Call it benign masochism, or a cheap thrill, but the appeal of hot peppers is that they hurt so good. If you love the burn, you’ll also love the benefits that hot peppers can have on inflammation, pain and metabolism.

Capsaicin, the chemical in peppers’ seeds that gives them their heat, is what makes some peppers fiery and others plain. Most species of pepper contain capsaicin, except for bell peppers, which is why they aren’t spicy. That burning feeling from capsaicin is courtesy of the body’s pain response system, a safety mechanism that alerts you when you’ve touched something too hot, cold or sharp. Capsaicin activates a protein in your body’s cells called TRPV1, whose job is to sense heat and inflammation. When TRPV1 senses a stressor, it sends a signal to the brain, which sends a jolt of pain back to the affected part of the body. Although the brain chemistry is the same, biting into a jalapeño doesn’t damage the body the way touching a hot stovetop will, at least not in small amounts, and can even relieve pain.

Exposure to capsaicin in large quantities can make neurons less sensitive to TRPV1. Thanks to this effect, capsaicin is frequently used as the active ingredient in skin patches, gels and creams that are effective at reducing feelings of acute and chronic pain from nerve damage, osteoarthritis, rheumatoid arthritis and skin conditions such as psoriasis.

Capsaicin has restorative effects internally too. The activation of TRPV1 stimulates antioxidant activity and reduces inflammation by inhibiting the release of inflammatory proteins known as cytokines in the body, which, if not treated, can eventually lead to the development of conditions like cardiovascular disease and diabetes.

Once in the body, the mighty chemical increases nutrients’ ability to move through the intestinal wall, enhancing the absorption of minerals like calcium, iron and zinc. Capsaicin also has metabolism-boosting potential. It’s shown to have similar effects on energy expenditure as cold temperatures, leading to a short-term spike in body temperature that increases the number of calories burned.

Hot peppers can be grouped into different categories depending on their flavour and heat. Mild peppers with a vegetal taste closer to a bell pepper include poblano and Anaheim varieties. These larger peppers are ideal for stuffing with cheese and meat, or for grilling and roasting. Jalapeños and serranos are smaller and moderately spicy, with a bright, citrusy taste. They work well in salsas, guacamole, dressings and chili. On the hotter end of the spectrum are Thai bird’s eye chilies, tiny red peppers that pack a big punch and work nicely thinly sliced and used as a garnish for stir fries and roasted vegetables. Not for the faint of heart are small, round Scotch bonnet and habanero peppers that hail from the Caribbean. These peppers have a fruity flavour and plenty of heat and are best used sparingly in marinades, like jerk sauce, or in a sweet fruit-based salsa.

Most varieties start off green, but they can turn all different shades as they mature. Rest assured, they are the same pepper, but the yellow, orange and red chilies that have been left to ripen on the vine longer will have more natural sugars and taste spicier. Whatever the variety (or colour), pick out peppers that are bright, have smooth, taut skin and are firm to the touch. And take precautions while handling peppers: Wear gloves—your eyes will thank you later!

Can’t take the heat? Remove the seeds and inner white membrane of the peppers, which is where the capsaicin hides out. Or fight heat with heat by grilling, sauteing or roasting peppers, which caramelizes sugars and leads to a deeper, sweeter taste. Pickling preserves the peppers’ flavour and crunch while taming the spice. Serve pickled peppers with cheese and a drizzle of honey for a sweet heat, or add them to salads and sandwiches for a hot and briny hit. If you love spicy margaritas, try mixing sliced hot peppers into a simple syrup made with equal parts sugar and water to add a quick kick to cocktails.

Peppers’ power is that they can improve health from both the inside and out. So whether it’s a melt-your-face-off habanero salsa or a slightly more therapeutic approach, they’re sure to bring the heat.

Next: This Spicy Corn Salad Needs to Be Made Before Summer Ends

This salad recipe features hot peppers, which have a whole suite of health benefits from aiding with inflammation and improving vitamin absorption.

Charred Anaheim and Corn Salad

Serves: 4-6
Prep time: 15 minutes
Cook time: 20 minutes
Ready in: 35 minutes

Ingredients

• 4 ears of corn, shucked
• 4 Anaheim or poblano peppers, ends trimmed, seeds removed and sliced in half lengthwise
• 1 shallot, thinly sliced
• 2 tsp honey
• ¾ tsp kosher salt
• 4 tbsp lime juice, from about 2 limes
• ½ tsp garlic powder
• ½ tsp onion powder
• ½ tsp smoked paprika
• ½ tsp cumin
• 2 green onions, white and light green parts only, thinly sliced
• ½ cup chopped cilantro, plus more for garnish
• ½ cup crumbled feta

Directions

1. Heat a large cast-iron or non-stick skillet over medium-high heat. Halve peppers lengthwise, trim stems and scrape out seeds. Rub the corn cobs with vegetable oil and cook in the skillet, working in batches if needed, turning frequently until charred in spots and cooked through, 12-15 minutes.
2. Meanwhile, in a large bowl combine the shallot, honey, lime juice and salt. Allow to sit while corn and peppers are cooking.
3. Remove the corn from the skillet and add peppers. Cook, turning frequently, until peppers have softened and are charred in spots, 5-8 minutes.
4. Remove corn kernels from cobs and slice the cooked peppers into 1/2-inch pieces. Add the corn and peppers to bowl with shallots along with spices, green onion, cilantro and feta. Stir to combine.

Tip: Try cooking corn and peppers on the grill over medium heat, turning frequently until charred, corn is cooked through and peppers have softened.

Next: The Health Benefits of Spicy Food, Explained

The Rookie is a Bluetooth-and-sensor-equipped skipping rope with a sleek app and, it turns out, a sense of humour—because when I first logged in, I discovered my daily goal had been pre-set to an eye-popping 2,000 jumps. That… simply wasn’t going to happen. I dialled the daily goal down to 200, reconsidered, then took it to 100. I should’ve kept dialling.

To be fair, a lot of the blame is mine. Skipping is—as should by now be abundantly clear—an enormously tough workout that makes a whole bunch of cardiovascular demands on your body. It also requires the sort of coordination that took me a while to remember from my 20th-century grade-school days. But some of the fault lies with the Rookie’s rope, which is made of a thin, polypropylene plastic. It’s good for speed but bad for tangles, leaving parts of the rope coiled back on itself and leaving me feeling like I was constantly tussling with an unruly headphone cord. At least it didn’t hurt much when the rope inevitably slammed into my legs.

The lightweight plastic handles are easy to grip—mine came in a very cheerful coral—and the length of the 300-cm rope is a snap to adjust. The app’s interface is super intuitive, but its metrics are about what you’d expect: number of jumps, time spent jumping, calories burned, percentage completed of your daily goal. While there are a couple interval programs designed around experience level, they’re pretty straightforward: jump 30 times, rest for 30 seconds, repeat twice, or jump 300 times (ha!), rest for 60 seconds, repeat thrice. It’s not especially difficult to track these metrics yourself, which is ultimately the hitch with any smart skipping rope. You can count just as well as it can.

I might feel more charitable if I were inclined to, say, compete with friends on Rookie’s app or chart my progress on its global leaderboard. But I just want to skip in peace (and maybe fudge my totals when I’m done). A dumb ol’ jump rope is perfectly up to that particular task

Rookie Smart Skipping Rope, $55, chapters.indigo.ca

Next: You May Want to Start Skipping Rope Again

Forget walking and chewing gum at the same time: At one point, ages ago, many of us could actually skip rope while we sang. In fact, somewhere, jammed into a closet or the corner of a basement, there’s probably a dusty old jump rope that would just love if you gave it another look. You might be surprised at how hard a workout you’ll get—and how quickly the words to “Miss Mary Mack” come flooding back (back, back).

Bit of skipping rope = big rewards

Like any exercise that involves short, quick, explosive movement, skipping is a plyometric workout, which offers plenty of high-intensity bang for its buck. Yes, that means more speed and power: A 2021 meta-analysis found that endurance runners improved their physical fitness and athletic performance after introducing jump training into their routines. But plyometric exercise also has a lot to offer anyone whose marathon days might be behind them. One 2018 Sports Medicine review determined that plyometric activity improved postural stability in older adults, leading to a reduced risk of falling. A 2020 European study found that plyometric exercise helped older men better climb stairs, especially when stacked against walking or resistance training. And a Cincinnati meta-analysis of female athletes connected plyometric exercise with a reduced risk for ligament injury, because of its ability to improve coordination.

And you don’t need to do a ton of it: An oft-cited study in Research Quarterly for Exercise and Sport revealed that skipping for 10 minutes a day over six weeks can provide the same benefits as half an hour of daily jogging. But, because skipping isn’t nearly as easy as nine-year-olds make it seem, work up to those 10 minutes. “You are definitely getting your heart rate up—the most I can last without stopping is somewhere between three to four minutes,” says Scott Lear, who holds the Pfizer/Heart and Stroke Foundation chair in cardiovascular prevention research at Vancouver’s St. Paul’s Hospital (and is an avid skipper himself). “But that’s how you get a similar workout to a moderate-intensity activity in less time.”

(Related: 6 Great Spin Bikes that Cost Less Than a Peloton)

Heart health benefits of skipping

Your calves, quads, hamstrings, biceps, shoulders, arms, core—they’re all pressed into service here. But skipping is also one of the most effective cardio workouts around. “Skipping makes your cardiovascular system more efficient at delivering and extracting oxygen from your blood,” Lear says. “So the heart doesn’t have to pump as much at a certain work level, and it can better manage the sort of stress that precipitates a heart attack.” A 12-week 2018 European study found that skipping positively affected several risk factors associated with cardiovascular disease, including blood pressure, inflammation and vascular function.

Bone heatlh benefits of skipping

Two million Canadians are affected by osteoporosis—more than 80 percent of them women. We know that regular exercise is good for bone health for young girls all the way through older women, but it turns out that skipping rope is really good for our bone health. By putting bones under the repeated stress of jumping, you encourage them to build back stronger. That’s why (American) study after (Chinese) study after (Australian) study has found that skipping rope increases bone mineral density in both pre- and post-menopausal women, even those with low bone mass.

Plus, skipping rope is just generally good for what’s known as our physical literacy: moving with confidence and competence. “A lot of the time, we talk about physical literacy in children, improving balance and coordination,” Lear says. “But that’s also important as we get older, because it’s not only age that reduces those things, it’s usually that we start doing less.” As we do less, our bodies adapt to doing less; they’re efficient machines that way. Skipping helps ensure our bodies stay healthy, no matter our age—so hop to it.

Check Your Technique

Kaitlyn Simpson, performing circus artist and coach at the Jumpsations jump-rope club in Hamilton, Ont., shares three tips for improving your jump rope technique.

1. For novices, keeping your toes and your heels together as you jump—and landing with a bent knee—will make sure your joints and ligaments don’t end up where they shouldn’t. Hips face forward, right under your shoulders, and hands are as close to those hips as possible, with elbows tucked back.

2. Beginners tend to think they need to turn the rope with their whole arms, but after you get those initial revolutions going, the work is all in the wrists. Shortening your rope a little will encourage you to keep your arms closer to your body, so the rotation can come from your wrists instead.

3. If you’re working on your coordination, go ahead and jump a little higher: It’ll give you more time to get the rope under you before you land. But once you figure out your rhythm, you shouldn’t need to get more than an inch or two off the ground.

Next: Can the Rookie Smart Rope Help You Get a Good Workout?

“A horror show.”
“Ew, disgusting.”
“I’m not into that crazy shit.”
“Step back.”

The above are a sample of responses I’ve received from partners when I disclosed I was on my period.

I always preface any kind of sexual activity by making it clear if I am menstruating, in case that might make my partner uncomfortable—because it does. For a lot of people. While this feedback didn’t put me off the great joys of period sex, it made me wary of sexual partners who treat a simple bodily function as something disgusting or shameful.

That being said, I’ve also had wonderful period sex experiences, where my partners expressed only curiosity and eagerness, which adds to the arousal.

One of the best representations I’ve seen of how normal period sex can be was in an episode of HBO’s I May Destroy You, when lead character Arabella (Michaela Coel) is in bed with Biagio (Marouane Zotti), a very hot Italian man. When he pulls off her underwear, he takes her liner with it, and when he then fingers her, he asks if he can remove her tampon. He even examines the blood clot that falls into his hand as he fingers her, asking polite questions about what it is, admiring its softness. It’s a touching, sensual scene with zero stigma—and totally realistic.

“The world has taught us lots of menstrual shame, and releasing that to make space for pleasure is very empowering—whether you have period sex or not,” explains Luna Matatas, a Toronto-based sex and pleasure educator. “Having an enthusiastic and non-shaming partner can be really healing for menstruating partners.”

If period sex sounds like something you want to try, you probably have more than a few questions, so let’s tackle them with some expert advice.

Discussing period sex can be awkward. Any advice for broaching the topic?

Start before things get steamy.

“Try having a conversation outside of sex and of your period to get a sense of what their take on period sex is. It may be a non-issue or you may discover it’s a solid ‘nope.’ But this conversation can be a lovely opener into all kinds of non-vulva or non-penetrative-focused sexual pleasure that is possible,” says Matatas.

It’s also totally OK to not want to have sex while on your period. And to be clear, not being in the mood does not mean you are obligated to perform oral sex on your partner.

“But many people do experience more horniness during their period due to hormonal changes,” says Matatas. Those changes include, for a cisgender woman, a rise in estrogen levels, which Matatas explains can make it easier to reach orgasm and experience greater sensitivity. What’s not to love?

OK, so how does having sex on your period work? 

Period sex functions exactly like regular sex, with this wonderful plus: you’ll have more and natural lubrication due to the menstrual blood. Although you might want to protect your sheets or wherever you decide to hook-up. More on that below.

Right, isn’t period sex super messy?

Absolutely, one cannot wax poetic about period sex without addressing the sheer messiness of it all. Because yes, it gets wet, it gets bloody and it gets potentially everywhere. But there are ways to take cover. If you want to keep the focus on stimulating the clitoris, for example, you can wear a tampon, tampon sponge or menstrual cup (ones that are particularly comfortable during penetration include SoftDiscs or Ziggy Cups). For lighter blood flow, you can also try using internal condoms, also called female condoms.

Otherwise, dark towels are your friend. Some people have a jerk-off towel, why can’t you have a period towel? You can also put down disposable incontinent pads, a mattress protector or waterproof sex blankets (like this one or this one), which are also called “squirt sheets.”

(Related: We Tried Knix’s Super Leakproof Period Underwear)

Can you have unprotected sex while your period?

The answer here is the same whether you’re on your period or not. Because like other bodily fluids (e.g. semen, vaginal fluids), blood can transmit sexually transmitted infections (STIs)—so using a condom is still important.

Dr. Christine Derzko, a physician at St. Michael’s Hospital and a professor of obstetrics and gynecology at the University of Toronto, says simply, “It’s not wise.” Why? “Because rarely— but sometimes—there is enough estrogen and therefore cervical mucus there to nourish sperm and give them a place to survive until ovulation. It’s also easier to pick up an STI during your period.”

(Related: Sex After 40: The Shocking Truth No One Talks About)

Wait, is it possible to get pregnant from period sex?  

Pregnancy is totally possible (though less of a risk during menstruation) as sperm can still easily find a warm home as Derzko noted above. If getting pregnant is not of interest, other than condoms, you can also turn to birth control, dental dams and gloves. 

Can having sex affect your period? For instance, does having sex on your period make you bleed more?

It’s complicated. “Male or female orgasmic release can change your cycle’s bleeding via a rise in prostaglandins (lipid compounds that are found in human tissue and have hormone-esque effects), which are involved both in coagulation and in cramping,” says Derzko. “That can lead to potentially less bleeding, more or less cramps, while the female orgasm can relieve some of those cramps.” 

So, sex can affect your period cramps?

Yes. In fact, many experts consider this one of the major potential benefits of period sex. Because an orgasm can release those kinds of chemicals—oxytocin, dopamine, endorphins—that make you feel happy, period sex can also ease the pain of cramping, and that is a true win.

However, not everyone agrees. Dr. Gail E. Robinson, a physician at Toronto’s Sunnybrook Health Sciences Centre, says the belief that sex can ease any kind of period pain is nothing more than “an old wives’ tale.” It seems more than a few things when it comes to women’s health are still up for debate, but the divisiveness here might be all the more reason to experiment. Wink wink. 

Will having period sex postpone your period?

No, period sex won’t delay your menstrual cycle, unless of course you get pregnant, in which case…yes, by about nine months.

Robinson explains, “When your period begins and ends has nothing to do with sex. Your period is determined by chemicals that are secreted from an area of your brain, go down to your ovaries, tell your ovaries to start producing an egg, then the system goes back to your brain and it tells different chemicals to come out and tells that egg to be released.”

(Related: Can Cannabis Help Kick-Start My Sex Drive?)

Is it possible to have better sex on your period?

Blood can be quite beautiful—sexy even—if you let it.

“You can eroticize your period,” says Matatas. “We do it with jizz through facials and body shots, but blood can be that way, too.”

For example, she says, here are some things you can do while having sex on your period that you can’t at other times of the month: body blood stamping, which can be a part of primal play or dominance and submission. Or watch menstruation together in the mirror while masturbating or touching each other and possibly discover a new sensual element together.

If and when you do give it a shot, it’s worth remembering: regular sex is super messy with sweat, sperm, discharge and even breast milk in some bedrooms. Fluids are our friends, not something worth taking an entire seven days off.

Next: Samantha Bitty Knows Good Sex (and Wants You to Know It, Too)

This dish is inspired by Chef Matthew Kenney’s delicious Kelp Noodle Cacio e Pepe. Cacio e Pepe is a classic Italian sauce traditionally made with Parmesan cheese and pepper that Chef Kenney recreates with cashews. I’ve substituted zucchini and pine nuts to make an unbelievably delicious low-FODMAP cream sauce that tastes garlicky, cheesy, and utterly craveable. Topped with beta glucan–rich, crispy, fried oyster mushrooms, it is a meal that will make you want to invite people over to share.

DAIRY-FREE • GLUTEN-FREE • LOW-FODMAP • VEGAN

Zucchini Cacio e Pepe Pasta with Pan-Fried Oyster Mushrooms

Serves 3 to 4

Ingredients

• 1 package (12 ounces/340 g) gluten-free pasta (see Tip)
• ¼ cup (60 mL) pine nuts
• 5 tablespoons (75 mL) avocado oil, divided (see Tip)
• 1⅓ cups (325 mL) peeled and chopped zucchini (about 1 medium zucchini)
• ¾ teaspoon (3 mL) salt, divided, plus more for seasoning
• ½ teaspoon (2 mL) freshly cracked black pepper, plus more for seasoning
• 2 teaspoons (10 mL) nutritional yeast
• 1 pound (450 g) oyster mushrooms, trimmed and separated
• 1 tablespoon (15 mL) fresh thyme leaves

Tip 1: If you are not following a low- FODMAP diet, I highly recommend making this dish with chickpea pasta to provide extra fibre and enough protein to make it a more complete meal.

Tip 2: You cannot substitute olive oil in this recipe. The sauce has such a delicate flavour that any bitter notes in olive oil will throw it off.

FODMAP Note: Most mushrooms are high-FODMAP, but oyster mushrooms are the exception. If oyster mushrooms are not available and you are following a low-FODMAP diet, do not substitute regular mushrooms. Instead, sauté some kale or another low-FODMAP vegetable to accompany the dish.

Directions

1. Bring a large pot of water to a boil. Cook the pasta according to package directions. Drain in a colander, reserving at least ¼ cup (60 mL) of the cooking liquid. Rinse the pasta under cool running water. Return the pasta to the pot off the heat.
2. Heat a medium skillet over medium heat. When hot, reduce the heat to medium-low and add the pine nuts. Toast, stirring often, until the pine nuts are fragrant and golden, 2 to 3 minutes. Transfer the pine nuts to a small food processor (or bullet blender).
3. In the same skillet, heat 1 tablespoon (15 mL) of the avocado oil over medium heat. Add the zucchini and cook, stirring occasionally, until softened, 6 to 7 minutes. If the zucchini is browning too quickly, reduce the heat to medium-low. You want the zucchini soft and golden, not crispy and brown. Season with ¼ teaspoon (1 mL) of the salt and some pepper. Transfer the zucchini into the food processor with the pine nuts. Wipe the pan clean.
4. To the food processor, add 2 tablespoons (30 mL) of the avocado oil, nutritional yeast, the remaining ½ teaspoon (2 mL) salt, and the pepper. Blend until smooth. It will be very thick at this point. Set aside.
5. In the same skillet, heat the remaining 2 tablespoons (30 mL) avocado oil over medium-high heat. Add the mushrooms and fry, shaking the pan occasionally so they don’t stick, until golden brown and almost crisp on one side, about 4 minutes. Turn the mushrooms over and fry for 2 minutes more until golden brown. Sprinkle with a generous pinch of salt, more pepper, and the thyme.
6. Add 2 tablespoons (30 mL) of the reserved pasta cooking liquid to the sauce. Mix together to loosen up the sauce. (I like to blend with an immersion blender.) Toss the sauce with the pasta. If the sauce looks too thick, add more pasta cooking liquid, 1 tablespoon (15 mL) at a time, tossing after each addition, until the sauce coats the pasta well but is not runny. To serve, divide the pasta among shallow bowls and top with the mushrooms.

Excerpted from Good for Your Gut by Desiree Nielsen. Copyright © 2022 by Desiree Nielsen. Published by Penguin Canada, a division of Penguin Random House Canada Limited. Reproduced by arrangement with the Publisher. All rights reserved.

Next: Chocolate and Peanut Butter Shortbread Bars Everyone Can Love

Erica West* was about three months postpartum with her first child when she had her first major pee leak in public. “I was putting the baby seat into the car, in a crowded grocery store parking lot, and I just could not hold it—at all,” says the 34-year-old mom of two from Ottawa. “I full-on peed my pants right there in front of everybody and it was awful.”

West is not alone. In the most recent Canadian Urinary Bladder Survey, 58 percent of women—across the survey’s age groups—reported dealing with a bladder issue. Stress incontinence (the kind that makes you pee when you laugh, jump or lift a baby in their heavy car seat, for example) and urge incontinence (the kind that seemingly gives you no warning when you have to go) are the two most common types. Pregnancy, childbirth, hormonal changes, genetics and aging (which comes with a slackening of our muscles and tissues) can all cause incontinence.

For the first year of her daughter’s life, West says she had no control of her bladder. It took many months of pelvic floor physiotherapy to help her regain that control and get back to some semblance of normal (though she still leaks occasionally). And, in the meantime, incontinence impacted her life in several surprising ways.

Skin irritation

“I wore pads and pantyliners way beyond when the postpartum bleeding stopped because I knew I didn’t have my pelvic floor under control. But I have sensitive skin and irritation was a problem for me,” says West. “When I was wearing pads daily, I had a lot of chafing.”

For people who experience frequent pee leaks, it’s common to have irritation around the outside of the vagina, says Monica Li, a dermatologist and clinical instructor in the department of dermatology and skin science at the University of British Columbia. Incontinence-associated dermatitis signals a breach in the skin barrier, which can be caused by the excess moisture, exposure to bacteria from the urine and pads rubbing on the skin’s surface. “These factors all contribute to skin inflammation, leading to a range of signs and symptoms, from redness to itching or even sloughing in more severe cases,” says Li.

To prevent rashes and chafing, and to deal with already irritated skin, Li recommends keeping the area clean by washing daily with a gentle pH-balanced cleanser, patting dry and then applying a petrolatum-based cream or an emollient balm (like a baby diaper rash cream) to seal in moisture and create a protective layer. Using an incontinence product, like a pad or absorbent underwear—as opposed to something designed for periods, like a panty liner—will do a better job of absorbing fluid and wicking away moisture. Incontinence pads should be changed as soon as they are wet. It’s also a good idea to go without whenever you can, like when you’re at home and have quick and easy access to a washroom.

Wardrobe malfunctions (and super quick changes!)

“Women can be nervous about leaking, even through an incontinence product, and so they end up only wearing black, or patterns, but no white or jeans, or anything tight on the bottom,” says Magali Robert, a urogynecologist and head of the Calgary Pelvic Floor Clinic. “And then if they are carrying around extra clothes and incontinence products, too—well, they always have a big bag or purse to carry, which can be really inconvenient.”

“For the first year, I did not leave the house without an extra set of clothes—it was that bad,” says West. She also felt the need to change what types of clothes she wore. “I stopped wearing my favourite light green pants after I went back to work,” she says. “One time, we had coffees during a meeting and I knew I had to go, so I was afraid to stand up. After that it was always dark bottoms.”

Other vaginal issues

“Leaking is not going to give you a bladder infection,” says Robert. “But you might think it is because leaking increases with age and urinary tract infections also tend to increase with age, especially around perimenopause and menopause.” So, she says, women often experience both. And while the two conditions aren’t directly related, they can both be helped by vaginal estrogen, so they are frequently treated in tandem.

Lifestyle modifications

“The impact socially, for me, was major—I peed in the grocery store more than once,” says West. Many women find themselves planning their outings and other errands around bathroom breaks (or the nearest coffee shop with a clean washroom).

Some women avoid social settings where they might feel trapped, like a two-hour-long movie date, for example, or a workout that could cause problems (hello, hiking down hills or any type of bouncing). Some will avoid running around with their kids, or even going on vacation, due to the stress of not knowing what the bathroom situation will be.

And incontinence can affect a woman’s life in even more intimate ways, too. “Leaking with intercourse is actually quite common,” says Robert. “Almost 50 percent of women who leak will also leak with sexual activity.” That could account for 10 to 15 percent of women who are sexually active—and if we’re still shy about sharing that we pee when we laugh, it’s no wonder this part of the problem remains undiscussed.

“The most important thing is to see a doctor, talk to someone—because there are things that can be done,” says Robert. Depending on the type of incontinence, pelvic floor and bladder training could be required. There are also medications, lasers, injections and surgery options.

Too many women think they have to live with pee leaks—and the ripple effect of problems they create—but for about 90 percent, the issue can be better managed. “Don’t wait until you can’t stand it anymore to ask for help,” says Robert.

*Name has been changed to protect privacy.

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From Our Partners

Caring for a loved one who has urinary incontinence

Being a caregiver isn’t easy. Throw in a full-time job (for 60 per cent of Canadian caregivers) and a household with kids (for one third) and you’re left with a packed schedule and zero free time. But your needs matter just as much as everyone around you, and it’s crucial that you make space for yourself. These tips can help.

Give yourself permission to take YOU time.

Taking time to care for your own physical and emotional health isn’t selfish, it’s necessary. If you’re irritable or rundown, you won’t be much good to anyone. Find something just for you—like a walk or a bath—and make it a priority every day.

Ask for help.

Think about what would make a difference in your schedule. Would it help if another parent could carpool? If your child unloaded the dishwasher every day? If you could have flexible work hours one day each week? It never hurts to ask.

Find the right support products.

Make a stressful job easier by choosing bladder incontinence products that keep the skin dry, clean and protected. Cleanse with TENA ProSkin Cleansing Cream or Wipes—no rinsing required!—and protect fragile skin with ProSkin Barrier Cream. You can also opt for briefs with tabs like TENA ProSkin Unisex Briefs for easier changes.

Visit tena.ca to learn more.

Next: How To Keep Your Pelvic Floor Happy and Healthy

Back in the 1950s and ’60s, psychiatrists prescribed therapeutic LSD to more than 40,000 patients as a treatment for alcoholism, anxiety and depression. And while the methodology might not have been as… rigorous as today, initial results were quite promising. “But then LSD escaped from the lab into the public, and there was a big clamp down under Richard Nixon,” says Dr. Emma Hapke, an attending psychiatrist at the University Health Network (UHN) in Toronto. “That kind of stopped research on psychedelics.”

But over the past two decades, decriminalization, destigmatization and dedicated researchers have helped usher in a psychedelic renaissance. Last year, landmark studies found that substances like MDMA can be combined with psychotherapy to provide considerable relief to patients struggling with PTSD and depression. And in January, Health Canada expanded its list of psychedelic drugs that doctors could apply for through its extremely strict Special Access Program (though just for patients facing “serious or life-threatening conditions”). “There is this knowledge that we’re sitting on these really powerful molecules, and it might be time to start studying them again,” says Hapke, who in October co-founded the Nikean Psychedelic Psychotherapy Research Centre at UHN, the first research centre of its kind in Canada. Here, she explains what exactly these drugs do, how psychedelic psychotherapy can help and why magic mushrooms still aren’t a magic bullet.

As a child of the late ’80s, I vividly remember the fried egg that was supposed to represent my brain on drugs. But what actually happens to our brains when we take psychedelics?

Molecularly, classic psychedelics—like LSD and psilocybin, the active ingredient in magic mushrooms—look almost exactly like serotonin. So when you take them, they bind tightly to serotonin receptors in the brain, and they quiet something called the default mode network. That network can almost be thought of as the conductor of the brain—it controls which parts communicate with each other. So when it quiets, parts of the brain that don’t normally communicate start to connect, and there can be significant changes in perception, emotion and thinking. For example, you might hear colours or see things outside the range of normal waking consciousness.

Psychedelics can also bring into your awareness stuff that may have been suppressed in your mind. So this could be past memories, past experiences, past traumas—and it brings them up because some of the typical defensive structures of the mind have softened. That can be very challenging in the moment, but it has the potential to be quite healing.

What goes on when you take MDMA?

When you take MDMA, which is the active ingredient in ecstasy, it not only causes a massive release of your own supplies of serotonin, but it also releases dopamine, norepinephrine, cortisol and oxytocin. MDMA quiets the fear-processing centre of the brain, so it reduces fear while keeping the person alert at the same time, which is very conducive to processing trauma. It’s also an empathogen, so it tends to increase feelings of empathy. That’s really helpful, because sometimes trauma survivors are stuck in a place that lacks self-forgiveness. MDMA really increases forgiveness and compassion for oneself and for others.

Do those feelings stick around even after the drug is out of your system?

For the trials of MDMA-assisted psychotherapy for PTSD that I’ve been involved with, we did three MDMA sessions over 18 weeks, and we found that at the end, 67 percent of people lost their diagnosis of PTSD. And when we followed up with people at the year mark, the same amount remained in remission.

(Related: Why I Celebrate My Birthday With Therapy)

And what do the sessions involve?

Generally there are three preparatory sessions, which is an opportunity for the therapist to get to know the patient and connect with them, because trust is really crucial for a successful outcome. Then there are the medicine sessions, which usually last anywhere from six to eight hours. Usually, for each dosing session, there will be three integration sessions, the first of which is typically the next morning. They’re really about making sense of what came up.

What if someone has a bad reaction?

I think it’s interesting to ask: How are we defining a bad reaction? With classic psychedelics, there can be an experience called ego dissolution, which is when your typical sense of self starts to dissolve. That can be quite scary for people because they’re losing control. But we do a lot of work to prepare them for that, and we coach them to continue to breathe—and to trust that even if it’s scary, it’s actually part of the process of significant healing and change. Facing what they’re afraid of gives people a sense of mastery.

How is this sort of psychotherapy different from more traditional forms?

In some ways, there’s an unlearning for therapists, because you are less active and you intervene less than in other forms of psychotherapy. You’re creating a safe space, but then you need to learn to sit back and allow self-healing.

So does the therapy amplify the effects of the drugs?

I really think about psychedelic healing as a triangle. At the top, we have the therapeutic modality, which is what you do in those preparation and integration sessions. On one side, we have the drug effects. And on the other side, we have the therapeutic relationship, which is incredibly important. They all work together. At the same time, we’re starting to see really interesting research about how you might combine different types of therapy with different psychedelics to treat different conditions.

(Related: How to Find the Best Therapy App for You, According to Experts)

Maybe cognitive behavioural therapy goes really well with mushrooms?

There’s a study at Remedy Institute in Toronto combining a trauma-based CBT with MDMA. There’s another form of therapy called ACT, which is acceptance and commitment therapy, that’s been studied at Yale where they combined it with psilocybin for depressed people. We’re also seeing lots of emotion-focused therapy be combined with ketamine. But I think it’s too early to conclude anything. People have really high expectations for psychedelic-assisted psychotherapy, but I tell people it’s not a magic bullet. It catalyzes therapy for people who are ready to go deeper. But it’s ongoing work, and if people aren’t yet ready to do that work, it can set them up to be disappointed with the outcomes.

What is the state of psychedelic psychotherapy in Canada right now?

It’s still very early days. There have only been a handful of clinical trials, but that’s rapidly expanding. The Canadian Institute for Health Research put out a specific call for funding for psilocybin trials, so that’s exciting. We’re seeing much more research and training programs emerge in universities across the country. In terms of what’s actually legal, it’s really mostly ketamine. There are private clinics that offer ketamine-assisted psychotherapy.

Why is ketamine already allowed?

It’s been previously approved by Health Canada as an anesthetic. So we know it’s safe, and it’s had this pretty strong effect in terms of treating depression and suicidality. What’s different, though, is that the effects of it might wear off, so some people need ongoing treatments. With MDMA, we have seen results continue in about two-thirds of patients—it’s been studied in veterans, who have this high burden from war. They’re able to process a lot of it through MDMA therapy, and then they tend to get better and stay better. With psilocybin and depression, it’s much less clear, so we need more research on how we improve the integration period. Maybe people need occasional booster sessions.

Are there challenges in that research?

In typical clinical trials, you blind people, so they don’t know if they’re getting the active drug or a placebo. With psychedelics, it’s really hard to do that, so our traditional double-blind randomized control trial model doesn’t necessarily fit. That’s something we’re trying to figure out.

What else are you working on at the Nikean Psychedelic Psychotherapy Research Centre?

We really envision that it’ll have three pillars. One is research, one is education, and then more clinical work down the line, once these medications become regulated. We’re starting our first clinical trial soon for patients working through end-of-life distress, combining psilocybin and psychotherapy. We’re also going to pilot that with caregivers, because they often have even higher levels of distress. And for people who have had complicated bereavement, we’re curious if psilocybin-assisted therapy would help. That’s one of our first big projects. And we’re working hard on launching a training program for therapists, with the first cohort launching in September 2022. People need really good training in order to be able to do this in a safe way. I do think, though, that the University Health Network being open to this research and work sends a signal to Health Canada—and to the general public—that it’s an area worthy of rigorous scientific exploration.

This interview has been condensed and edited for clarity.

Next: Magic Mushrooms for PTSD: Why Psychedelics May Help Heal Trauma

Reader’s Digest Canada sat down with Miriam Diamond, an environmental scientist at the University of Toronto, to learn if we need to change our shopping habits to prevent the long-term effects of toxic chemical-laden clothing.

Should I be worried about dangerous chemicals in my clothes?

Yes. Last year I worked with CBC Marketplace to look for toxins in a collection of cheap and mass-produced clothing, often known as fast fashion. We tested everything from bathing suits to bags to children’s clothing. I was already aware that clothing today contains more synthetic chemicals than it used to, but the results were scary: we found elevated levels of chemicals in one in four items tested. 

Why is this stuff in our clothes at all? 

After the Second World War, there was a big shift to the convenience of wash-and-wear. If you look at what makes clothing wrinkle-free and stain-resistant, that’s all chemicals. And many dyes today are made with potentially dangerous chemicals because it’s cheaper. Culturally, it used to be that people had their Sunday best and their work clothes, but today the appetite for new outfits is out of control. A company like Zara produces 10,000 new items a year, which has always been considered fast fashion, but now there are online retailers that produce 6,000 new items a day. It’s a trade-off. That top cost $15 and you don’t have to iron it, but you may be absorbing very dangerous substances into your body.  

What are the specific health risks? 

Quite a few of the items we tested contained per- and polyfluoroalkyl substances (PFAS), which are known as forever chemicals because they don’t break down and they stay in our systems. You’re not going to wear a garment and feel sick later that day. This is about long-term exposure, and the harmful effects can include cancer, type 1 diabetes, impaired immune function and increased obesity. We also found phthalates, which interfere with hormones and male reproductive systems, and lead, which can be particularly harmful to children and fetuses. Just as an example, we tested a raincoat that contained more than 20 times the amount of lead allowed in children’s products according to the Canada Consumer Product Safety Act. 

(Related: How Everyday Products Can Affect Your Fertility)

If companies’ products exceed the limits, how are they able to sell them? 

You just can’t inspect every piece of clothing, and that is especially true with the rise of global online retailers shipping from a factory on the other side of the world to your doorstep. 

Can these chemicals be washed off in a washing machine?

Although they’re not designed to come out that way, some do. But of course, when we put these items in our washing machines, the fibres are released and end up in our drinking water. So even if you can avoid wearing contaminated clothing—which is a lot of responsibility to put on consumers—you are still going to be exposed through drinking water. 

Is this only a fast-fashion problem? 

Certainly fast fashion is responsible for the massive volumes of products, but in terms of whether only cheaply made clothing contains chemicals, we don’t actually know. It’s possible that garments that advertise organic or natural fibres are less likely to contain chemicals, but there have been examples of these claims being false. The problem is that the textile industry is so unregulated. Pharmaceuticals and cosmetics require labelling, but that is not the case with clothing. 

How can we buy safe clothing? 

You can look for companies that are taking positive steps—for instance, Keen footwear has gone PFAS-free, and Patagonia is taking steps to do the same. But also, the European Union recently announced a plan to hold fashion retailers accountable for toxins in their clothing. It would be great to see the Canadian government follow suit. In the meantime, consumers can hold fast-fashion companies accountable by not buying their products. Change is possible when there is pressure from the public. 

Next: Meet Lyocell, a Potentially Sustainable Fabric That Could Become Your New Favourite Textile

These bars are a decadent, satisfying treat made from wholesome ingredients like almond flour and peanut butter.

Inspired by millionaire bars, the cookie base is made from protein-packed almond flour and the caramel layer is melt-in-your-mouth decadence. Even with the three layers, these bars are quite simple to make and well worth the bit of extra effort. Yes, low-FODMAP treats can be zero compromise.

DAIRY-FREE • GLUTEN-FREE • GRAIN-FREE • LOW-FODMAP • VEGAN

Chocolate and Peanut Butter Caramel Shortbread Bars

Makes 16 bars

Ingredients

Shortbread Base

• 2 cups (500 mL) almond flour
• ½ cup (125 mL) refined coconut oil
• ¼ cup (60 mL) pure maple syrup
• 1 teaspoon (5 mL) pure vanilla extract
• ¼ teaspoon (1 mL) salt

Caramel Layer

• 1 cup (250 mL) natural peanut butter
• ¼ cup (60 mL) pure maple syrup
• ¼ cup (60 mL) refined coconut oil, melted
• 1 tablespoon (15 mL) pure vanilla extract Pinch of salt

Chocolate Layer

• ¾ cup (175 mL) dairy-free dark chocolate chips (at least 70% cocoa)
• 1 tablespoon (15 mL) coconut oil Flaky sea salt (optional)

Directions

1. Preheat the oven to 350°F (180°F). Lightly grease the bottom and sides of an 8-inch (2 L) square baking pan with coconut oil. Cut a length of parchment paper long enough to line the bottom of the pan with extra hanging over the sides.
2. Make the shortbread base: In a medium bowl, whisk together the almond flour, coconut oil, maple syrup, vanilla, and salt. Evenly press the mixture into the baking pan and lightly prick the base all over with a fork. Bake until the edges start to firm up and turn golden, 13 to 15 minutes. Remove from the oven and let cool for 10 minutes while you prepare the caramel layer.
3. Make the caramel layer: In a small bowl, whisk together the peanut butter, maple syrup, coconut oil, vanilla, and salt. Spread the caramel mixture over the shortbread base, then place the baking pan in the fridge while you prepare the chocolate layer.
4. Make the chocolate layer: In a small pot, bring 2 inches (5 cm) of water to a simmer over medium heat. Stir the chocolate chips with the coconut oil in a small heatproof bowl. Set the bowl over the simmering water. Ensure that the bottom of the bowl is not touching the water.
   Gently and continuously stir until the chocolate and coconut oil are melted and smooth. Remove from the heat and let sit for a few minutes to thicken slightly. Pour the melted chocolate mixture over the caramel layer. Sprinkle some flaky sea salt over the chocolate, if using. Place the pan in the fridge until firm, about 30 minutes.
   Remove from the pan using the parchment paper overhang. Cut into bars. Store in an airtight container in the fridge for up to 1 week.

Excerpted from Good for Your Gut by Desiree Nielsen. Copyright © 2022 by Desiree Nielsen. Published by Penguin Canada, a division of Penguin Random House Canada Limited. Reproduced by arrangement with the Publisher. All rights reserved.

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