods can appear to be further apart and less frequent during this time in the cycle.
There is also premature menopause which could occur for women who are experiencing menopause before they hit their 40s. Generally speaking, 5% of women experience premature menopause, and although this number may seem low, many women suffer from the side effects of premature menopause.[2] Some of these side effects include reduced ability to get pregnant as ovulation is slowed, an increased risk of osteoporosis (which is when bones in the body become weak), and even cardiovascular disease.[3 ] As seen by these side effects, premature menopause leaves women susceptible to higher risks of serious health issues as women experiencing premature menopause go longer without experiencing or retaining the benefits of estrogen.
Stages
The 12 months before being diagnosed with menopause are known as perimenopause. While perimenopause may not significantly disrupt the day-to-day life of certain individuals, it is common for this time period to result in physical, emotional, mental, and social changes that can deeply affect women’s lifestyles. Similarly, the period of perimenopause can differ from person to person; while it could last for a year for one individual, it could last several more years for another.
Following perimenopause is menopause, which is the time after a woman has gone without a period for 12 months as previously stated. At this point, the reproductive system comes to a stop and the ovaries will cease to produce eggs. This also means that after menopause, women can no longer bear children naturally. However, with the use of ART, or assisted reproductive technology, the possibility of bearing children still exists. Despite it being a natural biological process, menopause can also occur as a result of surgery or other medical procedures such as chemotherapy.
The last stage is post-menopause which is simply the time after the 12 months of menopause and generally, this time period could alleviate some of the side effects and symptoms which are explained in more detail in the next section. Since every woman’s body is different, the post-menopause time period can differ for each woman; as a result, some women will experience the side effects for a longer period of time, sometimes amounting to a decade after menopause.
Effects
Some side effects of menopause include hot flashes, night sweats, vaginal dryness, urinary urgency, difficulty sleeping, emotional changes, dryness on the skin, breast tenderness, and sometimes even the worsening of PMS.[4] These are symptoms that are often experienced leading up to the time of menopause and are the most common ones that are experienced. Not only do these carry over into menopause, but they are also good indicators of the start of menopause.
Since menopause also causes a hormonal change in the body, symptoms can differ from person to person. Some uncommon effects include headaches, muscle and joint pain, racing heart, hair loss, and difficulty concentrating. [5]
What Can Be Done
The best way to deal with menopause and its effects is to understand what menopause is and how it can affect one’s body. There are always doctors available to help, and often gynecologists will support women through their journey throughout menopause by providing advice and guidance along the way. It is also important to recognize the changes that occur in the body and understand that it is a natural process, and with the proper support system and knowledge, the journey can be made less stressful.
References
[1] Mayo Foundation for Medical Education and Research. (2023, May 25). Menopause. Mayo Clinic.
[2] Early and premature menopause. NHS inform. (2024, January 22).
[3] Mayo Foundation for Medical Education and Research. (2023, May 25). Menopause. Mayo Clinic.
[4] Cleveland Clinic Medical. (n.d.). Menopause: What it is, age, stages, signs & side effects. Cleveland Clinic.
[5] Cleveland Clinic Medical. (n.d.). Menopause: What it is, age, stages, signs & side effects. Cleveland Clinic.
Breast Health Awareness: Understanding Breast Cancer Risk Factors & Screening Guidelines
Ivy Le
March 2024
Overview:
Breast cancer continues to be one of the most prevalent health concerns among women worldwide. In the pursuit of women’s wellness, understanding breast health is crucial. From recognizing risk factors to adhering to screening guidelines, knowledge is power in the fight against breast cancer.
What is Breast Cancer?
Breast cancer is a complex disease that is characterized by the uncontrolled growth of abnormal cells in the breast tissue. It typically begins in the milk ducts or lobules of the breast, where cells undergo genetic mutation that cause them to proliferate uncontrollably. As mutated cells multiply and accumulate, they form a tumor within the breast tissue. These tumors can be benign, meaning they are non-cancerous and confined to their site of origin, or malignant, indicating cancerous growth with the potential to invade nearby tissues and metastasis to distant organs. These mutations can occur from a variety of factors in which we will discuss in this article.
Knowing the Risk Factors:
Awareness begins with understanding the factors that can influence breast cancer susceptibility. While some risk factors are out of our control, such as genetics and family history, others are modifiable through lifestyle changes. For instance, age is a significant risk factor with the likelihood of breast cancer increasing as women grow older. Additionally, reproductive factors like early menstruation, late menopause, and nulliparity (never giving birth) can impact risk levels.
Lifestyle choices also play a role. Excessive alcohol consumption, smoking, a sedentary lifestyle, and a diet high in processed foods have been linked to increased breast cancer risk. Conversely, maintaining a healthy weight, regular exercise, and a diet rich in fruits, vegetables, and whole grains can potentially lower the risk of breast cancer.
Genetic mutations, such as those in the BRCA1 and BRCA2 genes, are known to significantly increase the risk of breast cancer. These mutations can be inherited from one’s parents or acquired over time due to exposure to carcinogens or other factors. Hormonal influences also play a crucial role in breast cancer development. Estrogen, in particular, can stimulate the growth of breast cells, making hormone receptor-positive breast cancers more prevalent.
Knowing the Symptoms:
Recognizing the symptoms of breast cancer is crucial for early detection and prompt intervention. While symptoms may vary among individuals, common signs may include:
New lump or mass in the breast or underarm area
Changes in breast size or shape
Nipple discharge
Nipple inversion
Skin changes on the breast, such as redness, dimpling, or puckering
Persistent breast pain or discomfort
Women should familiarize themselves with the normal look and feel of their breasts and promptly report any changes to their healthcare provider. Breast self-exams aren’t a substitute for a regular screening, but can serve as a valuable tool in early detection.
The Importance of Screening:
Early detection remains the cornerstone of breast cancer management, greatly improving treatment outcomes and survival rates. Therefore, adhering to recommended screening guidelines is crucial for every woman.
For women with average risk, screening typically involves mammograms, which are X-ray images of the breast tissue. Guidelines from organizations such as the American Cancer Society recommend starting annual mammograms at age 40, although individual risk factors may prompt earlier or more frequent screen discussions with healthcare providers.
Women at a higher risk, such as those with a family history of breast cancer or genetic mutation like BRCA1 and BRCA2, may require additional screening modalities, such as breast MRI or ultrasound, and may begin screening at an earlier age.
Breast Cancer Treatment:
Breast cancer treatment approaches vary depending on factors such as the stage of the cancer, its specific characteristics, and the individual’s overall health.
Surgery: Lumpectomy (removal of the tumor and a small portion of the surrounding tissue) or mastectomy (removal of the entire breast), which is sometimes followed by reconstructive surgery.
Chemotherapy: Using drugs to kill cancer cells or stop their growth.
Radiation therapy: Using high-energy rays to target and destroy cancer cells.
Hormone therapy: Blocking the effects of estrogen or progesterone on breast cancer cells.
Targeted therapy: Attacking specific vulnerabilities in cancer cells.
Facts About Breast Cancer:
In the United States, approximately 240,000 cases of breast cancer are diagnosed in women and about 2,100 in men annually.
Presently, over four million women in the United States have a past experience of breast cancer, encompassing those undergoing treatment as well as those who have completed their treatment.
Typically, women carrying a BRCA1 mutation face a lifetime risk of breast cancer of around 72%, while those with a BRCA2 mutation have a risk of up to 69%. Breast cancer linked to BRCA1 or BRCA2 mutations tends to manifest more frequently among younger women.
Black women face a higher likelihood of succumbing to breast cancer compared to women from other racial or ethnic backgrounds. This is attributed in part to the fact that approximately one out of every five Black women is diagnosed with triple-negative breast cancer, a proportion higher than that observed in any other racial or ethnic group.
Conclusion
Breast health awareness is a journey that begins with understanding and ends with action. By empowering women with knowledge about breast cancer risk factors and screening guidelines, we can strive toward more effective prevention, early detection, and treatment strategies, ultimately carving a path of a future where women know more about their health and well-being.
References
[1] Breastcancer.org Staf . “Breast Cancer Facts & Statistics.” Accessed 15 March 2024, Breastcancer.org, https://www.breastcancer.org/facts-statistics.
[2] CDC Staf . “Breast Cancer Awareness.” Accessed 15 March 2024, Center for Disease Control and Prevention,
Long-Lasting Effects of Social Media: Understanding How Online Misogyny is Affecting Our Youth
Shreya Shukla
March 2024
In recent years, the social media landscape has veered perilously towards misogyny. Far-right influencers like Andrew Tate, championing toxic masculinity and anti-feminist rhetoric among young boys, have been the driving force behind this trend. The post-pandemic era has witnessed a stark increase in misogynistic attitudes on social media, evidenced by the proliferation of sexist attitudes like slut-shaming and jokes undermining women’s capabilities on social media. Moreover, the notion of feminism being intrinsically malevolent, coupled with demeaning stereotypes questioning women’s intelligence and character, has become alarmingly common among social media users. As more and more teenagers interact and absorb such ideologies, we start to see more negative effects on the mental health and behaviors of our youth.
Multiple studies have demonstrated how sexism negatively impacts young girls. Among the many adverse effects, the American Psychological Associate Task Force has detailed decreased cognition, inability to focus, low self esteem, worsened physical and mental health, unrealistic expectations about sexuality, and reductionist beliefs of women as sexual objects as the harmful effects of social media sexism and sexualisation on young girls.[3] Meanwhile, for young boys, social media sexism gives them a false sense of superiority, causes them to internalize gender norms and alpha-male mentality, and decreases their ability to form and maintain meaningful connections with women. In general, sexism has long-lasting and deteriorating effects on young people and reduces their ability to live happy and successful lives.
A new study by the University College London and University of Kent has revealed that social media algorithms are specifically designed to push this material onto young boys and men, who suffer from poor mental health as well as anxiety. According to the Guardian, the researchers “detected a four-fold increase in the level of misogynistic content suggested by TikTok over a five-day period of monitoring, as the algorithm served more extreme videos, often focused on anger and blame directed at women”.[1] The TikTok videos on the “For You” page showed more and more videos featuring objectification, sexual harassment or discrediting women, increasing from 13% of recommended videos to 56%.[2]
Social media companies benefit from online sexism because it generates greater engagement and controversy, leading to people spending more time online on their apps. For young boys and men, it validates their experiences and encourages them to hold sexist beliefs and attitudes and blame women for whatever problems they might be struggling with. Meanwhile, for young girls and women, it feeds their insecurities and undermines their issues, leading to them spending more time trying to defend themselves. In the end, neither gender’s problems are solved, and the only person who benefits from the polarizing gender war is social media.
The revelations of this study suggest a need for greater safeguards as well as accountability for social media companies. These safeguards could include stricter content moderation policies, transparent algorithms, standards for measuring social media, and enhanced reporting mechanisms for harmful content. Transparent algorithms, for instance, would allow social media users to understand how content is curated and enable testing for any bias or discrimination across different demographics. Additionally, the establishment of standards to define and measure sexism on social media would make regulation easier. By implementing these measures, we can strive to create a safer and more inclusive online environment, and protect our youth from the long-lasting effects of sexism.
References:
[1] Weale, S. (2024, February 6). Social media algorithms “amplifying misogynistic content.” The Guardian. https://www.theguardian.com/media/2024/feb/06/social-media-algorithms-amplifying-misogynistic-content
[2] Lane, C. (2024, February 13). Social media algorithms amplify misogynistic content to teens. UCL News. https://www.ucl.ac.uk/news/2024/feb/social-media-algorithms-amplify-misogynistic-content-teens
[3] Ng, S. V., Search for more papers by this author, Dr. Ng is a third-year resident in the Department of Psychiatry, NJ, S., EA, D., LM, W., & B, K. (2017, March 10). Social Media and the Sexualization of Adolescent Girls. American Journal of Psychiatry Residents’ Journal. https://psychiatryonline.org/doi/full/10.1176/appi.ajp-rj.2016.111206
Healing Survivors of Violence Through Storytelling and Creative Arts
Isha Gupta
March 2024
Storytelling and creative arts can be powerful tools to promote awareness, healing, and empathy surrounding critical global issues, including violence. Recent estimates from the World Health Organization (WHO) depict that 1 in 3 of women worldwide have faced physical or sexual violence.[9] Although gender-based violence is commonly associated with affecting mainly females, it is important to recognize that males and LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other identities) individuals can face forms of violence too. The Centers for Disease Control and Prevention found that in the United States, about 1 in 10 men experienced sexual violence, physical violence, or stalking by an intimate partner during their lifetime.[1] Moreover, research reveals that male and LGBTQIA+ survivors can face more stigma due to gender stereotypes and the way domestic and sexual violence are commonly labeled as cisgender and heterosexual women’s issues, which, in turn, can especially bring up the fear of judgment and victim-blaming.[2] Unfortunately, violence can take on many forms, including domestic violence, sexual assault, torture, and acid attacks.[4] Violence can impact diverse aspects of health and wellness. In addition to bodily injuries and adverse physical health outcomes, violence is also associated with mental health concerns such as depression, anxiety, suicidal ideation, and post-traumatic stress disorder.[4] Violence can also affect future generations as the environments children are raised in can influence their behavioral and emotional outcomes.[9] According to the WHO, forms of violence can also bring negative social and economic costs such as isolation and loss of wages.[9] Since violence is such a crucial global health concern that can affect diverse populations, it is interesting to consider the role storytelling and creative arts can play in survivors’ healing journeys and how they may facilitate them.
Storytelling and the creative arts can help survivors feel heard and empowered, which, in turn, can help promote their healing journeys and well-being. Diverse forms of storytelling and creative arts can be employed including visual art, dance, music, and writing. There is even a field known as art therapy, which utilizes arts to treat mental health concerns and improve mental health. Research suggests that the arts are becoming more popular in therapeutic and mental health settings.[8] Engaging in arts-based activities can offer a safe space for survivors of violence to express themselves. Self-expression can be empowering for some survivors, especially since their traumatic experiences could be significantly accompanied by stigma or may be sensitive to share openly. Communication and sharing artwork with others could help survivors combat feelings of isolation and feel more acknowledged.[7]By the same token, research has found that inner-directed dance can impact survivors’ healing journeys, particularly by reducing social isolation, increasing body-self awareness, and boosting self-esteem.[5] Music can be an influential tool as well since it can significantly evoke emotions. Studies have found that even if music may encompass nonverbal expression at times, musical interventions could help improve physical health and well-being, including immune function.[3] Moreover, forms of storytelling and creative arts like expressive writing can be beneficial for survivors because they are relatively safe, accessible, and cost-effective.[6]
Although storytelling and creative arts can offer therapeutic benefits and support some survivors’ healing journeys, it is important to take note that each individual’s experience with violence can be different, and therefore, there may not be a one-size-fits-all approach. Some survivors may feel that storytelling and creative arts can help them process their emotions and feel acknowledged, while other survivors may not significantly feel the benefits. For instance, sharing stories about violence could be accompanied by stigma, and some survivors may feel re-traumatized by recalling and reflecting on their experiences. Furthermore, other sociocultural factors including gender stereotypes, discrimination, and fear of judgment[4] can influence how comfortable survivors may feel about incorporating storytelling and creative arts in their healing journeys. Research highlights the importance of supportive and nonjudgemental environments since this can ensure that survivors interested in sharing their stories feel genuinely supported and have a positive storytelling experience.[4] Additionally, more research studies should be conducted to further evaluate the efficacy and therapeutic benefits storytelling and creative arts could offer survivors.[7]
Violence is still a prevalent and important global issue to be aware of. Some research studies have supported the use of storytelling and creative arts among survivors, while some studies have challenged them for their potential limitations, and recommend further research to be conducted. Storytelling and creative arts are overall healthy coping strategies that can provide survivors of violence outlets to freely express themselves and empower them on their healing journeys. Simultaneously, survivors struggling with their mental health and emotional well-being can also consider starting to seek help from mental health counselors at their schools and colleges, primary care physicians, and organizations such as the National Alliance on Mental Illness, Crisis Text Line, and others. Along with utilizing the healing powers of storytelling and creative arts, more advocacy efforts, including the availability of gender-inclusive services,[2] mental health resources, and adequate education about consent, should be continued to help address violence across the globe and empower survivors.
References
[1] Centers for Disease Control and Prevention. (2020, June 1). Intimate Partner Violence, Sexual Violence, and Stalking Among Men. Centers for Disease Control and Prevention. https://www.cdc.gov/violenceprevention/intimatepartnerviolence/men-ipvsvandstalking.html
[2] Hine, B., Wallace, S., & Bates, E. A. (2022, September). Understanding the Profile and Needs of Abused Men: Exploring Call Data From a Male Domestic Violence Charity in the United Kingdom. National Center for Biotechnology Information.
[4] Mannell, J., Ahmad, L., & Ahmad, A. (2018, August 23). Narrative storytelling as mental health support for women experiencing gender-based violence in Afghanistan. ScienceDirect. https://www.sciencedirect.com/science/article/abs/pii/S0277953618304350
[5] Margolin, I. (2019, November 4). Breaking Free: One Adolescent Woman’s Recovery from Dating Violence Through Creative Dance. Springer Link.
[6] Meston, C. M., Lorenz, T. A., & Stephenson, K. R. (2013, September 1). Effects of Expressive Writing on Sexual Dysfunction, Depression, and PTSD in Women with a History of Childhood Sexual Abuse: Results from a Randomized Clinical Trial. Oxford Academic. https://academic.oup.com/jsm/article-abstract/10/9/2177/6940247
[7] Rouse, A., Jenkinson, E., & Warner, C. (2022, February 26). The use of “art” as a resource in recovery from the impact of sexual abuse in childhood: A qualitative systematic review. Taylor & Francis Online. https://www.tandfonline.com/doi/full/10.1080/17533015.2022.2034900
[8] Shukla, A., Choudhari, S. G., Gaidhane, A. M., & Quazi Syed, Z. (2022). Role of Art Therapy in the Promotion of Mental Health: A Critical Review. Cureus, 14(8), e28026. https://doi.org/10.7759/cureus.28026 [9] World Health Organization. (2024, March 25). Violence against women. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/violence-against-women
Tampons and Toxic Shock Syndrome: Understanding the Risks and Best Practices
Paz Etcheverry, MS, PhD
March 2024
What exactly is toxic shock syndrome, and why does the Food and Drug Administration (FDA) enforce a warning on tampon packaging?
Toxic shock syndrome, or TSS, is an acute illness predominantly caused by the toxin-producing bacteria Staphylococcus aureus.[6]TSS is characterized by fever, chills, body rashes, vomiting, diarrhea, muscle aches, and low blood pressure. It is a very serious illness that can lead to multiple organ damage (including of the liver, kidneys, and heart) and death.[1] [3]
TSS is primarily associated with the use of tampons, especially the super- and higher-absorbency types.[2] However, keeping a tampon inside the vagina for a long time can lead to TSS regardless of the tampon type.
The incidence of TSS related to menstruation, also known in the literature as menstrual TSS or mTSS, currently ranges between 1 to 3 per 100,000 in the US.[1] [6]This represents a considerable decline from the 1980s, when the incidence rate was between 2 to 16 cases per 100,000 menstruating women. This decline is mainly attributed to the implementation of consumer education and to the introduction of labeling requirements by the FDA.[7] [8] As per regulatory requirements, the FDA mandates that all tampon packages include the following warning: “Tampons are associated with Toxic Shock Syndrome (TSS). TSS is a rare but serious disease that may cause death. Read and save the enclosed information”.[9]
For mTSS to occur, two essential factors are necessary:
the presence of S. aureus in the vagina
the lack of antibodies to neutralize toxic shock syndrome toxin-1 (TSST-1) produced by the bacteria[10]
Among the women who use tampons, 1 to 5 percent have TSST-1-producing S. aureus in their vaginas and 10 to 20 percent have no protective antibodies against TSST-1.[1]In addition to the above two factors, scientists believe that tampons introduce oxygen, which creates a more aerobic environment in the vagina, which is favored by S. aureus.[10] The rapid removal of tampons may also cause small vaginal tears, which could lead to infections.[5]
To reduce the risk of mTSS, women should avoid wearing the same tampon for more than 8 hours, refrain from wearing tampons overnight, change the tampon preferably every 4 hours, and unwrap the tampon from its packaging only when ready to use it. Additionally, women should use tampons with the lowest absorbency for their flow and switch from tampons to pads every other day, especially when the menstrual flow is the heaviest. Compared to regular- and light-absorbency tampons, super and higher-absorbency types are larger in size. This increased size could potentially lead to abrasion and irritation in the vagina, making it easier for TSST-1 to enter the body. Furthermore, it is important to opt for all-cotton tampons, as opposed to tampons with rayon/cotton blends, as they may be less irritating.[5]
Treatment of mTSS usually involves intravenous fluids and antibiotics such as penicillinase-resistant penicillin, cephalosporin, or vancomycin along with either clindamycin or linezolid.[3]
While mTSS has been associated with tampon use, wearing menstrual cups, cervical caps, diaphragms, pessaries, and natural sea-sponges increases the risk of the illness.[4] [6] TSS may also occur in non-menstrual settings such as in soft tissue infections, post-surgical infections, burns, nasal packing—gauze or sponge-like materials placed inside the nasal cavity—, and dialysis catheters.[6]
If any signs of TSS arise, such as sudden high fever, rash, and low blood pressure, seeking prompt medical attention is of utmost importance. Overall, balancing menstrual practices with awareness and caution is key to minimizing potential risks associated with tampon use.
References
[1] Billon, A., Gustin, M. P., Tristan, A., Bénet, T., Berthiller, J., Gustave, C. A., Vanhems, P., & Lina, G. (2020). Association of characteristics of tampon use with menstrual toxic shock syndrome in France. EClinicalMedicine, 21, 100308. https://doi.org/10.1016/j.eclinm.2020.100308
[2] Bobel, C., Winkler, I.T., Fahs, B., et al., editors (2020). The Palgrave Handbook of Critical Menstruation Studies [Internet]. Singapore: Palgrave Macmillan. https://www.ncbi.nlm.nih.gov/books/NBK565605
[3] Gottlieb, M., Long, B., & Koyfman, A. (2018). The Evaluation and Management of Toxic Shock Syndrome in the Emergency Department: A Review of the Literature. The Journal of Emergency Medicine, 54(6), 807–814. https://doi.org/10.1016/j.jemermed.2017.12.048
[4] Hochwalt, A. E., Abbinante-Nissen, J. M., Bohman, L. C., Hattersley, A. M., Hu, P., Streicher-Scott, J. L., Teufel, A. G., & Woeller, K. E. (2023). The safety assessment of tampons: illustration of a comprehensive approach for four different products. Frontiers in Reproductive Health, 5, 1167868. https://doi.org/10.3389/frph.2023.1167868
[5] Nicole, W. (2014). A question for women’s health: chemicals in feminine hygiene products and personal lubricants. Environmental Health Perspectives, 122(3), A70–A75. https://doi.org/10.1289/ehp.122-A70
[6] Ross, A., & Shoff, H.W. Toxic Shock Syndrome. [Updated 2023 Aug 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459345/
[7] Roy, P., Sahni, A. K., & Kumar, A. (2015). A fatal case of staphylococcal toxic shock syndrome. Medical Journal, Armed Forces India, 71(Suppl 1), S107–S110. https://doi.org/10.1016/j.mjafi.2013.05.012
[8] U.S. Food and Drug Administration (2005, July). Menstrual Tampons and Pads: Information for Premarket Notification Submissions (510(k)s) – Guidance for Industry and FDA Staff. https://www.fda.gov/regulatory-information/search-fda-guidance-documents/menstrual-tampons and-pads-information-premarket-notification-submissions-510ks-guidance-industry#1
[9] U.S. Food and Drug Administration (2023, October). CFR – Code of Federal Regulations Title 21. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?fr=801.430
[10] Vostral, S. (2017). Toxic shock syndrome, tampons and laboratory standard-setting. CMAJ: Canadian Medical Association Journal = Journal de l’Association Medicale Canadienne, 189(20), E726–E728. https://doi.org/10.1503/cmaj.161479
The Dynamics of In Vitro Fertilization and Embracing Autonomy
Roma Bhavsar
March 2024
What is in vitro fertilization (IVF)?
Over the past five decades, IVF has emerged as a transformative treatment option for women, representing a substantial technological advancement in assisting families grappling with infertility and yearning for children. This intricate process entails a multi-step journey, requiring dedication and meticulous planning.
IVF involves several steps, with specific timing playing a crucial role throughout the process. Reproductive specialists explain that each IVF cycle begins with a patient self-injecting hormones daily for about 10 to 12 days to stimulate egg production within the ovaries. Regular monitoring follows until the eggs reach maturity, after which a different hormone triggers their retrieval under anesthesia – the second step.[1]
Subsequently, retrieved eggs are placed in a dish with sperm for fertilization, marking the third step in the process. The fourth step is the creation of a fertilized egg which is then cultured in a lab for approximately three to seven days until it reaches the blastocyst stage. This stage signifies a well-developed embryo containing cells for both the placenta and fetus.[1]
The last step in the IVF process involves either transferring the embryo into the woman’s uterus or freezing it for future use. Often, a combination occurs with one embryo transferred while any surplus embryos are frozen. The entire IVF cycle, from hormone administration to embryo implantation, typically spans about 2.5 weeks. However, frozen embryos may be transferred into the uterus in a separate cycle.[1]
Demand for IVF has surged globally, with IVF conceptions accounting for approximately 2% of all babies born in the United States. This percentage is projected to rise to 10% in the future as scientific advancements and reliance on IVF persist.[2]
Reproductive rights continue to divide the nation
As of March 2024, IVF remains at the forefront of discussions, marking it as one of the most talked about topics of the year. Following the reversal of Roe v. Wade, the discussion surrounding IVF also opens another dimension, inviting further scrutiny to women’s reproductive rights. This ongoing dialogue promises to reignite discussions and inquiries into the broader landscape of reproductive health and autonomy.
In a recent unprecedented ruling, the Alabama Supreme Court categorized embryos as children, sparking legal ambiguity regarding fertility treatments. This caused some IVF providers to suspend services for fear of wrongful death lawsuits when handling their routine disposal of nonviable and surplus embryos. Along with the potential liability for inadvertent destruction, it has ignited new debates within the realm of reproductive medicine in the United States.[3, 4]
This decision prompted public outrage and resulted in lawmakers taking political action by swiftly passing legislation to offer legal immunity to IVF providers. Following the enactment of the law, two of the three major clinics in Alabama resumed IVF services. However, legal experts say the future of those protections are on shaky ground.[4]
Medical professionals and advocacy organizations in the reproductive field have expressed apprehension over the ruling’s potential adverse effects on fertility treatments not only within Alabama but also across the nation as the discussions continue to evolve on the future of IVF.[3]
The future of IVF hangs in the balance
The Alabama Supreme Court ruling increased apprehension among IVF providers in Alabama and triggered political turbulence on a national scale, prompting Republicans to distance themselves from the decision amidst a pivotal election year where reproductive rights are one of the top issues.
As the debate rages on surrounding women’s autonomy and the complexity of reproductive decisions, a critical question remains: Will women emerge victorious in the struggle for control over their bodies, including the disposition of their eggs and embryos? It is essential that women are entrusted with this choice as it directly concerns their bodies. Women should be free from the constraints of legislation, honoring individuals’ rights to make deeply personal decisions regarding their lives and futures. Since the inception of IVF in 1978, the fundamental goal of infertility treatment remains the same – helping to build happy, healthy, and flourishing families.[2, 5]
References
[1] Godoy, M. (2024, February 23). The science of IVF: What to know about Alabama’s “extrauterine children” ruling. NPR. https://www.npr.org/sections/health shots/2024/02/23/1233023637/ivf-alabama-frozen-embryo-personhood-abortion-supreme court.
[2] Kushnir, V. A., Smith, G. D., & Adashi, E. Y. (2022). The Future of IVF: The New Normal in Human Reproduction. Reproductive Sciences, 29(3). https://doi.org/10.1007/s43032-021- 00829-3.
[3] Epstein, K. (2024, February 22). Major Alabama hospital pauses IVF after court rules frozen embryos are children. www.bbc.com. https://www.bbc.com/news/world-us-canada 68366337.
[4] Baker, L. (2024, March 6). Alabama lawmakers pass IVF immunity legislation. NPR. https://www.npr.org/2024/03/06/1235907160/alabama-lawmakers-pass-ivf-immunity legislation.
[5] Eskew, A. M., & Jungheim, E. S. (2017). A History of Developments to Improve in vitro Fertilization. Missouri Medicine, 114(3), 156–159.
