Practice these daily routines to help with managing depression

Sometimes, it’s easy to be harder on yourself than you’d ever allow or want yourself to be with someone else, especially when you’re dealing with depression. When you feel like this, picking some of the people in your life who you love, and who love you, and trying to talk to yourself the way you’d want someone to talk to those people if they were having a hard time can be a good frame for speaking generously to yourself. Like “fake it till you make it,” the way people speak to themselves inside their heads can have a huge impact of the way they think about themselves, and the way they feel, and can easily turn into feedback loops of bad feelings. Making a point to speak to yourself kindly can help to pull you out of the loop of speaking unkindly to yourself in a way that you internalize and feel worse because of.

Some suggestions for dealing with depression – or even most of them – can feel too simple to make much difference, or so often-repeated that it can feel like they can’t possibly make a difference. It’s true that no single one of these strategies may bring an end to depression, but finding the combination that works for you, in conjunction with the type of treatment that works best with your body chemistry and lifestyle, can make a big difference in helping you start to feel better.

Get it out there

Writing in a journal can offer an outlet for getting emotions out without opening them to any judgement, and can give you a way to keep track of your thoughts and notice any patterns in them. For example, do certain thought-patterns seem to go along with more severe depressive symptoms? That’s good information to have, and so is any strategy you might notices for steering your thoughts in other directions.

For endorphins’ sake

Getting into a regular exercise schedule is one of the most common pieces of advice when it comes to managing depression, and in turn, it’s one of the most dismissed pieces of advice. It’s true that exercise isn’t a magic bullet for depression, but getting outside and moving around on a regular basis has a whole host of benefits that can contribute to starting to feeling better. Between the sun, the change of scenery, the endorphins, and the fresh air, anything from a walk around the block to training for a marathon can be a healthy part of managing depression.

Treatment

Depression is a medical condition, but there’s a lot of stigma around it. Some may mistakenly characterize it as a personal problem, and to be resistant to seeking out treatment from professionals. If depression is negatively affecting your quality of life, seek help. Medication, psychotherapy, or some combination of the two, can have a huge positive impact on your life. Just like with these informal strategies, finding the treatment plan that works well for you can take some trial and error, and figuring out how to be patient with yourself and your medical team will be an important part of the process.

Setting up a pattern

Having a strong routine in your life  can help you demonstrate to yourself what you’re capable of, especially when you’re having an especially hard time. It can help to keep self-care tasks from slipping during difficult episodes, and when depression does become severe enough to interfere with routines, having those routines set up to begin as a control can show how much is changing.

General physical health

A lack of physical health doesn’t cause depression, but it can certainly contribute to it. Making sure to eat a balanced diet, get enough sleep (but notice if you find yourself sleeping more and more often), avoiding alcohol and street drugs can help keep you in your best shape possible to combat depression.

Reach out

Often, during periods of strong depression, spending time with people can be one of the early things that gets cut out. Isolating yourself can create a feedback loop of bad feelings, though, whereas spending time with someone, even if the sound of that feels exhausting, can be a way to get out of your own head a bit. Making a point to reach out to people who feel restful or helpful to you during this time, instead of the people who may ask more from your energy reserves, can help to make social experiences during periods of depression more meaningful and positive.

Fake it till you make it

Sometimes, especially during a spell of depression, putting on a can-do attitude – even if it’s not how you feel – is a great way to get through a difficult or challenging day, from a huge family gathering to coordinating with an electrician or landlord over an unexpected wiring problem in your house, to a normal day of work at a time when you just don’t think you can do it. One of the reasons faking it till you make it works is that putting on an attitude can help to infect you with some of the feelings you’re putting on, but that benefit also comes with a caution. It’s also key for you to know and understand how you’re really feeling. Denial about depression can mean putting off making the changes that can help you feel better.

Other things to consider

Depression can make even the simplest tasks feel more challenging, and managing changes to your life, routine, and comfort zone when you’re experiencing depression can feel like an especially dangerous game. Making changes can help you feel out the shifts in your routine that can better support your changes in mood, attitude, and mental health, though. Dealing with depression means that you may be able to benefit from a certain amount of extra support, but by making changes in your own life, some of that support can come directly from you.

Signs of depression and when to talk to a doctor about it

Most people experience majority of the symptoms of depression at some point in their lives, to one degree or another, and it can be hard to tell which moods and feelings are symptoms of disorders which require treatment. For this reason, many people who do have depression or other mood disorders are diagnosed many years after noticing symptoms, or are never diagnosed or treated at all.

Watch out for these symptoms and signs of depression

There are a wide range of symptoms of depression, and some of them are physical, which can make it easier for some people to figure out how and when to reach out and ask for help. Both physical and emotional symptoms may be signs of depression if they last for two weeks or longer. Physical symptoms of depression include:

• Changes in sleep, whether that’s sleeping more often than usual, or insomnia
• A loss of appetite, or increased craving for food, causing either over- or under-eating
• A loss of sex drive
• Tiredness or lack of energy
• Aches and pains or headaches with no obvious cause

The emotional effects of depression can vary widely, from a consistent level of negative feelings all the way to feeling suicidal or hopeless. Emotional symptoms of depression can include:

• Feelings of sadness, hopelessness or feeling on the edge of tears
• Anger, irritability, or frustration, especially anger or frustration that feels excessive to events
• A loss of interest or pleasure in favorite things or interests
• Slowed thoughts, speaking and movements
• Agitation, twitchiness or restlessness
• Feelings of guilt, inability to let go of past mistakes or blame
• Thoughts of death or suicide

Thoughts of suicide should be treated as a medical emergency and you should go to your local emergency room right away.

Depression can be caused and set off by different things at different times. Sometimes depression is triggered  more by life events and stressors. Other times, it’s more determined by brain chemistry, regardless of life and stressors. Often, it’s some combination of the two. In any case, when depression affects your life, reaching out to a healthcare provider  for treatment and support is one of the best ways to start to work towards recovery.

Talking to your provider

Depression is a serious condition, and not something that one snaps out of by force of will. The earlier treatment starts, the faster and more effectively one can begin to start feeling better.

Primary care providers tend to be the first line of defense against depression. Starting the conversation about your mental health with the healthcare provider you’re the most comfortable with is never a bad idea, but it’s also good to remember that most PCPs don’t specialize in mental health treatment, and mental health providers like psychiatrists can be fantastic resources as you start to figure out what your needs around treatment are.

Your health is important to your body’s ability to function and keep you going daily. Your heart, the center of your cardiovascular system, is crucial in maintaining your overall health. Unfortunately, in the United States, heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups. More than one in three women is living with some form of heart disease.

Taking preventive measures is essential to maintaining good heart function and another act of self-care from which we can all benefit. Below are steps towards preventive care to help support your heart health.

Stay informed and proactive in your healthcare

Preventive care can begin the next time you meet with your healthcare provider. Have a shared discussion about the factors that can contribute to your heart’s health.

• Monitor blood pressure, cholesterol levels, and diabetes screenings to catch any potential problems early.
• Early detection and management of elevated blood pressure, high cholesterol, and diabetes can prevent heart disease or its complications.
• Know your family history of heart disease and discuss it with your healthcare provider to personalize your prevention plan. 
• Follow your healthcare provider’s advice, including taking prescribed medications as directed to manage conditions affecting heart health.

Adopt a heart-healthy diet

Eating nourishes us, gives us energy and generally tastes delicious. Taking a heart-healthy approach to food can provide a better defense against cardiovascular issues.

• Eat plenty of fruits, vegetables, whole grains, and lean proteins to provide essential nutrients for heart health.
• Limit saturated fats, trans fats, cholesterol, sodium, and added sugars to reduce the risk of heart disease.
• Incorporate healthy fats from sources like fish, avocados, nuts, and olive oil, which can help improve blood cholesterol levels.

Maintain a healthy weight

• Balance calorie intake with physical activity to prevent obesity, a significant risk factor for heart disease.
• Be aware of your body mass index (BMI) and waist circumference as healthy weight and risk indicators.

Engage in regular physical activity

Anywhere from 10 to 20 minutes of activity and exercise daily can get your heart pumping and your body moving. And your heart will love it.

• Exercise helps control weight and reduces blood pressure, cholesterol levels, and the risk of type 2 diabetes, all of which are risk factors for heart disease.
• Aim for at least 150 minutes of moderate aerobic exercise or 75 minutes of vigorous exercise per week. 
• Add muscle-strengthening activities two or more days per week as recommended by health authorities to support your heart health.

Avoid smoking and limit alcohol consumption

Cigarette smoking and excessive drinking of alcoholic beverages can lead to many health issues, including certain heart diseases.

• Stopping cessation significantly reduces the risk of heart disease by improving heart function and blood circulation.
• Limit alcohol intake to moderate levels (up to one drink a day for women and up to two drinks a day for men) to avoid high blood pressure and other heart risks that arise due to excessive drinking.

Manage stress

Stress can affect your health in many ways, so look for ways to address and manage it. Managing stress can help reduce behaviors and factors that increase heart disease risk, like high blood pressure and cholesterol levels, physical inactivity, and overeating.

• Engage in stress-reducing activities such as meditation, deep breathing, and physical activity.
• Speak to your healthcare provider about managing your mental health as well as studies show that your mental health can also affect your heart’s function.

Sleep well

Sleep recharges your body, so working towards better sleep is another great way to support healthy heart function.

• Aim for 7-9 hours of quality sleep per night, as poor sleep can increase the risk of high blood pressure, obesity, and diabetes.
• Establish a regular sleep schedule and a relaxing bedtime routine to improve sleep quality.

Taking these preventive measures can significantly reduce the risk of developing heart disease. It’s about creating a balanced lifestyle that supports heart health and overall wellbeing. 

Reviewed by the Ovia Health Clinical Team

Read more

Connective Matters: About Your Heart

Sources

Center for Disease Control (CDC). Prevent Heart Disease. cdc.gov. March 21, 2023 https://www.cdc.gov/heartdisease/prevention.htm#:~:text=Eating%20foods%20high%20in%20fiber,prevent%20or%20help%20control%20diabetes.

American College of Obstetricians and Gynecologists (ACOG). Heart Health for Women. acog.org. https://www.acog.org/womens-health/faqs/heart-health-for-women#:~:text=Lack%20of%20physical%20activity%20can,of%20heart%20disease%20and%20stroke

The Mayo Clinic. “Strategies to prevent heart disease”. www.mayoclinic.org. https://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/heart-disease-prevention/art-20046502

Many studies have shown that physical activity is linked with lower breast cancer risk. The American Cancer Society recommends that adults get at least 150 to 300 minutes of moderate-intensity or 75 to 150 minutes of vigorous-intensity activity each week. A combination of these activities spread throughout the week would be ideal.

Avoid or limit alcohol

Alcohol increases risk of breast cancer. Even drinking small amounts of alcohol has been linked with an increase in risk. It is best not to drink alcohol at all. For women who do drink, they should have no more than 1 alcoholic drink a day. A drink is 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits (hard liquor).

Breastfeed if possible

Mothers who breastfed are less likely to get breast cancer. Mothers who breastfed for a lifetime total of more than two years get the most benefit.

Limit hormone therapy

Postmenopausal hormone therapy can increase the risk of breast cancer. If you must take hormones to manage menopausal symptoms, try to use the lowest dose that works for you and for the shortest time.

Know and explore your options

If breast cancer runs in your family, talk to your doctor about considering genetic counseling and testing. Testing will show if you have an inherited gene mutation that increases your risk of breast cancer. If genetic test results show you a gene mutation, you can consider drugs that can lower your risk or surgery.

Reviewed by the Ovia Health Clinical Team

When the pregnant person’s life is in danger

Some preexisting health conditions as well as some pregnancy complications can put your pregnancy health and safety at risk. Expert provider can help manage many of these conditions to allow a pregnancy to progress long enough that the baby is viable (able to survive outside of the womb). But some health conditions and pregnancy complications cannot be managed safely long enough to reach this point. Continuing the pregnancy in these cases would mean certain or high likelihood of death, loss of uterus, or other long-term medical complications — like stroke and other permanent disabilities for the parent. 

Recent federal legislation aims to secure abortion rights in all cases when a parent’s life is in danger, but it is in dispute in several states. Even a delay in care in these situations can have devastating short and long-term health impacts. 

Before we explain the conditions and complications you should be aware of, there are some steps you can take before you become pregnant to support your health. 

Understand the laws in your state

Abortion access varies depending on your state — and in many places your pregnancy trimester, your provider, and your age. In some states, if you’re a minor, you’ll need one or both of your parents’ consent. You can find a state by state breakdown here.

Schedule a preconception visit with your provider 

A pre-pregnancy checkup helps your healthcare provider make sure that your body is ready for pregnancy and often includes some health screenings. During this appointment, you can ask your provider any questions you have about your general and fertility health. 

Consider pre-pregnancy carrier screening

You may discuss this at your pre-pregnancy appointment. A carrier screen is a genetic test that can help you understand your risk of having a baby with a genetic disorder. And you can request it before you’re pregnant. Carrier screening is one of many tools to help you go into starting or growing your family with more information about your risks and options. 

Let’s review conditions and complications that can happen during pregnancy. If you experience one of these, then your state abortion laws could impact your care.

Ectopic pregnancy 

Ectopic pregnancies are early pregnancies that implant and grow in the wrong part of the body — outside of the uterus. The most common location of an ectopic pregnancy is in a fallopian tube, but can happen anywhere within the abdomen, including on the liver or bowel. 

Ectopic pregnancies can never result in a healthy pregnancy and lead to severe internal bleeding and death if left to grow. The only medical treatment available is abortion. The earlier these pregnancies are identified by ultrasound, and treated, the safer it is. If you live in a highly restrictive state, it’s important to know how your provider treats this type of situation. Will you have early ultrasounds? Will you have to travel if you need an abortion? Is there a local hospital that has experience navigating the legal difficulties of this situation? 

Severe hypertensive disorders 

Severe hypertensive disorders of pregnancy most commonly occur later in pregnancy. But, when they happen before viability (around 24 weeks), they are incredibly dangerous for parents. If the pregnancy is not ended, it can result in seizure, stroke, bleeding, and death. The only “cure” for these disorders is immediate delivery. There is no known long-term management option to safely allow the pregnancy to reach viability. Especially for parents with any history or high risk of hypertensive disorders, it’s important to discuss an emergency plan with your provider and any possible preventative steps.

Sepsis and bleeding 

Sepsis and bleeding are two other life threatening complications that can happen in early pregnancy where your body starts to miscarry or labor before about 24 weeks. In these situations, a pregnant person can experience their water breaking or heavy bleeding while their baby is still alive. The treatment for these conditions is delivery.

In states that don’t recognize the life of the parent as a valid reason for abortion, this can end in the death of the parent and the fetus. Even delaying care can increase the risk of serious infection (sepsis), need for blood transfusions and surgery, and death. Again, discussing your options with your provider early in pregnancy can help you feel at ease or make a necessary emergency plan.

When the fetus is at-risk or will not survive after birth

Finding out your baby has a complication or severe illness is one of the most devastating pieces of news to receive as a parent. Modern medicine has made enormous strides to treat certain conditions during pregnancy and work miracles for some people. However, there are chromosomal and genetic conditions that make it more likely for a fetus to die during the pregnancy or immediately after birth. There are also complex fetal differences that may survive birth, but not all parents feel they have the capacity to manage medically, emotionally, financially, or physically. Many people choose to end a pregnancy in these circumstances to reduce suffering for everyone and potential medical complications for the pregnant parent. 

The impact of abortion bans and restrictions

The abortion bans in many states do not have exceptions for these situations. These laws can be confusing and cause delays in care of the pregnant person. Knowing your state’s guidelines, and where you can travel to safely get the care you need is essential. In some states, specialized OBGYNs, called MFMs (Maternal Fetal Medicine specialists), will help identify and explain what is happening with your fetus, but they may be limited in discussing options. They may be able to refer you for a virtual appointment with an MFM out of state to have a more open discussion inclusive of more care options. Early genetic testing and counseling can leave more options open in states that only restrict abortion after a certain gestational age. 

If you find yourself in need of support or information after a devastating diagnosis here are some resources to explore: 

• Empty Arms
• Rare Disease information
• Neonatal donation
• Medical Ethics and Decision Making

Reviewed by the Ovia Health Clinical Team

Ovia’s goal is to support the health and wellness of our members throughout their reproductive health journeys. Ovia cannot, however, encourage or discourage the very personal decision of whether to have an abortion or counsel on whether and how an abortion may be performed in a particular case. Abortion may or may not be legal in your state and in your particular personal situation. None of the information made available through Ovia is intended to provide you with legal advice regarding abortion. Ovia may refer you to third-party websites or publications for additional information on reproductive health issues, including abortion. Ovia is not affiliated with these third parties and is not responsible for any information that they make available to you.

Here, we’ll break down the basics of male fertility and what to do if you and your male partner are having trouble getting pregnant.

What typically happens when sperm meets egg

A healthy male produces tiny reproductive cells called sperm, which are made in the testicles. When he ejaculates, the sperm mixes with fluid from the prostate, forming semen. During vaginal intercourse, ejaculation carries the semen into the vagina where it travels through the cervix and into the uterus and fallopian tubes. During ovulation, an egg is released from the woman’s ovary and, if fertilized by the sperm, a ball of cells (called the oocyte) is formed. Fertilization occurs in the fallopian tube and the embryo then implants inside the uterus. If the egg is not fertilized, it disintegrates and sheds during the next menstrual period.

When to see a doctor

It’s generally recommended to see a doctor for a fertility evaluation if you and your partner have been trying to conceive for at least a year with regular, unprotected sex with no success. Depending on your and your partner’s medical history, your doctor may decide to check one or both of you for a fertility workup. You may want to seek care sooner if the female partner is over 35 years old or if the male partner has certain medical conditions such as:

• Past surgery on the groin, testicle, scrotum, or penis
• A history of testicular or prostate problems
• Problems with erection or ejaculation, low sex drive, or other issues with sexual function
• Pain, lumps, or swelling in the testicular region

What to expect when seeking care

For men having trouble with infertility, a doctor may order tests to  measure the amount and quality of the sperm. This is called a sperm analysis. Your partner will provide a semen specimen at the doctor’s office and the doctor will look at the sperm under a microscope. There are 3 factors doctors look for in a sperm analysis. 

• Sperm count: This shows the amount of sperm produced in an ejaculation. A healthy number is 20 to 150 million sperm per milliliter of semen.
• Sperm motility: This test shows how well sperm are moving. At least 60% of sperm should have normal forward motion. Sperm that move erratically or not at all can affect the ability to conceive.
• Sperm morphology (size and structure): Normal sperm have an oval head with a long tail. Damage to any part of the sperm can affect fertility by decreasing the ability to reach and penetrate an egg. Many conditions affecting the shape of sperm are genetic.

Remember that infertility is no one’s fault. It can be difficult and frustrating to experience any kind of fertility troubles on your journey to getting pregnant. Communicating and empathizing with your partner can help make the journey to parenthood a little easier.

Reviewed by the Ovia Health Clinical Team

Sources

“How common is infertility?” National Institutes of Health. National Institutes of Health. February 8, 2018. https://www.nichd.nih.gov/health/topics/infertility/conditioninfo/common

Mayo Clinic Staff. “Male infertility.” Mayo Clinic. Mayo Clinic. August 13, 2021. https://www.mayoclinic.org/diseases-conditions/male-infertility/symptoms-causes/syc-20374773

“What is male infertility?” Urology Care Foundation. American Urological Association. n.d. https://www.urologyhealth.org/urology-a-z/m/male-infertility

Cedars-Sinai Staff. “Optimizing male fertility.” Cedars-Sinai. Cedars-Sinai Medical Center. May 31, 2017. https://www.cedars-sinai.org/blog/optimizing-male-fertility.html

Bradley D. Anawalt & Stephanie T. Page. “Patient education: Treatment of male infertility (beyond the basics).” UpToDate. UpToDate. November 11, 2020. https://www.uptodate.com/contents/treatment-of-male-infertility-beyond-the-basics

Ever wondered, “What’s the difference between an STI and STD”, “Is HIV the same as AIDS” or “What’s a finger condom”? Rather than taking the query to your search bar, keep reading.

What you should know about sexually transmitted infections (STIs)

Below, you’ll find definitions of all the terms in the sexually transmitted infection lexicon you could possibly need to know, broken down by categories.

First, what’s the difference between an STI and STD

STD: STD stands for sexually transmitted disease. Disease implies symptoms. So, sexually transmitted infections are only diseases when there are symptoms (for example: bumps, itching, or discharge) present.

STI: The now-preferred term in the sexual health space, STI stands for sexually transmitted infection. The switch from disease to infection took place to reduce stigma around these infections and to acknowledge the fact that the majority of these infections are asymptomatic.

All STIs are either curable or treatable

Curable: A curable STI is an STI that can be cleared up completely with the proper medication. Curable STIs include: gonorrhea, pubic lice, chlamydia, syphilis, and trichomoniasis.

Not only can curable STIs be cured, but they should be — leaving an STI untreated puts you at risk for things like pelvic inflammatory disease, infertility, and even death in the case of syphilis. That’s why it’s so important to get tested after every new sexual partner. And, if positive to talk to your provider and come up with a cure plan.

Treated: STIs that cannot be cured can be treated. Meaning, the symptoms associated with that STI can be managed with the help of lifestyle changes, and/or medication. Treatable STIs include: HIV, HSV, and HPV.

An example of treating — but not curing — an STI, might include taking valacyclovir or acyclovir, an oral antiviral medication that can either be taken daily (suppressive therapy) or at the first sign of outbreak (intermittent therapy). What makes most sense for you will depend on factors like cost and frequency of outbreaks. Because research has suggested a link between the number of outbreaks in HSV-positive people and stress, managing stress levels is another example.

Types of sexually transmitted infections, explained

AIDS: Also known as HIV Stage 3, AIDS (acquired immunodeficiency syndrome) develops when the HIV virus severely damages a person’s immune system.

In the U.S., most people who are HIV-positive never develop AIDS because they’re on medications that prevent the infection from progressing to AIDS. Due to lack of access, globally AIDS is much more common, but numbers are dropping.

Chlamydia: Caused by a bacteria, chlamydia is a curable STI that infects 4 million Americans each year, the majority of who are under 25 and women.

When symptoms appear, they usually include abnormal discharge, pain or frequent urination or bleeding after sex and/or between periods — but chlamydia is usually asymtomatic. The infections and accompanying symptoms can be cured up with proper antibiotics.

Crabs: Also known as pubic lice, crabs are itty-bitty parasites that feast on blood that are found on pubic hair (and other course body hair). Typically, crabs are transmitted during intimate contact between the pubes of a person with crabs and the pubes of someone else.

The most common symptoms of crabs is genital itching, but you may also be able to see the white-colored, micro-crabs crawling around between your legs. Crabs can be cured through special over-the-counter creams or shampoos. Important: Because crabs lay eggs (known as nits), after treatment then nits need to be removed with fingernails or comb.

Genital Warts: Genital warts are fleshy skin tags caused by a few strains of HPV (see “HPV” below). These contagious warts may be accompanied by itchiness, but can be treated with topical medication or by being removed by a healthcare provider.

Gonorrhea: Also caused by bacteria and also curable, gonorrhea is an infection responsible for half a million new STI cases in the United States each year.

Much like chlamydia, gonorrhea is hard to recognize due to its often asymptomatic nature. But, when symptoms do pop up they usually include: genital itching, bleeding, abdominal pain, abnormal genital discharge, and soreness and sore throat. To diagnose and get the medicine that will eliminate the infection from your body, go to your local walk-in clinic or healthcare provider.

HIV

Short for human immunodeficiency virus, HIV is a viral infection that attacks the body’s immune system making it hard for the body to fight any other infection, including common, everyday viruses. Wrongly known as a gay man’s virus, HIV is an STI that can affect all people.

Hepatitis A

A contagious viral liver infection caused by the Hepatitis A virus, Hepatitis A typically clears up on its own within a few months. Hepatitis A is not just sexually transmitted — it can also be transmitted through contaminated foods.

Hepatitis B

Hepatitis B is a contagious viral liver infection caused by the Hepatitis B virus that can be transmitted via exposure to the bodily fluids of an infection person. The difference between this form of Hepatitis, however, and the others is that Hepatitis B can be prevented with a vaccine.

Hepatitis C

Hepatitis C is a viral liver infection that can be spread through blood, breast milk, or pregnancy. Untreated, the infection can become life-threatening. But diagnosed and with proper treatment, the infection can be cured 90 percent of the time.

HPV

With more than 100 different strains, human papillomavirus (HPV) is the most common sexually transmitted infection in the world. Symptoms, long-term health risks, and treatment vary strain-by-strain.

HSV

Better-known by its full name, herpes, HSV is a lifelong viral infection caused by the herpes simplex virus that can be managed with proper care.

There are two distinct strains of the herpes infection: HSV-1 and HSV-2. Often, these are incorrectly re-named as “oral herpes” or “genital herpes” but both strains can affect areas like the vagina, anus, penis, or mouth.

Molloscum Contagiosum

Molloscum contagiosum is a viral infection spread through skin-to-skin contact, that causes benign bumps along infected areas. Sometimes the bumps will fade away on their own, other times they are removed through cryotherapy, laser therapy, or topical therapy with the help of  a healthcare professional.

Trichomoniasis

Often called “trich”, trichomoniasis is a sexually transmitted infection caused by a parasite that can be cured with a dose of antibiotics. Symptoms are trichomoniasis are rare — especially in people with penises. But when symptoms do appear, they often include discharge, genital itching, and pain while urinating.

Syphilis

Syphilis is a progressive bacterial infection spread through sexual contact. The symptoms of the infection vary based on how long it’s been in your system, and range from a skin sore to fatigue and fever to liver dysfunction. If caught early enough it can be cured with a single shot of penicillin, but left untreated for too long the infection can spread to the brain and other organs, becoming life threatening.

Barrier methods and birth control

Here’s some information on protection options people can apply to help stay safe during sex.

Barrier

Barrier is the general terms for a physical barrier that is designed to prevent direct skin-to-skin contact or fluid exchange during a sex act. Most common is the external condom. But there is also the internal condom, dental dam, glove, and finger condom.

Occasionally, certain birth control methods which do not prevent skin-to-skin contact or fluid exchange, but are highly effective at preventing a sperm from meeting an egg during vaginal intercourse — the sponge, cervical cap, diaphragm, and spermicide — are also qualified as a barrier.

Birth Control

Also known as contraception, birth control is designed to help prevent unwanted pregnancy. There’s a variety of different types of birth control options, which all function differently as well as feature  slightly different levels of effectiveness.

Condom

There are a few different types of condoms: finger condoms, internal condoms, and external condoms. But typically when people say “condom” they’re referring to the external variety. (See: “external condom” below).

Dental Dams

Dental dams are sheaths of latex designed to prevent direct contact between a mouth and an anus or vagina, and therefore reduce the risk of STI transmission.

External Condoms

External condoms are tight latex, polyurethane or polyisoprene tubes designed to go over a penis during vaginal, anal, or oral intercourse to protect against STI transmission and/or pregnancy. They are also often used on dildos and other pleasure products to increase ease during clean-up as well as to allow for sex-toy sharing between non-fluid-bonded partners.

Finger Cots

Sometimes called finger condoms, finger cots are micro-sized external condom designed to fit over a single digit. While most commonly worn by doctors sporting paper cuts, they can also be warn during vaginal or anal fingering to keep from or reduce the risk of STI transmission.

Fluid Bonded

Refers to sexual partners who have intentionally decided to forgo barriers and exchange bodily fluids during sex. Prior to becoming fluid-bonded, sexual partners typically discuss current STI status, potential risks, pregnancy prevention (if applicable), as well as relationship rules moving forward.

Internal Condoms

Formerly known as female condoms, internals condoms are soft, long tubes that are designed to line the vaginal or anal canal in order to prevent fluid exchange or skin-to-skin contact during vaginal or anal sex. Bonus: They are typically made out of nitrile as opposed to latex, making them a great alternative for those with latex allergies.

PEP

Post-exposure prophylaxis is a series of pills someone who was (or may have been!) exposed to HIV can begin taking up to 72 hours after exposure to prevent transmission of the virus.

PrEP

Pre-exposure prophylaxis, as the prefix suggests, is a daily oral medication that can be taken by an HIV-negative person at risk of coming into contact with the virus, in order to greatly reduce the risk of the virus being transmitted.

Reviewed by the Ovia Health Clinical Team

Sources

• “Chlamydia – CDC Fact Sheet (Detailed).” January 19, 2021. Centers for Disease Control and Prevention (CDC). CDC. January 19, 2021. https://www.cdc.gov/std/chlamydia/stdfact-chlamydia-detailed.htm.
• Cohen F, Kemeny ME, Kearney KA, Zegans LS, Neuhaus JM, Conant MA. Persistent Stress as a Predictor of Genital Herpes Recurrence. Arch Intern Med. 1999;159(20):2430–2436. doi:10.1001/archinte.159.20.2430. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/485171.
• “Sexually Transmitted Diseases.” National Institute of Allergy and Infectious Diseases. NIH. August 6, 2015. https://www.niaid.nih.gov/diseases-conditions/sexually-transmitted-diseases.

By Gabrielle Kassel, Contributing writer

PSA: Sexually transmitted infections are not the only infections that can make home in or on your genital area. Yeast infections, bacterial vaginosis, and urinary tract infections are all totally curable infections that can people can get, even if they’ve never ever had sex. Really!

Important things to consider about genital infections

Read on to learn more about the three types of infections — including intel on how they differ from sexually transmitted infections also found in genital areas.

What is a urinary tract infection?

A urinary tract infection takes place when bacteria (usually E. coli) gets lodged in the urethra, occasionally traveling up the urinary tract to the bladder and/or kidneys.

What causes UTIs, exactly? Anytime outsider bacteria gets introduced to the urethra, there’s risk for infection. This could happen in a number of ways, including through sex. A UTI could also be caused from bacteria from the anus being brought forward towards the urethra, for example while wiping or during sex.

While people of all genitals can get UTIs, urinary tract infections are far more common in those with vaginas than penises because the urethra is so much shorter. This means that the distance the bacteria has to travel in order to get to the bladder is shorter, increasing the odds that the infectious agent makes it to the infection-site.

Common symptoms include:

• Frequent urination
• Pain or discomfort while urinating
• Urine that is cloudy or pink in color
• Lower abdominal or pelvic pain or cramping
• Rectal pain

A UTI can be diagnosed with a quick urine sample — for more information on how to properly collect a urine same, head here. If tested-positive, your healthcare provider will prescribe a round of antibiotics which will begin to clear the infection up in as little as 24 to 72 hours. The type of antibiotics will vary based on the type of bacteria found in the sample, as well as the location (urethra, bladder, or kidneys) of the infection.

What is a yeast infection?

Also known as candidiasis, a yeast infection occurs when there is an overgrowth of the fungi “candida” in the body.

Anybody can get a yeast infection. But those with vaginas are far (far!) more likely to be infected — nearly 75% will have a yeast infection at least once in their lifetime. Less than 1% of those with pensises will get a yeast infection in their lifetime.

The health of the internal canal of the vagina is regulated by something called the vaginal microbiome which is made up of millions of bacteria, yeast, and fungi that work the vagina’s bodyguard and janitorial staff, keeping the it clean while also warding off infectious pathogens.

When the vaginal microbiome becomes disrupted — which can occur from a variety of things including antibiotic use, pregnancy, uncontrolled diabetes, sitting in wet or sweaty clothes, oral contraceptives, interaction with another person’s natural genital bacteria, or use fragrant body washes — the owner becomes susceptible to a yeast infection.

Common symptoms include:

• Cottage-cheese-textured discharge
• Itching and irritation on the vulva, penis, or taint, or inside vaginal canal
• Pain or burning while urinating or during sex
• Redness, swelling, or irritation

Yeast infections can be diagnosed with a pelvic exam or lab test. Usually, they can be cured with a one to seven day regimen of anti-fungal topical or oral medication. However, if left untreated long enough the infection can travel elsewhere in the body and require a more rigorous course of treatment to be eliminated.

What is bacterial vaginosis?

Bacterial vaginosis names the condition in which there is an overgrowth of certain bacteria in the vaginal microbiome. As the name suggests, BV is a condition that only affects those with vaginas.

Similar to yeast infections, anything that upsets the vaginal microbiome can result in BV. However, things like douching, having sex with someone new, using fragrant washes and detergents, and smoking can all increase the risk.

Common symptoms include:

• Fishy or foul smelling odor
• Thin or loose discharge
• Vaginal or vulvar itching
• Burning while peeing

Bacterial vaginosis can be diagnosed through a pelvic exam, vaginal secretion or vaginal pH test. To treat bacterial vaginosis, your healthcare provider may prescribe an oral or intravaginal cream that should clear up the infection within a few days.

How are these infections different from STIs?

The main difference is how the infections are classified. Yeast infections, bacterial vaginosis, and UTIs are not classified as STIs.

While sex can increase risk of yeast infection, bacterial vaginosis, and UTIs, they are not considered sexually transmitted infections because they are not infections transmitted from one person to another. All sexually transmitted infections are strictly transmitted from an STI-positive person, to someone who is not positive for that STI through direct skin-to-skin contact or through exchange of bodily fluid exchange.

Another difference is that all of the infections mentioned here are totally curable with adequate treatment. While some STIs are curable (gonorrhea, syphilis, chlamydia, trichomoniasis, and pubic lice), there are also some viral STIs that can be treated, but cannot be cured.

However, all genitals infections can be asymptomatic. Or, result in similar symptoms like itching, burning, or pain during sex or while urinating.

So…how do you know which of the genital infections you have?

Talk to your provider about your concerns and which genital (or other) infections you are worried about. Together you can come up with a plan for testing and treatment to get you feeling better as soon as possible.

Reviewed by the Ovia Health Clinical Team

Sources

• Mayo Clinic Staff. “Urinary Tract Infection (UTI).” Mayo Clinic. Mayo Clinic. October 14, 2020. https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/symptoms-causes/syc-20353447
• Mayo Clinic Staff. “Yeast infection (vaginal).” Mayo Clinic. Mayo Clinic. March 17, 2021. https://www.mayoclinic.org/diseases-conditions/yeast-infection/symptoms-causes/syc-20378999

Sex Ed. class 2.0

Here, we’ve rounded up five things you should have learned from sex ed. class before reading this article, but will be useful to you long after you close it.

1. It is normal and healthy to masturbate

Masturbation is not just expected by boys and men, but encouraged. Yet, common cultural narratives tell girls and women that masturbation is dirty and wrong.

Here’s the thing: Nothing could be further from the truth. For people of all genders, masturbating is both normal and healthy! Benefits of masturbating include: reduced stress, boosted mood, and increased self confidence long term. And beyond being healthy, masturbating also feels good, which is absolutely reason enough to partake!

In summary: You should have been taught that masturbation is healthy. Further, you should have been encouraged to touch yourself in whatever locations, using whatever pressures, at whatever speeds, for however long, and however often you want.

2. STIs can be transmitted during oral sex

Despite the fact that many sex education curriculums rely on fear-mongering, few programs acknowledge sex acts other than penis-in-vagina intercourse exist, and therefore do not touch on potential risks of such acts. Like, oral sex for example.

From fellatio and cunnilingus to analingus, oral sex can bring Big Time pleasure for the giver and receiver alike. Still, important to know the potential risks. Ready?

While the risk is lower than it is during vaginal or anal intercourse, an STI can be transmitted during oral sex from a mouth or throat, to a penis, vagina, vulva, or anus — and vice versa. That means that, yes, an STI can infect body parts other than the genitals.

When oral STI symptoms do appear, they may include: sore throat, pain during swallowing, sores around the lips, sores and blisters in the mouth, and swollen lymph nodes. But as is true with STIs located elsewhere in the body, the most common symptom of an oral STI is no symptom at all. And that’s why it’s so important to get tested for oral STIs, between (oral sex) partners or once a year (whichever comes first). Oral STI testing involves a simple mouth or throat, and treatment typically involves an oral antibiotic or prescription mouthwash.

What can you do to reduce risk of STI transmission during oral hanky-panky? Glad you asked. With a partner who’s STI status you don’t know or who has an STI , you can use an external condom or dental dam to reduce risk of transmission.

3. PReP can be taken by all genders

PReP (pre-exposure prophylaxis) is a daily oral medication that can be taken by HIV-negative people to greatly reduce their risks of contracting HIV, if exposed to the virus. Highly effective, PrEP is one of the best additions to the sexual health space…ever.

While there is more that can be done to spread awareness about PReP to all people, cis-women in particularly tend to be less likely to take PReP. The problem is that people of all sexual orientations, genders, and genitals are susceptible to HIV, if exposed to the virus through sex, intravenous drug use, contaminated blood transfusion, or pregnancy. In fact, globally more than half (52%) of HIV-positive people in the world are women.

No matter your gender, to figure out if you’re a good candidate for PrEP read the federal guidelines put out by the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) and/or talk to your healthcare provider.

4. Sex is not supposed to be painful

No, not the first time you have it. No, not during anal sex. No, not postpartum. Pain is the body’s way of telling you that something is wrong — and it’s a message worth listening to.

Sometimes pain during sex is a sign that you need additional lubrication or that your not-yet aroused-enough for what’s happening. In these instances, slowing down and adding lube can turn your sex session from “ouch” into “ooh!”.

When sex is consistently painful, however, or you experience these symptoms outside of sex (for example: while urinating or inserting a tampon) there may be an underlying condition. Pain during sex is a common symptom of conditions like hypertonic pelvic floor, endometriosis, vaginitis, vulvodynia, vaginismus, and pelvic inflammatory disease.

If you’re experiencing pain during sex, stop. If you want to continue having sex, try slowing down and/or add a store bought lubricant. If the pain becomes more chronic, bring it up with your healthcare provider or seek out the guidance of a trauma-informed pelvic floor specialist.

5. Consent is an informed, ongoing, and enthusiastic agreement to engage with someone that can be withdrawn at any time

As of 2020, only 9 states required consent be taught in sex education curriculum. That means that a whopping 41 states don’t teach students the importance of receiving “Y-E-S”, nor validated the decision to say “N-O” at any point during a sexual encounter.

The failure of this absence becomes obvious when looking at the responses from a recent survey of people ages 18 to 25. In it, 53% admitted that they didn’t realize that consent can be withdrawn once someone is already naked (it can!) and just 13% said they’d feel comfortable discussing consent with their sexual partner.

While the staggering sexual assault statistics cannot be blamed on any one thing — curriculums in sex ed. class suffer from widespread avoidance of consent, and it certainly isn’t doing anything to help reduce the number of people assaulted.

If you’re reading this and haven’t yet learned about consent, take the time to read The Consent Checklist by Meg-John Barker and/or Beyond Yes & No by Kai Werder.

Reviewed by the Ovia Health Clinical Team

Sources

• “Facts and figures: HIV and AIDS.” UN Women. UN Women. July 2018. https://www.unwomen.org/en/what-we-do/hiv-and-aids/facts-and-figures. 
• “Pre-exposure Prophylaxis (PrEP) Care System”. CDC. CDC. September 10, 2020. https://www.cdc.gov/hiv/effective-interventions/prevent/prep/index.html#About-PrEP. 

Here’s the latest from the Ovia Health Clinical Team, including answers to your questions and some practical guidance. 

If I’m pregnant and I get COVID-19, will the infection be worse?

It’s possible. Research indicates that pregnant people and recently pregnant people (within 42 days of giving birth) are at higher risk for significant complications from COVID-19 than their non-pregnant peers. This means that while the overall risk for severe illness is low, there is an increased risk of hospitalization, intubation and mechanical ventilation, blood clots, and requiring intensive care. There is also an increased risk of adverse pregnancy outcomes, including preterm birth and possibly an increased risk of pregnancy loss when compared to pregnant women who did not get COVID-19. 

These risks are compounded for Black pregnant people, who have long experienced nearly twice the risk of preterm birth when compared to white people. Many studies have demonstrated that race is likely an independent risk factor when it comes to healthcare outcomes like preterm birth, separate from other risk factors like income or education. That race-related risk may stem from chronic stresses of societal racism as well as the race-related inequalities that have been identified within the healthcare system. 

Pregnant parents who test positive for COVID-19 should be offered a discussion about the medication Paxlovid. You can read more about that here.

What can I do to prevent infection?

Prevention is no different for pregnant people than it is for anyone else. Follow the advice that you receive from your local health department, from the CDC, and from your healthcare provider. Avoid going to public places if you think or know you have COVID-19, to prevent spreading it to others. 

If you know local rates of Covid are high, wear masks when indoors and practice social distancing. Being vaccinated has been shown to provide protection against severe COVID-19 disease. However, you can still get sick and pass the illness on to vulnerable people who aren’t vaccinated or cannot be vaccinated (like newborns).

Is hand sanitizer safe in pregnancy?

Yes, Yes, YES. The CDC reports [3] that handwashing with soap and water is more effective than hand sanitizer. However, you can’t take the sink in your car or on a walk or to the grocery, so make sure you use hand sanitizer regularly in addition to handwashing. Furthermore, it’s often much easier to wipe hand sanitizer on your children’s hands than it is to get them properly washed, so consider this a regular habit as well.

If I get COVID-19, will I pass it to my fetus?

The most recent research on the topic says that transmitting COVID-19 while pregnant is very rare – for moms in North America, the rate was about 0.1%. This does not include the risk of passing it to your newborn during routine care postpartum. However, studies suggest that people who tested positive for COVID-19 during pregnancy are more likely to have complications, such as preterm birth [6]. There is no evidence that cesarean delivery reduces the risk of infection for Baby, so this is not recommended.

What about during and after birth?

It is extremely important that you call your healthcare provider before you go to the hospital if you think you have COVID-19. Once at the hospital, your provider knows what to do to reduce the risk that your baby (and the healthcare professionals who care for you) will become infected.

Keep in mind that testing positive for COVID-19 when in labor may cause changes to your birth plan and hospital stay. You may want to consider extra precautions in the last weeks of pregnancy to avoid this.

What is the risk to my baby? And what about the risk to my other children?

Children seem to be at less risk of becoming really sick with COVID-19 than adults are, but infants make up the bulk of serious cases and hospitalizations in children under 17. Current evidence suggests that babies are not likely to get COVID-19 from their mothers as long as preventative steps are taken, such as wearing a mask around your baby, washing your hands for 20 seconds prior to holding your baby, and having them sleep 6 feet away from you. You should still do everything you can to reduce the risk of exposure. Children with certain underlying conditions are at risk for complications from COVID-19, so it is important to keep them safe and communicate with their pediatrician.

Is breastfeeding safe if I think I have COVID-19?

There are many benefits to breastfeeding for parents and babies. It appears unlikely that COVID-19 can be transmitted through breast milk, though helpful antibodies can be passed along! 

If you test positive for COVID-19, this may impact the care of your newborn. In-hospital, the CDC recommends discussing with your provider the risks and benefits of caring for your newborn while sick. Mildly ill people generally room in and care for their newborns. If you are seriously ill, this may not feel like a physically possible or safe option. Once you are home, wash your hands frequently — and always before touching your baby. Wear a mask when you are within 6 feet of your baby or another person. If you have a caregiver who lives with you, they should also wear a mask whenever caring for your baby.

We know that with other illnesses, you pass antibodies to your baby through your breast milk. Antibodies are what your body makes to help fight off illness. The research into COVID antibodies in breastmilk is really encouraging and suggests that antibodies are passed through breast milk after infection or vaccination. 

What if I’m trying to conceive and not yet pregnant?

There’s no evidence that COVID-19 or any similar viruses impact conception or cause birth defects if you are sick when you conceive.

Should pregnant people get the COVID-19 vaccine?

Multiple well-respected clinical organizations, including the ACOG (the American College of Obstetricians and Gynecologists) and the ACNM (American College of Nurse-Midwives), recommend the vaccine to people who are trying to conceive, pregnant, and breastfeeding [11].

The first clinical trials for the COVID-19 vaccines manufactured by Pfizer-BioNTech, Moderna, and Novavax did not include participants who were known to be pregnant or breastfeeding. This is typical for pharmaceutical research. Recent studies have included pregnant people and show that there is no increased risk and that vaccines given in any trimester do not negatively impact pregnancy outcomes. In addition, vaccinating in the second or third trimester may offer additional protection to your newborn.

Additionally, none of these COVID-19 vaccines contain a “live” virus. This means you cannot get COVID-19 from the vaccines. In general, vaccines that do not contain “live” viruses are safe during pregnancy and do not have increased risks for infertility, miscarriage, fetal anomalies, or stillbirth. Side effects of the COVID-19 vaccines include pain at the site of injection, fever, fatigue, and chills. These typically go away after a couple of days. These side effects are normal and expected and are indicators of your immune system doing its job to learn to protect you from the virus. There have been very rare reports of unexpected, adverse reactions from the vaccines. A severe allergic reaction called anaphylaxis can happen in very rare cases. The incidences of these adverse events are so low that getting vaccinated remains safer than potentially getting infected with COVID-19. [12].

You can also reach out to the experts at Mother to Baby for more information. Your midwife, doctor, or other healthcare professional is also a great resource for more information about the COVID-19 vaccine. Ultimately, you are the one who knows what is best for your body and your family.

Reviewed by the Ovia Health Clinical Team

Sources:

Dara D. Mendez, Vijaya K. Hogan & Jennifer F. Culhane “Institutional racism, neighborhood factors, stress, and preterm birth”. Ethnicity & Health. 19:5, 479-499. October 18, 2013.

Jasmine D. Johnson et al., “Racial Disparities in Prematurity Persist Among Women of High Socioeconomic Status,” American Journal of Obstetrics & Gynecology 2. 2(3), 100104. Nov 10, 2020

James W. Collins Jr et al., “Very Low Birthweight in African American Infants: The Role of Maternal Exposure to Interpersonal Racial Discrimination,” American Journal of Public Health. 94(12), 2132–2138. December 2004.

Braveman Paula, et al. “Explaining the Black-White Disparity in Preterm Birth: A Consensus Statement From a Multi-Disciplinary Scientific Work Group Convened by the March of Dimes” Frontiers in Reproductive Health. Vol. 3. 684207 September 2, 2021.