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Reproductive Health. Caring for your reproductive health involves:
- Lesley Allen Evans
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1 Reproductive Health A healthy reproductive system makes the miracle of life possible. Taking good care of your reproductive health is important because problems with this system can make it hard or impossible for you to become pregnant. Reproductive health problems also can be harmful to your overall health and emotional well-being and can make it hard to enjoy a sexual relationship. Fortunately, many reproductive health problems can be prevented or corrected if you take good care of your body and see your doctor for regular checkups and screenings. Caring for your reproductive health involves: l Learning how your reproductive system works and what is normal for you. Knowing these things will help you to tell if you need to see a doctor. l Keeping away from substances and chemicals that can harm your reproductive health and ability to produce healthy children. l Seeing your doctor for routine checkups and screenings. This way, problems can be found early, so they can be treated or kept from getting worse. l Protecting yourself from sexually transmitted infections (STIs), which are very common and easily spread. They can damage reproductive organs and make it hard to get pregnant or cause problems during pregnancy. l Incorporating family planning. Reproductive Health 153
2 Your reproductive system A woman has reproductive organs both inside and outside her body. All the organs play a role in the reproductive process, which includes: l menstrual cycle a woman s monthly cycle, which includes getting your period l conception when a woman s egg is fertilized by a man s sperm l pregnancy l childbirth Fallopian tube Vagina Ovary Uterus Cervix Here are the major reproductive organs and what they do: Ovaries These two small glands contain eggs (ova) and make hormones. One of the ovaries releases an egg about once a month as part of the menstrual cycle. This is called ovulation. Fallopian tube When an egg is released, it travels through the fallopian tube to the uterus. You will get pregnant if you have sex with a man, and his sperm fertilizes the egg on its way to your uterus. Uterus The uterus, or womb, is a hollow, pear-shaped organ. The tissue that lines the uterus is called the endometrium. If a fertilized egg attaches itself to the lining of the uterus, it may continue to develop into a fetus. The uterus expands as the fetus grows. The muscular walls of the uterus help to push the mature fetus out during birth. If pregnancy does not occur, the egg is shed along with the blood and tissue that lines the uterus. This is menstruation, also called getting your period. Cervix This narrow entryway connects the vagina and uterus. The cervix is flexible so that it can expand to let a baby pass through during birth. Reproductive health topics found elsewhere in this book: Cancer, including breast, cervical, endometrial, and uterine cancers...page 51 Menopause... page 224 Pregnancy, preconception care, infertility... page 169 Sexually transmitted infections (STIs)... page 119 Urinary incontinence... page The Healthy Woman: A Complete Guide for All Ages
3 Mons pubis Urinary opening Clitoris Labia (outer) Labia (inner) Vaginal opening Anus Vagina Also called the birth canal, the vagina stretches during childbirth. Caring for Your Vulva The vulva does not need special care. But there are a few things you can do to stay comfortable and prevent infections: Do not douche. Douching may make a woman more prone to vaginal infections and make it harder to get pregnant for women who want to. Wear only cotton underpants and avoid tight-fitting pants and pantyhose. Use a personal lubricant for intercourse if the vagina is dry or more lubrication is needed. Frequent use of lubricants that contain the spermicide nonoxynol-9 (N-9) can irritate the vulva and vagina and might increase the risk of infections, including HIV. Use a mirror to check your vulva once a month. If you notice any signs of problems, such as swelling, changes in color, or change in your usual discharge, contact your doctor. The external female genital organ is the vulva. The vulva has five parts: mons pubis, labia, clitoris, urinary opening, and vaginal opening. Know your period Chemicals a woman s body makes called hormones rise and fall during the month and make the menstrual cycle happen. Keep track of your menstrual cycle with a menstrual diary or calendar, so you can know what s normal for you. Make a note of the day your period starts and ends in your calendar and if your bleeding is heavier or lighter than usual. Most cycles are about 28 days long. Your period might not be the same every month. Also make a note of changes in your Reproductive Health 155
4 mood or body during your cycle. Some women have mild pain on one side of their abdomen during ovulation. You might also notice these symptoms in the days leading up to your period: l cramping, bloating, and sore breasts l food cravings l mood swings and irritability l headaches and fatigue Women whose symptoms are severe may have premenstrual syndrome (PMS). Let your doctor know if you have trouble coping with the symptoms of your period, especially mood swings. l l Regular periods: A sign of good health Sometimes women have problems with their menstrual cycle. These are some common menstrual problems: l Abnormal uterine bleeding includes very heavy or long-lasting periods (menorrhagia) (MEN-uh-RAY-jeeuh) or irregular bleeding. Uterine fibroids (FY-broidz) are the most common cause of menorrhagia in adult women. Young teenage girls often have longer cycles until their reproductive system is fully mature. Also, periods may become irregular as you near menopause. l Amenorrhea (ay-men-uh-ree-uh) occurs when a young woman hasn t started menstruating by age 16, or when a woman who used to have a regular period stops menstruating for at least 3 months. The most common cause is pregnancy. But amenorrhea can be a symptom of a disorder, such as polycystic ovary syndrome, premature ovarian failure, or thyroid problems. It is also a sign of a less common but serious condition called female athlete triad, which affects a woman s menstrual cycle, eating habits, and bone health. Competitive athletes and women who engage in a great deal of physical activity are at risk of this disorder. Dysmenorrhea (diss-men-uh-reeuh) is severe pain during a woman s period. The natural production of a hormone called prostaglandin (PROSS-tuh-GLAN-duhn) can cause intense cramping. It is a problem found mainly in girls and young women. In women in their 20s, 30s, and 40s, a condition such as uterine fibroids or endometriosis (EN-doh- MEE-tree-OH-suhss) may cause painful periods. Premature ovarian failure (POF) is when a woman s ovaries stop working normally before she is 40. POF is not the same as early menopause. Some women with POF still get a period 156 The Healthy Woman: A Complete Guide for All Ages
5 When to Get Help for Problem Periods Problem periods often are a symptom of another condition, which may or may not need treatment. See your doctor if: you have not started menstruating by the age of 16 your period suddenly stops you are bleeding for more days than usual you are bleeding much more than usual your periods become irregular after having had regular, monthly cycles your period occurs more often than every 21 days or less often than every 45 days you suddenly feel very sick while or after using tampons, experiencing symptoms such as high fever, headache, throwing up, rash, or feeling faint you bleed between periods (more than just a few drops) you have severe pain during your period you have severe emotional or physical symptoms in the days before your period now and then. But getting pregnant is hard for women with POF. Women with POF also are more likely to develop certain conditions, including osteoporosis (OSS-tee-oh-puh-ROHsuhss), low thyroid function, and an autoimmune (aw-toh-ih-myoon) disease called Addison s disease. (See page 83 of the Autoimmune Diseases chapter for more information.) No treatment will restore ovary function. But some symptoms of POF and the risk of bone loss can be helped by hormone therapy. The cause of POF is not known. But it appears to run in some families. POF also occurs in some women who carry the mutated gene that causes Fragile X syndrome. Women with POF should talk to their doctors about being tested to see if l they are a carrier of this mutated gene. (See page 408 of the Appendix for information on genetic testing.) Premature menopause is when a woman s period stops completely before she is 40. This can occur naturally or because of medical treatment or surgery. Early menopause puts a woman at greater risk of heart disease and osteoporosis, but there are treatment options to lower these risks. Reproductive and gynecologic health There are many conditions and disorders that can affect the organs in a woman s abdominal and pelvic areas. We don t know what causes many reproductive health problems. But there are ways to manage symptoms or make them go Reproductive Health 157
6 away, such as with medicine, surgery, physical therapy, or lifestyle changes. The specific problem, your symptoms, your Disorder Endometrial hyperplasia (EN-doh-MEE-tree-uhl HEYE-pur-PLAY-zhee-uh) occurs when the lining of the uterus grows too thick. It is not cancer. But if the cells of the lining become abnormal, it can lead to cancer of the uterus. Endometriosis occurs when tissue that s like the uterine lining grows outside the uterus. It is very common, mainly affecting women in their 30s and 40s. It is one of the top three causes of infertility. Assisted reproductive technology (ART) helps many women with endometriosis become pregnant. (See the Pregnancy chapter on page 169 for more information on treating infertility.) Ovarian cysts are fluid-filled sacs in the ovaries. In most cases, a cyst is completely normal: It does no harm and goes away by itself. Most women have them at some point in their lives. Often, a woman finds out about a cyst when she has a pelvic exam. Cysts are rarely cancerous in women younger than 50. See also, polycystic ovary syndrome. Painful sexual intercourse (dyspareunia) (DISSpuh-ROO-nee-uh) can cause distress for a woman and her partner. Some causes of pain are: Vaginal dryness Infections Vaginismus spasms of the muscles around the vagina Uterine fibroids Scar tissue Past experiences, negative attitudes about sex, or fear of pain also can play a role Pelvic floor problems occur when tissues that support the pelvic organs weaken or are damaged. This can happen because of pregnancy, childbirth, weight gain, surgery, and normal aging. In uterine prolapse, the uterus drops into the vagina. In some cases this causes the cervix to come out through the vaginal opening. In vaginal prolapse, the top of the vagina loses support and can drop through the vaginal opening. age, and your desire to have children are factors that often guide treatment choices. Signs to look for Abnormal bleeding is the most common sign. Pelvic pain is the main symptom. Other types of pain include very painful periods; chronic pain in the belly, lower back, and pelvis; pain during sex; and pain during bowel movements or while passing urine. Difficulty becoming pregnant is another sign. Symptoms often improve after menopause. Cysts may not cause any symptoms. Some cysts may cause pain, discomfort, and irregular periods but not always. If you have cysts, watch for changes or acute symptoms. Call your doctor right away if you have: Sudden, severe pain in your pelvis or abdomen Pain with fever or throwing up Pain during sex can have many forms. Some women have pain outside the vagina, such as with vulvodynia. Some women feel like something is being bumped into when the penis is inside the vagina. You might feel pain every time you have sex or only now and then. It might be hard for women who have pain during sex to become aroused, even if they don t have pain all the time. You might notice a feeling of heaviness or pressure as if something is falling out of the vagina. It might also be hard to empty your bladder completely. You might also get frequent urinary tract infections. Sometimes, urinary and anal incontinence are signs of pelvic support problems. Kegel exercises can make your pelvic muscles stronger. (See page 256 of the Urologic and Kidney Health chapter for more information.) 158 The Healthy Woman: A Complete Guide for All Ages
7 Disorder Pelvic pain can have a number of causes. Often, it is a symptom of another condition, or infection. Sometimes, the reason for pelvic pain is not found. Pain that lasts a long time can disrupt a woman s quality of life and lead to depression. Polycystic ovary syndrome (PCOS) is a hormone imbalance problem, which can interfere with normal ovulation. This can lead to irregular periods and multiple cysts on the ovaries. PCOS is the most common cause of female infertility. Women with PCOS also are at higher risk of diabetes, high blood pressure, metabolic syndrome, heart disease, and perhaps fibroids and depression. Uterine fibroids are tumors or lumps that grow within the wall of the uterus. They are not cancer. Fibroids may grow as a single tumor or in clusters. A single fibroid can be 1 inch or less in size or grow to 8 inches across or more. Fibroids are very common, affecting at least one-quarter of all women. African American women and women who are overweight are at greater risk. Women who have given birth are at lower risk. Vaginitis is when the vagina is inflamed. It can happen for these reasons: Vaginal yeast infection an overgrowth of fungus, such as candida, which is normally present in the vagina Bacterial vaginosis an overgrowth of certain kinds of bacteria that are normally present in the vagina Sexually transmitted infections Allergy to douches, soaps, feminine sprays, spermicides, etc Vulvodynia is chronic pain and discomfort of the vulva. It can make it hard to sit comfortably, be active, or enjoy a sexual relationship. Over time, coping with pain can lower self-esteem and lead to depression. Signs to look for Pain comes in many forms. Acute pain lasts a short time. Chronic pelvic pain lasts for more than 6 months and does not improve with treatment. Describing your pain will help your doctor find out the cause. A pain diary is a good way to keep track of your pain. Signs of PCOS include: Irregular, infrequent periods Obesity Excess hair growth on the face, chest, stomach, thumbs, or toes Acne Trouble becoming pregnant Some women don t have any symptoms. But fibroids can cause: Heavy bleeding or painful periods Bleeding between periods Feeling full in the lower abdomen Frequent need to pass urine Pain during sex Lower back pain Infertility, more than one miscarriage, or early labor Most women with fibroids are able to become pregnant. Often, fibroids stop growing or shrink after menopause. Vaginitis may not always have symptoms. When it does, you might notice these signs: Burning Itching Redness or puffiness Abnormal discharge with a fishy odor or change in the way it normally looks. Yeast infections often cause cottage cheese like discharge. You might feel burning, stinging, rawness, or aching even though the vulva might look normal. Pain might be felt all over the vulva or in a single spot. Pain can be constant or come and go. You might feel pain only after touch or pressure, such as from using tampons, having sex, or riding a bike. Reproductive Health 159
8 Hysterectomy Hysterectomy is surgery to remove the uterus. It is the second most common surgery among women in the United States. Some reasons a woman might need a hysterectomy include: uterine fibroids endometriosis uterine prolapse cancer abnormal uterine bleeding In some cases, women have other treatment options, such as new medicines or procedures. These alternatives might offer lower risk and quicker recovery time. But they might have drawbacks, too. With your doctor, discuss all the treatment options that might help your problem. Consider getting a second opinion to help you make a wise choice. Breast health Breast health is important to a woman s sexual health, overall health, and breastfeeding. Your breasts will change at different times of your life. You might notice lumpiness or tenderness during your period. Your breasts might get bigger during pregnancy. As you get older, the milk-producing tissue of your breasts turns into soft, fatty tissue, which might feel different to you. It s important to know the way your breasts normally feel and look so you can tell your doctor if you notice changes. A change can be a sign of a problem, including breast cancer. Although not all lumps or breast changes mean you have cancer or a problem, any change in breast tissue should be checked by a doctor. Ask your doctor how you can do a self-exam. Checking your breasts once a month, a few days after your period ends, can alert you to these reasons to call your doctor: l a hard lump or knot in or near the breast or in your underarm l dimpling, puckering, or ridges of the skin on the breast l a change in the size or shape of your breast l clear or bloody fluid that leaks out of the nipple l itchy, scaly sore or rash on the nipple l unusual swelling, warmth, or redness You should also get a clinical breast exam as part of your regular checkup. This is done by your doctor. Women age 40 and older should have screening mammograms every 1 to 2 years. It is an x-ray of the breast. Ask your doctor how often you need one. A mammogram along with a clinical breast exam is the best way to find breast cancer. (See page 62 of the Cancer chapter for more information.) 160 The Healthy Woman: A Complete Guide for All Ages
9 Preventing unintended pregnancy About one-half of all pregnancies in the United States are unintended. Not having sex or using a safe and effective birth control method (contraception) is the best way to avoid pregnancy. Use this chart to learn about birth control methods, and talk to your doctor to find one that s right for you. Method How you get it Failure rate* (Number of pregnancies expected per 100 women) Methods range in effectiveness from light (most effective) to dark (least effective). Sterilization surgery for women Sterilization implant for women Sterilization surgery for men (vasectomy) Implantable rod Intrauterine device (IUD) One-time procedure, which is permanent One-time procedure, which is permanent One-time procedure, which is permanent One-time procedure, which lasts up to 3 years One-time procedure, which can stay in place for 5 to 10 years Less than 1 Less than 1 Less than 1 Less than 1 This method might not work as well for women who are overweight or obese. Less than 1 Some side effects and risks** Pain Bleeding Complications from surgery Ectopic (tubal) pregnancy Pain Ectopic (tubal) pregnancy Pain Bleeding Complications from surgery Acne Weight gain Cysts of the ovaries Mood changes Depression Hair loss Headache Upset stomach Dizziness Sore breasts Changes in period Lower interest in sex Cramps Bleeding between periods Pelvic inflammatory disease Infertility Tear or hole in the uterus Reproductive Health 161
10 Method How you get it Failure rate* (Number of pregnancies expected per 100 women) Methods range in effectiveness from light (most effective) to dark (least effective). Shot/injection Your doctor gives Less than 1 you one shot every 3 months Oral contraceptives (combination pill, or the pill ) Prescription 5 Being overweight may increase the chance of getting pregnant while using birth control pills. Oral contraceptives Prescription 5 (continuous/ Being overweight may increase the chance of getting extended use, or no-period pill ) pregnant while using birth control pills. Oral contraceptives Prescription 5 (progestin-only pill, Being overweight may increase the chance of getting or mini-pill ) pregnant while using birth control pills. Skin patch Prescription 5 The patch may be less effective in women weighing more than 198 pounds. Some side effects and risks** Bleeding between periods Weight gain Sore breasts Headaches Bone loss with long-term use Dizziness Upset stomach Changes in your period Changes in mood Weight gain High blood pressure Blood clots Heart attack Stroke New vision problems Same as combination pill Spotting or bleeding between periods Hard to know if pregnant Spotting or bleeding between periods Weight gain Sore breasts Similar to those for the combination pill Greater exposure to estrogen than with other methods Vaginal ring Prescription 5 Similar to those for the combination pill Swelling of the vagina Irritation Vaginal discharge Male condom Over the counter Allergic reaction 162 The Healthy Woman: A Complete Guide for All Ages
11 Method How you get it Failure rate* (Number Some side effects and of pregnancies expected per 100 women) risks** Methods range in effectiveness from light (most effective) to dark (least effective). Diaphragm with spermicide Prescription 15 Irritation Allergic reactions Urinary tract infection Toxic shock if left in too long Sponge with spermicide Over the counter Irritation Allergic reactions Hard time removing Toxic shock if left in too long Cervical cap with spermicide Prescription Irritation Allergic reactions Abnormal Pap smear Toxic shock if left in too long Female condom Over the counter 20 Irritation Allergic reactions Natural family planning Spermicide alone Ask your doctor or 25 None natural family planning instructor for information Over the counter 30 Irritation Spermicides can offer added Allergic reactions pregnancy protection if used Urinary tract infection with another barrier method, such as a condom. Emergency contraception if your primary method of birth control fails. It should not be used as a regu- Emergency contra- Over the counter for 15 Upset stomach lar birth control method. ception ( morningafter pill ) than 18 need a adults. Girls younger It must be used within 72 Vomiting hours of unprotected sex. prescription. Stomach pain Fatigue Headache *Failure rates depend on whether a birth control method is used correctly and consistently. Your chances of getting pregnant are lowest if birth control always is used correctly and every time you have sex. **Only condoms can protect against most sexually transmitted infections (STIs). The male latex condom offers the best protection against STIs if used correctly and all the time. Reproductive Health 163
12 Birth Control Warning Using the pill or patch may increase your risk of stroke or heart attack. Seek immediate medical care if you have any of the following: sudden change in vision, blurring, or flashing lights severe headache unusual leg pain, particularly in your calf chest pain, trouble breathing, or coughing up blood severe pain in your belly l l l Mammogram Women age 40 and older should have screening mammograms every 1 to 2 years. Pap test and pelvic exam Women should have a Pap test at least once every 3 years, beginning about 3 years after they begin to have sexual intercourse, but no later than age 21. Women who have had the HPV vaccine still need to have Pap tests. Sexually transmitted infection (STI) screening New partners should get tested for common STIs, including HIV, before becoming sexually active. See your doctor regularly, even if you re feeling fine Talk to your doctor about how often you need to schedule a general checkup and specific screenings or tests. This will depend on your age, risk factors, symptoms, and other issues. Here are guidelines for some of the exams, screenings, and vaccines you might need. l Human papillomavirus (HPV) vaccine It is recommended that girls 11 and 12 years of age get the HPV vaccine. Also, girls and women 13 through 26 years of age should get the vaccine if they did not get it when they were younger. For information on testing, see pages of the Sexually Transmitted Infections chapter. By taking steps to prevent problems and seeing your doctor for regular checkups, you can feel good knowing you re doing all you can to take care of your reproductive health at all stages of life. n For more information on the HPV vaccine, see page 134 of the Sexually Transmitted Infections chapter. 164 The Healthy Woman: A Complete Guide for All Ages
13 One Woman s Story Ihave long suffered from cramps, excessive bleeding, feeling bloated, and frequent urination. I thought that it was normal and did not complain to my parents. During my first trip to the OB-GYN, I learned that I had a uterine fibroid the size of a small gumball. My doctor suggested we monitor its growth but not take action. Consequently, each month I continued to deal with the same problems. During the birth of my daughter, a nurse suggested that I have the fibroid removed after I was back on my feet. I did have to use the bathroom even more frequently while pregnant, but I didn t blame it on the fibroid. With all of the excitement of having a new baby in the house, I forgot about Each month I had to take a couple of days off from work because of severe pain. addressing my problem. Also, my OB-GYN recommended we leave it alone because it would shrink as I aged. A move led to a new doctor who told me that the fibroid was about the size of an egg, but that we would continue to monitor the size. I was concerned that it had grown so significantly. The problems that I experienced continued to get worse over time, and it became increasingly more difficult to get my job done because of frequent trips to the ladies room. I was embarrassed to fly on an airplane because I did not want to disturb the people who sat in my row on the plane. Each month I had to take a couple of days off from work because of severe pain. I was very physically active, but I did not see any reduction in the size of my abdominal area. Finally, I decided to seek advice from an OB-GYN surgeon, who explained my options. We discussed laser technology to shrink the fibroid and a hysterectomy, although I was not prepared to experience menopause. After much consideration and discussions with my spouse, I determined that the best option for me was a myomectomy surgical removal of the fibroid. My hope was to minimize the changes to my body. The surgery was successful, and I learned that there were actually three fibroids connected to one another. Afterward, I no longer experienced excessive bleeding, cramps, bloating, or frequent urination. I recommend that every woman with these symptoms schedule regular checkups and talk about her options with her doctor. You may not have to suffer! Cordelia Chicago, Illinois Reproductive Health 165
14 For More Information Office on Women s Health, HHS 200 Independence Ave SW, Room 712E Washington, DC Web site: menstru.htm cysts.htm Phone number: (800) , (888) TDD Center for the Evaluation of Risks to Human Reproduction, NIH PO Box Research Triangle Park, NC Web site: Phone number: (919) Division of Reproductive Health, CDC 4770 Buford Hwy NE, MS K-20 Atlanta, GA Web site: Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH PO Box 3006 Rockville, MD Web site: Phone number: (800) , (888) TTY Office of Women s Health, FDA 5600 Fishers Ln Rockville, MD Web site: Phone number: (888) American College of Obstetricians and Gynecologists th St SW, PO Box Washington, DC Web site: Phone number: (202) Resource Center American Society for Reproductive Medicine 1209 Montgomery Hwy Birmingham, AL Web site: Association of Reproductive Health Professionals 2401 Pennsylvania Ave NW, Suite 350 Washington, DC Web site: Phone number: (202) Endometriosis Association 8585 N 76th Place Milwaukee, WI Web site: Planned Parenthood Federation of America 434 W 33rd St New York, NY Web site: Phone number: (800) Polycystic Ovarian Syndrome Association PO Box 3403 Englewood, CO Web site: 166 The Healthy Woman: A Complete Guide for All Ages
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Mumsnet has not checked the qualifications of anyone posting here. If you need help urgently, please see our domestic violence webguide and/or relationships webguide, which can point you to expert advice and support.
So it's not all in my head then:( (long)(468 Posts)
Can't quite believe I'm writing this, but need to get it written down before I minimise it again.
This morning, DH and I both a bit tired, DS (3) acting up a bit. DH offered to take DS and dog for a walk so I could get some peace. DS was being difficult about getting his coat on and DH was acting as though his temper was getting strained. He muttered 'I don't work hard all week to come home to this!' And then pinned DS on the stone floor and wrestled him into his coat. DS was sobbing and I wanted to comfort him, bu DH snarled t me to go upstairs and let him get on with it. I would normally retreat at this point so as not to provoke him, but today I decided not to and stood m ground.
He asked me again to go and I said if he was upset he should take the dog out and clear his head, and leave DS with me. He said 'you really don't want to push me just now' and I asked why he was threatening me? He walked over and shoved me really hard through the doorway into the next room and onto the floor. DS saw this and ran over to me. We both somehow ended up upstairs and DH followed us up and stood there saying I was over-reacting as it was only a shove had provoked him so i deserved the shove.
I was crying and DS was upset and brought me his muslin and dummy . I refused to let DH touch me and he told me again I was overreacting and denied the comment about me deserving it, said I had made that up. He then took DS and went for the walk. I haven't been able to send being in the same room all day, but daren't leave in case he gets really angry and does something worse.
He has only physically assaulted me once before, 8 years ago on holiday, and was so drunk at that time that he passed out and claimed no memory of it. He can be grumpy and I feel I walk on eggshells and that I have to justify myself a lot. Since the incident 8 years ago, I've always backed down before he lost his temper, and fooled myself that he'd changed, but I discovered mumsnet 6m ago and have been reading a lot on this board and feeling increasingly uneasy that quite a lot f it applied to me.
He is not at all financially controlling, but was very jealous and quite controlling of my social life (back when I had one) and can be quite argumentative after a drink (not that he drinks much these days). He can also be loving and affectionate and we have long periods of time where everything seems fine, but I've been excusing his behaviour for a very long time and now there are really no excuses left.
Don't know what to do really. Thoroughly miserable and very confused.
This is worth a look: www.hiddenhurt.co.uk/cycle_of_abuse.html
merlot it wouldn't have changed him, but it would have been an acceptance of the seriousness of the situation, and for him to be reprimanded and acknowledge his actions
It would have also have me the courage to leave, instead of stay on another year, hurt myself more and see the state of myself now. They only get worse
You are all being so lovely and helpful. I don't feel I can phone anyone at present. I'm posting whilst hiding under the covers in a dark room pretending to be 'resting'. I feel scared of what would happen if he overheard me talking.
I keep having to remind myself that I'm not being silly or foolish to be this upset. I can't think clearly. I have this recurring thought that maybe I did just push my luck, I am finding it difficult to 'see' the EA that has lead to this. I've been with him since I was 21 - I don't really know any other way to be.
I need to keep my son safe. I need to leave tomorrow. Trying to go tonight would escalate things a lot I fear. After all, today is the first time in 8 years that I've stood my ground when DH has been in a 'mood', and look what happened.
Excellent posts from jess and HappyNewHissy.
We're all here for you in the meantime
You did not push your luck - he had your son pinned to the floor. He is the only one to blame for his actions, you did not 'make' him do this.
If slipping away quietly is what you need to do tomorrow, then use tonight to make a mental list of things you need, passports, important documents etc. do you have anywhere to stay?
Merlot do you know how to delete your history from the laptop / phone so he can't come across this thread?
I think going tomorrow sounds like the best plan.
Make sure you take with you your passports, birth certs, all important documents and ID.
Don't put yourself or your DS at any further risk. If tomorrow is the day that suits you best, then go tomorrow.
This is the most dangerous time in an EA relationship.
HOWEVER... If at any time before you leave, you feel scared or threatened by him, call the police, don't even blink before doing so, ok? Promise me?
Stay safe sweety, we'll all be here for you when you need us.
There's no need for you to go anywhere, either tonight or any other night, when one call to the police will have him removed from your home.
Much as I would very much like to believe that being cautioned or convicted of a dv related offence would result in doctors, judges, lawyers, police officers, social workers, etc losing their jobs, the fact is this rarely occurs unless perhaps a prison sentence has been meted out to the abuser.
I would suggest you give some thought to the way in which you are enabling him by not reporting his abuse of you and your ds.
Doctors hold exalted position in society and, particularly if he's a paediatrician, or a GP who is called on in respect of child protection cases, or ministers to any female patients, it would be thoroughly unprofessional of you to collude with him by failing to report his crime(s).
Thank you, am crying again a little bit. I'm planning to wait until he goes to work, then phone my parents and get them here to help me pack up and get away.
I promise I'll call police if any hint of further trouble. I'll take documents with me. I'm going to put DS to bed now. Will try to check in later.
This thread is my lifeline tonight, to keep it real in my head until I can talk in RL. Thank you all so much
I will report him tomorrow Izzy. I know that makes no sense to you, but it's the best I can manage. I know I'm enabling and I'm not proud of myself, but the fog is thick in my head just now and I can't take another scene tonight.
Thanks. Your posts (and Cogito's) on other threads have been the triggers that started my realisation. I decided this morning that I would stand up to him, that I didn't have to watch my son be upset, that if it was all in my head, the nothing would happen...
MerlotforOne, DO be proud of yourself. You have acknowledged that you are the victim of abuse; you are taking steps to get out of the situation.
You didn't ask to become an enabler; you didn't ask to be in this situation, or to have to find ways to cope with it. Do not for one second think you should blame yourself for ending up in a situation where you have to cope with being abused. That is his doing. Not yours.
You are being very brave. I promise you that you don't have to put up with this, and it's not in your head.
Merlot, I spoke at a Child Safeguarding Conference to Hampshire doctors last summer. If you are practising in Hants, you might have come, you may have seen me speak.
I was told that my words really helped GPs see how best to help abuse victims get out, at the very tentative early syages.
We victims are not what others thing battered women look like, we're not stupid, low, common or poor per se.
We may feel monumentally stupid when the scales fall from our eyes, but in time we can see that it's THEY that are stupid, they have a good partner, a life, a family and they screw it up cos they have to crush and destroy it.
We don't feel stupid forever, that stops fairly quickly as we start to process what THEY have CHOSEN to do to US.
It'll be ok love, in fact it will be a lot better than OK, trust us, you and your son will be safe, happy, relaxed and will thrive. You will laugh again. It won't always hurt like this. Not for long.
I'm worried for you, OP. Please be careful not to give him any indication tonight that you'll be going tomorrow.
Could you email your mum and dad to tell them? I would feel happier knowing they know they should come. Or would they phone up to speak to him?
What can you do tonight to keep out of his way? Will you be expected to sleep in the same bed as him?
Just thinking about it, I think you have to report him, hard though you might find that. If you don't, you run the risk of him going for 50-50 custody.
Of course she has to report him. What if another victim of abuse goes to him for help, needing to get children away from an abuser...
He's unfit to be a doctor. Where is his Oath now? 'First Do No Harm?' ??? Do his wife and child not count?
Today is not the day though, Merlot will need strength and clarity. That will come.
Report it to your GP first, get it logged.
Thing is even if you did "push your luck" that's not a normal situation - I can't ever imagine a situation where my DP would physically hurt me or push me over, perhaps in self defence if I was coming at him with a knife or something! Most adults don't have arguments where they lash out at each other, even if the other is being utterly infuriating.
I agree that the police would definitely take this seriously. You don't say "My husband and I were arguing and he pushed me" you say "He pushed me so hard that I fell to the floor, my 3 year old was upset." They would absolutely see this as physical violence/abuse - it's not just about hitting/punching or a full-on beating.
The point of reporting now means that in the future if you are worried about him having unsupervised access to your son you have some proof backing up your experience of DV, so that he and the courts can't later claim that you are making up accusations of DV in order to stop him seeing your son because you don't like him. Unfortunately without a trail in place even if you have serious concerns in the future it can be hard for you to block contact if you ever need to - it seems easier for courts etc to believe the "She's a psycho bitch who hates me" line than the "I am seriously worried for my child's safety" truth
I'm not saying it's impossible to block contact later if you need to, and you don't have to stop him from having contact now (although I would strongly suggest you go for supervised if anything) but if you become concerned at some point in the future it's going to make life a lot easier for you if you have a paper trail.
I agree don't do anything that puts you at risk now. Please try to talk to Women's Aid in the morning though - they won't say anything to the police etc, that is up to you and your decision.
OP, I just wanted to remind you how it's harder to see this when it's your life and your partner and not someone else. If one of your patients came to you saying her husband had violently shoved her you would be in no doubt that this wasn't okay. But your own situation feels different because you love him, because you hope he will change, because you think it is your fault.
It isn't your fault.
He can't change or "get better" without professional help.
It shouldn't be to to you to walk on eggshells so things are "okay".
Loving him isn't enough.
I've never forgotten the words of a woman on another forum I go on. She was talking to a poster who said her fiancé was abusive, but she loved him. And this woman said: "Of course you do. I loved my ex husband. I loved him while he punched me in the face, and I loved him while he told me it was my fault."
It's normal to feel horribly conflicted; to ask yourself if it's really so bad and wonder if it's somehow your fault. That's what years of conditioning, of walking on eggshells, of keeping him happy at the expense of all other happiness, of feeling afraid, of feeling weighed down, will do to you.
It's normal to feel stupid and ashamed, but that doesn't mean you should feel those things; this is not your fault. Nobody has the right to behave like this. You don't shove your spouse, tell them they deserved it and refuse to acknowledge what happened. That is not okay, end of.
You are leaving because your partner was aggressive towards your son. Your son was crying. Your partner was angry with you for wanting to comfort him and violently pushed you, then claimed you deserved this.
This is what you need to remember tomorrow when you start questioning yourself, when you wonder if it's really as bad as you thought, when that doubting voice he has put in your head starts telling you that it's your fault. It's not your fault.
^^agree with everything. It took me 7 years to realise all that.
jess the article on the abuse cycle is very helpful and true
Thanks Jess. I'm in bed, alone, full of doubt.
We ate dinner in virtual silence, then he held me and said sorry. Nothing else, just 'I am so sorry'. We sat and watched tv and I pretended nothing had happened. Then we came to bed and I lay here frozen until he offered to sleep in the spare room.
The thing that gets me is that I don't pacify him at he expense of all happiness. in general we have a pretty honest relationship and he does listen, take things on board, modify his behaviour. He is generally considerate of my wants and needs. We are a pretty good team, it's just that when he's in a bad mood, I do the eggshells thing. It's not every day, or even every month, and it has got less and less over time. I just feel, as you say, that I shouldn't have to feel scared when he gets angry or frustrated. That's not right.
Look at it this way. You're so scared of his reaction that you couldn't risk removing you and your ds from the house tonight for fear of reprisals.
That, if nothing else, demonstrates what's wrong with the relationship - with him. The blowups may be intermittent, even infrequent, but you have to live - always - with fear.
"We are a pretty good team, it's just that when he's in a bad mood, I do the eggshells thing."
You're in grave danger of rationalising this away. Careful. You're getting the 'shit sandwich' at the moment. Nice behaviour... shit behaviour... nice behaviour. Designed to make you feel relieved it's over & make you so grateful things are back to normal that you give him another chance. You're probably not even conscious how much you pacify him any more because it's second-nature. As tribpot says... someone who hides under the covers, pretending to be resting, frightened that they are going to be overheard on the phone is not someone who is in a 'good team'. Good luck.
You're probably not even conscious how much you pacify him any more because it's second-nature.
This is what gets me, that I feel I have no perspective, no sense of normal any more, if I ever did. And yes, things would be completely back to normal now if I let them be, and it's so damn tempting, but I keep remembering how frantic DS was, and I can't let it go.
The thought of telling my parents, or anyone in RL, is terrifying at the moment. There's no way back from this once I've done that.
There's no way back from this once I've done that.
Yes, that's the point. At the moment you are inside the conspiracy of silence, you are colluding with him to keep this from your family, the GMC, etc. It's 'safe' because most of the danger is internal and you know how to manage him 99 days out of 100. It's at the expense of your own soul, but you know how to do it now.
But that doesn't change the fact that it did happen. That your son saw it. In a year or two he will be at school. He could tell a teacher, or another parent. Now suddenly he has to be inside the conspiracy of silence as well, aged 4 or 5. That can't be.
And your parents find out eventually anyway and are devastated both that it happened and you didn't tell them - just as you would be if, god forbid, your ds ended up in an abusive relationship and didn't tell you.
The effort involved in keeping the secret becomes greater and greater - for you. For him, as long as he ensures your silence, he's golden. No problems for him. And he already knows how to heap the emotional pressure on to you, he's doing it now.
This is why the posters above are telling you to get out before you reach the next stage, or the next.
You must make this real. This happened. Denying it can never help the situation.
When my ds was about your ds' age, we were playing football in a friend's garden and my friend kicked the ball at me and it hit me in the legs. Of course a complete accident, it barely hurt at all, I'm sure I didn't even say 'ow'. But my ds insisted on standing in front of me to protect me from this again - that's how your ds feels now. My thing could be laughed away. Yours can't.
merlot tell your parents!
They will understand
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Church's Honey Biscuits
Recipe by Juju Bee
I have been looking for a good biscuit recipe for a long time, and I came across this recipe. It is a copy cat recipe for Church's biscuits from cdkitchen.com I tried it out, and it was wonderful! My husband loved them too! You should try it for yourself.
Top Review by redheadedrach
I liked these! The texture was great. Very tender. Next time I make these, because I will absolutely make them again, I will use butter instead of shortening, I will increase the sugar by a teaspoon, and I will actually put the biscuits into the oven with some of the honey and butter mixture on them from the beginning and then brush them again after baking. Great recipe!
See Discussion:20 Reviews 3 Tweaks
Ingredients Nutrition
- 2 cups flour
- 4 teaspoons baking powder
- 1⁄2 teaspoon salt
- 2 teaspoons sugar
- 1 teaspoon cream of tartar
- 1⁄2 cup vegetable shortening
- 2⁄3 cup whole milk
- 1⁄4 cup butter, melted
- 1⁄3 cup honey
Directions See How It's Made
- Preheat oven to 450°F.
- Mix flour, baking powder, salt, sugar, and cream of tartar in a medium bowl.
- Work the shortening into the flour mixture by crumbling with your hands until the mixture feels like cornmeal.
- Pour milk into flour mixture and mix well.
- On a slightly floured surface, knead the dough about 12-15 times.
- Make dough into balls (about 2 inches) and place on baking sheet.
- Brush Dough balls with some of the melted butter.
- Bake 10-12 minutes or until golden.
- Meanwhile Bring the remainder of the butter, and all of the honey to a boil in a sauce pan, then set the honey butter aside.
- When biscuits are done remove from the oven and immediately brush each biscuit with honey butter.


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|3,000 sq. ft.
|Property type
This listing is for the Large Spacious UPPER LEVEL of this home pictured. The Upper Level - nestled into a hill both levels walk out on ground level with concrete floors between levels for privacy. It features 3000 sq ft of luxury living space with gourmet kitchen, vaulted dining room/ living room, Sun Porch, 4 Bedrooms with 1 king, 2 queens and 2 twin beds, futon and 2 comfy couches if needed. 3 Bathrooms. Large patio with grill and fire pit available. We have two units in this 9,000 sq foot home if need more space. Located on 88+ acres of premier Minnesota woodlands, You'll love being able to seclude yourself away for a few days away or weekend retreat, fun exploring Itasca State Park or shopping/dining in Park Rapids. Miles of hiking trails to explore, a river for an afternoon swim, and the peace and quiet you need to refresh and relax. Plenty of space for family and friends to relax and have fun. 3 night minimum on holiday weekends.
Get 4 Couples together to Share the Value
Need More Space? Combine units on the Lower level if available. #759402 Great for family reunions, ladies get-away, sportsman fishing, golfing, or hunting, crafting, scrapbooking, or quilting. Create a Package today! Call for details: area code 218 phone 2528598 for more information
We would like our Home left in the Same Condition it was found. Thank You.
I am "Grandma" Grace this year and love it! My husband and I grew up in the Park Rapids Area but have lived in the Twin Cities, Oklahoma, Australia and the Philippines along with traveling around the world to Europe, New Zealand and our beautiful United States. I am a power-seller on Ebay of vintage and toys. Terry my husband is a "artist" remodeling homes and cabins in the area with his fine building skills. Would love to host you at our home for a day or two or even longer.
Grace or Terry Becker purchased this estate in 2001
This large country estate is way to big for us; so decided to offer it to you as vacation rentals. We offer this listing of a luxury private 4 bedroom 3 bath home which takes up the whole upper level of this house with 3000 sq feet of luxury living. We also have 4 other units available to combine on the lower level: a 1 bedroom. 1 bath Suite plus in addition, we have 3 large motel style bedrooms with shared bathroom which feature common areas that are large offering full kitchen, outside patios and room to roam. We have 5 units that can be grouped together for family reunions, craft retreats and fun get together for an occasion. We do rent the house out for small weddings and anniversary events.
Large Country Estate on 88 acres of beautiful Minnesota backwoods. The Fish Hook River run through the property for tubing, or bring your canoe. We are within walking distance of the Long Lake Access which offers boat ramp, dock and swimming beach. Park Rapids is located just 7 miles north for fun shops, candy store, and restaurants and start of the Heartland Bike Trail. 1/2 mile to Hubbard where you can go the the Hubbard Theater or Eat at Hilltop. 25 miles to Itasca State Park. Jasper & Woodtick Theaters are close by and not to be missed! Lots to do, Lots to See or Do Nothing in the Beautiful Area.
Everything that was listed in the ad is exactly what we found when we arrived. Exceptionally clean, beautiful kitchen, bedrooms, and living room. The location worked very well for our couples golf weekend as it was centrally located between Headwaters and Blueberry Pines Golf Courses. The only downside was it only had one shower for four couples. The 2nd bath only has a tub. We made it work just fine though and will definitely book again!
The property was very nice and just as the photos showed. We had a group of 7 people and were very comfortable. Grace quickly responded to my emails and we were able to check in early. The things we liked best: large kitchen, huge patio with a great fire pit, firewood available for a reasonable price, comfortable Adirondack chairs, walking path to the river, no stairs, close to Itasca State Park and Walker. A few things that would be nice to improve upon: non-stick pans, add a hand held shower to the tub in the master bedroom because one shower isn't enough for groups, signs on the path to the river (it was a little confusing when the path would split in two directions). Overall, we had a wonderful weekend and would definitely rent The Patio again.
16911 State 87 is located 4 miles south of Park Rapids on US Hwy 71 and 3.5 miles east on State 87. We are on the right side of the road, as you enter driveway; it says Do Not Enter but if you have reservations, Come on in.
|Rental Period
|Minimum Price
|Additional Nights
|Weekend Night
|Event Price
My Standard Rate
1 night minimum stay
for 1 night
|Refundable Damage Deposit
|Tax Rate
Rates are subject to change until reservation is confirmed.


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The Pretty Renewal Of Your Pretty Love - Poem by MOHAMMAD SKATI
Your pretty love never replenishes me, so I renew it with more and more with pure and true love Of mine that is endless until the last moment. It's my pretty love to you and my eternal love That is obedient to love every time willingly, It's a huge love that has no borders and unlimited That makes me on fire every time you come to mind, It's your pretty and pure love that erupts me Like a huge volcano erupts every time, It's your pretty and great love that its waves Are carrying me into the kingdoms of beauty, Love is renewed every time and every moment just To make you happy and sweet in its shape and its content, It's the wonderful renewal of this pretty love To suit your great sublimity and your sublime greatness, It's love that pushes me to be or not to be in your Eyes and every member of your body greatly, The greatness of love and your pretty love make Go ahead in my pretty and sweet love to you till the end because I have no choice, but go further and further in my love, It's the power of your pretty love that exceeds the Tsunamis of all other loves and may be more. Wonderfully and greatly I renew my pretty love to you Every day and every moment until the last day of my life. My pretty renewal of your pretty love is like that pretty Renewal of the sea waters and that of that of the winds'air.
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For security, you should not ignore the recommendations of the closest people in choosing an online florist to buy flowers bouquet online as a Valentine's gift. Especially that that has made transactions online florist, satisfaction or just inconveniences them in shopping becomes a real testimony that is needed for consideration.


text:
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text:
Malthusian crisis refers to the ideas of Thomas Robert Malthus who argued that while populations grow exponentially the rate of increase in the food supply is much less. This creates a natural limit on populations and produces miserable conditions for society and inevitable mass starvation, unless of course individuals practice birth control.
Thomas Robert Malthus, English economist, pioneer of the science of political economy and is known for his theory, as expressed in Essay on Population, that the rate of increase of the population tends to be out of proportion to the increase of its means of subsistence; controls on population are therefore necessary to prevent catastrophe.
Prof. Greene discusses how the population apparatus is being re-built and US leadership re-defined by an alliance between neo-liberal and cultural forms of Malthusian reasoning. He documents the re-configuration of the Malthusian modern by investigating the rise of sustainable development, the feminist challenges to the population apparatus, the desire to contain human migrations, and the changes in US welfare policy during the 1990s.
The global issue is the continuing need to produce more food given current deficiencies in particular regions and anticipated population increases averaging 80 million per annum up to 2015 followed by 50 million per annum to 2050. The challenge today is the same as Malthusian crisis, identified by the Reverend Thomas Malthus.
Malthus described a China in which early and universal marriage ensured high fertility and therefore high mortality. He contrasted this with Western Europe, where marriage occurred late and was far from universal, resulting in lower fertility and higher demographic responsiveness to economic circumstances.
Books on Malthusian crisis:
Malthusian Worlds: U. S. Leadership and the Governing of
the Population Crisis (Polemics)
Land Resources: on the edge of the Malthusian
Precipice.(Review)(Brief Article) : An article from: The Geographical Journal [HTML] - by
Donald A. Davidson


text: Winchester SXP Shadow Marine Defender 20 Gauge 512328695 For Sale from Fort Apache Guns | Positive feedback: 100% View | Verified Seller | 110 Completed Sales View Sellers Items Description: SXP SHAD MARINE DEF 20/18 3 HARD CHROME FINISH|PISTOL GRIP Pump Action Shotgun 18 Matte Hard Chrome 7 lbs. 8 oz. Read More Condition: New In Box Brand: Winchester UPC: 487020073618 Location: GA Trades Accepted: No Read More We have a wide selection of Semi-Automatic Pistols, Revolvers, Shotguns, and Tactical Weaponry. All products are new and covered under the Manufacturer's warranty. Product defects must be handled by contacting the manufacturer directly. Cancellations; Firearm(s) cancellations will incur a 15% restocking fee, unless exchanged for an item(s) of equal or greater value. We are an FFL dealer. Therefore, we HAVE TO ship all types of firearms to a current FFL dealer. We do not sell to California. We have a flat $35 shipping fee within the continental United States. Customers in Alaska or Hawaii will need to contact us for a quote on shipping. All payments must be received within 10 days af Shipping Notes: $35 to Continental U.S. Buyer pays all shipping fees. Read More Share Item Item #: 944584634 Stock No.: 512328695 Fort Apache Guns Seller Since: Dec. 2015 Seller Level: Local Seller Promotion This seller is an FFL Address: 3806 NORTH PEACHTREE RD City: Chambleee State: GA Price: $479.00 Buy It Now (Price reflects 3% cash discount.) Please Login/Register to Order Login or Register to buy This Seller Accepts Online Payment Shipping: Arrange local transfer Accepted Payment Methods: Returns: Send Message to You must login or register to send a message to this seller. Contact Seller as Guest Message To Seller Email * That Email Address is already in use. If you typed your email correctly, you are already registered and you should login or click here for the password recovery system. First Name * Last Name * Phone * Address 1 * Address 2 City * State * -State- AK AL AR AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY Zip * Already have an account? Login Your Recently Viewed Items


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What are your secrets Roger Ailes? Brian Lewis has been paid $8 million to not tell us.
Word has leaked that Brian Lewis, former top aide to Fox News President Roger Ailes, received $8 million in severance money, after being abruptly fired last summer. In exchange for his $8 million, Lewis will not spill the nefarious secrets of Fox News, whatever those are. The New York Times reported that Lewis' severance deal with Fox News explicitly includes a non-disclosure agreement regarding Fox News' secrets:
"A former colleague and current worker at the channel — who spoke on the condition of anonymity out of fear of being fired — revealed two weeks ago that Mr. Lewis had agreed to a deal that would pay him a sizable sum to remain quiet about whatever he knows about operations at the notoriously secretive company."
One day we are going to find out a whole lot of insane, sordid dirt on Fox News. It won't be from Brian Lewis and his 8 million dollar bills, but big secrets can't stay secrets forever. Some disgruntled employee with less to gain than Lewis will spill the beans one of these days.
My guess: spying. Hacking phone and email records of notable figures, especially Democrats, for juicy gossip. It fits Fox News' twin purposes, which are to make money and to support the Republican Party, and a major Rupert Murdoch news source (News of the World) has already been caught doing this.
That's just a guess, however. The truth really could be anything. If there's one thing we know about Fox News, it's that you should never doubt their capacity to shock and amaze.