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Speaker 1: to stuff Mom Never Told You. From how Stuff Works
Speaker 1: dot com. Hello, and welcome to the podcast. I'm Kristen
Speaker 1: and I'm Caroline, and today we're talking about a health
Speaker 1: issue requested by a number of listeners that a lot
Speaker 1: of listeners probably have not heard of before. And frankly,
Speaker 1: I was not aware of this either before we started researching,
Speaker 1: and that is uterine fibroids. Yeah, I actually am ashamed
Speaker 1: to say that I did not know about this either
Speaker 1: until a former co worker of mine told me about
Speaker 1: her experience with fibroids and said, well, you know, Caroline,
Speaker 1: you should do a podcast on this because it affects
Speaker 1: so many women, and a lot of the women it
Speaker 1: effects are women who haven't had children. And so to
Speaker 1: my former co worker and to our listeners out there
Speaker 1: who were hoping to learn more about this, this is
Speaker 1: for you. We're going to tell you today about uterine
Speaker 1: fibroids a k a. Lie o mioma's which just makes
Speaker 1: me think of lego my ego. Not to reduce that
Speaker 1: to a catch phrase, but laomoma literally means growth of
Speaker 1: smooth muscle. So fibroids are non cancerous, brain important, non
Speaker 1: cancerous growth in the uterus that typically appeared during a
Speaker 1: woman's childbearing years. And it bears repeating these are non
Speaker 1: cancerous growth. In most cases, your chances of developing a
Speaker 1: cancerous fibroid are super small. They're somewhere between one and
Speaker 1: four hundred and one in a thousand cases, and just
Speaker 1: having a fibroid or fibroids plural does not increase your
Speaker 1: risk or your chances of developing cancer. And they develop
Speaker 1: from uterine tissue when a cell divides repeatedly, which then
Speaker 1: forms this firm mass, and the mass can be so
Speaker 1: small that it's undetectable to the eye, but it also
Speaker 1: can grow large enough in some cases that it distorts
Speaker 1: the size of the uterus. In fact, there are some
Speaker 1: women with fibroids so large that it distends their stomach right.
Speaker 1: And so let's talk about how common this actually is
Speaker 1: and the symptoms that you might experience, because I think
Speaker 1: when we tell you a little bit about these issues,
Speaker 1: you'll understand why maybe more people don't know about it
Speaker 1: or don't know whether they have it, and how we
Speaker 1: should know about it. My mind is blown that I
Speaker 1: didn't know about this. I know this is exactly another
Speaker 1: issue like endometriosis, where so it's so common for so
Speaker 1: many women out there, and so many women do go
Speaker 1: through the pain of fibroids, but not a lot of
Speaker 1: people know about it. So estimates as to how common
Speaker 1: fibroids are range from about women up to about seventy five.
Speaker 1: So that's like a that's a huge window not how
Speaker 1: many women potentially suffer from five fibroids. But many of
Speaker 1: these women are unaware that they have them because they
Speaker 1: don't have symptoms, or they miss stake their symptoms for
Speaker 1: something else, and it's easy to see why you might
Speaker 1: not get diagnosed because the symptoms aren't exactly a fibroid
Speaker 1: specific Yeah, this totally reminded me two of our episode
Speaker 1: on polycystic ovarian syndrome, where you have all sorts of
Speaker 1: symptoms that could be anything. So a lot of women
Speaker 1: go through a number of medical exams before they get
Speaker 1: an actual diagnosis. So these symptoms can include things like
Speaker 1: heavy or prolonged periods, pelvic pressure or pain, frequent urination,
Speaker 1: difficulty emptying your bladder, constipation, back ache, or leg pains.
Speaker 1: Um It can also cause acute pain, which has caused
Speaker 1: when a fibroid outgrows its blood supply, then it dies
Speaker 1: and in bits and pieces from the dying fibroid can
Speaker 1: make their way into surrounding tissue. And another thing that
Speaker 1: causes acute pain is something that really gave me pause
Speaker 1: when I was reading these sources. But it's the issue
Speaker 1: of when a fibroid that does grow ing from a
Speaker 1: type of stock can end up twisted, thereby cutting off
Speaker 1: the blood supply, and so that leads to very acute
Speaker 1: pain as well. So again just to keep in mind,
Speaker 1: because I had to keep reminding myself of this as
Speaker 1: we were reading about fibroids, is that they are very common.
Speaker 1: Most of the time they come with no symptoms whatsoever.
Speaker 1: This is more talking about what happens when they do
Speaker 1: enlarge or they grow in such a way that do
Speaker 1: lead to very painful symptoms. Um. So there are different
Speaker 1: kinds of uterine fibroids as well. There are three main classifications,
Speaker 1: and your symptoms will depend on the type. So you
Speaker 1: have submucosal fibroids which grow into the inner cavity of
Speaker 1: the uterus, and these are likelier to cause prolonged heavy periods.
Speaker 1: Then you have sub crusal fibroids, which project to the
Speaker 1: outside of the uterus, and these are likelier to cause
Speaker 1: urinary symptoms because they can press on your bladder and
Speaker 1: also bulging from the back of the uterus can press
Speaker 1: on your rectum causing a pressure sensation, or on your
Speaker 1: spinal nerves causing back ache. Yeah, and of course I
Speaker 1: feel like I've said this on every health episode we've
Speaker 1: ever done that I automatically assume I have whatever it
Speaker 1: is that we're talking about, and so of course my
Speaker 1: back was killing me yesterday and it's still kind of
Speaker 1: hurting today, and I was like, oh no, oh, no,
Speaker 1: I have subsruscial Oh no, way. I went to the
Speaker 1: gym for the first time and forever and my back
Speaker 1: is killing me. Okay. But so the third and final
Speaker 1: type is intramural fibroids, which grow in the uterine wall
Speaker 1: itself and can distort the shape of the uterus and
Speaker 1: cause prolonged heavy periods and pain and pressure sensation. So
Speaker 1: there's no winning. Thanks a lot fibroids. These a lot
Speaker 1: of body and we've been treating these fibroids for a
Speaker 1: long time, even though today doctors are still kind of
Speaker 1: scratching their heads about them. Um. In eighteen o nine,
Speaker 1: President Lincoln's cousin, Jane Todd Crawford, became the first person
Speaker 1: to undergo surgery to remove a fibroid, and a procedure
Speaker 1: called a laparotomy, which involves a large cut through the
Speaker 1: abdominal wall. And it wasn't necessarily just to remove a fibroid,
Speaker 1: because at this time doctors probably weren't entirely sure what
Speaker 1: was wrong with Jane Todd Crawford. Yeah, I mean, she
Speaker 1: had some some distention of the stomach and everything like that,
Speaker 1: and they had some theories about what was wrong with her,
Speaker 1: and they went in and they removed this thing and
Speaker 1: it was a fibroid. It turns out it was a fibroid. Uh.
Speaker 1: And in eighteen forty we have the first successful myomectomy,
Speaker 1: which is a surgery for fibroids whose goal is just
Speaker 1: to remove the masses themselves and leave the uterus intact.
Speaker 1: And this surgery was specifically to remove fibroids. It wasn't
Speaker 1: just exploratory. And it's interesting that after the eighteen fifties
Speaker 1: this procedure was largely abandoned. There were some safety issues,
Speaker 1: some healthy shoes. Uh. It was picked up again in
Speaker 1: two when a British surgeon actually improved methods, so it
Speaker 1: became another option again. And today the most common surgery
Speaker 1: used to treat fibroids is a hysterectomy, which is the
Speaker 1: full removal of the uterus, and it's the only proven
Speaker 1: permanent solution for uterine fibroids. And some women will choose
Speaker 1: to also have their ovaries removed, a lot of women
Speaker 1: will choose to keep them because if you also remove
Speaker 1: the ovaries as you would imagine it immediately induces menopause, right,
Speaker 1: And so myomectomy is still a surgical option today, and
Speaker 1: that's like we said, removing just the growth itself, not
Speaker 1: the entire uterus. And luckily it can actually be performed
Speaker 1: as a laparoscopic or minimally invasive procedure today. It doesn't
Speaker 1: have to be the radical opening of the entire abdominal cavity.
Speaker 1: And speaking of minimally invasive options, women do have some
Speaker 1: things open to them to choose from things like injecting
Speaker 1: small particles into the arteries that supply blood to the uterus,
Speaker 1: which ends up cutting off blood flow to the fibroids
Speaker 1: as well. You can also use an electric current or
Speaker 1: a laser to destroy them, which in my mind, I'm like,
Speaker 1: why wouldn't you just do that all the time, But
Speaker 1: obviously there are other issues. Um, and then there's a
Speaker 1: very controversial option of power more selation, which involves using
Speaker 1: a very tiny rotating power blade to slice uterine growths
Speaker 1: into strips that can be removed through a small incision.
Speaker 1: And that doesn't sound controversial, that seems like okay, cool
Speaker 1: advancements in science. However, it may cause small benign tumors
Speaker 1: to form in the abdominal cavity or in rare cases
Speaker 1: when the fibrod actually is cancerous, to spread cancer cells. Yeah,
Speaker 1: because essentially when they're removing those strips, they might sometimes
Speaker 1: leave stuff behind which can migrate. And there was a
Speaker 1: very recent case where UM a woman underwent the surgery
Speaker 1: and she developed stage for cancer because of that, and
Speaker 1: so power more sulation is now a procedure very much
Speaker 1: under review. There are also some medications out there to
Speaker 1: temporarily treat fibroids. You have gnatotropin releasing hormone agonists of
Speaker 1: course you know. Of course this blocks the production of
Speaker 1: estrogen and progesterone and it stops menstruation, thereby shrinking the
Speaker 1: fibroids and improving anemia. Anemia is something commonly associated with
Speaker 1: this UM. Then there's also the Marina, which is a
Speaker 1: progestin releasing intra uarine device or i u D, and
Speaker 1: it can also relieve heavy bleeding associated with fibroids, but
Speaker 1: it doesn't shrink the actual fibroids. And in a fascinating
Speaker 1: twist myth of priss Stone a k A are you
Speaker 1: for eight six can also shrink fibroids. And if it's
Speaker 1: ringing a bell in your brain, that's because myth of
Speaker 1: PRIs stone is an abortiveation. It's often for two as
Speaker 1: the abortion pill because it's a drug used to end pregnancies,
Speaker 1: and it can shrink those fibroids, like I said, but
Speaker 1: only in postman apozzle women, and once you stopped taking it,
Speaker 1: the fibroids grow back. It's so interesting, so very very
Speaker 1: interesting and scary distressing. Yeah, and and you know we've
Speaker 1: listed a whole bunch of treatments basically for the express
Speaker 1: purpose of illustrating that. Well, yes, there are a ton
Speaker 1: of options out there. They're all sort of uh leading
Speaker 1: us to what we're about to talk about, which is
Speaker 1: that even though we've known about fibroids for a long time,
Speaker 1: we're still not exactly sure the best way to treat them,
Speaker 1: nor are we exactly sure the exact cause. And so
Speaker 1: we're gonna talk way more about that when we come
Speaker 1: right back from a quick break and now back to
Speaker 1: the show. So when we left off, we were talking
Speaker 1: about all of these different treatment options, the only one
Speaker 1: of which that's proven to be permanent is a hysterectomy,
Speaker 1: which is a pretty aggressive surgery. I mean, it's removing
Speaker 1: having your uterus and possibly your ovaries as well removed. Um.
Speaker 1: But the thing that left both Caroline and me saying
Speaker 1: what is the fact that we've known about them for
Speaker 1: a long time, and yet even today doctors aren't really
Speaker 1: sure what causes it. And I feel like this is
Speaker 1: a common refrain through so many of the women's health
Speaker 1: related podcasts that we've done. I mean, and when we
Speaker 1: say we've known about them for a long time, we're
Speaker 1: talking about going back to ancient Greece when Hippocrates called
Speaker 1: them uterine stones, and then in the second century Greek
Speaker 1: physician Galen referred to them as scleromas, and more recently
Speaker 1: in the nineteenth century. In eighteen fifty four, German doctor
Speaker 1: Rudolph Virtuow introduced the term myoma, which means a benign
Speaker 1: tumor of muscular tissue, after demonstrating that those fibroid masses
Speaker 1: were composed from smooth muscles and speaking of fibroids. It
Speaker 1: wasn't until eighteen sixty that the term fibroid was actually
Speaker 1: introduced by Baron Carl von Roka Tanski. Carl, I just
Speaker 1: like that, Carl Dr carl Um. But so, despite the
Speaker 1: fact that even Hippocrates was talking about these things, nobody
Speaker 1: knows exactly why they happened. They do know that there
Speaker 1: are two main factors at play, one hormones to genetics.
Speaker 1: And so let's look at some of these interesting hormonal clues. Yeah,
Speaker 1: and of course the hormones implicated in this are estrogen
Speaker 1: and progesterone. As with everything, is it everything here? I
Speaker 1: think it's everything. I think that some days. Um. So
Speaker 1: the hormonal clues are the fact that they do tend
Speaker 1: to grow rapidly during pregnancy when hormone levels are running high.
Speaker 1: But the more pregnancies a woman has, the lower her risk.
Speaker 1: The risk is also lower for women who take oral contraceptives,
Speaker 1: and they tend to shrink when you take anti hormone medicine.
Speaker 1: They actually stop growing and shrink once you hit menopause. Yeah,
Speaker 1: and there's also a link where women who get their
Speaker 1: periods at a young age also appear to be at
Speaker 1: a higher risk. And there's a higher incidents among women
Speaker 1: whose mothers took d e S, which is a synthetic
Speaker 1: estrogen and endocrine disruptor UH during their pregnancy. And the
Speaker 1: link between in utero d e S exposure and early
Speaker 1: onset fibroids is actually particularly pronounced among African American women,
Speaker 1: and there are other factors as well. A diet has
Speaker 1: been talked about, especially diets high in red meat and
Speaker 1: low in green veggies and fruit, so people eat your veggies.
Speaker 1: Another reason to do that a drinking alcohol, and also
Speaker 1: age because it's more common as we age, especially once
Speaker 1: we hit our thirties and forties. And obesity is also
Speaker 1: a big risk factor. It actually amplifies your risk two
Speaker 1: to three times higher um if you are obese. But
Speaker 1: the biggest risk factor that we need to talk about
Speaker 1: that a lot of doctors are looking into is this
Speaker 1: very strong connection between uterine fibroids and African American women.
Speaker 1: They disproportionately affect Black women and they're more likely to
Speaker 1: experience symptoms longer before they seek help, which could be
Speaker 1: contributed to a number of different factors. But just for instance,
Speaker 1: fortent of women waited over four years to go to
Speaker 1: the doctor and seek out a diagnosis, which again who
Speaker 1: knows how many doctor visits that takes right exactly. And
Speaker 1: fibroids also tend to strike African American women earlier. On average,
Speaker 1: it hits in their late twenties as opposed to their thirties,
Speaker 1: so it's more likely to impact their childbearing plans, especially
Speaker 1: if it took them a long time time to get
Speaker 1: a diagnosis. And then there was a survey in the
Speaker 1: Journal of Women's Health that found that Black women were
Speaker 1: significantly more likely to have severe symptoms like heavier, prolonged periods, cramping,
Speaker 1: and anemia. They were more likely to report that fibroids
Speaker 1: interfered with physical activities and relationships. They were also more
Speaker 1: likely to miss work for fibroid related reasons and more
Speaker 1: likely to seek out health information about fibroids but then
Speaker 1: report feeling like they couldn't find good answers. Forty percent
Speaker 1: of these women said that they visited two or more
Speaker 1: specialists before doctors detected fibroids, and the incidents in relative
Speaker 1: risk grade for uterine fibroids, according to the study, was
Speaker 1: three times greater for black women, and that was compared
Speaker 1: to uh their study population of white women who had
Speaker 1: the same levels of education, employment status, and overall health status.
Speaker 1: So all other factors being equal, you still have this
Speaker 1: much much higher risk. And on top of that, there
Speaker 1: are two point four times likelier to have a hysterectomy
Speaker 1: as a result, and six point eight times likelier to
Speaker 1: have a myomectomy, which is the procedure where they go
Speaker 1: in to remove the fibroid, but they leave the uterus intact.
Speaker 1: And we're gonna hit more on the whole the significance
Speaker 1: of those surgery numbers in just a second. But what
Speaker 1: I thought was very interesting was this study in the
Speaker 1: American Journal Epidemiology linking hair relaxing chemicals with fibroids. Uh.
Speaker 1: They write that these chemicals are used by millions of
Speaker 1: black women, possibly exposing them to various chemicals through scalp
Speaker 1: lesions and burns, and they found that the instances of
Speaker 1: fibroids were linked to higher reports of frequency and duration
Speaker 1: of use and number of burns, but the risk was
Speaker 1: not related to age at first use or the type
Speaker 1: of formula. That's a huge deal. The blog is sphere
Speaker 1: kind of exploded around this time, talking about the fact
Speaker 1: that like something that so many African American women use
Speaker 1: as part of a beauty routine could potentially have horrific
Speaker 1: health effects. And when we talk about the broader significance
Speaker 1: of this condition, and its treatment and the need for
Speaker 1: more attention to it, just even having women like us
Speaker 1: being aware that this is something that could happen, that
Speaker 1: that could very well be existing in our bodies right now.
Speaker 1: Um is the fact that fibroids are the biggest indication
Speaker 1: for women in the US to get hysterectomys, which is
Speaker 1: a major surgical procedure that has equally major life and
Speaker 1: economic effects, not to mention all of the different symptoms
Speaker 1: and how that pain and discomfort, um and bleeding or
Speaker 1: nemia can lead to just difficult lifestyle, hindrances of affecting
Speaker 1: relationships and missed work or school whatever it might be. Right,
Speaker 1: And so if we look at the numbers, fibroids lead
Speaker 1: to two hundred thousand hysterectomies in the United States each year,
Speaker 1: not to mention thirty thousand myomectomies each year. And granted,
Speaker 1: the time spent healing is reduced if you go for
Speaker 1: a minimally invasive type of hysterectomy or myomectomy, but even so,
Speaker 1: we need to talk about the very real costs of
Speaker 1: that many women experiencing that big of surgery every year.
Speaker 1: There is a two thousand twelve study publishing the American
Speaker 1: Journal of Obstetrics and Gynecology which adjusted up the previously
Speaker 1: reported costs four fibroids to five point nine to thirty
Speaker 1: four point four billion dollars annually in the United States,
Speaker 1: and that includes not only the medical costs, but also
Speaker 1: the cost of lost work productivity attributable to uterine fibroids.
Speaker 1: And again going back to African American women, they a
Speaker 1: seventy seven percent likelier to miss work because of this
Speaker 1: health condition. And for an even further cost breakdown from
Speaker 1: that study, UM the estimated annual direct costs that includes
Speaker 1: things like surgery, hospital admissions, outpatient visits, and medications. They
Speaker 1: put it between four point one and nine point four
Speaker 1: billion dollars, So no chump change, right, And in terms
Speaker 1: of that whole lost work productivity thing, Christians absolutely right
Speaker 1: that African American women are seventy seven percent more likely
Speaker 1: to miss work UM and in general, when you look
Speaker 1: at the numbers UH that survey found that more than
Speaker 1: one quarter of women report lost work days and more
Speaker 1: than one fifth reported actual concerns about losing their job
Speaker 1: due to the whole situation stemming from uterine fibroids um
Speaker 1: and so the estimated lost work our costs is between
Speaker 1: one and a half and seventeen point two billion, and
Speaker 1: of course the estimated cost of obstetric outcomes that are
Speaker 1: attributed to those fibroid tumors fall between two hundred and
Speaker 1: thirty eight million and seven point seven billion dollars. That's
Speaker 1: a lot of lost money and lost time. Yeah, And
Speaker 1: I mean, in no way, like none of the statistics
Speaker 1: that we've signed throughout this podcast minimize the importance of
Speaker 1: knowing about this very real health issue. And it's startling
Speaker 1: to me that it is isn't talked about very much
Speaker 1: at all. Um. I feel like it's indicative of a
Speaker 1: lot of issues with women's health in general, where there
Speaker 1: are a lot of things that we usually aren't aware
Speaker 1: of in terms of how our bodies work and can work.
Speaker 1: And again, in a lot of these situations, if you
Speaker 1: have fibroids, you durn fibroids you don't even know and
Speaker 1: that's totally fine. This isn't Ladies, go to your doctor's
Speaker 1: right now and find out if you have fibroids. Half
Speaker 1: the time, it's totally fine, But they can grow into
Speaker 1: these tumors can cause all of these symptoms, and in
Speaker 1: much less likely circumstances, they can become cancerous. Right, And
Speaker 1: so this definitely ties in issues of doctors not listening
Speaker 1: to women, of women having to spend so much time
Speaker 1: and money going from doctor to doctor to seek out
Speaker 1: a diagnosis of what's wrong with me. I'm in this
Speaker 1: pain or I'm having these issues with my period, and
Speaker 1: maybe not even knowing that those kinds of symptoms are
Speaker 1: worth a doctor visit, or maybe not being able to
Speaker 1: afford or to have insurance to be able to go
Speaker 1: to a doctor, or not being able to take time
Speaker 1: off work. I mean, there's so many different factors they
Speaker 1: can go into this very real health care issue. Um,
Speaker 1: but I hope that this was a p s A
Speaker 1: for listeners of at least, you know, validating the health
Speaker 1: issues of women out there who have had to deal
Speaker 1: with uterine fibroids, and also news for listeners who might
Speaker 1: not have been aware of this condition of Hey, if
Speaker 1: these kinds of symptoms start crop being up, this could
Speaker 1: be something to talk to your doctor or nurse practitioner about.
Speaker 1: So I have a feeling that there are listeners whom
Speaker 1: this is very much resonating with and we want to
Speaker 1: hear from you. Were you able, have you been able
Speaker 1: to get treatment for it? Um? What has been your
Speaker 1: experience when it comes to this. Mom Stuff at house
Speaker 1: Stuff Works dot Com is our email address. You can
Speaker 1: also tweet us at mom Stuff podcast or messages on Facebook.
Speaker 1: And we've got a couple of messages to share with
Speaker 1: you when we come right back from a quick break
Speaker 1: and now back to the show. So I've gotta let
Speaker 1: her here from Rosie about our episode on domestic violence,
Speaker 1: and she writes, I wanted to share with you some
Speaker 1: constructive work that's taking place in Australia in terms of
Speaker 1: supporting victims of domestic violence. The trade union movement spearheaded
Speaker 1: by my Union, the Victorian branch of the Australian Services Union,
Speaker 1: has been pushing to get a special category of leave
Speaker 1: included in employment agreements. This domestic violence leave is a
Speaker 1: special category of paid leave to allow victims of domestic
Speaker 1: violence time to attend court and other appointments, move houses,
Speaker 1: or other urgent requirements that being a victim of domestic
Speaker 1: violence may cause. This additional category of leeve allows people
Speaker 1: to not have to use their holiday time undecidedly unpleasant
Speaker 1: tasks like getting a restraining order. It also keeps employers
Speaker 1: mindful that their employees have lives outside the office that
Speaker 1: can interrupt or impact their work. The first employment agreement
Speaker 1: to include this category of leeve was negotiated by a
Speaker 1: city council in two thousand eleven. I think while it's
Speaker 1: absolutely imperative to work hard on preventing domestic violence, the
Speaker 1: sad fact is that it's an ongoing issue and I
Speaker 1: don't see that changing any time. For all the pledges,
Speaker 1: fundraising and education programs about not committing violent acts, we
Speaker 1: as a society also need defined ways to support the
Speaker 1: people who are affected by this. Money issues and stability
Speaker 1: are often reasons that women will not leave an abusive partner.
Speaker 1: For workplaces to be supportive of women who are trying
Speaker 1: to leave abusive relationships, additional leave is an excellent way
Speaker 1: to empower women to be able to make the choices
Speaker 1: they want to make. The Australian Council of Trade Unions
Speaker 1: is lodging a claim at the Fair Work Commission to
Speaker 1: secure ten days paid domestic leave as a minimum entitlement
Speaker 1: for all employees. As a unionist and a feminist, I'm
Speaker 1: very proud to be part of a movement that is
Speaker 1: doing something to support people in abusive relationships and allow
Speaker 1: them to get things done so they can continue to
Speaker 1: live their lives. So thanks so much, Rosie for letting
Speaker 1: us know about that very important work that the Council
Speaker 1: of Trade Unions is doing. Okay, I have a letter
Speaker 1: here from Jenny. She says, I worked on the domestic
Speaker 1: violence field for five years before I returned to school
Speaker 1: to get my master's degree in social work. During that time,
Speaker 1: I accompanied survivors to court and at the hospital during
Speaker 1: forensic exams. I was often the first and last person
Speaker 1: they saw as they attended to leave situations of intimate
Speaker 1: partner violence. I say intimate partner rather than stick because
Speaker 1: it addresses the fact that nine point four percent of
Speaker 1: high school students report being hit, slapped, or physically hurt
Speaker 1: on purpose by their boyfriend or girlfriend in the twelve
Speaker 1: months prior to the survey, and she cites the Centers
Speaker 1: for Disease Control and Prevention Youth Risk Behavior Survey. Unfortunately,
Speaker 1: many states, including Kentucky where I practice, do not offer
Speaker 1: legal production to people in dating relationships, which makes teens
Speaker 1: particularly vulnerable. And then she has a couple of other
Speaker 1: things that she says she wants to address. She says, well,
Speaker 1: you addressed how there are many types of domestic violence.
Speaker 1: You forgot two types that strongly contribute to the difficulty
Speaker 1: of leaving an abusive relationship, economic abuse and reproductive abuse.
Speaker 1: Economic abuse involves withholding money, ensuring that no property or
Speaker 1: credit cards are in the victim's name, or refusing to
Speaker 1: allow the victim to work. Reproductive abuse involves replacing or
Speaker 1: sabotaging birth control, forcing the partner to obtain an abortion
Speaker 1: or preventing her from getting one, or lying about the
Speaker 1: methods of birth control. Both of these categories can affect
Speaker 1: straight and gay couples differently. One category people for get
Speaker 1: about is victims of domestic violence who are disabled. Women
Speaker 1: with disabilities are more likely to experience domestic violence and
Speaker 1: sexual assault than non disabled women, simply due to the
Speaker 1: fact that women with disabilities have particular vulnerabilities that non
Speaker 1: disabled women do not have, such as meeting assistance with
Speaker 1: self care and day living activities, and requiring medical assistance.
Speaker 1: Research from Michael Johnson, who I believe you quoted at
Speaker 1: one point, differentiates intimate terrorism from situational couple violence and
Speaker 1: his research, he separates the cycle of violence that includes
Speaker 1: planning for future violence from violence between couples that is
Speaker 1: frequently mutual and more often than not fueled by drug
Speaker 1: and or alcohol abuse, economic difficulties, and youth. It is
Speaker 1: the latter group of offenders who are most frequently successful
Speaker 1: in batterers treatment programs. As most programs teach people alternative
Speaker 1: conflict resolution skills, people who fit the category of intimate
Speaker 1: terrorists will use treatment groups to learn new ways of
Speaker 1: concealing or getting away with violence. They may also use
Speaker 1: the participation in the group as further ammunition to gas
Speaker 1: light their partners. I can't be to be, so if
Speaker 1: I'm in a group, you should see the other guys.
Speaker 1: And Jenny goes on to say that she hopes that
Speaker 1: more attention is brought to domestic violence through the promotion
Speaker 1: of Domestic Violence Month in October every year. And so, Jenny,
Speaker 1: I just want to thank you so much for all
Speaker 1: of your incredible points, and thanks to everybody who's written
Speaker 1: into us. Mom Stuff at how stuff works dot com
Speaker 1: is our email address, and I just want to put
Speaker 1: a word out there speaking of domestic violence. Since we
Speaker 1: just read a couple of letters about it um. There
Speaker 1: is a new ish Now documentary called Private Violence UM
Speaker 1: produced by hbo UM that is very difficult to watch
Speaker 1: but very much worth watching to learn more about this issue,
Speaker 1: particularly in the US, and if you want to learn
Speaker 1: more about it, go to private violence dot com. Um
Speaker 1: And if you want to learn more about us, you
Speaker 1: can find all of our social media links as well
Speaker 1: as all of our blogs, videos, and podcasts, including this
Speaker 1: one with links to all of our sources so you
Speaker 1: can read along with us over at stuff mom Never
Speaker 1: Told You You dot com For more on this and
Speaker 1: thousands of other topics. Is that how stuff Works dot com.