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To E or Not to E

Much has been said about the recreational pill Ecstasy – though the mainstream information received is against it, so that those who still use it get information from those who are similarly lacking in information. Not to be taken as a backing, this piece provides information that could save the lives of those who decide to take E, by knowing the pros and cons of doing so.

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He popped a pill. Or probably two. And it wouldn’t have mattered – except that he was in the middle of a dance floor, a weird spot to take medication. He saw me look. He smiled, winked, then turned to make small dance steps. Half an hour later, he was on a ledge, took his shirt off, tucked it in his back pocket, then danced, this time wildly, without a care as he shook, swayed, gyrated, whatever, eyes closed as if in concentration. When somebody banged against him, his eyes opened – and I expected a fight to erupt. But he was smiling. Widely. “Sorry,” the offender said. “It’s okay,” he said. “Everything’s cool!” And then he was back to his dancing. Much, much later, when people were already starting to leave, he was still on the dance floor, extra nice to everyone, incessantly stating “I love you!”. And he looked like he meant it.

“Took E,” somebody said.

And he must have. He looked happy. No, he didn’t just look it, he was happy. And I guess that was all that mattered to him then.

THE PARTY DRUG

Ecstasy – a.k.a. E, Adam, Bean, M, Roll, X, XTC, Playboy bunnies, Nike swoosh and CK, among others – is one of the most popular drugs among young people today, with an estimated 10 million people – 2.8 million of them teenagers – having tried the drug at least once, and many becoming regular users afterwards (2002 National Survey on Drug Use and Health). This is no wonder because, although even simple possession (much more pushing) of the drug is highly illegal, the designer drug gives temporary justice to its name by giving feelings of emotionally based love and empathy, expansive sense of well-being, ego softening, neurotically based fear dissolution, heightened present moment awareness, and a high that interrupts the feeling of fatigue and tiredness allowing the person to be active all day and into the night – all without visual effects (hallucinations) so lucidity is retained.

Interestingly, even with all the hullabaloo surrounding it, E was an unplanned by-product of the synthesis of Hydrastinin, a vasoconstrictive, and styptic medicine (Methylenedioximetamphetamine or MDMA) by the German Merck Company in 1912. Since then, it has been used as an appetite suppressant, cure to Parkinson’s disease, a possible truth serum, psychedelic therapy drug, and a reducee of hostility in marriage counseling sessions. Sometime in those years, E started to be used for “recreation.”

From that time on, E was on its way to infamy.

While it has become a controlled substance (only licensed physicians may prescribe it), illegal possession of which carries the stiffest penalties (even death), the number of users continue to grow every year, as if proving the local saying Masarap ang bawal. Thus, it is always worth giving attention to – not to promote it, but because even with the accompanying risks, there are those who’d still use it, and knowledge (not just prohibition) alone may save them.

THE GOOD AND THE BAD

There are numerous misinformation about E, e.g. that it causes Parkinson’s disease (a confusion between MDMA and MPTP); or that users simply fall while dancing (people have actually died from heatstroke while at raves on E, but caution and use of common sense could prevent this).

Taking effect in as less as 30 minutes, with two to three hour plateau, and then six hours to baseline, E is popular because of its effects. There’s entactogenesis (touching within), a generalized feeling that all is right and good with the world. Empathogenesis, a feeling of emotional closeness to others (and to one’s self), coupled with a breakdown of personal communication barriers. An enhancement of the senses, since E can significantly enhance (sometimes distort) the senses – touch, perception, vision, taste, smell. Prolonged stamina, with users dancing ‘til the wee hours of the morning. And, since E can catalyze a broad range of psychotherapeutic effects (surfacing of repressed memories, dealing with emotional issues, et cetera), alternative psychotherapy.

With a detection period of one to two days (though generally depending on the amount and frequency of usage), E, nonetheless, has been known to have numerous ill effects.

While the physical effects of usual doses of E are subtle and variable (including dryness of mouth, jaw clenching, teeth grinding, nystagmus (eye wiggles), sweating, shivering, tremor or nausea), E causes an increase in blood pressure and pulse rate, modest in most people, similar to moderate exercise, so that people with a history of high blood pressure, heart trouble, or stroke are advised not to use E, or at the very least are advised to start with a much lower than average dose. Liver or kidney problems. Loss of appetite. Mild to moderate post-session fatigue. Lessening of the awareness of pain (whether through chemical analgesia, or through psychological analgesia), so bodily damage from extensive dancing, hiking, climbing, et cetera, without noticing it until after the damage is done. Inhibition of serotonin reuptake (though this could be prevented by taking anti-oxidants). Possible internal hemorrhage (E has anticoagulant properties that can cause this). And Psychoses.

Taking the drug is, then, at your own risk.

KNOWLEDGE IS POWER

This is not an encouragement to take E, but at least if/when you do, be safe doing so.

  • Avoidance is the first advice. But since many avoid the avoidance recommendation, check physical condition before using, since E puts serious strain on the body.
  • If you feel that you are uneasy about taking it, and not comfortable with being that open with yourself and having your image stripped from you, then don’t do it.
  • Find a situation you feel comfortable and safe in – and find someone you can trust.
  • Drink as much water as you like, but avoid alcohol (while it’s not going to kill you or make you sick, alcohol will deaden the effect of the drug) and other drugs (combining with any kind of speedy drugs like cocaine, shabu, et cetera can kill you).
  • If you are dancing, realize that you may be dangerously overheated even without feeling uncomfortable. Look after friends and get them to look after you. Taking vitamin C and E may help reduce exhaustion. Get good sleep afterwards.
  • Don’t take more than one pill or take it more than once a week. Your body builds a tolerance to X very quickly.

The drug is HIGLY ILLEGAL, and, if caught, you will be jailed and be even sent to die by lethal injection just for a brief moment of ecstasy.

You have been warned. Now learn the truth for yourself and make up your own mind about E before taking it.

REFERENCES:
Toxicology Associates, Inc.
National Institute on Drug Abuse
www.a1b2c3.com/drugs/#ecstasy
American Journal of Forensic Medical Pathology
Neurology Journal
csdp.org
DanceSafe.org
maps.org

"If someone asked you about me, about what I do for a living, it's to 'weave words'," says Kiki Tan, who has been a writer "for as long as I care to remember." With this, this one writes about... anything and everything.

Health & Wellness

Trans women can safely maintain estrogen treatments during gender affirming surgery

The practice of withholding estrogen prior to gender affirming surgery was not necessary. Most transgender women can now safely remain on their estrogen therapy throughout surgery.

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There was no difference in blood clots when estrogen hormone therapy was maintained during gender affirming surgery.

This is according to a study (titled, “No Venous Thromboembolism Increase Among Transgender Female Patients Remaining on Estrogen for Gender Affirming Surgery”) helmed by John Henry Pang with Aki Kozato from Mount Sinai, and was published in the Journal of Clinical Endocrinology & Metabolism.

Historically, the lack of published data contributed to heterogeneity in the practice of whether doctors and surgeons advised transgender women to withhold their estrogen therapy before surgery. The sudden loss of estrogen in the blood was sometimes very uncomfortable with symptoms that amounted to a sudden, severe menopause.

So the researchers tapped 919 transgender patients who underwent gender affirming surgery at Mount Sinai’s Center for Transgender Medicine and Surgery between November 2015 and August 2019. Notably, including 407 cases of transgender women who underwent primary vaginoplasty surgery.

This study found that the practice of withholding estrogen prior to gender affirming surgery was not necessary. Most transgender women can now safely remain on their estrogen therapy throughout surgery.

The bottom line: This study found that most transgender women can  safely maintain their estrogen hormone treatments during gender affirming surgery.

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Health & Wellness

Bisexual men more prone to eating disorders than gay or straight men – study

80% of bisexual men reported that they “felt fat”, and 77% had a strong desire to lose weight, both figures higher than the 79% and 75% for gay men, respectively.

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Bisexual men are more likely to experience eating disorders than either heterosexual or gay men. This is according to a report from the University of California San Francisco, published in the journal Eating and Weight Disorders.

A handful of studies have actually indicated that gay men are at increased risk for disordered eating, including fasting, excessive exercise and preoccupation with weight and body shape. This newer study, however, suggest that bisexual men are even more susceptible to some unhealthy habits.

For this study, the researchers surveyed over 4,500 LGBTQ adults, and a quarter of the bisexual male participants reported having fasted for more than eight hours to influence their weight or appearance. This is higher when compared to 20% for gay men.

The research also found that 80% of bisexual men reported that they “felt fat”, and 77% had a strong desire to lose weight, both figures higher than the 79% and 75% for gay men, respectively.

Now this is worth stressing: According to study co-author Dr. Jason Nagata, not everyone who diets or feels fat has an eating disorder. “It’s a spectrum — from some amount of concern to a tipping point where it becomes a pathological obsession about body weight and appearance,”Nagata was quoted as saying by NBC News.

For Nagata, several factors may be at play here, including “minority stress” (the concept that the heightened anxiety faced by marginalized groups can manifest as poor mental and physical health outcomes).

“LGBTQ people experience stigma and discrimination, and stressors can definitely lead to disordered eating,” Nagata was also quoted as saying. “For bi men, they’re not just facing stigma from the straight community but from the gay community, as well.”

Of all the respondents, 3.2% of bisexual males were clinically diagnosed with eating disorders (compared to 2.9% of gay men). For heterosexual men, it’s only 0.6%.

For the researchers, there is a need to conduct eating disorder research on various sexual identities independently. This is also to raise awareness on this issue (and how it affects different people of various SOGIESCs).

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Health & Wellness

Timing and intensity of oral sex may affect risk of oropharyngeal cancer

Love giving head? Consider this: Having more than 10 prior oral sex partners was associated with a 4.3-times greater likelihood of having HPV-related oropharyngeal cancer.

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Human papillomavirus (HPV) can infect the mouth and throat to cause cancers of the oropharynx.

This is according to a study published in CANCER, a peer-reviewed journal of the American Cancer Society, which has found that having more than 10 prior oral sex partners was associated with a 4.3-times greater likelihood of having HPV-related oropharyngeal cancer. The study also shows that having oral sex at a younger age and more partners in a shorter time period (oral sex intensity) were associated with higher likelihoods of having HPV-related cancer of the mouth and throat.

Previous studies have shown that performing oral sex is a strong risk factor for HPV-related oropharyngeal cancer. To examine how behavior related to oral sex may affect risk, Virginia Drake, MD, of Johns Hopkins University, and her colleagues asked 163 individuals with and 345 without HPV-related oropharyngeal cancer to complete a behavioral survey.

In addition to timing and intensity of oral sex, individuals who had older sexual partners when they were young, and those with partners who had extramarital sex were more likely to have HPV-related oropharyngeal cancer.

“Our study builds on previous research to demonstrate that it is not only the number of oral sexual partners, but also other factors not previously appreciated that contribute to the risk of exposure to HPV orally and subsequent HPV-related oropharyngeal cancer,” said Dr. Drake. “As the incidence of HPV-related oropharyngeal cancer continues to rise… our study offers a contemporary evaluation of risk factors for this disease. We have uncovered additional nuances of how and why some people may develop this cancer, which may help identify those at greater risk.”

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Health & Wellness

Sexual, gender minority youths more likely to have obesity, binge eating disorder

Findings suggest that weight and eating disorder disparities observed in SGM adolescents/adults may emerge in childhood. As such, “clinicians should consider assessing eating- and health-related behaviors among SGM youths.”

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Sexual and gender minorities (SGM) youths were more likely to have obesity and full-threshold or subthreshold binge eating disorder. This is according to research – “Obesity and Eating Disorder Disparities Among Sexual and Gender Minority Youth” by Natasha A. Schvey, PhD; Arielle T. Pearlman, BA; David A. Klein, MD, MPH; et al -published in JAMA Pediatrics.

SGM are those who identify as lesbian, gay, bisexual and/or transgender, or whose sexual orientation and/or gender identity/expression do not conform to societal conventions.

For this study, the researchers noted that as it is, “obesity and eating disorders in youth are prevalent, are associated with medical and psychosocial consequences, and may persist into adulthood. Therefore, identifying subgroups of youth vulnerable to one or both conditions is critical.”

For them, one group that may be at risk for obesity and disordered eating is SGM.

In total, 11,852 participants were considered (aged 9-10 years), derived from the Adolescent Brain Cognitive Development Study. The mean age was 9.91, and 5,672 (47.9%) of the total number were female. The sample comprised 1.6% (n = 190) probable sexual (n = 151) and/or gender minority (n = 58) youths, of whom 24.7% (n = 47) responded yes and 75.3% (n = 143) responded maybe to the SGM queries.

The researchers found that one in six youths (1,987 [16.8%]) had obesity and 10.2% (n = 1,188) had a full-threshold (86 [0.7%]) and/or subthreshold (1103 [9.4%]) eating disorder.

They also reported that adjusting for covariates, SGM youths were more likely to have obesity (odds ratio, 1.64; 95% CI, 1.09-2.48) and full-threshold or subthreshold binge eating disorder (odds ratio, 3.49; 95% CI, 1.39-8.76).

SGM and non-SGM youths did not differ in the likelihood of full-threshold or subthreshold anorexia nervosa or bulimia nervosa. The same pattern of results remained when limiting SGM youths to those responding yes to the SGM items, although significance for the likelihood of obesity was attenuated.

For the researchers, the findings suggest that weight and eating disorder disparities observed in SGM adolescents/adults may emerge in childhood. As such, “clinicians should consider assessing eating- and health-related behaviors among SGM youths.”

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Health & Wellness

Sexual dysfunction hits some women harder than others as they age

Factors other than use of hormone therapy, such as higher importance of sex, positive attitudes toward sex, satisfaction with one’s partner, and fewer genitourinary symptoms associated with menopause appear to be protective and are linked to better sexual function across the menopause transition.

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Sexual dysfunction often accompanies the menopause transition. Yet, not all women experience it the same. A study identified the determinants that affect a woman’s risk of sexual dysfunction and sought to determine the effectiveness of hormone therapy in decreasing that risk and modifying sexual behavior.

The study – “Sexual behaviors and function during menopausal transition–does menopausal hormone therapy play a role?” – was published in Menopause, the journal of The North American Menopause Society (NAMS).

Although hot flashes easily rank as the most common symptom of menopause, the transition is often accompanied by other issues, including changes that affect a woman’s libido, sexual satisfaction, and overall sexual behavior. Because hormone therapy is the most-effective treatment option to help women manage menopause symptoms, it was the focus of a new study designed to determine why some women experience greater sexual dysfunction than others.

The study involving more than 200 women aged 45 to 55 years found that women with secondary and higher education and a greater number of lifetime sexual partners were less likely to experience sexual dysfunction. In contrast, women with more anxious behaviors during sexual activity and those with more severe menopause symptoms were more at risk for sexual dysfunction.

Hormone therapy was not found to mitigate the risk for sexual dysfunction, nor did it play a major role in determining sexual behaviors. However, women using hormone therapy typically had higher body esteem during sexual activities; better sexual function in all domains, except for desire/interest; better quality of relationships; and fewer sexual complaints (other than arousal problems) than those women who do not. Of importance to helping maintain a woman’s sexual function were positive sexual experiences, attitudes about sex, body image, and relationship intimacy.

“These results are consistent with the findings of prior studies and emphasize that factors other than use of hormone therapy, such as higher importance of sex, positive attitudes toward sex, satisfaction with one’s partner, and fewer genitourinary symptoms associated with menopause appear to be protective and are linked to better sexual function across the menopause transition,” says Dr. Stephanie Faubion, NAMS medical director.

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Health & Wellness

LGB adults less likely to take cholesterol-lowering meds

Lesbian, gay and bisexual (LGB) adults who could benefit from cholesterol-lowering medicine to prevent heart disease are less likely than non-LGB adults to take them.

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Lesbian, gay and bisexual (LGB) adults who could benefit from cholesterol-lowering medicine to prevent heart disease are less likely than non-LGB adults to take them.

This is according to new research – “Statin Use for Atherosclerotic Cardiovascular Disease Prevention Among Sexual Minority Adults” – written by Yi Guo, Christopher W. Wheldon, Hui Shao, Carl J. Pepine, Eileen M. Handberg, Elizabeth A. Shenkman, and Jiang Bian, and which appeared in the Journal of the American Heart Association.

As it is, sexual minorities – including LGB individuals – are at increased risk for cardiovascular disease. This can be attributed to elevated rates of health risk factors, including smoking and having obesity.

For this study, the researchers conducted a cross‐sectional online survey about statin use in adults ≥40 years of age between September and December 2019 using Facebook advertising. In total, 1,531 people responded to targeted Facebook ads.

The researchers calculated the prevalence of statin use by age, sexual orientation, and statin benefit populations. They used multivariable logistic regression to examine whether statin use differed by sexual orientation, adjusting for covariates.

Analysis showed that less than 21% of LGB adults were taking statins, compared to 44% of their non-LGB peers.

“We observed a significantly lower rate of statin use in the LGB versus non‐LGB respondents (20.8% versus 43.8%; P<0.001) in the primary prevention population,” the researchers reported.

In a news release, study author Yi Guo – an assistant professor of health outcomes and biomedical informatics at the University of Florida College of Medicine in Gainesville – said that “there could be many reasons for the difference we observed… LGB individuals may not go to the doctor as often, which leads to lower chances of being recommended statins for cardiovascular disease prevention.”

But looking at the use of statins among people who already had cardiovascular disease, there was no disparity between LGB and non-LGB adults.

For Guo, members of the LGB population may be less aware of the protective effect of statins.

For the researchers, the “results emphasize the urgent need for tailored, evidence‐based cardiovascular disease prevention programs that aim to promote statin use, and thus healthy aging, in the LGB population.”

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