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Long-Lasting Effects of Social Media: Understanding How Online Misogyny is Affecting Our Youth

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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.

Image by freepik

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 

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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. 

Image by prostooleh on Freepik

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. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9682499

[3] MacIntosh, H. B. (2002, October 21). Sounds of healing: music in group work with survivors of sexual abuse. ScienceDirect. 

https://www.sciencedirect.com/science/article/abs/pii/S0197455602002290?via%3Dihub

[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. 

https://link.springer.com/article/10.1007/s10465-019-09311-9

[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 

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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. 

Image by freepik

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: 

  1. the presence of S. aureus in the vagina
  2. 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 

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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] 

Image by rorozoa on Freepik

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. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140213/.

Learning to Exercise With, Not Against, Your Cycle 

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Learning to Exercise With, Not Against, Your Cycle 

Emily Bergin

March 2024

Across the world, approximately 26% of the population menstruates each month.[1] The majority of these individuals experience their first period between the ages of 10 and 16 with it lasting for about 50 years after, eventually encompassing more than 50% of their lifespan.[1] 

Many individuals suffer from negative symptoms during this time, encompassing both physical and psychological pain.[1] Despite the commonality and long duration of this experience, few truly understand the changes that occur during this time of the month and what can be done to mitigate them. Thus, this time of the month is often met with apprehension and dread, especially when it comes to exercise. In reality, education is significantly needed to teach individuals how to work with and not against their cycles. Exercise has been proven to be a great coping mechanism for many of the negative side effects of the menstrual cycle.[2] However, it is important to understand how different phases of the menstrual cycle may help and hurt exercise performance. 

Image by freepik

The follicular phase is the first part of the cycle where hormones are generally low and symptoms rare.[3] Thus, this tends to be the best time of the month to push hard in exercise. Long runs, heavy lifting and other intense exercise are best done when during this time of the cycle.[3] 

The end of the follicular phase is met with ovulation, about two weeks before the next period will begin, and this is the time when estrogen levels are the highest. The elevated mood and energy that comes with this makes it a great time to push for new heights in exercise.[4] 

The next phase, the luteal phase, is marked by a slight rise in an individual’s temperature.[3] While often unnoticed, this raising of body temperature can make exercising in hot and humid climates more difficult. Additionally, a rise in progesterone during this phase increases resting heart rate and breathing rate, which can cause additional strain and make exercise feel harder than previous phases.[3] Moderate exercise is often better for this time, but simply the knowledge that performance may take a hit during this phase can help alleviate psychological burden. 

During actual menstruation, exercise can be a great tool to help mitigate negative symptoms. Once the period starts, levels of estrogen and progesterone begin to rise and are higher than they’ve been in previous weeks, making it a bit easier for individuals to find the energy and strength to exercise. Many individuals find that exercise reduces cramps and can help boost mood for those who find this impacted during their cycle.[4] 

Overall, everyone experiences a different range of symptoms to a different degree during their menstrual cycle. Knowing what to expect can help with better understanding your body and being informed on what adjustments can be made to keep exercise enjoyable and beneficial.

Learning to embrace the ebbs and flows can make for a more enjoyable and thoughtful exercise experience. 

References 

[1] Rohatgi, A., & Dash, S. (2023). Period poverty and mental health of menstruators during COVID-19 pandemic: Lessons and implications for the future. Frontiers in global women’s health, 4, 1128169. https://doi.org/10.3389/fgwh.2023.1128169 

[2] Samadi, Z., Taghian, F., & Valiani, M. (2013). The effects of 8 weeks of regular aerobic exercise on the symptoms of premenstrual syndrome in non-athlete girls. Iranian journal of nursing and midwifery research, 18(1), 14–19. 

[3] Rose, A. (2021). How (and why) to cycle your exercise with your menstrual cycle. Healthline. https://www.healthline.com/health/fitness/female-hormones-exercise 

[4] Office on Women’s Health. (2021). Physical activity and your menstrual cycle. US Department of Health and Human Services. 

https://www.womenshealth.gov/getting-active/physical-activity-menstrual-cycle#:~:text=Many% 20women%20wonder%20whether%20it,month%20than%20at%20other%20times.

The Silent Struggle: Chronic Fatigue in Women

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The Silent Struggle: Chronic Fatigue in Women

Kyanda Bailey

March 2024

Nyala lays in bed exhausted after walking up the stairs to brush her teeth and attempting to make breakfast. She becomes overwhelmed thinking of her tasks for the day, which includes laundry and working for 8 hours. Nyala cannot make it out of bed and decides to request working from home. Her employer denies her request and Nyala goes back to bed.

In a world consumed by noise, work and busyness, there exists a silent struggle that has existed for decades and Nyala’s day reflects aspects of it. This struggle is chronic fatigue.We are all exhausted from time to time, though to varying extents. What many aren’t aware of is Chronic Fatigue Syndrome or Myalgic Encephalomyelitis. ME/CFS is defined as “a complex multisystem illness characterized by activity limiting fatigue, worsening of symptoms after activity and other symptoms.”[3] ME/CFS affects millions of people worldwide, specifically around 836,000 and 2.5 million people in the U.S. are affected alone.[2] Women are more likely than men to have ME/CFS as well as have more symptoms than men do.[4] Black and Latinx Women are disproportionately affected.[2]

Image by freepik

Obtaining a diagnosis of CFS is not easy for women. This is significantly related to the lack of medical education in medical schools as well as social beliefs that women are over dramatic. Many people, especially women, are diagnosed after years of multiple doctors visits, seeing multiple providers, misdiagnoses, etc.[2] CFS is often misdiagnosed as depression.[1] The exact cause of ME/CFS is unknown. However, there are currently studies being done to identify possible causes such as infections, immune system changes, stress, etc.[3] It is important to note that there are other conditions that recognize chronic fatigue as a symptom. Some of these conditions are Fibromyalgia, Hypothyroidism, Hashimotos Disease, Digestive Issues, and Iron Deficiency Anemia. Multiple are also active co-occuring conditions.[4]

Nyala possessed some of the symptoms of ME/CFS. She had a lowered ability to complete activities such as making breakfast and running errands. Major symptoms include post-exertional malaise, unrefreshing sleep, and cognitive dysfunction. Pain is also a common symptom.[6] Cognitive dysfunction makes it a struggle for women to get through their daily activities. Confusion, difficulty retrieving words and overall, brain fog impacts work performance, completing to-do lists, socializing and more. Trouble falling asleep and staying asleep poses a major struggle. We all know how important it is to get good quality sleep. It is imperative for us to function well. Muscle weakness, headaches and digestive issues are among other symptoms. Though there is no cure or one treatment option for ME/CFS, some of these symptoms can be managed. General therapies such as low intensity exercise, Vitamin B12 injections, and increasing energy by taking appropriate medications have been used to manage symptoms.[7]

ME/CFS certainly impacts all aspects of daily life. This syndrome poses social, educational, personal and occupational consequences. Around a third of ME/CFS patients also suffer from depression and anxiety disorder.[7] Treating anxiety and depression can be helpful with managing ME/CFS. The importance of self care and pacing should not be underestimated. Pacing yourself can prevent post-exertional malaise or the effects of it. “Post-exertional malaise (PEM) refers to a worsening of ME/CFS symptoms and/or the appearance of new symptoms after physical or cognitive exertion which was previously tolerated and is often delayed 24-72 hours or more.[8] PEM is considered to be the hallmark symptom of ME/CFS and interferes with the ability to lead a “normal” life.”[8]

CFS is a silent struggle that is affecting millions and it will not go away. Affectedness ranges from mild to very severe. We must keep in mind that Chronic Fatigue Syndrome often leads to disability. A study shows that “up to 75% of those affected are unable to work, and an estimated 25% are consistently housebound or bedbound.[3] The level of severity can fluctuate, with 61% reporting being bed bound on their worst days.”[3]

Chronic Fatigue in women should not be ignored. “Experts identified being a woman and having ME/CFS for more than 10 years are risk factors for severe illness. Symptoms increase in intensity as people age.”[4] This struggle should be better recognized and cared for in healthcare settings as well as receive more funding for research. Women should no longer struggle in silence. Advocacy is imperative and this disease should no longer be deemed as a silent and debilitating struggle amongst women.

Feel free to visit https://www.meaction.net/about/ to learn more about ME/CFS and the people fighting for awareness as well as a world where people with ME/CFS are believed and supported by systems that work and have access to effective medical treatment.

References

[1] Vahratian, A., Lin, J. S., Bertolli, J., & Unger, E. R. (2023, December). Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in Adults: United States, 2021-2022. NCHS Data Brief, (488), 1-8. PMID: 38085820.

[2] Griffith, J. P., & Zarrouf, F. A. (January 1, 8). A Systematic Review of Chronic Fatigue Syndrome: Don’t Assume It’s Depression. National Center for Biotechnology Information. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2292451/#:~:text=Objective%3A%20Chronic%20fatigue%20syndrome%20(CFS,is%20often%20misdiagnosed%20as%20depression.

[3] Mayo Clinic. (2021, August 25). Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Essentials of Diagnosis and Management. Mayo Clinic Proceedings. Retrieved March 2, 2024, from https://www.mayoclinicproceedings.org/article/S0025-6196(21)00513-9/fulltext

[4] National Institute for Health and Care Research. (2023, January 1). ME/CFS affects women more severely than men. Retrieved March 3, 2024, from https://www.nihr.ac.uk/news/mecfs-affects-women-more-severely-than-men/34277

[5] Centers for Disease Control and Prevention. (n.d.). Possible Causes. Retrieved from https://www.cdc.gov/me-cfs/about/possible-causes.html

[6] ME Action Network. (n.d.). People with ME. Retrieved from https://www.meaction.net/learn/people-with-me/?gad_source=1&gclid=Cj0KCQjw-r-vBhC-ARIsAGgUO2Bgw7IbN5fRVwcGrm8g8R-k_-VdbYUS8blp54BpXdWaVdKPn_klAzQaAlWJEALw_wcB

[7] ME/CFS Roadmap. (n.d.). Retrieved from https://mecfsroadmap.altervista.org/[8] MEpedia. (n.d.). Post-exertional Malaise. Retrieved from https://me-pedia.org/wiki/Post-exertional_malaise

Autism in Women: Why it Can Easily Fly Under the Radar 

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Autism in Women: Why it Can Easily Fly Under the Radar 

Lisa Samy

March 2024

Rachel Moseley, a Psychology Lecturer at Bournemouth University, recounts how she had endured bullying, social isolation, and depression throughout her adolescence.[2] Her strange incapability to fit in with everyone else was a shadow that loomed over her head for years.[2] However, when she received an autism diagnosis during adulthood, it felt like a “light in the darkness.”[2] She stopped blaming herself for her differences and found her footing in the world. 

Still, this revelation isn’t the norm for many autistic women; in truth, autistic women constantly struggle to be understood by friends, family, and even medical professionals.[2] 

Society’s View of Autistic Men vs Autistic Women[1][4] 

The medical world has largely treated autism as a traditionally “male” condition, with studies showing that men are four times more likely than women to receive a diagnosis successfully.[1][4] The traits and behavior problems autistic men display are a contributing factor, since they tend to be obvious and visible, such as aggression or hyperactivity.[4] On the other hand, women tend to internalize their symptoms, with these categorized as the following: sensory sensitivity, intense interests, social difficulties, and often coexisting conditions (ADHD, eating disorders, depression, etc.).[2][3][4] 

It doesn’t help that the comprehension of autism within the medical community derives mostly from research conducted on autistic men[3] This leads to medical professionals having a minimal understanding of autistic traits unique to women. They’re more likely to brush off women seeking an autism diagnosis, discouraging women from ever seeking professional help again. 

Image by freepik

The Truth Behind the Mask 

As autistic girls grow up, most become adept at hiding their autistic traits. Incidentally, there is a word that autistic women use to describe this behavior: masking.[1][2] They may mimic the behavior of people nearby, force themselves to make eye contact with others, or prepare jokes and phrases in advance for a social setting.[4] 

In an autistic woman’s world, every social interaction is a challenge—not a time for leisure. If

they slip up, they risk becoming prime targets for harassment and bullying.[2] Therefore, their “social disguise” becomes the only way they can feel they can navigate their lives. Still, this mask isn’t without its drawbacks. Suppression of their symptoms undoubtedly contributes to the low diagnosis rates.[4] 

The Grim Consequences of Going Unnoticed 

Studies show that autistic women have higher rates of poor mental health compared to autistic men.[4] When their narratives are weaved by neglect and powerlessness, it’s no surprise that this is the reality. It also seems that the time of diagnosis and mental health are inextricably connected.[4] An earlier diagnosis naturally leads to fewer mental health risks, while a later or even no diagnosis fuels the deadly flames of mental illness. 

Sometimes, the outcome is a grim one—indeed, there are high rates of suicide among undiagnosed autistic women. 

A Rocky Road to Support 

Many autistic women who struggle to obtain a professional diagnosis often peruse online forums and social media for a like-minded community of autistics. While this is certainly beneficial, it should not be the only way they feel they can comfortably find help. A professional diagnosis can provide easier access to a multitude of resources.[3] For instance, it can open up the pathway to receiving cognitive behavioral therapy (CBT), social skills training, or medications for coinciding mental illnesses.[1][3] Also, it can provide a welcomed gift of validation and support that autistic women have long craved 

The truth is this: when we focus on increasing awareness, we give autistic women the courage to seek out a diagnosis, bolstering their chances of attaining acceptance and freedom from shame. 

References 

[1] Autism in Women: Why We Get Diagnosed Late. A Center for Mental Wellness. https://www.acfmw.com/autism-in-women-why-we-get-diagnosed-late 

[2] Moseley, Rachel. (2023). Like many women, I didn’t know I was autistic until adulthood – how late diagnosis can hurt mental health and self image. The Conversation. https://theconversation.com/like-many-women-i-didnt-know-i-was-autistic-until-adulthood-how late-diagnosis-can-hurt-mental-health-and-self-image-212561 

[3] Osborn, Corrine. (2023). Understanding Autism in Women. HealthLine. https://www.healthline.com/health/autism-in-women#takeaway[4] UCLA Health. (2023). Understanding undiagnosed autism in females. Ucla Health. https://www.uclahealth.org/news/understanding-undiagnosed-autism-adult-females

A “Silent Holocaust”: The Real Victims of Alabama’s IVF Court Ruling

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A “Silent Holocaust”: The Real Victims of Alabama’s IVF Court Ruling

Lula Dalupang

March 2024

In the ever-changing environment of the reproductive healthcare system, American legislation faces unprecedented cases without clearly defined solutions. In the past few weeks, Alabama has faced a new challenge: determining the personhood of an extrauterine embryo.

In Vitro Fertilization

In vitro fertilization (IVF) is a fairly new medical practice that was developed in the mid-20th century. Typically, IVF is a main option for those with fertility issues. The way this procedure works is by removing eggs from the patient’s ovaries and then fertilizing them with sperm in a laboratory. The developing embryo is then transferred back into the uterus to complete the impregnation. These embryos are impossible to see by the naked human eye as they are only eight cells large. 

The standard IVF protocol includes extracting as many viable eggs as possible in order to assure a successful fertilization and pregnancy. Only the embryos with the highest development potential will be implanted back into the patient, while the rest are stored in cryo-preservation. Thus, there are over 1.5 million frozen embryos across the United States (U.S.) as of 2024.[3]

The quantity of frozen embryos can be attributed to the large proportion of women that seek out IVF. The Pew Research Center surveyed women ages 15-44 in the US and found that 1 in 10 participants received some form of fertility service from 2017 to 2019. Additionally, research by the Center of Disease Control found that 91,906 births in the U.S. utilized assisted reproductive technology, including IVF in 2021. Out of that population, 1,219 of those procedures were performed in Alabama. [1]

Image by vecstock on Freepik

Le Page v. Center for Reproductive Medicine

In December 2020, multiple embryos belonging to three different couples pursuing in vitro fertilization were accidentally destroyed in a fertility clinic. A patient had entered the cryo-preservation unit and burnt their hand from the sub-freezing temperature, causing them to drop the embryos on the floor.[3] The first attempt at legal justice from the couples were shut down, so the trial was appealed to reach the Alabama Supreme Court. 

The Alabama Supreme Court determined three charges to this case: negligence, wanton endangerment, and the Wrongful Death of a Minor Act. This act was introduced to Alabama legislature in 1872, nearly a century before the first IVF procedure.[3] Despite being applied to intrauterine embryos in the past, Le Page v. Center for Reproductive Medicine is the first case that takes extrauterine embryos into consideration. 

Many Alabama lawmakers are concerned by the amount of embryos that are intentionally discarded or indefinitely preserved. The court justices referenced anti-abortion language found directly from a 2018 amendment to the Alabama constitution.[4] Chief Justice Tom Parker bases his stance on religion instead, believing that embryos are an image of God and “cannot be destroyed without effacing his glory”.[1] Representative Ernie Yarbrough boldly claimed that the destruction of frozen embryos across the U.S. is a “silent holocaust”, comparing a genocide to a medical practice on eight-cells.[2] Yarbrough also unsuccessfully proposed an amendment to prohibit the intentional discarding of embryos. 

The Resulting Disruption of IVF Treatment

In fear of the Alabama Supreme Court Ruling, multiple providers shut down their IVF services to protect their physicians and patients from criminal prosecution. Out of the seven available clinics in Alabama, three of them halted IVF treatment within a week from the ruling.[2] One of these clinics is the University of Alabama at Birmingham (UAB) Health System. UAB is the largest hospital in the state, and a main resource for those seeking fertility treatment. 

Despite the court ruling, UAB continued to perform egg retrievals for IVF since at that point the egg is still unfertilized and is not considered an embryo. However, the health system put a pause on sperm fertilization, embryo development, and uterine implantation which are essential steps in continuing IVF treatment.[1]  Thus, patients who were scheduled for embryonic transfer were forced to cancel their appointments due to the risk of criminal charges if embryos become damaged, destroyed, or unsuccessfully transferred. 

Similarly, hesitancy to pursue pre-implantation genetic testing has risen after the court ruling. Approximately 50% of all IVF treatments involve embryonic genetic testing in a laboratory.[3] This procedure screens for mutations that indicate certain diseases or conditions in the embryo. 

In addition to the decline of fertility treatment accessibility, the court ruling also caused emotional consequences. Many patients who were mid-treatment at the time of the ruling felt devastated upon discovering they may never bear a child. LeeLee Ray, an IVF patient, had undergone eight miscarriages, a failed ectopic pregnancy, and many surgeries before finding a surrogate. When told that her embryos could not be transferred, she felt as if she lost the “light at the end of the tunnel”.[4] This feeling describes the pain of many IVF patient populations, those with fertility issues, uterine or fallopian damage, male-factor infertility, and queer couples. 

The unstable state of reproductive healthcare is a burden on both physical and mental health. It is a prime example of human rights and healthcare becoming a matter of politics and religion. With political polarization in America, opposing sides will narrow their perspectives in order to create a strong, yet extreme, belief. In this case, the concept of reproductive healthcare has been reduced to an eight-cell genocide. 

References

[1] Betts, A. (2024, Feb 21,). After ruling, university of alabama at birmingham health system pauses I.V.F. procedures. The New York Times, Retrieved from https://www.nytimes.com /2024/02/21/us/university-alabama-birmingham-ivf-embryo-ruling.html

[2] Quinn, M. (2024). Alabama legislature approves bills to protect IVF after state supreme court ruling. CBS News, Retrieved from https://www.cbsnews.com/news/alabama-ivf-bill-house-to- protect-ivf/

[3] Sharfstein, J. (2024). The alabama supreme court’s ruling on frozen embryos. Retrieved Mar 3, 2024 from https://publichealth.jhu.edu/2024/the-alabama-supreme-courts-ruling-on-frozen- embryos[4] The Associated Press. (2024). Alabama legislature moves to protect IVF services after state court ruling. NPR, Retrieved from https://www.npr.org/2024/02/29/1235023057/alabama-ivf- bill-passes

Reading and Mental Health

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Reading and Mental Health

Kyanda Bailey

February 2024

Scientists have proven that humans have been reading and writing for about 5,000 years.[4] This can be traced back to 3,000 BCE in Ancient Mesopotamia.[4] Literacy rates have drastically risen in the last 200 years.[4] Reading has not only been used for acquiring knowledge and information from academic fields, but has long been a staple activity done for pleasure. I am unsure if it was always consciously well-known, but reading has now been proven to impact mental health. 

I fell in love with books at the tender age of 4. Once I learned how to read on my own, I became consumed by a plethora of stories written by children’s authors. My love for reading evolved as time went on. As a teen, reading became an escape from the effects of teenage angst. In a 2021 study by Civic Science, it was discovered that 44% of adults read for fun every single day. Therefore reading is a healthy escape.[3] 

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When you go to the doctor, they sometimes ask you if you have been experiencing any stress or anxiety lately. Stress levels are at an all-time high due to the state of the world. Relational and systemic problems plague our daily lives. If your doctor advised you to read more as a form of routine stress management, would you do it? We are often tense, we may feel our muscles aching and our chests tightening when feeling stressed. “Reading can lower your heart rate and ease tension in your muscles.”[2] 

I mentioned that reading was an escape from my teenage angst and it is still one of my favorite escapes. Reading is deemed a healthy escape for a multitude of reasons. It helps us to become more creative, more understanding, feel less alone, etc. Most people can create visuals as they read. This allows them to become further entrenched in what they are reading. Literary fiction, in particular, has been found to improve empathy. This is due to the fact that “literary fiction focuses more on the psychology of characters and their relationships.”[1] I am an avid reader of literary fiction and I become enthralled by the inner worlds of a character or all characters presented in a story through introspective dialogues. Literary fiction is a genre that emphasizes social behaviors and often teaches readers about human differences. This, in turn, may help us to develop a better understanding or empathy for those who are different from us. At the same time, we must keep in mind that different book genres can help us become more resilient, and empathetic as well as help us with social skills, mindfulness, and so on.

I have recently discovered “Bibliotherapy.” According to Psychology Today, it is a mental health intervention that is basically reading therapy. “It mainly refers to structured book reading programs run by libraries, clinics, or schools with the purpose of promoting recovery in people with mental health difficulties. The term bibliotherapy is also used to refer to self-initiated book reading pursued by an individual with mental illness. This can be supported by a clinician, family member or peer supporter, or pursued alone.” [5] 

“Several studies have examined whether bibliotherapy can facilitate recovery from mental illness.”[5] According to multiple studies, women read more than men do. However, reading can benefit everyone’s mental health, and I would like to encourage people to try finding books or genres that they enjoy reading. If you do not like to read physical books or e-books, you can try listening to audiobooks. While reading will not fully eradicate the mental health crisis in the United States, it can improve your mental health. 

Reading should be accessible to everyone. There are often literacy programs at public libraries that will assist in learning how to read. I would also like to encourage others to obtain a library card. “I am aware that this is not always possible due to not having a permanent home address, among other reasons, among other reasons, but it is worth trying.” A library card can give you access to free books and programs in person and through apps like the Libby app. Additionally, places to purchase inexpensive books include eBay and local used bookstores. Since reading can be a healthy coping strategy, it is important to be aware of the benefits that reading can offer to individuals and the benefits to mental health. Reading may have a surprising impact on your life! 

References

[1] Chiaet, J. (2013, October 4). Novel Finding: Reading Literary Fiction Improves Empathy. Scientific American. https://www.scientificamerican.com/article/novel-finding-reading-literary-fiction-improves-empa thy/ 

[2] National Alliance on Mental Illness. (2020). Why Reading is Good for Mental health. NAMI California. https://namica.org/blog/why-reading-is-good-for-mental-health/ 

[3] Rittenberg, J. (2021, June 10). 44% of U.S. Adults Who Like to Read, Do So for Fun Every Day. CivicScience. https://civicscience.com/44-of-u-s-adults-who-like-to-read-do-so-for-fun/#:~:text=In%20a%20ne w%20survey%2C%20CivicScience,for%20fun%20every%20single%20day.

[4] University of Texas Permian Basin. (2024). The Evolution of Literacy Education. University of Texas Permian Basin. 

[5] Whitley, R. (2019, May 24). Can Reading Books Improve Your Mental Health?. Psychology Today. https://www.psychologytoday.com/us/blog/talking-about-men/201905/can-reading-books-improv e-your-mental-health

Back To Basics: Menstrual Cycles 

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Back To Basics: Menstrual Cycles 

Ganna Mahmoud

February 2024

Despite the amount of biology, anatomy, and even sex education classes taught in schools, the vast majority of people still do not grasp the basic foundational knowledge of menstruation or female health and sexuality in general. Unfortunately, this can be for so many reasons such as the unwillingness of society or the government to invest in women’s health education, the idea of menstruation or female sexuality being shameful, a taboo, or just simply “disgusting” or “unimportant.” 

It is time to start from scratch. 

Menstruation is simply monthly bleeding that occurs in the female body, famously known as the “period,” or jokingly, “the time of month.” It is the biological flow of blood and tissue, from the shedding of the uterine lining traveling all the way to the cervix and then eventually unleashed through the vagina. Not the vulva. The vulva is the external part of the female genitals while the vagina is the inner muscular channel that connects the vulva to the cervix. 

As a whole, the menstrual cycle is the sequence of events or phases that take place in the body to prepare for pregnancy and reproduction. The normal average length of a menstrual cycle is 28 days. There are four phases: menstrual, follicular, ovulation, and lumenal phases. This guide will explain all of the phases of cycles in the simplest ways possible. 

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Menstrual Cycles

Menses Phase

Starting with day one, if pregnancy still has not occurred, the lining of the uterus( endometrium) shreds through the vagina. 

Follicular Phase

This is the first day of the period when estrogen levels increase which leads to the uterine lining growth and thickness 

Ovulation Phase

This is the last day of the period where you ovulate. At this time, estrogen is still on the rise but along the way, there was a sudden rise in another hormone. This hormone is called the luteinizing hormone aids in making the ovary unleash its eggs. 

Luteal Phase

After the eggs get unleashed from the ovary and make their way through the fallopian tubes to the uterus, the level of progesterone begins to increase in the process of preparing the uterine lining for pregnancy. 

Pregnancy will occur if the egg becomes fertilized with sperm and the egg becomes implanted too. However, if not then all levels of hormones will drop and the thick lining of the uterus sheds during the period. 

If you would like to learn more about menstruation and the menstrual cycle in detail then stay tuned for future articles explaining cycles and more detailed information about menstruation. 

References

[1] Parenthood, Planned. “What Is Menstruation?: Get Facts about Having Your Period.” Planned Parenthood, professional.
[2] Cleveland Clinic Medical. “Menstrual Cycle (Normal Menstruation): Overview & Phases.” Cleveland Clinic.