SRH Matters

A new study of more than 133,000 women confirms that regular mammography screenings reduce a woman’s risk of dying from breast cancer.

The Swedish Two-County Trial study began in the late 1970s. In its first phase, researchers divided the study participants in to two groups: Women who were given regular mammograms, and women who were treated with “usual care,” or treatment that did not include mammograms. That screening period lasted for seven years, after which the study’s second phase began and the women were followed for an additional 29 years.

“We estimated about 1,300 mammograms need to be done to save one life,” explains Robert A. Smith, Ph.D., director of Cancer Screening at the American Cancer Society and one of the study’s authors.

To put that number another way, Smith and his fellow authors estimate that screening 300 women every two to three years for 10 years total prevents one death from breast cancer. Among the study participants, Smith calculates that 42 years of life were saved for every 1,000 women who were invited to have a regular mammogram during the study’s screening period.

Yet despite studies like Smith’s, who should get a mammogram and how often can be confusing questions. The American Cancer Society advises women to begin annual mammogram screenings at age 40.

“Women should think of mammography as a kind of insurance against getting a diagnosis with a breast cancer that will be harder to treat and may actually become uncurable,” says Smith.

“It’s not a perfect examination by any means but we have quite an accumulation of data that shows mammography is associated with a reduced risk of dying from breast cancer and the opportunity to be treated less aggressively.”

But the United States Preventive Services Task Force says the decision to get a mammogram at the age of 40 is an individual choice that women should make with their doctors. Otherwise, the Task Force recommends women wait to begin regular mammography screening at the age of 50 and even then advises that mammograms are only needed once every two years.

In a statement to CNN, Dr. Virginia A. Moyer, chair of the task force, said these latest findings would probably  not change the panel’s guidance.

“Overall, this study adds depth to our knowledge of the potential adverse effects of radiation exposure for mammography, but is not different from the estimates used in the 2009 recommendation, so would not be expected to significantly impact the debate.”

http://thechart.blogs.cnn.com/2011/06/28/study-confirms-mammography-reduces-risk-of-breast-cancer-death/

Obesity experts have been saying for years that children who sit in front of the TV screen day in and day out tend to be heavier. It’s the sedentary lifestyle. But now experts are finding it’s not only the couch potato effect, but the television ads children are watching, along with other factors that can add inches to their waistlines.

According to a new policy statement from the American Academy of Pediatrics, titled, “Children, Adolescents, Obesity and the Media,” junk food and fast food ads increase a child’s desire to eat those types of foods. Studies also show that snacking while watching the tube increases. And if kids stay up late at night while watching the tube or playing video games, their lack of sleep can be a major factor in raising their risk for obesity.

“We’ve created a perfect storm for childhood obesity – media, advertising, and inactivity,” said the statement’s lead author, Dr.Victor Strasburger, a member of the AAP Council on Communications and Media. “American society couldn’t do a worse job at the moment of keeping children fit and healthy – too much TV, too many food ads, not enough exercise, and not enough sleep.”

1 in 5 Pre-K kids carry too much weight

The statement recommends a number of tips so parents can help curb their children’s weight. They include:
-Discussing food advertising with their children as they monitor children’s TV viewing and teach them about good nutrition.
- Limiting a child’s time in front of a TV monitor and avoid putting TV sets and Internet connections in children’s bedrooms.
- And be aware that kids with high levels of screen time also have more stress, putting them at risk not only for obesity but for a number of other conditions such as diabetes, mood disorders and asthma.

“Thirty years ago, the federal government ruled that young children are psychologically defenseless against advertising. Now, kids see 5,000 to 10,000 food ads per year, most of them for junk food and fast food,” said Strasburger.

The AAP also recommends that pediatricians ask two questions about media exposure when parents bring their children in for checkups. How much time is the child spending on screens each day? And is there a TV set or Internet connection in the child’s bedroom?

“Having the conversation around these two questions can go a long way toward a thoughtful approach to each family’s – and each child’s – media use, and that can quickly translate into healthier choices and healthier weight,”  Strasburger said.

http://thechart.blogs.cnn.com/2011/06/27/obesity-is-caused-by-more-than-sitting-on-the-couch/

When comparing male and female sexuality, there’s no shortage of adages: “Men are like light switches – just flip them on and they’re ready to go. Women are like irons – plug them in and let them warm up.”

Or, wait: Is it that men are like microwaves – just push a button to turn them on – and women are like Crock-Pots that need to simmer?

Dr. Emily Nagoski, author of “The Good in Bed Guide to Female Orgasms” writes that “men are like driving standard transmission – if you move through the gears in the right order, you will get where you want to go – and women are like baking a souffle – the outcome depends on the ingredients and the chef, sure, but it also depends on the reliability of the oven, the altitude, the humidity of the day… more variables, more variability.”

Regardless of your metaphor of choice, the oversimplifications of male sexuality abound, as do the explanations:

• Evolutionarily, men are wired to spread their seed indiscriminately, while women are wired to cultivate.
• Psychologically, inside every man is an insecure little boy who needs constant sexual approval.
• Neurochemically, it’s the male “testosterone-brain” versus the female “estrogen-brain.”
• Behaviorally, men respond to simple cues like visual stimulation, while women respond to complex emotional cues.
• Inter-galactically, men are from Mars and women are from Venus!

Whatever the myth, we tend to view male sexuality as simple and female sexuality as complex. Maybe it’s true.

Lately, as reported in the Chart, there have been some really good books by really smart people that support this theory. In their book “Why Women Have Sex,” for example, psychologists Cindy Meston and David Buss purposely excluded men from their research.

“We do bring in men occasionally by way of contrast,” they say, “but we wanted to focus exclusively on women so that the complexity of women’s sexual psychology was not given short shrift, so to speak.”

In the more recent book “A Billion Wicked Thoughts,” neuroscientists Ogi Ogas and Sai Gaddam analyzed a billion web searches, a million websites, a million erotic videos, a million erotic stories, millions of personal ads and tens of thousands of digitized romance novels in order to better understand the sexual differences between men and women.

They concluded that a single cue triggers arousal in the male brain, but women’s brains require multiple cues to become aroused. “The male sexual brain is like a single toggle switch, whereas the female sexual brain is like the cockpit of an F1 fighter jet,” Gaddam says. “There are tons of dials and instruments, and there’s sophisticated calibration going on.” Again, the switch/knob comparison.

But are men really that simple? And are women really so different?

In one of the first episodes of “Sex and the City,” Carrie wonders why, in an age where women often make the same money and enjoy the same successes as men, women can’t enjoy sex like men? If men are capable of having sex without any meaning or attachment, why can’t women?

Well, in my experience, women certainly can have sex like men, and as I’ve discussed in previous entries about women and porn and the rise of female infidelity, women are indeed doing just that.

But if women can have sex like men, then men are also capable of having sex like women: with complex motivations.

For example, when I talk to men who have cheated, some tell me they have done so simply for the sex or in the heat of the moment, but many, if not most, say they cheat for more complex reasons: because they were bored, emotionally disconnected in their relationship, depressed, or seeking passion.

And while it would seem that, in our age of Anthony Weiner, Arnold Schwarzenegger, and John Edwards, men are ruled by the passions of their penis, there are actually just as many men with low sexual desire as there are women.

I also know plenty of women who don’t like to cuddle after sex, and plenty of men who do. There are also lots of women who love casual sex, and plenty of men who want sex to be part of an emotionally committed relationship. In short, I know plenty of male “souflees.”

So is female sexuality is really more complicated than male sexuality? It depends on the individual woman, and how she’s using sex at the time.

Same goes for the guys. There are times when sex (and our desires) are simple and times when they’re more complex.

So is your sexuality like a light switch that goes on and off, or like a dimmer or volume knob that operates on a spectrum? More than likely, whether you’re a man or a woman, it’s both: You can be both switch or knob depending upon the context.

And sometime you’re probably a complex souflee. In their book on “Why Women Have Sex,” the authors found that women had sex for approximately 237 reasons, ranging from love to pure pleasure to a sense of duty to curiosity to curing a headache.

Why do men have sex? I haven’t counted all the reasons men have sex, I bet I could get up to 237.

http://thechart.blogs.cnn.com/2011/06/23/when-it-comes-to-sex-are-you-a-switch-or-a-knob/

What is the menopause?

The menopause is the time when a woman’s periods stop. In the UK, this usually happens between the ages of 47 and 53.

In 2004, two Scottish scientists developed an ovary-ultrasound test which predicts when you will reach your ‘change.of life’. However, it is not available on the NHS. It’s now possible to obtain this Wallace-Kelsey test privately; the current cost is about £250.

In the years leading up to the menopause, the level of oestrogen (an important female sex hormone) starts to fall.

This fall can have several effects:

• the vagina and vulva (the vaginal opening) may become a little dryer
• as a result, the woman may become slightly more vulnerable to urinary infections
• the breasts may lose some of their bulk
• the skin may become a little less elastic.

If you are unlucky, the changes in your body may possibly lead to two distressing symptoms:

• hot flushes
• sweating attacks.

However, a lot of women do actually sail through the menopause with little or nothing in the way of unpleasant symptoms.

Can I have sex after the menopause?

Yes! Even today – one sometimes reads articles in the newspapers which suggest that nearly all women lose their sexual desire at the menopause – and that most of them have little sexual activity thereafter. This is nonsense.

The truth is that there’s no reason why you can’t continue to enjoy a happy and satisfying sex life during and after the menopause, if you want to.

My colleagues and I have found that many women enjoy wonderful sex lives after they’ve passed the menopause – and continue to do so for a very long time. We have even uncovered some evidence that:

• women who are interested in sex are more likely to be orgasmic after the ‘change’ than younger females.
• they are also more likely to be multi-orgasmic!

There are three main reasons for this.

1. After the ‘change’ women are glad to be able to quit worrying about contraception.
2. By the time they reach 50 or so, a lot of women have gained a great deal of love-making experience and skill.
3. Very often, they now have partners who actually know what they’re doing in bed! (Though of course, a few postmenopausal women – notably certain film stars – decide to take ‘toy boys’ as lovers.)

In 2009, one of us (Christine Webber) conducted a survey among women aged 45-65. The findings showed that in that age group 26 per cent of women were definitely up for sex, while 29 per cent ‘quite liked it’. Only 6 per cent were not at all keen, and 16 per cent said that they’d be more interested if they had a new partner!

How could the menopause affect my sex life adversely?

It’s fair to say that many women have a great time in bed after they pass the menopause. However, others don’t.

These are some problems that can occur.

• Night sweats and hot flushes. These can be counterproductive to relaxation and romance. At night, such symptoms produce an intolerable feeling of heat, often accompanied by profuse sweating, and even a feeling of acute claustrophobia. If the sufferer has to throw off the bed sheets and open the windows when night sweats are at their worst, she’s not going to feel like absorbing even more body heat from her sexual partner!
• Relative oestrogen deficiency can bring about vaginal dryness and thinning of the vaginal lining. The lack of lubrication and support for the vaginal walls can reduce arousal during sex and increase friction, which in turn may produce soreness, burning or irritation.
• Irregular periods can make the timing of spontaneous love-making difficult. (However, the menopause shouldn’t really cause badly irregular periods; if yours are ‘all over the place’ consult your doctor.)
• stress urinary incontinence (SUI) can occasionally arise during love-making – or during a climax.
• Some women are conscious of dry skin, changes in the shape of their breasts and of a gradual redistribution of weight away from their breasts towards their waistline.
• Loss of libido can occur; a minority of women complain that after the menopause they simply lose their desire for sex. Husbands may feel rejected because of this, and so relationship difficulties can arise.
• Psychological symptoms such as mood swings, insomnia and depression can make it difficult to enjoy sex.

The good news is that all these problems can usually be remedied - chiefly through commonsense advice from a doctor (or from a therapist who is experienced in dealing with menopause problems), together with sympathy, understanding and love from the woman’s partner.

Also, there will soon be some new treatments which will allegedly boost a woman’s libido.

Hormone replacement therapy (HRT)

‘HRT’ means giving natural or synthetic female sex hormones that replace the hormones which the woman is not producing enough of.

HRT comes in the form of tablets, patches or gels and always contains oestrogen (either in a natural or synthetic form), and often a progestogen as well. (A progestogen is similar in effect to the female hormone progesterone.)

HRT is extremely good for relieving menopausal symptoms like hot flushes, night sweats and vaginal dryness. Unfortunately, since about 2003 it has becomer increasingly clear that it is not as free from ill-effects as we had been led to believe.

However, if used sensibly, it can be a great help to many women – particularly where sex is concerned.

What does ‘used sensibly’ mean? Basically, it means following the current (2009) official UK guidelines – which are to take the lowest possible dose for the shortest period of time.

One particularly important use of a form of HRT is the application of hormone creams (or hormone-containing pessaries or rings) to the vagina to correct vaginal soreness and dryness. While ordinary sex lubricants – like K-Y Jelly, Liquid Silk and Pjur Woman – can be very helpful for making intercourse comfortable and satisfying, sometimes the prescription of a female hormone preparation is necessary.

So if your vagina and vulva have become a little dry or sore, it may well be worth asking your GP, Family Planning doctor or gynaecologist about the following preparations which are currently available:

• Estring vaginal ring.
• Ortho-Gynest cream or pessaries (estriol).
• Ovestin cream (estriol).
• Premarin vaginal cream (conjugated oestrogens).
• Vagifem (estradiol).

Please note that although these products are used for their ‘local’ (ie vaginal) effects, some of the hormone could be absorbed into your system. So there is a small possibility of side-effects elsewhere – notably in the womb.

Therefore, current (2009) advice is that these vaginal preparations shouldn’t be used for more than three months without having a check-up, and possibly a change in medication.

Note: My own (David Delvin) clinical experience is that these vaginal hormone products can sometimes improve urinary symptoms which occur round the menopause.

Making the most of the menopause

It is now known that women have much the same ability as men to enjoy sex. Indeed, many females are a good deal more highly-sexed than their partners!

Women also have the advantage of retaining their capacity to have several orgasms one after another until very late in life.

Young men are capable of frequent love-making, but as they get older they aren’t able to do it so often.

Ironically, some women discover a renewed or even redoubled libido after the menopause, and sometimes report that their husbands can no longer keep up with their sexual demands. In these cases, buying a sex aid – such as a vibrator – can be a good idea.

For many postmenopausal women, the fact that their husbands take longer to reach a climax becomes a bonus; it makes love-making far more enjoyable than when they were younger and everything seemed to be over in a matter of breathless seconds. This more prolonged love-making can provide time for both partners to explore new sensations and enjoy a variety of feelings.

Touching and intimacy

After the menopause, touching and intimacy can sometimes become more important than the physical pleasure of penetrative sex. This need to touch and be touched, physically and emotionally, is well worth nurturing. Such contact offers reassurance and comfort and the opportunity to show tenderness, companionship and love.