Rebecca's Blogs

Rebecca's Blogs

Some musings, mental notes and generally some ramblings from author Rebecca Warner.

Friday, 01 July 2016 19:38

You Deserve Pleasurable Post-Menopausal Sex Featured

A friend of mine, at the age of 55, was in a new relationship that was heading towards sexual intimacy. Concerned because she had not had sex in three years, and knowing from experience that it could be a painful encounter because of vaginal dryness, she asked me—a sexually active woman in a twenty-seven-year marriage—what I used to combat that discomfort.

I had a great recommendation, based upon my own experience. The first time I had painful intercourse with my husband, I was astonished. Vaginal dryness came on seemingly overnight, and our lovemaking had to be halted. The next morning, I called my gynecologist’s office and asked to be worked in that day. You see, I love having regular sex with my husband, and I was certain there was a medical remedy to keep that viable, and there was.

My doctor prescribed Vagifem 10 mcg, and after using that small vaginal suppository only a few times, I was back to normal, and so was our sex life.

Vagifem is an estrogen replacement suppository consisting of estradiol. It treats the underlying cause of menopause-related vaginal changes by helping to replenish the vagina’s lost estrogen. It’s used primarily after menopause to treat changes in and around the vagina, including atrophic vaginitis (dryness and soreness in the vagina) and dyspareunia (pain during sexual intercourse.) It is also beneficial in preventing UTIs. The cells lining the vagina are basically the same cells that line the urethra and the bladder. When the vagina is dry, the bladder is dry, and UTIs occur with greater frequency.

There are other such treatments for these afflictions, including patches, ointment, and vaginal rings; but the Vagifem suppository has been very effective for me, so I happily recommended this simple treatment to my friend. She saw her doctor, got a prescription, and began using it. When sexual intimacy occurred the following week, she experienced no discomfort with her new beau. Wonderful, right? I mean, here’s a medical solution for a painful condition, a remedy that can be prescribed by your doctor, and it is covered by insurance.

Until it isn’t.

That same friend called me a few days ago to tell me that her insurance company would no longer cover the cost of Vagifem. She said her out-of-pocket cost for a 90-day supply (24 tablets) would now be $425. My insurance company still covers it under my grandfathered plan, but I have a high deductible, so my out-of-pocket cost for a 90-day supply is $546. But because it is a covered medication, it at least goes towards my deductible. Not so for my friend. The total cost is now hers to bear. Thankfully, my friend and I can afford Vagifem, but many women cannot.

The Affordable Care Act did a great thing in mandating that plans in the Health Insurance Marketplace cover contraceptive methods and counseling for all women, as prescribed by a health care provider. Plans must cover these services without charging a copayment or coinsurance when provided by an in-network provider, even if a woman has not met her deductible. If her employer is granted an exemption to pay for a plan that covers the cost of birth control based on religious reasons (Hobby Lobby) the insurer will provide birth control coverage to the company’s female employees at no additional cost to the company. Birth control addresses both pregnancy prevention and women’s health issues, such as regulating periods, stopping menstrual migraines, easing endometriosis, helping with polycystic ovarian syndrome, and reducing the risk of endometrial cancer. Vaginal estrogen replacement medication address multiple symptoms related to women’s health, so why shouldn’t it be covered as well?

In doing some research, I ran across plenty of forums with discussions that date back years, with post-menopausal women complaining that their health insurance would not cover treatment for their symptoms, because they consider “hormone-level decline a normal part of aging.”

Medicare Part D covers much of the cost for Vagifem, but atrophic vaginitis and dyspareunia occur in women much younger than 65. So why would some private insurance companies not cover a medication that is essential in alleviating a post-menopausal woman’s painful dryness symptoms? Are vaginal dryness, UTIs, atrophy and the related pain not legitimate medical conditions?

Or is it just that the vaginas of women who can no longer reproduce are considered—well, not worthy of  consideration? Are we just supposed to dry up and blow away?

Aging takes enough of a toll on women mentally and physically, and our desire to stave off this particular painful biological effect of aging should not take a large financial toll as well. Aging gracefully simply cannot occur if a woman who wants to have sex cannot do so without pain. Which makes me wonder: How did insurance companies arrive at the conclusion that women should personally bear the cost of treating the medical conditions known as atrophic vaginitis and dyspareunia? Which executives decided that women not of child-bearing age should pay such a high price to maintain a healthy vagina, one that is still primed for pleasurable intercourse? This isn’t plastic surgery, an optional choice for looking younger. This is a medical issue of alleviating pain and maintaining the health of the most vital area of our feminine realm. It should not be optional based upon affordability.

If we remain healthy, we can enjoy sex long into our “old age,” given the availability of erectile-dysfunction pills and vaginal atrophy treatment. If women want to enjoy sex after menopause, but before age 65, they may have to pay dearly for it. Our sexuality is being devalued by tight-fisted insurance companies. The ACA gives us the right to appeal such insurance company decisions through an internal appeal or an external review. If every woman who is denied coverage for FDA-approved atrophic vaginitis remedies appealed, we might be able to reclaim our right to painless sex for decades before we are eligible for Medicare.

REKINDLING THE TORCH OF CHOICE

Those of us who are over 50 have reached that comfortable age when we no longer have to worry about an unintended pregnancy. For us, the issue of reproductive choice has faded in importance. But for our daughters and granddaughters of childbearing age, it should still matter—now more than ever.

Those of us who became sexually active in the 70s had protections in place to safeguard us from unwanted pregnancy. In 1972, the Supreme Court ruled that unmarried women could legally be prescribed birth control pills. And then in 1973, the landmark Roe v. Wade decision gave women the right to make decisions about whether or not to have an abortion. These protections are still largely in place in 2015. However, with the aggressive anti-choice agenda being pushed by state and federal lawmakers, that may not be the case by the next presidential election.

I’ve always advocated choice, simply because I felt another person should never have any say over any decisions regarding my body. Choice dovetailed with the years I became sexually active, and my reproductive choices were protected under the law.

Legal protection of women’s reproductive choices has been under relentless assault for some time, and those efforts are escalating. Republicans in Congress, emboldened by their new majority, introduced five abortion restrictions in the first three days of the new legislative session! Their proposed restrictions would severely limit women’s access to abortion. Politicians are inserting themselves in the most private and personal medical decision that should be left up to a woman and her doctor.

What is truly baffling is their quest to defund Planned Parenthood. One in five women visits a Planned Parenthood clinic at least once in her life. Why would Republicans want to defund Planned Parenthood when it helps to prevent more than half a million unintended pregnancies each year, thereby making the need for an abortion moot? It seems irrational, and at cross-purposes. Yes, Planned Parenthood is there when a woman needs abortion care, but performing abortions is only three percent of the many services they provide. Why inhibit a woman’s access to birth control, pelvic screenings, breast exams and other health-and-reproductive-related services?

We are going backwards, and the generations of women who are of child-bearing age do not seem meaningfully motivated to halt this persistent march back to the days of no choice. They’ve lived with the victorious results of a hard-won battle that raged through the 60s and early 70s. That is ancient history to them, but it isn’t ancient history to those of us who saw the battle being waged and first benefitted from its accomplishment.

The Women’s Liberation Movement, like the Civil Rights movement, required organization, dedication, and unification to be recognized. The impetus for that kind of solidarity is not there today. The pro-life movement, on the other hand, has burgeoned and is gaining strength day by day. Both the Civil Rights and Women’s Liberation Movement brought about positive changes in society. Imagine if legislation were being churned out to prohibit African-Americans from having the same rights as white people, such as drinking from the same water fountain? Would you not think, That’s nuts! They can’t do that! We’re way past that!

Why aren’t women reacting as strongly to the potential loss of their right to make decisions about their own bodies?

Perhaps it is because we older women have become unworried, since we are no longer personally affected. Maybe it is because younger women don’t know about or can’t relate to the horrors of backroom abortions. They may know women who have had an abortion–a safe, legal medical procedure; but they don’t know women who died from a botched abortion.

The Nineteenth Amendment that gave women the right to vote was also hard fought for and won. Think about how you took for granted your right to vote when you turned eighteen. In that same way, younger women are taking for granted that they will have reproductive choices in the future. But that is not so. Even access to birth control, as we can see by the assault on Planned Parenthood and the SCOTUS decision in the Hobby Lobby case, is under attack.

It is time for women of every generation to stop taking choice for granted. Let’s acknowledge that the Republican’s answer to birth control—total abstention—is unrealistic, and that it is up to us to keep birth control and safe abortions accessible. This is going to require our generation’s involvement. Those of us who enjoyed virtually worry-free sex must educate younger women about how difficult it was when women had no access to birth control or safe abortions.

It is time for our generation to rekindle the torch of choice, and to pass it down. It is time for us, the most outspoken, inspiring and audacious women in history, to shake women of all ages out of their complacency! Our legacy should be the empowerment of younger women in constructing stronger, independent lives that aren’t lived according to ideals imposed by men. It is our duty to encourage them to fight for the continued right of choice, so that they can in turn inspire the generations of women who come after them to do the same.

We are not too old to take up the battle. Let us give others the benefit of our experience and knowledge. We lived it, so we can talk of it with intelligence and confidence. Let’s start by engaging our daughters, granddaughters, and young friends in meaningful conversations about what the loss of choice will mean for them. Let’s emphasize the value of their vote, and enlist their support of organizations that support choice, like Planned Parenthood, NARAL and Emily’s List.

Let us not go gently into our golden years. Instead, let us reinvigorate and do what we can now to help preserve a woman’s most fundamental right—the right to have total control over her own body.

Wednesday, 02 December 2015 23:57

Do Book Awards Matter? Featured

There was a debate raging on LinkedIn recently, when someone asked the question, "What value do you put on authors when they describe themselves as 'Award Winners?'"

Responses ranged from vitriolic to meh to upbeat--the last provided by award-winning authors, for the most part.

I don't describe myself anywhere as "an award-winning author." I do say, "Author of the two-time award-winning book, Moral Infidelity."  My input on that LinkedIn thread was that I thought I wrote a good book, I wanted validation, and so I entered two contests--and I won in both. And yes, there was a fee for entry to both The Great Southeast Book Festival Book (GSBF) Award Contest ($50), and the Readers' Favorite (RF) Book Reviews and Award Contest ($89.) This *fee* sparked a lot of, "If you have to pay for it, it has no value" comments.  

Not so, I exclaim!  Paying a modest fee to enter a competitive, professionally-judged contest is by no definition “pay for play.”  Sure, there are vanity presses out there that will publish you or promote you strictly based on what you pay—that is totally different. When I learned from the President of Readers' Favorites, James Ventrillo, at the awards ceremony in Miami on November 21, 2015, that there were over 600 entries in my category of Fiction: Thriller General, I felt there was indeed value in that award. I had won a bronze medal--third place--in a category that was highly competitive. In fact, there were two silver and two bronze awards in that category; and as Mr. Ventrillo explained, there are five judges awarding points to each book. In my category, there were actual ties for the silver and bronze awards. So, technically, I was in the top five of that category. Still, I feel my book has been, well, validated.

In addition, I received a glowing 5-star review from one of the Readers' Favorite reviewers, and I was able to use it on my Amazon book page under "Editorial Reviews." I also peppered my social media pages with a high-resolution bronze digital medal that looked pretty spiffy alongside my Great Southeast Book Festival Honorable Mention gold digital badge. I don't know how many entries there were in the Great Southeast Book Festival, but I do know there was one winner, one runner-up, and ten honorable mentions--of which Moral Infidelity was one. I photo-shopped both onto my book cover, which I feel adds interest.

Now, I admit that when I won the GSBF award in January, 2015, I myself pooh-poohed it. It didn't get media coverage, and sales of my book did not budge. I had to pay for the gold stickers to use on the book ($25) but didn't find that exorbitant. When I received notification on September 1, 2015 that Moral Infidelity had won the bronze in the Readers' Favorite contest, I walked into my husband's study and laconically informed him. Of course, I had no idea of the level of competition at that time, so I couldn't assign a lot of value or enthusiasm to the award. But I decided we would attend the awards ceremony in Miami (any excuse to go to Miami, where I had lived for 30 years), so I went to the Readers' Favorite winners' page, made reservations, and ordered the complimentary bronze stickers. 

After winning that second award, my proud husband contacted a friend who had been a book reviewer for three different national newspapers, asking him if he knew of anyone with a major periodical who could review my book and get it more exposure. He mentioned both awards, and surprisingly, the reviewer replied, "If she's won the Great Southeast Book Festival award, she's already accomplished something. There's buzz about that award in the industry."  Who knew?  There was an awards ceremony for GSBF winners being held in California, but I didn't even consider going. Learning that there was some measure of prestige attached to that award, I now wish I had. 

Readers' Favorite posted the information about the winning books on numerous social media sites, including Facebook and Twitter. They put on a heck of a fine awards banquet, and delivered some high-quality photos that can be used for marketing and promotion. So do I feel I got $89 worth of value from Readers' Favorite? You bet I do! Best of all, sales ticked up that awards weekend when I ran a promotion, and Moral Infidelity entered the top 5,000 on Amazon for the first time. Do I feel I got my value out of the $50 Great Southeast Book Festival Award (plus the $25 for stickers?) Hard to say, but I know that I am now almost as proud of the GSBF award as I am of the RF award. 

For those who think any paid entry for a contest makes it bogus, I would like to point out that someone has to read and review the entries, and someone has to read and judge those entries. I can't imagine any organization that is altruistic enough to pay those persons on authors' behalf. I can't imagine any reviewers who would read dozens of books and review them as a favor. Somehow, the costs for the banquet venue and food, the medals, and the photographer, had to be paid. That booth at the Miami Book Fair International, where the award-winning books were displayed, was not free. When you consider all that Readers' Favorite delivered, I think $89 is a bargain.

So yes, I feel I got my money's worth...Validation, promotion, and a fun time in Miami, where I met so many interesting authors. Book promoters and marketing specialists were there to offer advice, along with their services. Of course, the promoters and marketers have other (paid) services to offer, and for those who wish to take it further, they at least have a place to start. 

I'm now working on my fourth book, and though at this point I have no idea if it will be good enough to win another award, I might just pony up the money and go for what I originally intended to get out of the entire awards process--validation. Where's the flaw in that?

Tuesday, 18 August 2015 16:00

Writing With Purpose

I have just self-published my third book in 15 months, and although there has been a great deal of satisfaction in writing those books, I know I need to take a breather--but my "purpose" in writing them won't allow me to do so!

I self-published my first two books, MORAL INFIDELITY and DOUBLING BACK TO LOVE, at the age of 59. Yes, quite a late age to start a career in writing. In this, my 60th year, I published Book 1: HE'S JUST A MAN: Making the Most of Your Womanly Power.

All of my books embrace the concept of women standing in their own power. The escalating assault on a woman's reproductive choices, especially her right to an abortion, compelled me to publish MORAL INFIDELITY, a book about a hypocritical pro-life governor whose mistress becomes pregnant, and the choices he is forced to make when an unintended pregnancy threatens to ruin his life. Choice  takes on a whole new meaning for him.

DOUBLING BACK TO LOVE is about a woman who asks the question, "Why does it have to come down to choosing just one man, when no one man can give me everything I want?" She won't be shackled by conventionality and duplicitous morality in seeking love.

Both of those books are works of fiction.

HE'S JUST A MAN is a non-fiction, self-help book for women. It is intended to help women build their self-esteem so that they can approach men and relationships from a position of strength, versus an unhealthy position of perceived need. 

I am working hard to write these books that explore concepts and actions that empower women, because we are at a critical time in the history of women's rights. Those rights are being assaulted by right-wing politicians and religious fundamentalists like never before. Women's Choice is in danger of being extinguished, and that is something I want to fight against--and my best weapons are my words.

None of my books have reached a wide audience, though they have garnered many five-star reviews and ratings from those who have read them. I have yet to "move into the black"'in terms of making more money than I have spent in self-publishing them; but I feel compelled to keep writing about the issues that matter most to me, issues which I feel should matter to all women: The right to control our own lives and to have control over our own bodies.

I don't have delusions that my books will change the world, but I do wish for them to empower and embolden women to fight back against the assault on their rights to social, political and economic equality to men.

So I'll keep writing and hoping that my 60 years of living--during which I have accumulated knowledge, experience and information--will find ears to listen, and hearts to follow, in the quest to put to rest, finally and forever, the idea that women are not as deserving of equality in all areas of their lives as men are. 

Is that an impossible dream? Perhaps, but then, I always was one to tilt at windmills!