While many of us look forward to the autumn period, excited by the cooler weather, the cosiness of our houses, lighting candles and sitting with warm blankets, drinking hot chocolate and mulled wine, and also the build-up till Christmas, buying presents, singing Christmas songs. For many of us, it is a time to look forward to and a time to enjoy. For some people, however, this season brings a feeling of dread. For those suffering with Season Affective Disorder (SAD), also commonly referred to as winter depression, this season can be crippling, lonely, and difficult. Research claims that SAD affects more women than it does men, however, we believe this to be incorrect. It is known that men are less likely to reach out for help regarding mental illness, due to various societal factors that makes it difficult to do so, namely hypermasculinity. Regardless, this is an extremely important and relevant topic for us to discuss. We will first begin by highlighting the causes of SAD, then discussing ways the symptoms can be reduced, or managed. Please do not use this piece as a substitute for professional help, if you are feeling down, lonely, or need someone to speak to, please see your GP.
SAD is caused by the change in season; colder, gloomier weather, coupled with fewer hours of daylight have a huge effect on our moods. Symptoms of SAD are similar to that of general depression, and include loss of interest in activities, lethargy, interpersonal problems, irritability, inability to concentrate, changes in sleeping pattern, and changes in appetite. The root of depression is a chemical imbalance in the brain, where serotonin (the happy chemical) is lower than usual. SAD is not well understood; however, experts believe that it is caused by an out-of-sync body-clock or improper levels of either melatonin or serotonin. It also appears that some people are more susceptible to SAD due to their genetics, as some cases appear to run in families.
Furthermore, there may be a link between SAD and one’s racial background and skin colour. Melanin is the pigment that gives skin, nail, and hair their colour, and protects the skin from UVB rays. The more melanin you have, the more sun you need so your body is able to absorb a sufficient amount of vitamin D. One of the most well-known and commonly experienced symptoms of vitamin D deficiency is depression. Black people and other groups of colour with darker skin have the highest amounts of melanin in their skin, and therefore need more sun so their bodies are able to produce vitamin D. Therefore, the less sun there is, the less vitamin D highly melanated individuals can produce, and this generates seasonal depression. If you are a person of colour who experiences SAD, it is important to see your GP and get your vitamin D levels checked, as this is what could be causing you to feel this way.
The main way people tackle SAD is replacing sunlight that is lost due to reduced daylight hours with a lightbox. This is referred to as ‘light therapy’, or ‘phototherapy’, and it involves daily sessions of sitting close to a light source that is more intense than indoor light, which aims to replicate sunlight. Light is absorbed through the eyes to be effective; research has shown that light absorbed through the skin does not seem to have much of an affect. These lightboxes can look like medical equipment, or like a regular house lamp. Other ways to reduce the symptoms are to move your body more, go on walks, go to the gym, even go ice skating if you wish. Moving your body and exercising is known to release endorphins, which trigger a positive feeling in the body. We realise that it can be quite hard to motivate yourself to move when you are feeling sad and low, but all it takes is to push yourself a few times before it becomes a part of your routine. This is essential to incorporate during this season to aid with the symptoms of SAD.
If you decide to visit your GP, they may recommend talking therapy, such as cognitive behavioural therapy (CBT) or counselling. They may also recommend taking an antidepressant medication, such as selective serotonin reuptake inhibitors (SSRIs). Regardless of what you decide to do to deal with SAD, it is important to be open and honest about the way you are feeling, and never feel like you have to suffer in silence. If you are experiencing SAD, it is very likely someone else in your circle is too, so it makes talking about it together even more important to normalise the situation and make others feel like they are not an anomaly. Do not be afraid of the change in season, embrace it and list the things you do like about winter and look forward to spring.
Here are some numbers you can call if you are feeling down, and you can always visit us at HWC; we are always more than happy to sit and talk over a warm drink and some biscuits.
Mind: 0300 123 3393 (Monday to Friday, 9am to 6pm)
Rethink Mental Illness: 0300 5000 927 (Monday to Friday, 9.30am to 4pm)
Samaritans: 116 123 (free 24-hour helpline)
Female Sexual Health
Part 1: Being Aware of Reproductive Cancers
Discussion about female sexual health is often supressed and discouraged, as it is viewed as a taboo. As a result, many women grow up uneducated about sexual and reproductive health, and unaware about ways they can keep themselves healthy in that respect. This piece will be the first of a series of articles, where we will be discussing some important issues relating to women’s sexual and reproductive health, how to seek medical advice, and who to contact.
One of the most important things to do, that doctors encourage, is to familiarise yourself with your body. This is vital, as it allows you to detect any changes that are out of the norm for you (since everybody is different). Unfortunately, a history of suppression of female sexuality (which still takes place in many cultures) has made it extremely difficult for women to be open to having these conversations, and as a result, issues regarding sexual health are often neglected and ignored. This piece will be the first in a series, where we will discuss issues related to female sexual health. In this piece, we will be going over two very important topics: cancers of the female reproductive system, and breast self-examinations.
In the UK, women are invited by the NHS for a pap smear (also commonly referred to as a smear test) from the age of 25 years old. The test is often avoided by women, mostly out of nervousness as it involves a screening of the vagina. However, the test itself is very quick (taking around 45 seconds to swab the cervix) and is performed by very experienced nurses. The sample of cells collected is then sent off to a lab to check for cervical cancer cells, pre-cancer, and human papillomavirus (HPV), which is the virus associated with causing most cervical cancers. Women aged 25 to 49 are invited to a screening every 3 years, whereas women aged 50 to 64 are invited every 5 years. It is extremely important to attend these screenings; while tests come back negative the majority of the time, they are important to detect any changes in cells, which in many cases present no symptoms and can only be detected via pap smear. Cervical cancer has no symptoms in its early stages, but can make you have abnormal bleeding, bleeding between periods, after sex, or after menopause. Abnormal bleeding does not mean you have cervical cancer, but it is important to see a GP if you are experiencing this.
The NHS does not offer regular screenings for other female reproductive cancers, such as ovarian, uterine, vaginal, and vulvar, so it is important you are familiar with your body in order to be able to detect any changes, so they do not go unnoticed. Changes in your menstrual cycle, discharge, and even appearance of your vulva should be discussed with your GP. We will list the symptoms for these cancers below:
This is the cancer of the ovaries, which are the two organs that make female hormones and produce eggs. Ovarian cancer symptoms often present themselves in the form of abnormal bleeding, pressure or pain in the pelvic area, pressure or pain in the abdomen and back, bloating, feeling full quickly while eating, and changes in bathroom habits (constipation, blood in urine or stool). The risk of ovarian cancer is higher in those over 40, those with a family history of ovarian, breast, or colon cancer, and never giving birth.
This is the cancer of the uterus (womb), which is the organ in which the baby grows when a woman is pregnant. Again, symptoms of uterine cancer include abnormal discharge or bleeding, pressure or pain in the pelvic area, and bleeding after menopause. Those at a higher risk are women 50 years old or older, women who are overweight, and having a family history of cancers of the uterus, ovaries, or colon.
This is the cancer of the vagina, which is the hollow channel that leads from the uterus and cervix to the outside of the body. Vaginal cancer symptoms include abnormal discharge or bleeding. Women who smoke, who have HPV, cervical cancer or pre-cancer, have HIV or a weakened immune system are at a higher risk.
This is the cancer of the vulva, which is the area surrounding the opening of the vagina. The symptoms of this include itching, bleeding, or burning of the vulva, or a rash or sores around the opening of the vagina that do not go away. Or, changes in the colour of the skin around the opening of the vagina. These symptoms are common in many other diseases and infections, including STDs and yeast infections, which are fairly common and treated with over-the-counter medication. If symptoms persist, please see your GP. Again, those at risk of vulvar cancer are women who smoke, who have HPV, cervical cancer or pre-cancer, have HIV or a weakened immune system.
Breast cancers are often grouped with female sexual cancers, however, since its symptoms are not present in the vaginal area, we have decided to discuss it separately. Breast self-examinations are highly encouraged by the NHS, and again, allow you to detect any changes to your breast tissue that needs to be addressed by a doctor. Often, we are told to feel for any lumps or bumps in your breast, however, the texture of breast tissue is naturally very lumpy and bumpy, so women examining their breasts for the first time may panic, or not know what they are searching for.
Self-examination of the breasts is easy and quick to do and involves checking for any changes in the breasts. We recommend following the following steps to thoroughly check for any changes:
Check breasts in the mirror. Look for any discolouration, visible bumps, changes in size, bulging, puckering, or dimpling of the skin, redness, soreness, a rash, or any other visible changes or pain in the breasts.
After checking in the mirror, raise your arms up and look for the same changes. Often, lumps and bumps may appear in, or near your armpits as the lymph nodes in that area are sometimes the first to be affected.
Check your nipples. Are there any changes? Any watery or milky discharge? Any yellow fluid or blood? Any puckering or retraction of the nipple? Any bump under or around the nipple?
Feel your breasts while lying down. Use your right hand to feel your left breast, and your left hand to feel your right breast. Move the pads of your fingers across your breasts while keeping a firm touch, moving your fingers in circular motions. You may feel your breasts naturally lumpy texture and panic, but the lumps you are searching for are generally hard and circular. Breastcancer.org recommend the following method:
“Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically, in rows, as if you were mowing a lawn. This up-and-down approach seems to work best for most women. Be sure to feel all the tissue from the front to the back of your breasts: for the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you've reached the deep tissue, you should be able to feel down to your ribcage.”
Ensure you are feeling not only your actual breast, but your armpits, the area up to your collarbones, and cleavage.
Feel your breasts while sitting or standing, with arms up and arms down. This is easiest and most conveniently done in the shower when you are wet and slippery, so your hands can glide easily across your skin. Use the same method described in the step above, checking for any lumps, bumps, or abnormalities.
It is extremely important to be aware of cancers that can affect the female body, as they are often not discussed openly. Also, like with many other illnesses and diseases, the early symptoms are ones that can only be detected by you, so it is vital to be aware of them. Many women will notice abnormal changes to their breasts or vaginal health and will ignore it, as they feel anxious or embarrassed to speak about intimate issues with a doctor. While the majority of the time, these symptoms will most likely be nonthreatening, in some cases, they can lead to the discovery of cancer in the body and catching this as soon as possible increases the chances of a full recovery significantly. So please, if you do notice any changes, book an appointment to see your doctor as soon as possible, and do not feel scared or embarrassed as they come across cases like these every day.
Finally, it is important to erase the shame and stigma around female sexual health. Do not be afraid to speak about these issues openly and confidently, do not be afraid to enquire or ask questions. By being more open with ourselves and others, we can lead the change and empower each other.
Women and the LGBT Community
While pride month is over, it is important we continue discussing LGBT issues, especially those relating to women. This is a perfect time to reflect and become educated on these issues, as the LGBT community continues to fight for inclusion, equality and visibility all year round, not just during pride month.
This year, 2019, has marked 50 years since the Stonewall riots, which was a revolutionary moment in LGBT history. The Stonewall riots served as a tipping point for the Gay Liberation Movement in the United States; it brought with it a new cultural awareness for a community which was largely ostracised and has been referenced to pin point the historical moment wherein “pride began”. In fact, women have been at the centre of the fight for LGBT equality, as Marsha P Johnson, a black trans woman, famously led the stonewall riots. And ironically, 50 years later, black transgender women remain one of the most disadvantaged members of the community, due to combined systemic prejudices stemming from misogyny, racism, and transphobia.
Women in the LGBT community who come from minority ethnic backgrounds continue to be faced with cultural and religious barriers when coming out, and often, coming out comes with life-threatening risks. Many religions and cultures are not open to the idea of homosexuality and being transgender, and instead subscribe to the traditional belief that relationships consist of a man and a woman, who each have different societal roles. Many LGBT people of minority ethnic backgrounds go through their whole lives without being able to openly live as their authentic selves, however, we are making some steps as a society to allow for the liberation of these members through healthy discussions and representation. However, we still have a long way to go to ensure the safety of these members.
Historically, women have been taught that they exist for the pleasure of men, they should upkeep their external appearance for the attention of men, they should focus on developing skills that they will use to cater to men, and so on and so forth. Centuries of this outlook has allowed these beliefs to become ingrained in the foundations of our society, and they are manifested and observed through everything; societal hierarchy, laws, interaction, entertainment, so on and so forth. Therefore, when women express that they are attracted to women, and women only, they are not taken seriously by men, who often feel entitled to them due to the patriarchal system. Lesbian women are seen as a “challenge” for men to “convert”, often using statements such as “you’ve never been with a real man”, “you haven’t met the right man” etc. This demonstrates how women are not seen as people capable of making their own decisions, but as helpless creatures that need to be guided and taught.
Furthermore, in a hyper-sexualised male dominated world, lesbian women are often subjected to increased objectification and fetishization by heterosexual males. The fetishization of lesbians is often a result of lesbian representation in society, coupled with views towards women stemming from the patriarchal system. For example, lesbian couples are frequently portrayed as overly sexual, with all romantic aspects of the relationship omitted; this indicates that this media is created for the consumption of heterosexual men, and not for the inclusion of queer and lesbian women. Not only does this lead to eroticisation, objectification, and fetishization, it also represents lesbian women in an unrealistic way, which influences people’s perceptions of them and alienates lesbian women. This narrative of lesbian women is dangerous, and can lead to violence; for example, recently, a lesbian couple were attacked on the bus on their way home by a group of men for refusing to kiss each other. The behaviour leading to the physical attack signals that the group of men felt entitled to be “entertained” by these women and did not take their sexuality or their relationship as legitimate, or worthy of respect.
Although we have made great strides as a society to respect LGBT people’s rights, create visibility and representation, for example, members of the LGBT community can legally marry, can join political movements and represent their community, and their history becoming a part of the school curriculum, it is important to continue the conversation and highlight issues that still exist. Many of the issues women in the LGBT community face stem from misogyny, which is a by-product of the patriarchal system. As a result, unlearning and unpacking the dynamics of the patriarchal system is key to addressing these issues. Additionally, women from minority ethnic groups face added hurdles due to racism, with black trans women being the most disadvantaged. It is important to understand these issues and allow for healthy discussion, as through this, change can happen.