3 Things You Probably Didn’t Know About Ectopic Pregnancies, Like Mine

A little over a month ago I had emergency surgery to treat an ectopic pregnancy. 

It was scary and painful and unexpected and I am still recovering physically and emotionally. I am lucky to live somewhere where, when the doctors realized it was not a simple case of appendicitis and I was already open on the operating table, they did not hesitate to perform the surgery that saved my life. My abdomen was already full of blood, and my fallopian tube on that side—which had to be surgically removed—was ruptured due to the expanding embryo. I was about five and a half weeks pregnant at the time (I know specifically, down to the day, since I’m an IVF patient). If it had been possible to preserve the pregnancy somehow, I would have done it happily, but science hasn’t found that path yet. 

Some questions I ask myself: Was it an abortion, since an implanted, fertilized embryo was removed from my body? Was it a miscarriage, since it could never have grown to term, no matter what anyone did? Does it matter? To me, it doesn’t, since the outcome would always be the same, and I have absolutely no issue referring to it as an abortion. An ectopic pregnancy is never viable, and I was already bleeding internally when I went into surgery. To the rest of the world in a post-Roe v. Wade society, that seems to be a very important question. Whatever you want to call the operation that was performed on me, it saved my life. I just wanted to take a minute to remind people of that, especially the Supreme Court and certain Oklahoma senators who ask why exceptions to trigger law abortion bans have to include treatment for ectopic pregnancies. (Because they lead to death. That’s why. Without care, you die.)

I was genuinely surprised by the way my ectopic pregnancy unfolded, and by the things I found out after—from how common they really are, to signs that you should go to the hospital.

It’s Not As Rare As You Think

According to the American Pregnancy Association, the rate of ectopic pregnancies is 1 in 50, or roughly 1 to 2%. To me, that doesn’t sound that rare at all, even though it is still classified as a rare diagnosis. I felt this on a physical level when I came into the emergency room and it still took over 12 hours to get me into surgery, and even then it was for what was assumed to be appendicitis, not an ectopic pregnancy. There is a genuine misconception that it’s such an uncommon diagnosis that it probably isn’t happening to you. 

Here’s another kicker: it’s slightly more common in IVF patients, so I was already at a higher risk. There are other risk factors I didn’t have, but even having one seems like enough of a reason to consider it more seriously early on. I think a part of me was also a bit in denial, and I kept hoping the doctor would tell me I could go home. It’s a good thing I didn’t.

It’s The Leading Cause Of Maternal Death In the First Trimester

If an embryo implants anywhere but the uterus, it isn’t a viable pregnancy and requires medical treatment. In cases like mine where the ectopic pregnancy is in the fallopian tube and the tube has ruptured, surgery is necessary. I don’t need my fallopian tubes as much now that I’ve moved from IUI (intrauterine insemination) to IVF (in vitro fertilization), because the embryo will be implanted directly by a doctor as opposed to a fertilized egg traveling down my tubes. That’s my silver lining: one less tube, one less potential problem! 

Ectopic pregnancies can be diagnosed at different stages, and not all need emergency surgery like mine, but they are the leading cause of maternal death in the first trimester. That’s a scary statistic. They do happen, and when they do, they’re dangerous—even if they are caught early on and can be treated without surgery.

Getting A Diagnosis Can Be Confusing

I wasn’t bleeding, as far as I could tell. I wouldn’t find out about the internal bleeding until later.  My stomach felt distended and uncomfortable, but bloating is common in early pregnancy. I’ve always had digestive issues, so the G.I. symptoms and pressure weren’t all that uncommon, either. I think the real moment when I should have started feeling more alarmed was when I had intense pain and extreme pressure in my lower abdomen on one side. 

I remember a moment where I was on my hands and knees on the bathroom floor. When I stood up, my legs shook uncontrollably and I had to try not to pass out. I went to the emergency room shortly after that; it was probably in those minutes that my tube ruptured fully. For the next 12 hours or so, some of the sharpest pain subsided, but there was a consistent throbbing, sick feeling in my stomach. It still took hours and hours to diagnose. So my advice would be to seek help immediately if you have pain like mine, and to ask the doctor early on if an ectopic pregnancy could be possible. I assumed that because I’d told the treating doctor in the emergency room that I was pregnant, they’d take the possibility into account, but sometimes (always, as someone with a uterus seeking care) you do have to push harder. Don’t dismiss it, or wait to see if it gets better, and ask to talk to the ob-gyn on call if you can’t see your own. The sooner treatment can be given, the better.

When I woke up from what I thought was an emergency appendectomy to a doctor telling me I’d actually been treated for an ectopic pregnancy, I was devastated. But I also knew that I was alive, that my fertility treatment didn’t depend on my fallopian tubes, and that I could probably try IVF again. In all the time spent trying to get pregnant, an ectopic pregnancy wasn’t an outcome I expected—and I thought I was prepared for all the worst possibilities: failed embryo transfers, miscarriages, complications, the works. But this one I didn’t see coming.

It’s important to realize ectopic pregnancy happens more than you’d think, and when it does, it can be life-threatening. I’m lucky to be healing well from that day. Every day I feel stronger. It’s a weird sensation, to feel lucky after having gone through what I did, but I received the care I needed in time. That’s a miracle in itself in this country right now.

Images: Sergey Filimonov /Stocksy.com

I Had A Late-Term Abortion And I Have No Regrets

The day I decided to end my unborn child’s life at 27 weeks pregnant is forever burned in my memory. Subsequent to a week of fetal ultrasounds, MRIs, and amniocentesis, my husband and I sat in our OB’s office while I anxiously tapped my fingernails awaiting the results as to what could be the problem with our baby boy, considering every checkup up to this point had been blissfully uneventful.

As it turns out, he had severe brain abnormalities. The hemispheres of his brain had not properly formed together and a significant part of his frontal lobe was missing. He would undoubtedly face severe cognitive issues and it was fairly certain that he would never be able to speak, walk, or even breathe without medical intervention.

We were faced with the unimaginable decision of moving forward or ending the pregnancy. A decision that felt like a proverbial fork dividing the path of our entire existence.

Would I be able to submit myself to a life of such uncertainty? A life where I would have to constantly worry about who would take care of my child in my demise, a life where I could possibly not afford the health care necessary to care for a person with severe physical and mental disabilities? Would we be able to afford a house that’s wheelchair accessible? Would my marriage crumble under the stress? Would we be able to have more children given the fact that so much of our time and resources would probably be going to the needs of our firstborn?

Many people would say these concerns are all completely selfish, and they would be correct, but what felt even more selfish was bringing this child into this world when I knew he didn’t have a fair shot at a good life and to watch him suffer so I didn’t have to feel guilty about having an abortion.

Our decision was made.

Shortly after we ended the pregnancy, word seemed to travel fast and we were inundated with messages of (mostly) support from friends and family.

As we were trying hard to make peace with our decision, I received several texts and emails from various people in my life sending me pictures and videos of beautiful disabled children with big smiles on their faces, posing with their happy families, clearly trying to “debunk” my apparent “beliefs” that children with physical or mental disabilities were incapable of living happy, fulfilled lives.

Messages such as these, as well as politicians haphazardly slinging terms like “baby killer” around, sent me downward spiraling into a rabbit hole of depression which took months of therapy to crawl out of.

I am still working on breaking the stigma of having a late-term abortion, and the more open I am about my story, the easier it gets. Because that’s exactly what it is—my story. And while I have the utmost respect and admiration for anyone raising a child with significant disabilities, it simply wasn’t what I wanted for my life or the life of my unborn child.

In the wake of the assault on women’s rights in this country, I feel absolutely terrible for women who don’t or might not have the right to decide for themselves what is best for them, their family, or their unborn child as I did. People are so quick to judge as to what they would or wouldn’t do when faced with a life-altering decision such as having an abortion at any stage, and it’s one I hope you never have to face.

I made my decision, and I have no regrets.

Image: Gayatri Malhotra  / Unsplash

Ohio’s Latest Abortion Bill Would Create A New Crime: ‘Abortion Murder’

It is with deep regret that I must inform you that the term “abortion murder” is a thing.

The term reads like an attempt to psychically coax people into believing the first word is synonymous to the second one by simply lumping them together, like “rape consent” or “Nickleback good.” And that’s because that’s exactly what it is. But it’s also very serious, because it is being used in an official bill that has been drafted by Ohioan legislators. *Le sigh*

Ohio House Bill 413 is 723 pages long (dramatic much?), sponsored by Ohio State Rep. Candice Keller, and would add several new felonies to the state’s criminal code: “abortion murder” and “aggravated abortion murder.” The law would allow the state to punish doctors who perform abortions — and people who get them — to 15 years to life in prison. Not abortions before six weeks — not abortions in the case of rape or incest — but any abortion whatsoever.

Unlike previous extreme abortion bans, the Ohio bill does not include exceptions for rape or incest, with very narrow exemptions when it’s “highly probable that the pregnant woman will die from a certain fatal condition” should she carry on with the pregnancy.

It also includes provisions that suggest doctors should attempt to re-implant an ectopic pregnancy in a patient’s uterus. An ectopic pregnancy is when an egg is fertilized somewhere outside of the uterus, usually in the fallopian tubes, and has to be terminated in order to prevent complications or even death of the pregnant person. Re-implanting an ectopic pregnancy into a person’s uterus is a procedure that literally does not exist, but go off, Ohio.

But wait, there’s more! The bill also refers to a crime called “aggravated abortion murder,” which is when someone performs an abortion while committing or attempting to commit kidnapping, rape, aggravated arson, arson, aggravated robbery, robbery, aggravated burglary, burglary,or other crimes. K, what criminal mastermind is out here performing abortions while robbing a bank? Asking for a friend.

The bill has yet to be passed or even voted on, but much like my ex at my family’s holiday party, the mere introduction of it is troubling.

House Minority Leader Emilia Sykes called the bill “the most brazen and absurd attempt yet to deny Ohio women their fundamental freedoms, to interfere with the patient-doctor relationship and disproportionately target communities of color across Ohio.”

Even if it is not passed, the bill seems to be the beginning of a movement that wants to give fetuses the same legal rights as pregnant people, and in many cases even put fetuses’ lives above pregnant people’s. Even just creating a bill that proposed re-implanting ectopic pregnancies is dangerous, because now people will likely hear this language and continue to push for the practice of it, even though it’s not medically possible. Like, even pro-life medical professionals have said that it isn’t possible.

Ingrid Skop, chair of the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG), told Vox:  “To my knowledge we are nowhere near having the technology to do that.”

So WTF is this idea doing in a bill, then? Most likely trying to get people behind the idea, so they will push for it becoming a reality. But doing so could put pregnant people’s lives at risk, as the need to terminate their fetuses won’t be at the forefront, and hesitating to do so can be fatal. In short, pregnant people — cis women, trans men, and non-binary people — might find that their lives are not protected by the law, but their unborn fetuses’ are.

Feeling absolutely terrified? Great, let’s keep going!

Ohio has been a pioneer in strict, arguably inhumane, abortion laws in the past. They were the first to introduce a “heartbeat bill” which bans pregnancy after six weeks, back in 2011. It didn’t pass then, but did earlier this year, not just in Ohio, but in other states like Iowa, Georgia, and Alabama.

Important reminder: abortion is currently legal in all 50 states.

These bills have since been blocked by courts, but we can see the pattern of progression here. When the heartbeat bill was first introduced in Ohio in 2011, it was regarded as too extreme by most. Now, it’s clearly gaining popularity and traction, as various states attempt to pass it into law. The same could happen with this “abortion murder” bill. It’s like when you plant the idea of a present you want your partner to buy you by bringing it up over and over again, except in this case it’s bringing up “abortion murder” and the result is the jailing and death of women (and trans men and non-binary people).

This all seems to be part of a big push to chip away at abortion laws until they are illegal entirely, short of a Supreme Court decision removing the right to end a pregnancy. This term, SCOTUS will hear a Louisiana abortion case that could change how states are allowed to regulate the procedure.

Bills like Ohio’s are scary, but it’s important to remember that we have the power to elect lawmakers who are pro-choice. (Our friends at EMILY’s list, in particular, focus on grading and supporting women candidates who are prochoice.)

Aggressive reminder to do your homework and find out who you can vote for who will fight to keep abortion safe and legal. Bodily autonomy should be a human right given to all, because deciding what you want to do with your body should be your choice and your choice only. And yet we keep finding ways to criminalize people — mainly women and minorities — for attempting to obtain the legal right to do with their body as they choose, so here we are. Keep fighting the good fight, my queens.

Want to keep up with the news without crying into your sad desk salad? Subscribe to the Betches Sup newsletter for a lunchtime briefing to make you laugh, instead of cry, about the news. 

Images: Giphy (3)

Across The Country, Tampons Are Taxed As A Luxury. Here’s How To Fix It.

October 19th is National Period Day, which aims to bring awareness to the issue of period poverty (meaning, lack of access to hygiene products because of financial constraints) and make period products more affordable for people who menstruate everywhere. One main way we’re trying to do that is by ending the Tampon Tax—a sales tax placed on hygiene products like pads and tampons, that other items, like Viagra, do not have. We tapped Nadya Okamoto, the founder of PERIOD, to tell her story on how she found out about period poverty, why she’s so passionate to end it, and what we can all do to help.

It’s 2019. People have been menstruating since the beginning of humankind. Periods make human life possible. And yet, still today, 34 states have a sales tax on period products, basically considering them luxury items. WTF?

When I was 16-years-old, I discovered an unaddressed natural need I’d never thought about before: periods. At the time, my own family was living without a home of our own, and I was facing a two-hour commute to school on public transportation. I became friendly with homeless women who I saw at my bus stop every day. In asking them, “what do you find most challenging about your living situation?” I collected an accidental anthology of women using toilet paper, socks, brown paper grocery bags, and even cardboard to take care of their periods. I distinctly remember one woman showing me how she would take a small piece of cardboard, rip off the outer layer from each side, and then rub the middle section in between her hands to make it a more flexible homemade version of a pad. 

Privilege check: Even when my family was experiencing housing instability, I always had access to menstrual products, and had never even thought about using trash to take care of my period. In fact, I had never even thought about what it would be like to menstruate without access to period products. Hearing these first-hand stories of period poverty ignited anger and curiosity within me. I kept thinking: How is it that menstruation makes human life possible and we haven’t figured out a solution for all people to have period products?! While simultaneously wondering, how far does the issue go? Who else can’t afford access to period products? 

So naturally, I took my questions to Google. In my free time, I would search keywords about menstruation, poverty, and different geographical regions, just trying to learn more.

Through my research, I learned that periods are the number one reason why girls miss school in developing countries, and often times a girl’s first period is the single event that leads to her dropping out of school, getting married early, or undergoing female genital mutilation or social isolation. It was actually easier to find information about period poverty in other countries than it was about the United States. I learned that at the time, in 2014, 40 states in the US had a sales tax on period products, considering them “non-essential goods”—so, basically luxury items. 

Meanwhile, products like Rogaine and Viagra were considered essential and didn’t have this tax. I remember reading this and refreshing the page a few times to make sure I was reading it correctly before thinking: Are you f*cking kidding me?! Old man hair growth and erections are considered more of a necessity than over half of our population feeling clean, confident, and capable 100 percent of the time, regardless of something so natural like a period? What?! 

These exact thoughts and emotions have not left my mind since I discovered the “tampon tax,” the term used to describe the taxation of menstrual hygiene products. 

Since 2014, when I started my activism in the #MenstrualMovement, we’ve seen incredible progress: countries like India and Australia have nationally axed their tampon tax, the UK has repurposed the revenue from their version of the tax to directly provide period products to girls in secondary schools, and the US is down to 34 states (still an overwhelming majority) that still have the tampon tax. 

Eliminating the tampon tax is not going to be a blanket solution to period poverty—I mean, realistically, the tax is not impacting the menstruators who have the least access to tampons. It’s affecting the people who are already purchasing the product, making the cost a burden for primarily low-income consumers. That being said, the reason period poverty persists is because menstrual hygiene is not treated like a right, it’s treated as a privilege.

Here’s an example: Just earlier this year, a GOP Representative in Maine voted against a bill to make period products accessible in prisons, saying that “the jail system and the correctional system was never meant to be a country club.” As if we can opt out of periods like they’re a Netflix subscription.

The #tampontax frames menstrual hygiene as a LUXURY—an inaccurate assumption we need to deconstruct once in for all in the movement against period poverty. At the end of the day, this fight isn’t just about periods, this is about the fundamental human right to be able to discover and reach one’s full potential regardless of a natural need. And what could be more natural than menstruation? 

Join us this Saturday for the first-ever National Period Day. On October 19, my organization PERIOD will be mobilizing rallies in all 50 states and major cities, demanding action and an end to the #tampontax. Join us at one of our rallies in-person, or share why you’re joining the #menstrualmovement on social media by using #nationalperiodday and tagging @periodmovement. There are so many ways to get involved both nationally and statewide—check out Utah’s legislative campaign and help us keep putting pressure on Ohio lawmakers to end their “pink tax”! I truly believe that if we unite and we refuse to shut up about periods, we can take down the tampon tax in the new few years. Just 34 more states to go. 

Let’s do this.

Image: Noah Shaub

The Top Mistakes Women Make When It Comes To Their Sexual Health

Hello, female brethren. Is there a female word for brethren? Okay, I Googled it, and it’s sistren, which is super weird because I have never heard this word in my life, and even spell-check is telling me it’s wrong, but IT IS NOT. Also, spell-check does not flag brethren, so yeah, that means spell-check is sexist. Do better, world.

Anyway. This conversation we’re about to have is going to be super icky and also NECESSARY, because it’s about sexual health. I literally had a conversation this evening (wine may or may not have been involved) with a friend who was not using protection with a man she barely knows because she assumed they were exclusive. Okay, first of all, NO. Assuming you are the only hole a guy is putting it in without verbal confirmation and possibly a legal contract is incorrect. Just ask Jeff Bezos. Which leads me to believe that the beautiful, smart, successful millennial women I know and love, are not aware of the importance of sexual health. So let me enlighten you. A study performed by Zava, a leading online doctor that operates in the UK, France, Germany, Switzerland, and Austria, revealed what women are getting wrong about sexual health, and even though the survey did not poll American women, the findings are nonetheless kind of scary.

But before we get into the scary sh*t, some good news: Zava found that millennials are the most in control of their sexual health, with 29% saying they have at least one STI checkup per year, and 36% of women from 25-24 saying they pay a lot of attention to their discharge. Apparently that 29% statistic is much higher than that of other age groups, which, like, guys?? That’s not good. I get that the older you are, the more likely you are to be in a committed relationship or marriage, but still! If reading Reddit relationship advice forums nonstop has taught me anything, it’s that cheaters gonna cheat. So now let’s get into the more concerning statistics Zava found.

Not Being Tested

According to Zava, 2/5 women across the UK have never had an STI check. Did you guys have that little chart in your college medical office with the people matching? Do you know the one I’m talking about? It shows how many people you’ve basically had sex with in terms of sharing germs—like, one person has sex with one person, they share germs with one person. But one person starts having sex with someone that had sex with two other people, and now it’s like person one had sex with those people, too. And it multiplies. I’m not slut-shaming here (you do you, Samantha Jones), but for the love of God, use protection. STI rates in the U.S. reached an all-time high in 2018, so clearly this is not just a problem in jolly old England. No matter where you are, be responsible, use protection, and get tested.

Assuming “Exclusivity”

LOL @ this in general. You should never just assume you’re exclusive. And if RHONY has taught me anything, it’s that even when you’re married, maybe you should just be aware, too. You’ve got to protect yourself, and unless you trust the person you’re dating, you’ve had the dreaded “what are we talk”, and you both show clean STI tests, you should definitely be using protection every time and getting tested on the reg. And even after you’ve done those things, still get tested, because it’s literally one extra form to sign off on at your yearly exam anyway. You can never be too careful, and although I’m all for love/trust/etc., you need to protect yourself. Not to bum you out, but PyschCentral says over an entire relationship there’s a 25% chance someone will cheat. Don’t be caught off-guard and risk your health. Also? A friend of mine once told me a story that I think is hilarious/sad/men for you. She was dating a guy, she thought exclusively, and could see him every day except Sunday. She was like, “of course we’re exclusive, he spends almost every day with me.” The mofo had a Sunday girlfriend that he only saw/slept with on Sundays. Protect yourselves, ladies.

Not Paying Attention

This is about to be super gross, but it’s also necessary and I’m only telling you this because I love you. A sad but real truth is that most women do not know wtf is going on in their vaginas. I don’t know where you went to school, how good your sex ed was, or what you think is normal. But according to Zava, only 16% of UK women actually follow medical advice and have a checkup once a year, and 62% don’t pay attention to what is going on down there.  Ladies, you’ve got to educate yourselves and make sure you know the signs of an infection, in addition to getting regular checkups and testing. Without treatment, you could have serious health effects, including becoming infertile, or God forbid you have an STI and don’t treat it that causes you to become infertile. Just be aware. This infograph from Zava is super helpful, especially if you grew up in an area of the country with terrible sex ed (so like, many areas).

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Thinking You’d “Know”

Have I traumatized you yet? No? Let’s go ahead and make it worse. Only 19% of women were able to recognize the symptoms of thrush correctly. I don’t even know wtf thrush is, so I looked it up, and it’s what the Brits call a yeast infection. The scary part is that women assume that they know the symptoms of disease or infection, when the truth is they do not! Also, there are some types of infection where 70% of women don’t even show symptoms at all! So how would you know? Especially when Zava states that 61% of women had little to no education on sex health whatsoever. Are you sure you’d know? Are you willing to risk it? Listen, no offense, but unless you’re a f*cking doctor, maybe leave it to the professionals. Get tested, get regular checkups, use protection, and know for sure. Part of being in charge of your sexuality is taking responsibility for your sexual health. Go ahead, be Samantha Jones. Just be smart about it.

Even though education systems and the world in general are like, biased and sexist, we as women have to take charge and be knowledgeable about our reproductive health. One more time for the people in back: if you’re sexually active, make sure you are getting tested regularly, and be sure you are checking in on your discharge and go to the doctor if something doesn’t feel/smell/look right.

Images: Yuliya Kosolapova / Unsplash; Giphy (2); Zava

What Your Pelvic Floor Is & Why You Should Care About It

So, you’ve heard about the pelvic floor before: you tried kegels a few times but weren’t sure if you were doing them right… you heard how giving birth can damage your pelvic floor muscles and afterwards you might pee when you sneeze… your friend has maybe told you about their jade egg… or you might’ve read about other kegel toys on O.school. But, when you get down to it, what’s the deal with the pelvic floor?

Well, this group of muscles may just be the unsung hero of your body. The pelvic floor plays a critical role in bladder control, bowel function, childbirth, orgasms, ejaculation, erections, and more, so having a healthy pelvic floor is a pretty big deal for your health and your sex life. When the pelvic floor is healthy, these processes go smoothly, but when the pelvic floor is not healthy, there can be issues.

What Is Your Pelvic Floor?

The pelvic floor is a group of muscles in the pelvis that sits like a sling between the pubic bone at the front of the pelvis and the tailbone at the back. The muscles support the organs inside the pelvis, including the bladder and bowel, as well as the uterus (for people who have one).

In case you need to know for a trivia quiz in future: levator ani, ischiocavernosus, bulbospongiosus, and coccygeus are the names of the muscles that comprise the pelvic floor. They sit at the base of the pelvis under all the pelvic organs, and wrap around the urethra, anus, and vagina, controlling the opening and closing of these passages.

Everyone has a pelvic floor—regardless of gender, age, body type, or any other kind of difference. So, pelvic floor health is not just about vaginas. We can all benefit from maintaining a healthy pelvic floor.

What Does Your Pelvic Floor Do?

Firstly, the pelvic floor keeps your organs inside your body, so gravity doesn’t let them fall out when you’re standing upright and walking around. Yikes. Ok, it’s not a very sexy thing to think about, but it is kind of an important job.

Secondly, the pelvic floor muscles squeeze closed and relax open to allow the passage of waste (both kinds) and, when relevant, babies. Being able to squeeze and relax the muscles is also essential for arousal, orgasm, erections, ejaculation, and pain-free sex.

Why Should You Care About Your Pelvic Floor?

Did you not read when I said “pain-free sex”? But for real, having a healthy pelvic floor is important because it controls so many important bodily functions. Peeing when you want to, and not when you don’t? Thank your pelvic floor. Same with poop control—thanks, pelvic floor! Being able to achieve orgasm? You can thank your pelvic floor for that too. Having sex without pain? Yup, I mentioned that one already. See what I mean about it being the unsung hero?

On the other hand, if you’re having any of these problems, an overly weak or overly tight pelvic floor might be the culprit:

How To Care For Your Pelvic Floor

Let’s get one thing straight first, being “tight” down there is not actually a good thing. Sure, you want those muscles to be strong, and to be able to clench when you want them to, but you also need to be able to relax them too. An overly tight pelvic floor can cause as many problems as a weak one.

The right balance of strength exercises, like Kegels, and relaxing exercises, like stretching, keep the pelvic floor in tip-top shape. According to pelvic floor physical therapist Dr. Uchenna Ossai, “If you don’t strengthen your pelvic floor, if you don’t work on relaxing your pelvic floor, if you don’t work on lengthening your pelvic floor, it’s not going to be functioning the way you need it to”. So how do you exercise your pelvic floor? Here’s how.

How To Do Kegel Exercises

Doing Kegels is basically like going to the gym, but for your pelvic floor. And on the bright side, it takes way less effort than the gym, and you probably won’t break a sweat doing it. But before you dive into Kegels, it’s important to know that they’re not suitable for everyone. If you have a healthy or weak pelvic floor, then go for it. On the other hand, if you have an overly tight pelvic floor, Kegels can make things worse. Seeing a pelvic floor physical therapist will help you work out the state of your pelvic floor and which exercises are best for you. Below is a step-by-step guide to Kegels for people with vaginas.

Step 1: Isolate The Correct Muscles

You’ll want to be in a neutral spine position, that means you aren’t too arched and you’re not too flexed. Find somewhere in the middle where everything feels natural and comfortable. You can isolate different parts of your pelvic floor by focusing only on the anus, vagina, and urethra! But for general purposes, focus on engaging the entire muscle group.

For more info on how to isolate the correct muscles click here

Step 2: Squeeze AND Lift Your Pelvic Muscles

Think about picking up a Kleenex with your pelvic muscles. Imagine squeezing your urethra, anus, and vagina to pick up a Kleenex and pull it up towards the ceiling.

Step 3: Keep Breathing Throughout Your Kegels

Breathe normally while you do your Kegel exercises. Don’t hold your breath, pull your belly in, tighten your inner thighs, or arch your back. You are just trying to work those specific pelvic floor muscles and keep everything else relaxed.

Step 4: Release The Muscles

After a few seconds, release the muscles. Imagine you are letting go of the Kleenex and let it float down to the floor. You should completely relax the muscles at this stage. But don’t push down with your muscles when releasing. Remember, the goal is to have good pelvic floor tone, which means muscles that are able to relax as well as squeeze.

Step 5: Repeat

Before you decide on how many reps you need to do, you first need to figure out where you stand. Start with a 10 rep max; lay down and repeat the above instructions for a max of 10 reps. If you get tired after four reps (it will feel like you cannot find your muscles), then that is your starting point. Begin with two to three sets of four reps, once a day for general maintenance and then build yourself up to two sets of 10 reps.

You also might want to work on your endurance, which means you should practice holding the contraction for a few seconds, and then release and relax the muscles.

Some Final Notes

Many people think “tight is right,” but that’s not always the goal. Your pelvic floor needs to have rhythm—it needs to be able to tighten when you need it to tighten and relax when you need it to relax. Having good muscle awareness and coordination are key ingredients to a healthy pelvic floor.

If you want to delve deeper to work on your own muscle awareness and coordination, Dr. Uchenna Ossai suggests talking with a health care provider that can do a pelvic floor assessment and help you come up with a program that is right for you.

Images: Openstax, Rice University; video courtesy of O.school

How A Cervical Biopsy Rocked My Understanding of HPV

“The HPV test was positive again. We’ll need to do another cervical biopsy.” I immediately burst into tears as soon as I hung up with the phone OB-GYN. I’d had my yearly Pap Smear three days earlier and was ready to say f*ck-all to HPV. I was DONE with that.

The year prior I’d undergone my very first colposcopy after a positive HPV test. I felt cursed. Finding out someone is going to cut pieces out of your cervix is sh*tty under normal circumstances, but for someone with an anxiety disorder, it was fuel on an already heavily unstable fire.

I’d broken up with my boyfriend of over three years in September, only to wind up with HPV in October. I had had the Gardasil vaccine. I’d had sex with two people. TWO PEOPLE. And here I was with a positive HPV test. I wish I could say the first cervical biopsy was no big deal. I cannot.

My sister came to the appointment. My doctor had advised I take “two Ibuprofen” before coming. I took two Valium and four Advil. My doctor used no numbing cream, no local anesthesia, no anything for the pain. The cervix, she explained, has very few nerve endings and so pain management isn’t necessary for this in-office procedure.

She used a hole puncher-like device to “punch” cervical tissue in five different places. The pain was so immeasurable I thought I’d throw up. My sister was there holding my hand. She wasn’t prepared for the gore she was going to witness. She literally fainted on the f*cking floor. I cannot emphasize enough how scary this experience was.

Also, she FAINTED and it wasn’t even her procedure. Way to make it about you, Scarlett, you asshole.

After this first colposcopy, the cells had come back “highly abnormal.” Meaning, I’d need a cervical ablation. My doctor would use a laser to remove the abnormal cervical cells so they didn’t become cancerous. F*ck me, right?

The surgery was a breeze. I was under anesthesia, my whole family came to support me, and they gave me the good drugs. I didn’t love paying $3,000 out of pocket (my insurance would only cover 75 percent of the surgery), but overall I can say with complete certainty that I would have rather have a weekly cervical ablation than ever have another cervical biopsy.


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Had my yearly pap today. Even though the CDC specifies that women 21-25 get Pap smears every three years (and every five after that), it’s my recommendation as a sexual health professional to ask your OBGYN for a Pap every single year. And additionally, to request an HPV test every single time. Get tested. Stay safe. Stay informed. Do not get intimated by doctors when they tell you you “don’t need one.” HPV is dangerous and extremely prevalent.

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Yet, here I was, about to be subjected to yet ANOTHER cervical biopsy. I’d only had one new partner since the surgery, a combination of being scared sh*tless of sex and, like, falling in love with my now-fiancé. What the actual hell was my life?!

I was a nervous wreck for the week leading up to colposcopy #2. My fiancé, god bless him, is very nurturing and loving, so having him with me was calming. Sorry, sis, but after Faint Gate, she was NOT going to be my emotional support system through this hell. I love her, but no.

I decided to document the entire experience on Instagram. As a sexologist and journalist, I felt it was my duty to actually talk about what happens during this experience. It feels like NO ONE does. I was so woefully unprepared for my first colposcopy that I didn’t have the slightest idea of what to expect.


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Me tomorrow ??‍♀️ “Take two ibuprofen before you come” -advice from my doctor

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I went into the office, having not slept the night before due to intense anxiety, high as a kite on Valium and Xanax. Look, a girl has to do what she has to do. My doctor simply said, “I don’t do that,” when I asked her for lidocaine or some other form of numbing cream, a tip I’d gotten from a friend whose mother is an OB-GYN.

Cool, cool, cool. I guess we were going to do this the good old fashioned way again like it was the Victorian Area. Dope.


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A Cervical Biopsy, in III Acts I will always share with you. I will always be vulnerable for you. I will always answer your questions about sexual health. I love you. I see you. Girl love forever. ???

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This second time, I requested that a nurse I liked be in the room. She seemed nice and didn’t force me to get on the scale, a thing I am very against during random procedural visits. I was given a cup and told to give a urine sample. Doctors need to do a routine pregnancy test before a cervical biopsy. If only they gave you a routine Vicodin, amiright?!

My fiancé held my hand, letting me squeeze it as hard as I needed. My doctor applied a solution to my cervix with a Q-tip. This is used to highlight any abnormal cells that need to be biopsied. It burned a lot.

She needed two samples, one from the cervical canal and another where cells had glowed-up as “abnormal.” The cervical canal is necessary because you can’t physically see it with the microscope.

She instructed me to “cough” each time she punched out a section of tissue. The coughing supposedly helps push the cervix out, making it easier to retain a sample. It absolutely SUCKS and causes the pressure of the biopsy tool to reverberate through your abdomen. At least, that’s how it felt to me.

After about nineteen hours (ten minutes), it was over. My fiancé took me home, putting me on the couch, wrapped in blankets. He fed me chicken fingers, painkillers, and Xanax. We watched Scream Queens.

A week later I went in for my follow-up appointment. My doctor let me know the cells had only had mild changes and no cervical ablation would be necessary. “We’ll just do another Pap next year and keep an eye on it.”

Once again I burst into tears. The relife was immense and overwhelming. I don’t know what will happen next year, but I’m praying to every higher power that the HPV will get the f*ck out of my system and die.

Oh, and if this ever happens to you, please advocate for yourself. Tell your doctor you’d like some kind of numbing cream on your cervix. Ask for any kind of pain management they can offer. And for f*ck’s sake, take a Valium.

Gigi Engle is a certified sex coach, sexologist, educator and writer living in Chicago. Follow her on Instagram and Twitter at @GigiEngle.

Queen V’s New Product Line Is A Game Changer For Feminine Wellness

Sponsored by Queen V

Last summer (guys, remember summer?!), I wrote about the launch of feminine wellness brand Queen V. In case you missed it, Queen V is a female-run company that shares my frustration with mainstream feminine hygiene products: they’re gross, expensive, loaded with chemicals, and—in my personal experience—work about half the time. (If you’re internally rolling your eyes right now, you are either a man or have never had a vaginal issue. I will not be accepting comments from either group at this time.) Queen V’s products one-up existing products at every turn: they’re affordable, formulated with your comfort and health in mind, and f*cking cute. (Sue me, I love a good bathroom shelf aesthetic.) 

I’m not just here to rant about the state of feminine hygiene, though trust me—I could do that all day. I’m here to bless your winter with the news that Queen V is launching 7 new products and a subscription service (like FabFitFun for vaginas!). Here are my personal faves from the new product line—all available nationwide at Walmart and online

Royal Pain

Royal Pain is an essential oil spray designed to reduce general pain, and I’ve found that it’s especially helpful for cramps, headaches, the all-consuming need to eat your body weight in chocolate (ok, not the last one). You know, just girly things! Specially formulated with lavender, cardamom, marjoram, and sage, this spray is applied to wherever you feel pain for instant relief. I’ll be honest: I’d do just about anything to get relief from bad period cramps, which means I’m currently taking a disgusting amount of Advil every month and probably f*cking up my stomach even more. So yeah, happy to replace that with a cute lil spray bottle of essential oils.

You’re The **it

You’re the **it (get it??) is a pack of feminine hygiene and after-bathroom wipes. Yes, they are flushable. Yes, they would have completely changed my life this past year when I spent three months on set using Port-a-Potties. Nope, not bitter at all, why do you ask? Obviously, these wipes are a godsend for any kind of risky bathroom situation—whether you’re backpacking (ew), going to Coachella, or just staying over at a guy’s place for the first time. And speaking of that last scenario, I will certainly be bringing You’re The **it with me if I think I’m getting lucky that night. Not that there’s anything wrong with my lady parts as they are—but if I could trick a guy into thinking I naturally smell like evening primrose instead, then yes, I’ll take that option.

Let’s be real, no one is 100% their authentic self while dating.

Queen V Wipes

Livin’ Libido Loca

Livin’ Libido Loca is a sexual enhancement dietary supplement, a product I would be wary of from most other companies. I’ll be honest: I would love to think of myself as a wanton sex goddess, flitting from one man to the next with ease. But frankly, I don’t have the time, energy, or Teflon vagina required for that lifestyle. Every now and then, my body needs a little boost to join the party, and that’s where Livin’ Libido Loca comes in. It helps up your energy levels, increase blood flow, and counteract dryness. If you’ve ever sexted someone for hours, then felt too exhausted to follow through on it later, congratulations on being human these supplements are for you. 

V Basic Kit

V Basic Kit is the subscription service I mentioned earlier. The box arrives at your door every month, and contains four of Queen V’s original products: the dd probiotic, swipe right wipes, v bar, and the spritzer. Basically, products you should already be buying on a monthly basis anyway (if you don’t use a probiotic by now, WTF are you doing?), and none of the hassle of actually leaving your house. Yes please!

(Note: p.s. i lube you, pictured below, is not part of the Basic Kit. I do strongly recommend buying it separately.)

V Basic Kit

So, the good news: now that you know about Queen V, you can start giving your lady parts the treatment they deserve. It literally couldn’t be easier—all products are available online, but even if you have a day-of emergency, Queen V products can be found nationwide at your local Walmart. (If you’re an NYC-dweller like me and can’t remember the last time you saw a Walmart, no worries: Queen V’s Original products are now available nationwide at Rite Aid, too.) Other new products include Itch Don’t Kill My Vibe (an itch-reducing spray), On Your Mark (a stretch mark stick), Queen It Up (a pH-balanced cleansing wash), and Rub Me The Right Way (an anti-chafe stick). So please, stop buying products made by people who don’t understand your needs (men). Your body and your bank account will thank you. 

Images: Queen V
Sponsored by Queen V