Sex Facts

Dr.Joe's Data Base

Sexual Assault, and Date Rape

Incest or Sexual Assault Within a Family

What to Do If You Have Been Sexually Assaulted

Protecting Yourself From Assault

Breast Self-Examination

Menstruation

Pre-Menstrual Syndrome or PMS

Menopause

Bladder Infection in Women

The Pelvic Exam

Pap Tests

Infertility

Eating Disorders

Severe Depression and Suicide

Sexual Assault and Date Rape
Sexual assault happens when a person does something sexual to someone else by
force or without the other person's permission. Unwanted sexual intercourse is
also called rape. Sexual assault of any kind is a criminal offense, even in
marriage and common-law or dating relationships. Statistics show that 1 in 4
females and 1 in 8 males have been sexually assaulted.
Although most sexual assaults are committed by men against women and children,
anybody can be assaulted. People who commit these crimes are sometimes
strangers, but not usually. They can be sexual partners, parents, relatives,
friends, co-workers, bosses, doctors, youth leaders, religious leaders,
teachers, neighbors or other acquaintances.
Sometimes, on a date, one person forces the other into some kind of sexual
activity. This is called "acquaintance assault", or "date rape". The person who
was assaulted, often the woman, may wonder whether she is to blame because she
knew the guy and agreed to be with him. She may feel responsible, that she gave
the wrong idea or was encouraging him somehow. It is important for a woman to
realize that she is not to blame for sexual assault under any circumstances,
even if she knew the person, and no matter how far they had gone sexually before
she said "No".
A person who commits sexual assault is committing a crime. You don't have to
have any kind of sexual contact with anyone unless you want to, even if you have
had sex with that person before. People have a right to control their own
bodies, and sexual assault violates that right. Sexual assault is a kind of
violence. Neither alcohol nor drugs is an excuse for sexual assault.
Under the law, every person has the right to say "No" to any form of sex or
sexual touching, even in marriage or when dating. "No" always means "No", even
if it is said only once, and whatever the situation. Only "Yes" means "Yes".
Sexual assault may include anything from touching to violent rape. Sometimes sex
is demanded in exchange for a promotion or a good report. What may seem like a
harmless joke may be a sign of lack of respect for a person. Remember, sexual
assault is a criminal act.
If you have been sexually assaulted or abused it is not your fault. It is normal
to feel upset, confused and alone. You might feel bad about yourself and about
sex. There are people you can talk to. If you are a survivor of sexual assault
or abuse, think about telling someone about it. Even if it happened years ago,
you might find it helpful to tell someone now. It is possible to bring charges
to court even years later.
You can also read the messages on What to Do If You Are Sexually Assaulted and
Protecting Yourself From Sexual Assault, both in this section of the Facts of
Life Netline.
You can get medical and emotional help by calling a sexual assault centre or a
rape crisis centre. The Kids Help Phone Line for those 19 and under is
toll-free: 1-800-668-6868. Or you can call your local Public Health Unit -- see
References/Resources.

Incest or Sexual Abuse Within a Family
Incest is sex between people who are closely related. It is illegal for a father
and daughter, a mother and son, a grandparent and grandchild, or a brother and
sister to have sexual intercourse.
Unwanted sexual activity within a family is called sexual assault or abuse.
Sexual abuse includes a physical assault such as intercourse, inappropriate
touching, making the child touch someone else's body, or making the child watch
sexual activity of others. There are laws against incest to protect children.
People who abuse children often threaten them not to tell. They may say,
"Something bad will happen to your mother," or "They'll send you away," or "I'll
do it to your little sister if you tell." Sometimes, more than one person in the
family is assaulted. But, telling someone you trust about the abuse may help
stop it.
Often sexual abuse within a family can go on for many years. But there are
people who will listen and can help. There are professionals who will
understand, believe and support the child. You also can tell a parent, another
relative, or a teacher. Or call the Kids Help Phone Line: 1-800-668-6868. This
is free, and completely confidential.
People who sexually abuse family members are committing the same crime as those
who assault strangers. It is an act of violence, and abusers can be brought to
court, even if it happened years ago. It is possible to bring charges even years
after the offense.
Adults must report actual or suspected cases of sexual abuse. If you know of
incest or family sexual abuse, tell someone you trust about it. Again, for those
19 and under, the Kids Help Phone Line is 1-800-668-6868. There may be a Sexual
Assault Centre in your area. Or you can call your local Public Health Unit --
the number is listed in the Referrals section of the Facts of Life Line.

What to Do if You Have Been Sexually Assaulted
If you have just been sexually assaulted, it's hard to know what to do. You can
call a Rape Crisis Centre or a Sexual Assault Centre if there is one near you.
These numbers may be listed on the inside cover of the telephone book, or the
operator may help. The Kids' Help Phone Line, for those 19 and under, is
1-800-668-6868. If you are in immediate danger, the Emergency number in most
areas is 911. There will be other suggestions at the end of this message.
Meanwhile, here are some ideas to help you:
Go to a safe place.
Think about telling someone as soon as possible.
Ask for support and help.
Get the medical attention you need, and
Write down everything that happened to you.
First: go to a safe place. If you are in your own home and the attacker has
left, you may feel safe remaining there. Or, you may prefer to go to a shelter
or a friend's home. In any case, ask yourself, "Where is the best place to be?"
If you need it, ask for help in getting there.
Ask for support and help. Most people find that it is important to have support
right away to help them cope with their feelings and to help them make
decisions. Tell someone you trust what has happened to you --a family member or
a friend, or a counsellor on a Distress Line.
The choice to report sexual assault to the police is one that each person must
make on her own. The police can get you out of a dangerous situation and they
can decide whether or not to lay charges against your attacker. What is
important is that you choose the kind of support you want. You need to be able
to make decisions regarding the police without pressure and with full
understanding of what your decision will mean to you.
Sexual Assault Centres always have a counsellor "on call" to give you this
information and support, and help you make the decision that is best for you.
Get the medical attention you need. It is important to take care of any injuries
resulting from the assault. Some women do not even realize that they are injured
because they are in a state of shock. A hospital's Emergency Department will
test you for disease, and can take steps to prevent pregnancy. The decision to
report to the police need not be made immediately. However, if you decide to lay
charges, the hospital report can be used as evidence in court.
Tell hospital staff that you've been sexually assaulted. They may ask if you'd
like a Sexual Assault Centre volunteer to help you through the medical
procedures, and the legal procedures if you decide to report the assault. Ask
questions about anything you don't understand.
Even if you feel that you want to wash and get clean right away, it is important
not to wash or change your clothes before your medical examination. Evidence
that could be used in court against your attacker could be destroyed. Do not
take any drugs or alcohol, as you need to be able to think as clearly as
possible.
If you choose not to go the hospital, a Sexual Assault worker can help you find
other medical care. The Morning After Pill, taken within 72 hours of unprotected
intercourse, may prevent pregnancy.
Write down everything that happened to you, and mark down the date and time of
writing. Writing down everything you can remember is important for three
reasons:
Taking time to write can help you sort out your emotions and deal with what
has happened.

If the case goes to trial, your notes will help you remember details of what
happened.

Something you write down may become important to the police investigation.
Often people who are sexually assaulted are threatened by their attackers and
told not to tell anyone. A Sexual Assault worker will understand this because it
is common, and will help you make plans to increase your safety.
Again, the emergency number in most places is 911. The Kids' Help Phone Line is
1-800-668-6868. Some communities have Sexual Assault or Rape Crisis Centres,
Assaulted Women's Helplines and Distress Centres. Or you can call your Public
Health Unit in your area -- see References/Resources.

Protecting Yourself Form Assault
You have the right to set your own sexual limits. You may have different
boundaries with different people, and those boundaries may change. It's a good
idea to know what you want or don't want before a difficult situation arises.
It's also helpful to communicate those limits to the other person. No one can
read your mind!
Trust your feelings. Most sexual assaults are not committed by strangers; they
are committed by partners or other acquaintances. It's often difficult to
imagine someone you know doing this to you -- that's part of the reason why it's
so difficult to prevent sexual assault. But, if you feel you are being pressured
into unwanted sex, you're right!
Be alert to behavior that doesn't seem right, for example, inappropriate
touching or comments. Beware of someone who sits or stands too close, blocks
your way, "power stares", looking through you or down at you, grabs or pushes
you, or ignores what you say.
Can you be assertive and speak forcefully when someone does something to you
that you don't want? Is there something you can do immediately? In some
situations, it might help to say something like, "I don't like that," or "Don't
touch me like that," or "NO!". You can practice this by yourself or with a
friend.
You have rights. If somebody sexually assaults you, you can tell someone,
including the police. Letting the other person know that you know your rights
may help stop an attack.
You can take a self-defense course. Stand up for yourself. You don't have to be
polite to someone who is sexually pressuring you, even if you are worried about
hurting their feelings or getting into trouble. After all, that person doesn't
respect your rights or feelings.
Some people might think that the way you dress, talk or behave gives them the
right to treat you in a certain way, sexually. No matter what people think, you
always have the right to say "no".
Alcohol and drugs can make a person lose control over their own body and mind.
If you are tempted to use them, think: Will I be in control? Can I take care of
myself?
Avoid situations which may be dangerous or make you feel uncomfortable, such as
going into dark or out-of-the-way places. When you leave home, take change with
you to make a phone call to arrange a ride home, or have another way to get home
(such as with a friend or a group of friends) without depending on a date.
Don't broadcast the fact that you might be walking home alone. Someone might try
to follow you. Try to stay on main roads, not back streets, and walk facing
traffic. Have your keys ready before you reach your car or door. If you think
that someone is following you, go to the nearest phone and call the police.
Watch for houses you could run to if you should need help. Carrying a whistle or
screamer might help get people's attention if you need help.
Finally, if something happens, don't panic. Your best defense is clear thinking.
Unfortunately, there's no sure way out of every situation. You have to do what
you believe will keep you safest.
Remember, only people who sexually assault can stop sexual assault. These
suggestions are only intended to lower risk. A person does not get raped or
attacked because they did something wrong. Whatever happens, if you are sexually
assaulted, it's not your fault!
If you want to talk to someone about what has happened to you, or if you want
information, you can call a sexual assault centre or rape crisis centre. Or, you
can call your local Public Health Unit -- see References/Resources.

Breast Self-Examination
The earlier breast cancer is found and treated, the better chance for a
successful recovery. Examining your breasts once a month can prevent a small
problem from becoming very serious.
It takes just a few minutes. Examining your breasts allows you to become
familiar with them, and to recognize the changes that they go through every
month.
The best time to do the examination is at the end of your menstrual period. This
is the time that breasts will be least tender, and also at their smallest. If
you are not having periods, choose a regular day, such as the first day of the
month. Also, if you do it just after a doctor has checked and found no lumps,
then you can become familiar with the normal glands and muscles. Most lumps are
found by self-examination, not by doctors.
This is how to do it:
Part One is the "looking part". Stand in front of a mirror with your arms
relaxed at your sides. Look for any changes in the size or shape of your
breasts. Look for any rashes or changes in the skin and the nipples, or for
discharge from the nipples. Then move your arms up and down, looking to see if
either breast doesn't move as easily as the other. Press your hands on your
hips. No one has two breasts which are exactly the same. However, if one breast
looks quite different from the other, have this checked by a doctor.
Part two is the "feeling part". You will be feeling for hard lumps or a
thickening. Do not use your fingertips. Instead, hold your fingers together, and
use the flat part of two or three fingers, just below the tips. You need to
press your breast against your chest.
Stand up and raise one arm above your head. With the other hand, feel the breast
on the side of the raised arm. Move your fingers in little circles, starting at
the outside of your breast. Then move your fingers closer to the nipple, and
feel all around your breast again. Repeat this until you have covered your whole
breast and up to your shoulder. Then lower your arm and carefully feel your
armpit. This is a very important part, as many breast cancers start here.
Repeat all of these steps on the other breast. Then do the "feeling part" twice
more, once when you are lying down, and again in the shower. Using soap on your
skin helps the fingers to be sensitive. If you find anything unusual, ask a
doctor to check it right away.
Most lumps are not cancer. If it is cancer, the earlier it is treated the
simpler the treatment will be, and the greater chance for complete recovery.
Breast self-examination is a good habit. If there is a history of breast cancer
in the family, or if a woman is over 50, you might consider having regular
mammogram tests. A mammogram is a special x-ray which can help find cancerous
lumps while they are still small.
For more information, contact the Canadian Cancer Society, ask a doctor or go to
a clinic. Or, you can call your local Public Health Unit -- see
References/Resources.

Menstruation
Menstruation is natural. It is a sign of good health and fertility, or the
ability to get pregnant.
Normally, a woman has a menstrual period about once a month, unless she is
pregnant. This starts at puberty, between 9 and 14, and ends at menopause,
between 45 and 55. The time from one period to the next is called a menstrual
cycle.
During a menstrual cycle, the woman's uterus, or womb, builds up a thick lining
of blood and nutrients to protect and feed a fetus. At the same time, a few of
her eggs begin to ripen. Usually, one egg moves from an ovary into her uterus.
This is called ovulation. If the egg is not fertilized by sperm, she doesn't get
pregnant. In that case, she doesn't need the thick lining in her uterus. About 2
weeks later, the lining flows out through her vagina. This is called "a
menstrual period".
A period usually lasts from 3 to 7 days. The heaviest bleeding is in the first
days. You may feel tired during your period. This may be because your body is
losing iron. To stop your body from losing too much iron, called "anemia", you
can take a vitamin with iron.
To absorb menstrual blood, you can wear sanitary pads outside the body or
tampons inside the vagina. If the bleeding is light, you can wear panty liners.
These can all be bought at grocery or drug stores.
It is O.K. for both women and girls to wear tampons. They come in different
sizes, so if you decide to wear them, you can find a size that is comfortable
for your body. If they are inserted correctly, they can't be felt. They also
can't get "lost" inside your vagina. A string attached to the bottom of a tampon
makes it easy to take it out.
Tampons should be changed every four to six hours. Leaving a tampon in longer
than that can allow bacteria to grow, andd lead to an infection called Toxic
Shock Syndrome. This is very rare, but is very serious when it does happen.
Some women have a very regular menstrual cycle, every 27 days, for instance, or
every 33 days; others have an irregular cycle. The cycle may be longer one month
than another. This is also normal. Most cycles are from 21 to 34 days. The
average is 28.
It is common for periods to be very irregular for the first year or so.
Emotional upsets, illness, stress, gaining or losing a lot of weight, all can
cause a woman's period to be late or even missed. A woman just starting the
birth control pill may skip a period, or have spotting between periods for the
first few months. Periods may change after pregnancy, or just with time.
A woman is as healthy during her period as she is at any time. She can shower or
bathe, swim or exercise, have sexual intercourse, or do anything she would
normally do. Most women have some cramping or pain the first day or two of a
period. This can be relieved by exercise, a heating pad, or taking a pain
reliever.
However, some women do need help for problems with their periods. Women may go
to a doctor or clinic if they have such serious cramps that they can't go to
school or work, or if the period is very heavy, requiring 10 to 12 pads a day
for more than 5 days. Bleeding, spotting or cramping when she is not
menstruating should also be checked out. And, if she misses a period and there
is any possibility of pregnancy she should have a pregnancy test right away.
Remember, once you start having your period, you can get pregnant. So, if you
have sexual intercourse and don't want to get pregnant, you'll need to use some
form of birth control.
There are books which can tell you more about menstruation. You can talk to your
mother, a school nurse or doctor. Or, you can call your local Public Health Unit
-- see References/Resources.

Pre-Menstrual Syndrome or PMS
Pre-Menstrual Syndrome, or PMS, is what some people call the changes that women
may experience during the days before their menstrual period begins.
The most common physical changes are headaches, feeling tired, craving certain
foods, being unable to sleep, feeling bloating or heavy, and tender breasts.
Some women also find that they might feel more depressed or sad, anxious, or
irritable, that their moods just change more easily, or that it's more difficult
to concentrate.
Not all women get PMS. Some women find that they have much more energy in the
days before their period. They feel well and, sometimes, more creative.
Some women who do get PMS notice only some of these changes. For some, however,
the symptoms are so severe that their ability to function is affected. But,
there are some ways a woman might be able to make life easier during this time.
Learn what brings on the symptoms. Stress and diet can be very important.
Try to avoid stressful activities as much as possible during this time of the
month. Let family and co-workers know what PMS is like and you might make them
more supportive and understanding. Some women have found yoga, meditation or
other relaxation methods helpful. Avoiding foods high in sugar, salt and
caffeine as much as possible, especially 10 days before the next period, is also
helpful for some women.
Eating several small meals a day rather than three large ones helps keep a
steady amount of sugar in your blood. Eating foods high in potassium, such as
bananas, nuts, milk and spinach, and plenty of carbohydrates, such as whole
grain bread, cereal, pasta, potatoes and fruits, helps replace vitamins and
minerals that your body needs.
Regular exercise throughout the month is helpful, and may also release stress
and tension. Get plenty of rest.
You can try keeping a record or chart of your menstrual cycle, and physical or
emotional changes. This may help you predict how you will feel, and see if doing
anything differently affects the PMS. It may help you have more control, and may
be useful when you talk to a doctor about your pre-menstrual changes.
Some women have even started support groups. Do you know other women who might
be interested in this idea? Is there a women's centre in your area that could
help you start up a group?
For more information, you can call your local Public Health Unit -- see
References/Resources.

Menopause
Menopause, or sometimes called the Change of Life, is a normal part of a woman's
life. It usually starts between the ages of 45 and 55, and means the end of
fertility, or the ability to get pregnant.
Menopause brings a woman new freedom, freedom from menstrual periods, needing to
use contraceptives, or fear of pregnancy.
The last periods of a woman's life may be irregular and gradually taper off or
just stop. But unusual bleeding or cramps should be reported to a doctor right
away. Menopause may take a while to complete. Until it is complete, a woman can
still become pregnant. If she is sexually active and doesn't want to start a
pregnancy, she should use birth control until at least a year without a period.
Menopause occurs because the ovaries produce less of the female hormones. It may
take a while for the body to adjust to this. Most women notice some changes in
their bodies, but aren't bothered by them. Some women have physical or emotional
changes that seem uncomfortable.
A common discomfort of menopause is having hot flashes or flushes. These are
caused by an overreaction of blood vessels in the skin. A short sensation of
intense heat travels from the chest to the head. The woman may sweat heavily,
and feel cold afterwards. This can occur when she is awake or asleep.
The vagina gradually becomes drier and thinner, and sexual intercourse may
therefore become uncomfortable. Lubricating jelly bought at a drug store or a
vaginal cream with estrogen, prescribed by a doctor and used before intercourse,
can help prevent discomfort.
Some women experience emotional upsets, such as depression, anxiety or
sleeplessness. The decrease in estrogen may have some effect on emotions. Many
people think that these emotions are also affected by the new lifestyle that
many women are adjusting to during menopause. A woman may feel sad because her
children are grown and leaving home. Perhaps her husband is also coping with
mid-life changes. She may feel unsure of herself in a society that values youth
more than experience. Talking to friends, joining a support group or getting
professional counselling all might help her understand the changes she is going
through and her reactions to the changes.
Experts agree that good nutrition and exercise help the body get used to the
decrease in estrogen. Some doctors suggsest that women can benefit from taking
small dosages of the female hormones, which the body no longer makes after
menopause. This is called Estrogen Replacement Therapy, or ERT. A woman may take
hormones orally, or wear a skin patch which delivers them. Like many
medications, hormones may have both benefits and risks. A woman should talk with
her doctor about the advantages and disadvantages of all her choices before
making a decision.
Osteoporosis, when bones become brittle and break more easily, may also become a
problem. A woman may shrink a little in height. The best prevention is doing
"weight-bearing" exercises, such as walking, to increase bone strength and
getting plenty of calcium, at least 1500 milligrams a day. Calcium is found in
dairy products, some vegetables, vitamin tablets and regular antacids. Three
antacid tablets supply the daily requirement.
Regular medical check-ups are important to a woman's health, whether or not she
is being treated for menopause symptoms. Healthy practices include seeing a
doctor once a year, and examining her own breasts every month.
If you'd like more information about menopause, you can talk to your doctor or
staff at a women's health centre. Or, you can call your local Public Health Unit
-- see References/Resources.

Bladder Infection in Women
Women get bladder infections more frequently than men because the tube that
leads from the bladder to the outside is much shorter. Also, the opening from
the bladder is very close to the vagina and the anus. This means that it is easy
for bacteria or germs to get from the anus to the opening, especially during
sex.
A first sign of a bladder infection is needing to urinate more often. Sometimes
the woman feels she needs to urinate again, right after she has finished. There
may be blood in the urine, or it may have a different smell. Sometimes urination
is painful and difficult.
There might be infection in the kidneys, rather than in the bladder. This might
cause fever, chills, nausea, throwing up or backache, along with the other
symptoms.
A woman may need to see a doctor, whether the infection is in the bladder or in
the kidneys. A sample of urine will be sent to a lab for testing. Treatment will
probably be with antibiotics. Be sure to follow instructions carefully, and
finish all of the pills. Infection can come back easily if the prescription is
not finished.
There are some things a woman can do to help prevent bladder infection:
Drink between 8 and 10 glasses of water or other fluids a day. Fruit juices
are good, especially cranberry juice; however coffee, tea, and alcohol are
not fluids that help.
Urinate often and completely. Don't hold back.
Urinate before and after intercourse. This may help to wash away some germs.

After using the toilet, wipe yourself from front to back. This way you won't
spread germs from the anus to the bladder opening.
Don't allow your sex partner to touch your anus and then the bladder
opening.
Change from a wet bathing suit to dry clothing immediately after a swim.
Avoid bubble bath, or scentecd tampons, sanitary pads and panty-liners.
Use cotton underpants or pantyhose with a cotton-lined crotch.
If you think you might have a bladder infection, see your doctor. For more
information, you can call your local Public Health Unit -- see
References/Resources.

The Pelvic Exam
A pelvic or vaginal or internal exam is an important medical check-up. It is
recommended for every woman at least once a year. Although it may feel
embarrassing or uncomfortable at first, women ususally find it easier as they
get used to having it done. Having this exam helps you take responsibilty for
your own health. It can stop small problems from becoming large ones.
A woman should go for the appointment when she is not having her menstrual
period. Before she goes she might want to shower and change her underwear. But
she shouldn't douche for several days beforehand.
The doctor asks a few questions: the date of her last period, if she has had
sexual intercourse, and if she has ever been pregnant. Her answers are
confidential.
After the woman has undressed she is asked to put on a gown and lie back on an
examining table. Her feet are raised and her legs are spread apart. Some women
feel more comfortable having this done by a woman doctor, or with another woman
in the room.
Relaxing and taking deep breaths can help make this much easier. You can ask
questions during the exam and ask for a mirror to see yourself if you wish.
The doctor examines the outer area of the vulva, or genital area, for infections
or sores. Then a speculum is inserted into the vagina. The speculum, made of
metal or plastic, has two halves which are spread apart inside the vagina so
that the cervix can be seen. You may want to listen to the message on Women's
Sexual Organs, in the Sexuality Menu, for more information about this area of
your body.
The doctor checks for cervical discharge, irritation or injury. Some cells are
taken from the cervix. This is called a Pap test. The cervix has few nerve
endings, so it doesn't cause much pain. A test for infection can also be done by
taking a sample of mucus from the cervix.
After the speculum is removed, the doctor does an exam using both hands, using
one hand to feel inside the vagina and the other one to press down on the
abdomen. This way, the doctor can feel the inner pelvic organs, the uterus,
ovaries and fallopian tubes. Any pain or tenderness can be a sign of infection
or another problem, so be sure to tell the person doing the exam if you feel any
discomfort or pain.
Getting the results from the tests may take a week or two. You can call the
doctor's office to ask about the results.
For more information, you can call your doctor or local Public Health Unit --
see References/Resources.

Pap Tests
Having a Pap test, sometimes called a Pap Smear, is one of the easiest, most
responsible things a woman can do to protect her health. A doctor who does a
pelvic or vaginal exam may do a Pap test at the same time.
Cells at the opening of a woman's womb, the cervix, may change. Some changes,
left untreated, may become cancerous. Cancer of the cervix grows very slowly.
So, if the cancer is found and removed early enough it will not cause harm.
During the Pap test, the doctor will gently scrape some cells from the cervix.
Because there aren't a lot of nerve endings on the cervix, it's not very
painful. You can get the test results after a week or two. However, the doctor
will contact you if the cells are unusual in any way. Then you will need to have
another Pap test.
There can be several causes of unusual cells, such as sexually transmitted
diseases or other infections, and exposure to certain chemicals. Most unusual
cells do not mean cancer. So, if your doctor wants you to have a repeat test,
this does not necessarily mean that you have cancer. However, it is very
important to go back and find out more. And remember, if you do have cancer of
the cervix, it can nearly always be cured.
If you have an infection, your doctor can treat you for it. If you have unusual
cells which need to be removed, this is done in one of three ways: by cutting
them out, by freezing them, or by destroying them by laser treatment. None of
these procedures is very painful. Unless cancer is widespread, which is rare,
you will still be able to have children afterwards.
You should start having yearly Pap tests when you are eighteen or when you start
having sexual intercourse, whichever comes first. Some women need Pap tests
twice a year. Women who have had cervical cancer, or women who have genital
warts or several male partners, should have Pap tests every six months.
You may also want to listen to the message on The Pelvic Exam, in the
Miscellaneous Menu.
For more information, you can call a doctor or clinic. Or, you can call your
local Public Health Unit -- see References/Resources.

Infertility
Infertility means having a problem which makes it hard to start a pregnancy.
Many couples find that starting a pregnancy is not as easy as they had expected.
Although it may be upsetting, most doctors suggest that you should keep trying
for at least one year before looking for help. Infertility can happen because of
a problem in either a man or a woman.
Here are some things both men and women can do to increase the chances of
pregnancy: get healthy and stay healthy. Avoid caffeine, tobacco, drugs and
alcohol.
For women, being stressed and tired may make it harder to become pregnant.
Maintaining a healthy weight and doing some -- but not too much -- exercise can
make it easier.
Men should avoid wearing very tight jeans or underwear, as their testicles need
to hang away from the body in order to keep cool to produce sperm. Hot baths can
kill sperm.
It may help if the woman lies on her back during intercourse, and remains still
for at least 20 minutes afterwards.
There are courses on fertility, books and pamphlets on the subject. A couple can
learn to chart the woman's temperature and check her vaginal mucus to figure out
when she ovulates. Ovulation is about 14 days before her next menstrual period.
Having intercourse a day before ovulation gives the best chance for conception,
or starting a pregnancy.
There are doctors and clinics offering treatment for infertility. Both women and
men can be checked, and need to provide information about their histories. The
man supplies a sample of sperm, and the couple learn how to figure out when the
woman ovulates. Tests are done, and treatment may include hormonal therapy or
surgery.
Some couples become pregnant, while others don't. Some try to adopt a child, and
some will try a process called "in vitro fertilization". For this the woman will
be given fertility drugs. Her eggs will be collected and fertilized with her
partner's sperm. Eggs that start to develop will be replaced in the woman's
uterus. The success rate for this process is about 10%. OHIP may cover some of
the costs, depending on what the problem is.
Trying to conceive is often an emotional time, full of frustration and
disappointment. There may be support groups in your area. Talk to a doctor or a
clinic specializing in infertility treatment. Or, you can call your local Public
Health Unit -- see References/Resources.

Eating Disorders
Eating right is especially important for young people, pregnant women and
mothers who are breast-feeding babies. Children who are well-fed are stronger
and can learn more easily. Adults who eat well tend to live longer and have
fewer health problems. Some illnesses may be complicated by a diet with a lot of
sugar or fat, or not enough vitamins, minerals, protein and carbohydrates.
Sometimes people, especially girls and women, become very concerned about their
size or shape. Being too worried about fashion and weight can cause very serious
health problems. We need some fat in our diet. Thinness does not guarantee
happiness or success.
Dieting can mean temporary weight loss, but losing pounds too quickly is
dangerous. It is unhealthy to gain, lose, then regain weight. Most people who
diet gain the weight back again, and often more weight as well. "Fad" diets
don't work!
Sometimes people, particularly girls, develop anorexia. They are so afraid of
gaining weight that they don't recognize how underweight they are. They don't
eat, or they over-use laxatives, or they exercise so much that they can
literally starve themselves unless they get help.
Food can be used as a way of feeling in control or stuffing down emotions:
frustration, loneliness, fear, anger or insecurity. Some people "binge" or
overeat to try to escape from emotional pain, worries or trouble. It's easier to
fall into these patterns if you have low self-esteem, that is, you don't feel
good about yourself.
Some people overeat or binge and then throw up, to get rid of the unwanted
calories. This is called purging or bulimia. Throwing up is extremely hard on
the body, and it rots the teeth.
Although we don't always know why people overeat, we do know that obesity, that
is, weighing 20% or more than the normal range, increases the risk of stroke,
heart attack and diabetes. Obesity contributes to many health problems and
shortens life expectancy.
Poor eating habits are often learned in childhood, and serious eating disorders
often result from childhood pain, abuse or fear. Trying to follow Canada's Food
Guide can help improve eating habits. This is not easy, and people with a
serious eating disorder might find that they need professional help or a support
group to help them learn new eating habits. There are doctors and clinics to
help. Some hospitals have eating disorder or nutrition programs. Some even have
support groups, or might be able to help you start one. For more information,
you can call the National Eating Disorder Information Centre at (416) 340-4156,
or your local Public Health Unit -- see References/Resources.

Severe Depression & Suicide
You may be calling because you feel desperate, and think that life isn't worth
living anymore. Please listen. You are not alone. A lot of people feel that way
sometimes.
There may be some terrible things in your life right now. Maybe you just broke
up with a friend, failed at school, or lost a job. Maybe your parents, or you
and your partner fight a lot or have just separated. Perhaps alcohol or drugs
are a problem. Maybe you're not sure why, but you feel hopeless about your
future. Is there someone you can talk to, someone you trust, who will listen and
believe in you? A good friend, parent, counsellor, teacher or religious leader?
There are places where someone will listen to you. You can always call the Kids
Help Phone Line, a distress centre or crisis line, a community health centre or
the hospital emergency department, and someone will listen to you and help you.
If you are listening to this message because you are a parent, relative or
friend of a person who is talking about suicide, take the person seriously.
People often try to let others know how they're feeling and what they're
thinking about doing before they actually attempt suicide. Sometimes, they don't
come right out and say it, but there are other kinds of signs. Here are some
signs to look out for:
suicide threats or repeated discussion about death
talking about how they could commit suicide
unexplained, sudden absences from school or work
no interest in anything
giving away personal belongings
long crying spells
extreme anxiety, or problems sleeping or eating
using alcohol or drugs
taking risks, for instance, driving dangerously
feeling completely unwanted, useless and alone
or a powerful feeling of loss
These signs of deep depression need attention immediately.
Professional help may come from psychologists, psychiatrists, social workers or
other counsellors. Talk to someone at a crisis line, a distress centre or at
school. You can also call a hospital, Public Health Unit, community health
centre or, if you're under 19, the Kids Help Phone Line. The Kids Help Phone
Line is 1- 800-668-6868.
Those who are close to someone who has committed suicide or tried to may also
need help. They may find it hard to cope with their feelings. The same
professionals and agencies just mentioned are there to help. There are also
support groups in many communities. And once again, the Kids Help Phone Line, 24
hours a day, is 1-800-668-6868.

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