Health Advocacy

The Heart of Menopause

As I mentioned in my Menopause post, once your periods cease and you are postmenopausal, you are at a higher risk of several health issues, including:

  1. Heart Disease
  2. Osteoporosis
  3. Bladder Issues
  4. Vaginal/Pelvic Floor Problems; and
  5. Weight Gain.

A higher risk is subjective, and not everyone experiencing menopause will have any — let alone all — of the above issues. Today, let’s explore heart disease and menopause.

Heart disease is the leading cause of death in adult females. According to the American Heart Association, a decline in estrogen levels, a rise in blood pressure, and a rise in the “bad” cholesterol during menopause may contribute to the rise in heart attacks among cisgender women 10 years after menopause. (Note that available research and statistics frame heart disease and cardiovascular risk through a gender-binary lens.)

You can evaluate your risk level for heart disease via the CDC website here. The CDC site notes that “about half of all Americans (47%) have at least 1 of 3 key risk factors for heart disease: high blood pressure, high cholesterol, and smoking.”

During your annual physical with your primary-care physician, you can have your blood pressure checked, confirm via a blood test that cholesterol is in a normal range, and discuss your family health history and your risk for heart disease. This appointment also serves as an opportunity to evaluate whether you should see a preventative cardiologist.

Being in some stage within menopause also should be part of this conversation. As the Mayo Clinic describes, hormonal changes such as menopause and hormone-replacement therapy make some people more sensitive to salt and/or cause weight gain. Both of these things may increase your blood pressure, and that, in turn, is one of the key risk factors for heart disease.

This weekend is the American Heart Association Walk in Washington, DC. The organization has been at the forefront of the fight against stroke and heart disease for over 90 years. I encourage you and your family to talk about heart disease risks, learn more, and share critical information with others. If you’re in a position to volunteer or donate, there are so many ways to help through the American Heart Association and local organizations and hospitals.

Note: I continue to be neither a doctor nor do I play one on TV so please discuss your health history and risks with your doctors. xoxo


In my previous post, we learned about perimenopause (also known as pre-menopause) and that there are three stages of menopause:

  1. Perimenopause
  2. Menopause
  3. Postmenopause

Remember I mentioned how being “in menopause” seems like a misnomer since menopause isn’t a discrete event? Well, I also feel that way about classifying menopause in stages. It gives the impression that there are clear delineations between each phase and what happens within each stage. That’s not exactly the case.

  • Menopause starts when you have your final period. But if the main symptom of perimenopause is irregular periods, when your last period starts, you have no way of knowing that it is actually your last.
  • From a medical perspective, menopause is the point when a person* no longer has periods for at least 12 months.
  • Postmenopause is the period after menopause.

By the time you can be clinically diagnosed as menopausal, you’re already postmenopausal!

Who came up with these confusing delineations?**

Perimenopause may start when you are in your 30s, 40s or 50s. For some, this phase lasts months and for others, a decade. You are still pre-menopausal unless you haven’t had a period for 12 consecutive months.

Signs that you are in perimenopause include: 1) irregular periods; 2) perimenopausal symptoms; and/or 3) elevated follicle-stimulating hormone (FSH) levels in your blood. You still can get pregnant during perimenopause, but not when you are postmenopausal. After 12 months without periods, your ovaries no longer are producing eggs.

Much like perimenopause, menopause and postmenopause impact people differently. The average age to experience natural menopause in the United States is 51. However, the age range varies with a 20-year spread. Menopausal symptoms generally abate in frequency and severity after your last period, but this also depends on the individual.

The average person still experiences menopausal symptoms for four years after their last period with a range of 1-10(!) years!

If you experience troublesome menopausal symptoms, you may wish to speak with your internist or GYN to evaluate whether you are a candidate for hormonal-replacement therapy (HRT). (And, by troublesome, this is troublesome for you. There is no objective standard here.) By restoring the hormones levels that change during menopause, HRT has been shown to successfully alleviate menopausal symptoms for many individuals. If your body responds well to HRT, consult with your doctor annually to weigh the benefits and risks of continuing the treatment. Most people stop HRT once their menopausal symptoms abate. It’s important to note that if you have a history of stroke, blood clots or cancer, you might not be a candidate for HRT.

Once your periods cease and you are postmenopausal, you are at a higher risk of:

By this point in the post, if you haven’t uttered, “Ughhhhhh!” or some variant of that, feel free to do so now. Then I recommend reminding yourself that menopause is a part of life, and you will adjust to the changes that ensue as you have to previous life and health changes. And, whatever phase you are at with menopause and your acceptance of the process, know I’m only a message or comment away!

In my next posts, I’ll write more about postmenopausal health risks, the stigma surrounding menopause, my menopause journey, and how to find community and support during menopause. Until then, be well xoxo

* Since 2008, the majority of my posts were written as though everyone with a vagina identified as female. I know better now and am trying to approach this post correctly using gender-inclusive language.

** The American Society for Reproductive Medicine classified the stages of menopause. “Menopause” comes from the Greek words for mēn (month) and paûsis (pause), and Aristotle is credited with one of the early references to the term.

Image credit: Literariness

Disclaimer: Although I wear many hats, I’m not a doctor nor do I play one on TV. This post is not a substitute for medical advice. Hyperlinks are plentiful in this post to help steer you toward additional information from reliable medical sites.

Welcome to My New Site!

When I first began blogging in December 2008, I had a basic WordPress platform. The pale mint green and grey template was neither busy nor fancy. Since I blogged anonymously back then, there were no images embedded in my posts. I appreciate that a strong blog is about the written word, but I also acknowledge that my posts were very text heavy.

In September 2010, I obtained my City Girl Blogs™ logo via crowdsourcing and had my site professionally redesigned. I loved the new look of my brand and my blog!

The same month that my site launched, I started chemotherapy. I honestly didn’t know where my blog – or my life – was headed. Getting through treatment was my main priority, and blogging about my relationships was a fun diversion.

Back in 2010, I thought that I would finish treatment and put the whole cancer journey behind me. In retrospect, that approach seems blissfully ignorant! I’m thankfully in remission, but the experience still impacts me on a daily basis in both positive and negative ways. I know that one of my life’s missions is to write, speak and advocate about cancer and cancer prevention.

My blog led me to teach at American University. Three years later, I feel blessed at how much joy my job continues to bring me.

The most significant change in my life is that I’m the mom of an eight-month-old miracle baby named Roya! Every decision is made with her in mind.

This new site reflects who I am now and the many hats I wear. In addition to my blog posts, the site also includes information about:

My blog will continue to feature content that’s as varied as my life. From Roya to health advocacy to sex advice to giveaways to cancer, you’ll never know what topic you’ll find when you click on the latest post! For those who’ve missed my Sex and the City-esque adventures, fear not! Quite a few of my old dating tales are still accessible.

I’ve genuinely missed writing and being a part of the blogging community.  It’s nice to get back to both.

I hope that you enjoy my new site as much as I do!

Many thanks and much appreciation to Earl Wyatt of for all of his help with the site transfer, design and updates!

xoxo, Stef

50 Shades Class in AmWord Magazine

Earlier in the semester, Alex Korba, a writer for the American University literary magazine, asked if she could interview me regarding my 50 Shades trilogy class. Alex's article is available in the latest issue of AmWord Magazine and reprinted with permission below. (Fellow bloggers might find the last paragraph to be especially relevant!) Hope you enjoy the piece as much as I did!

Fifty Shades Risque? American University's Newest Class

By Alex Korba

Professor and sex educator Stef Woods came up with the idea for the course based on her interest in the double standards regarding female sexuality.

When asked why she picked Fifty Shades as the subject for the course, Woods responded passionately.

“My background is as an attorney, so I started thinking about copyright issues with books on the computer and fan fiction,” she said. “I am also a sex educator; I do a lot of health advocacy and health education. I read it and I immediately thought, this is an abusive relationship.”

It is not uncommon for college courses to use polarizing books as a lens to study cultural facets.  For example, Twilight and The Wire have both been utilized in classes as case studies to examine issues that transcend the books themselves. In the case of Fifty Shades, the very real topics of abuse and mental instability are at play. Just behind the glossy love story these issues beg for attention and they deserve to receive more of it.

Though she believes fervently in the goals of the class, Woods has no delusions as to the literary merit of the book.

“You’re not reading them as you would read a Shakespearean sonnet,” Woods said with a laugh. “You don’t have to analyze every word, or even every chapter.” As an exercise in literary criticism, the class has to edit the first chapter of the book. Woods believes this to be good practice for future careers where employers will need documents proofread promptly.

When asked her opinion on whether the Fifty Shades books give American girls an unrealistically rosy image of BD/SM relationships, Woods replied that she believes this current generation knows better.

“My entire class agrees that there are glaring control issues. The author wrote it as her fantasy and it was targeted at women of that same demographic,” she said. “Their idea of a perfect man on paper is one who takes control of everything when at the end of the day they’re just looking for a man to take out the garbage.”

Because of the controversial subject of the class, opposition is inevitable. Since its publication, the series has been dubbed “mommy-porn” and received scathing reviews by many reporters. This didn’t stop hordes of women from flocking to the bookstores and firing up their Kindles. If anything, the taboo reputation served to increase the book’s popularity.  Like these women, Woods is not fazed by the book’s repute.

 “It’s not a book club,” Woods asserted, “There are 60 other resources. My syllabus is 11 pages single-spaced. I stand by my work product; I stand by this course idea. If you think it’s an easy A, that’s not my class.”

When asked whether she would consider teaching the class again next semester, Woods shrugged and responded, “It’s a short shelf-life class.” She continued on to say that she is very interested in teaching a course with the topic of blogging as a social force. In a world where technology is ever changing, Woods is a professor unafraid to adapt to the changes, even if it means embracing a subject that she could potentially catch flack for.

“Opposition? Ok, that’s fine,” she said dismissively. “For every compliment there’ll be a hundred criticisms, especially in an anonymous online world.”

Tips if You’ve Found a Breast Lump

I regularly receive emails and texts from friends and readers who are concerned about breast lumps. It can be nerve racking if you or a loved one has found a breast lump!

What are my suggestions?

1. Try not to panic, if you can. Remind yourself not to let your emotions be controlled by that which you don’t know. You found something that may or may not be of concern. You’ll need more information before you know if this is something that warrants a lot of your emotional energy.

2. Take some comfort in the statistics. Only a small number of breast lumps turn out to be cancerous. In fact, if you’re in your early 20s-50s, there’s at least a 90% chance that the lump is non-cancerous (benign). For those of you in your mid-50s or older, 80% of lumps are benign. In the overwhelming majority of cases, breast lumps are found to be fibrocystic and normal.

3. Wait until after your next period to see if you can still feel the lump. Women’s breasts and breast tissue change throughout their cycle. If you’re unsure about how to perform a breast self-exam, this video from Georgetown University Hospital is informative.

4. If you still feel the lump after your next period, then schedule an appointment for a clinical breast exam. A clinical breast exam is a more thorough breast exam performed by a medical professional. Your primary care physician or gynecologist can perform a clinical breast exam, but you also can make an appointment with a breast surgeon. Men can see their internist or general practitioner to examine a new mass on their chest, and then get a referral, if needed. For those of you without insurance, all Planned Parenthood centers offer clinical breast exams. In the DC area, you can also go to Capital Breast Care Center by the Eastern Market Metro.

Following the clinical breast exam, the health care professional will decide how best to proceed. Options include:

  • Waiting six months to follow up with another clinical breast exam. That’s a common reaction to lumps found in younger women. I appreciate the statistics, but you also have the right to ask for a follow up in three months.
  • Ordering a sonogram (ultrasound) and/or a mammogram. I had my first benign breast lump removed at the age of 26. Over the next three years, I had three more lumps biopsied and/or removed. All of the information that my doctors needed was obtained from sonograms and biopsies. Medical professionals typically don’t order mammograms for women under the age of 35 since younger breasts have denser tissue that lead to false positives. Sonograms provide a better reading than mammograms for denser breasts. If you’re under the age of 35, ask your doctor whether a mammogram is right for you.
  • Ordering a breast biopsy, if the above methods didn’t yield a conclusive result. Breast biopsies are done on an outpatient basis and do not require you to be under anesthesia. For more information about the different types of breast biopsies, check out this link from Mayo Clinic. If you require a biopsy, try not to jump to the worst possible conclusion. According to the University of Michigan, only 15% of biopsies performed turned out to be cancerous.

5. Reach out for support. Chances are that a female friend or relative has gone through this process before. Ask them for their advice.

6. Use online resources in a restrained manner. You can look online for information, but stick to reliable sites from medical institutions and cap how much time a day you spend searching about lumps and biopsies. Don’t let information overload increase your anxiety!

I’m not a doctor, but I do care. Since I was diagnosed, I’ve let it be known that I’m happy to serve as a resource for those with questions. Feel free to reach out anytime via citygirlblogs (at) gmail. And, please, regardless of gender identity, stay on top of your breast health! xoxo

Health Advocacy Found Me

Shortly after I was diagnosed, one of my doctors said:

I hope you don’t take this the wrong way, but out of all of my patients, if one of them had to get cancer, I’m glad it was you. I don’t worry about you not being able to handle it.

I laughed out loud, as I understood her thought process. I've been advocating for my own health since I was a teenager. I knew the system and how to interact with doctors, and I could use those skills to my advantage as I battled cancer.

I’ve become a Subject Matter Expert in health advocacy because I had to.

My first memories are of being in the hospital as a toddler. During one stay, my mom and I were both in the hospital at the same time.

At 16, one of my lymph nodes was sent to medical facilities from California to Boston to Minnesota to be studied. I would later be accepted at NIH for a study related to this condition.

I started to go paralyzed at the age of 20.

My mom passed away from cancer of unknown primary origin when I was 24.

I had unexpected complications from neurosurgeries in my early 30s. Those complications have caused me to have repeated concussions and Post-Concussion Syndrome.

I’ve been in physical therapy 10 out of the past 12 years.

Since the age of 26, I’ve had 13 breast biopsies. I was diagnosed with breast cancer in 2010 at 37.

My health has always been unique, and doctors are typically fascinated by my body. Managing my health is a full-time job. But, most importantly, I’m still standing! I have so many blessings in my life, and health insurance, a wonderful support system, and a great team of doctors are high on that list. And, despite everything that I’ve been through, I’ve never – knock on wood – thought I wasn’t going to survive.

Over the course of my life, I’ve had more than 25 MRIs. I must admit that the one on Monday was slightly stressful, though. As I type, I’m staring at my telephone, trying to will it to ring with a call from the doctor with the results. I just keep telling myself silently,

I’m cancer-free. I’m cancer-free. I’m cancer-free.

As I was on the table during the test, I realized that all of my life experiences brought me to this point for a reason. I needed to be an advocate for myself so that I could be an advocate for others. This is where I’m meant to be, and I’m thankful that I’m here in every sense of the word to do that.

It’s a New Year. Please be on top of your health, self-exams and annual doctors’ appointments. Please. xoxo

What negative have you turned into a positive?

Third Blogiversary Thanks!

Today is the third anniversary of my blog.

In December of 2008, I was getting over Lawyer Boy, working on my thesis, and battling the side effects of repeated concussions. It seemed like the perfect time to finally write down my crazy dating and steamy sex stories. I blogged anonymously since I had planned to return to legal policy work. Back then, the majority of my readers were friends in real life.

In December of 2009, I recognized that I could turn heartbreak into blog gold by writing about the relationship debacle that was my time with "Buckeyes" Boy. Within six months, my readership had increased 10-fold, and I started realizing that my blog had turned into a brand. Could I write about sex and relationships and conduct workshops for a living?

In December of 2010, I had finished my fifth round of chemotherapy. I hadn't slept well in three months. I was on way too many medications, including steroids, and was in chemo-induced menopause. There wasn't much in my life at that time that was joyful, but I (somewhat thankfully) was too sick and out of it to care. I just wanted to get through treatment and wanted my life back. I did find moments of happiness when I used my experience to help educate others and when I received attention from either Mr. Agency or Best Boy.

This December, my blog is so much different than it was because I'm so much different than I was. This blog has changed me for the better. Cancer has changed me, too, and with respect to relationships, those changes are also for the better.

Have I made my share of mistakes over the past three years? Sure. But, I'm proud of myself for realizing that life provides enough drama for me all on its own. I don't need my relationships to provide anymore drama. My blog hits aren't as high as they were a year ago, and I'm 100% okay with that. My love life isn't a train wreck, and I don't make questionable choices anymore. A reader who enjoys going online to critcize others will be bored by my site now. A person who just visits this blog for entertainment purposes and doesn't want to hear about cancer or health advocacy will be similarly disillusioned.

I was talking to a group recently about my first book in the sex and relationships arena. I have enough posts to compile a book about my own dating adventures, but I don't know that I see myself going back. Do I really want to go to bookstores or college campuses and speak about my relationship mistakes or give added energy to guys who wronged me years prior? I won't say that will never happen, but it's just not my priority now.

I care about educating others. I care about talking about those topics that people don't often talk about — from anal to cancer to first orgasms to prioritizing our health to spicing up a stale relationship. I care about putting a face to cancer and letting people know that it's okay to date and have sex during a health crisis.

In the next month or two, my site will be redesigned to reflect the new direction. If you're still reading now, there will be more of the same, but the site will be easier to navigate. I'll also be linking my name to my brand more since I'm no longer anonymous. Stef Woods and City Girl Blogs are now one and the same.

For those of you who have read my blog faithfully, I thank you for standing by me after the train wreck has been cleaned up. I'm appreciative that so many of you out in the blogosphere have become my friends. You stuck by me through the highs and lows, and for that, I'll always be grateful. A special shout-out to Abby, Erika, Intrigue Me, Jean, Jo, Kat, Simone and Teacher Girl. I look forward to thanking you all in person some day soon!

With much appreciation from the bottom of my heart, a huge virtual hug, and best wishes for the happiest of holidays,