If you have a private insurance plan, such as through an employer or Healthcare.gov, your plan documents should include in-network providers who can perform the surgery, and one may offer partial coverage for an out-of-network provider. If you go this route, you might be billed directly and will then need to seek reimbursement through your insurance company.If you have Medicaid, it’s possible your surgery will be covered, but it depends on where you live. (You can see if Medicaid in your state covers transition-related care here.) As of 2014, Medicare covers medical transition-related surgery.What if I don’t have health insurance?Not everyone seeking top surgery has insurance or can get their carrier to cover their surgery. According to a recent report from the Centers for Disease Control and Prevention (CDC), 31.6 million—that’s almost 10%—of people in the US were uninsured in 2020. Additionally, transgender people face higher unemployment and poverty rates compared to cisgender people which makes them more likely to be un- or underinsured. If you fall into that category, one option is to seek out community funding to cover the cost of the procedure, as well as related costs like transportation and meals while you recover. There are grants you can apply for, such as Point of Pride’s Annual Trans Surgery Fund, the Jim Collins Foundation grant, and others. Another option, though no one should have to do this, is raising money for your surgery using crowdfunding. For help with insurance, check out the legal resources compiled by T4T Caregiving, which includes services that help people get their gender-affirming treatments covered.Does my top surgery need to be “approved” in some way?Between barriers to gender-affirming care (caused by stigma, lack of provider awareness, and other systemic issues) and the administrative process of getting any medical care covered by insurance, pursuing top surgery can seem frustratingly complex. The gatekeeping around who should be allowed to receive gender-affirming care is detrimental and actively prevents people from getting the treatments they need. With that in mind, familiarizing yourself with what’s ahead and knowing how to access resources and required paperwork will demystify the process and make it more accessible. Let’s get into it. First, you should know a few things about WPATH: The World Professional Association for Transgender Health is a professional organization made up of clinicians and researchers working in medicine, psychology, law, social work, counseling, psychotherapy, nursing, and other disciplines dedicated to understanding and treating gender dysphoria. They publish a comprehensive document called the Standards of Care (SOC) that contains clinical guidance for health care professionals who treat transgender and gender-diverse people. Loren Schechter, MD, medical director of the Gender Affirmation Surgery Program at Rush University Medical Center serves on WPATH’s executive committee. He tells SELF that the SOC are intended to be used to “help provide a framework” for how health care providers should offer gender-affirming treatment. One thing the SOC do is make recommendations for what criteria a person should meet before being approved for gender-affirming care, like hormone therapy or surgery. Over the years, WPATH criteria have been criticized by trans and gender-diverse people because of the barriers it can pose to getting treatment. And even though, as Dr. Schechter explains, health care providers and insurance companies are not required to follow the SOC, many do use them for guidance. As a result, your surgeon’s office may require you to meet some (or all) of the criteria for surgery established by the SOC. Unfortunately, many surgeons will not move forward without documentation that certain criteria have been met (typically in the form of a letter from another doctor or a therapist or other mental or behavioral health provider). So what are the criteria? According to the latest update to the SOC (SOC 8, which was released in September 2022), criteria include “marked and sustained” gender incongruence, an understanding of the effects of gender-affirming surgery, identifying and ruling out other possible causes of “apparent gender incongruence,” the ability to consent to surgery, and more. You can see the full list here, but keep in mind that the most important thing to determine is what, specifically, from these guidelines your doctor and insurance company (if applicable) will require in order to have your surgery approved. How can I go about getting the approvals I need for surgery?Some folks have affirming primary care providers and/or therapists who will happily write a letter to a surgeon and/or insurance company as needed stating that a person meets all the criteria for gender-affirming surgery. Others may not have access to health care providers at all, let alone affirming ones. And other providers require you receive specific treatment (like therapy, for example), before they’ll write the letter, and that might not be something you can afford. The good news is that there are some resources that can help fill this gap. The Gender-Affirming Letter Access Project (GALAP) is a group of transgender, nonbinary, and allied mental health providers working to increase access to free letters for trans and gender-diverse people who need them. GALAP’s directory can help you find a provider who has signed GALAP’s pledge that they’ll provide free, accessible documentation and don’t believe in institutional gatekeeping for trans and gender-diverse people. How do I find a good surgeon?First, make sure that any prospective surgeons are board certified in plastic surgery and meet the rest of the criteria listed by the American Society of Plastic Surgeons. Dr. Liebman also recommends choosing a surgeon who has experience not just as a plastic surgeon but with top surgery specifically, who he says “have the best toolbox for multiple different types of procedures to accomplish top surgery.”
FYI, walking counts. It’s actually a great way to exercise when you’re pregnant. Don’t think you have to take a workout class or do something totally draining for it to “count.” Just moving in the ways you can will be extremely beneficial.Before I got pregnant, working out in some form was a must for me every day. It has always helped me keep my stress levels under control and sleep like a baby. During pregnancy, I’ve tried my best to keep up with movement in ways that feel doable for me. On the days when I am so tired I don’t want to get up off the couch, I promise myself to just take one slow lap around the block. I almost always end up doing an extra lap or two because once I get moving I feel more awake and energized. (And on the days I’m really not feeling up to it, I listen to my body and promptly go back home to sit or lie down again.)3. Find ways to de-stress and reduce anxiety.Even if you had relatively low levels of anxiety pre-pregnancy, I can assure you that you’ll experience it tenfold throughout these 40-ish weeks. There are so many changes happening in your body, so many things to think and worry about in regard to the fetus’s development, impending labor, and an enormous life change on the horizon, whether it’s your first kid or not.It’s totally understandable to have some sort of anxiety about all of that. (FWIW, I am a very low-stress person and have experienced my fair share of worry and anxiety throughout my own pregnancy.)“A lot of those stresses and anxieties can definitely interfere with sleep and can make you tired during the day as well,” Dr. Paik says.Finding a way to de-stress and calm your mind is essential. The best method is going to look different for everyone, but here are a few things to try: prenatal yoga, mindfulness meditation, deep breathing exercises, getting regular prenatal massages, going for walks, and connecting with people you love. Walking and at-home Peloton classes have been an important outlet for me. Another one of my go-to stress relievers: baking and cooking.4. If you can, take naps. Lots of them.Let me first acknowledge that I know this is not possible for everyone. Depending on your job, and if you’re running after other kids all day long, napping may be an absolute impossibility. But for those who are privileged enough to work from home or otherwise have a flexible schedule, I highly recommend taking advantage during this time.Dr. Bianco suggests napping during the day if you can, even if it’s just for 20 minutes. When I feel too tired to keep working or get anything else done, I’ll lie down, set an alarm for 30 minutes (working in some time to actually fall asleep), put on an eye mask, and snooze away. On the weekends, I’ll nap for a lot longer if I feel like I need it.5. Try your best to eat well—and make sure to get enough iron.Food gives you energy, so you want to make sure you’re loading up on stuff that’s full of nutrients and giving your body what it needs to keep chugging along at its new, high level. “Sometimes it’s hard to do that early on, because you’re combating nausea and vomiting and can only tolerate what you can tolerate,” Dr. Bianco says. If you’re not getting enough of your essential nutrients (and maybe loading up on simple carbs that don’t exactly give you sustained energy, like I did all first trimester) this can also contribute to fatigue.
If you’ve recently passed the wave of engagements and weddings among friends, you may soon notice the chatter quickly turns to another topic: babies. Pretty soon, it can feel like everyone you know is starting a family—or trying to. And with that, chances are you have at least one friend experiencing infertility, even if they’re keeping it to themselves.According to the National Institutes of Health, about 9% of men and 11% of women of reproductive age in the U.S. have experienced fertility problems. And if a friend discloses that they’re going through this, either alone or with a partner, your instinct is probably to reach out and offer your support, right? But figuring out the right thing to say or do isn’t exactly easy, especially if you’ve never been in their shoes.Infertility comes with its own special kind of visceral pain and grief, which is why it’s so important for people to have a support network throughout their journey. At the same time, the difficulty of the situation is also what makes having the right words so challenging. “It’s such a sensitive topic because it’s really an unexpected pain,” Allison Ramsey, MS, LMHC, a psychotherapist specializing in fertility, grief, and perinatal loss, and owner of nature-focused support group Bloom Where You Are Planted, tells SELF. “We’ve all been taught that getting pregnant is so easy, so when it doesn’t work, it just destroys every core of our sense of being.”And that can be especially difficult when someone’s friends and family all seem to be getting pregnant. “Everybody around you is successfully doing this thing that you can’t make happen, and it feels like a knife wound, like getting stabbed. It’s pretty visceral,” Lucille Keenan, PsyD, a psychologist and fertility counselor in North Carolina, tells SELF. “Oftentimes, people have been able to achieve so many things in life by pushing through, by doing more, but then there’s this thing you can’t make happen.”Just being with that person, through the good news and bad news, can be very helpful as they navigate this, Dr. Keenan says. Here, experts share the best things to do and say (and what not to say) to best support a friend who is experiencing infertility.1. Let them know you’re there to listen.“The best thing to say is ‘I’m here if you want to talk,’ and then just be there to listen to them,” Kim Crone, PhD, a psychologist at The Center for Advanced Reproductive Services in Connecticut, tells SELF. “This gives them space during this very distressing experience to talk about it without judgment and without opinions.” If you’re not sure what to really say, you can start with something like: “What’s this been like for you? This must be really hard.” This leaves things open ended so that they can talk and share in the way they want to, Dr. Crone says.Keenan says that texts are a great way to let someone know you’re thinking of them and are wondering how they are doing, because it opens the door for conversation in a low-pressure way. Adding something along the lines of “No need to reply if you are not up for it,” can help make it clear that they are in control. Just letting them know you’re there to support them and talk if they ever want to can go a long way, she says.2. Encourage them to set boundaries.If you want to keep checking in regularly but are unsure if they’d like that, just ask, Ramsey says. Something like, “Do you feel like telling me where you are in the process? If not, that’s totally OK and I will stop asking.” This can help you strike the right balance between managing your own desire to be there for them and their tolerance for discussing this difficult journey, Keenan says. It can also help them identify what they’re feeling and what they need from their support network, since they may be grappling with that as well.
If you miss one pill but have been consistent previously, you probably don’t need a backup plan or emergency contraception, according to Planned Parenthood. You can simply take two pills in one day to stay on schedule. If you miss two pills, you should take the most recent missed pill as soon as you remember and then continue taking it as normal, but you should also use backup birth control (like a condom), or—if pregnancy is your biggest concern—avoid penis-in-vagina sex altogether until you’ve taken the pill for seven consecutive days.If you can’t ever remember to actually take the pill when you’re supposed to, or are often late refilling your prescription each month, a LARC takes away that responsibility. “A LARC’s main advantage is ‘set it and forget it,’” Dr. Dunham says. “It may require more effort to start up, but requires less effort over time.” Basically, once it’s in you’re good to go. No daily alarms or relying on good memory required.2. You want a little more control over your fertility.Research estimates that LARCs are up to 20 times more effective against pregnancy than the pill. Each LARC method is over 99% effective in preventing pregnancy.1 In theory, the same goes for the pill—but only if it’s used perfectly (more on that later). A more realistic figure for the effectiveness of the pill in preventing pregnancy, based on typical use, is 91%, according to Planned Parenthood. In other words, about 9 out of 100 pill takers get pregnant each year.On the flip side, the pill can be appealing if you eventually decide you want to get pregnant, Dr. Dunham says. “It’s easy to stop and doesn’t require a doctor’s visit to start trying to conceive,” she explains.Even if you want to get pregnant in the near future, you can still use a LARC method for birth control in the meantime. “LARC doesn’t affect or decrease your chance of getting pregnant in the future,” Anita Sit, MD, chief of gynecology at Santa Clara Valley Medical Center in San Jose, California, tells SELF. The hormonal implant and IUDs require removal at your doctor’s office, but the process is generally quick and easy for most people.When you stop taking birth control, it can take a bit of time for your cycle to return to normal. A 2020 study that analyzed data from nearly 18,000 people who menstruate found that fertility returned quickest in those who had used IUDs or implants; they waited for an average of two menstrual cycles before conceiving, while pill users had to wait for three cycles.23. The pill is too risky for you.Sometimes, your health history or lifestyle choices factor into your choice of birth control. If you’re older than 35 years and smoke, for example, your doctor may advise you not to take the pill due to the changes increased estrogen levels can make to your blood, according to the CDC. The same goes if you have a history of blood clots, breast cancer, or in some instances, high blood pressure, among other health conditions.
Mental health changes: There isn’t definitive proof that using hormonal birth control exacerbates depression or other mental health issues, according to 2020 research, but mood changes are a commonly reported symptom.1 So it’s important to write down any mood-related symptoms right along with your physical symptoms each day and try to name them as best you can, such as feeling particularly emotional at certain times, having sharp swings in your moods, or feeling depressed, says Dr. Sridhar. You should also include references to specific life events or happenings—say, a breakup or a high-stress period at work, or any other impactful life events—that correlate with the time period you started birth control, she adds.Medications or supplements you’re taking: There are plenty of medications that can trigger similar side effects to birth control. For example, some antidepressants and blood pressure drugs can also impact libido. So, make sure you write down other meds you’re taking in your journal (yes, including supplements); add the medication name, dosage, and how often you take it, Dr. Sridhar recommends. It’s not always easy to decipher exactly which side effect is coming from which medication on your own, she points out, so having all this information down can be helpful if you need to have a conversation with your doctor.Diet and exercise changes: If you changed up either of these recently, include them in your tracker, Dr. Sridhar says. For example, if you recently started eating a vegan diet and your mystery symptoms are stomach-related, it’s worth documenting what foods you’re eating and how you feel after to see if there’s any sort of connection. The same goes for your exercise habits: Major shifts in your activity—for example, you start training for a marathon—can also prompt changes in your body, like muscle soreness, headaches if you’re dehydrated, or GI symptoms (runners trots are so real). Basically, write down any workouts that feel especially new to you, says Dr. Sridhar, and note how your symptoms change during and after.3. Take a break to see if you notice any significant changes.If you feel that your symptoms are bothersome and interfere with your normal activities, another way to parse whether your birth control might be causing your symptoms is to stop using that method of birth control, if you can. Keep up with your journal for a good three months after so you can see if there’s a difference, says Dr. Sridhar.It’s generally safe to stop taking birth control pills, wearing the patch or ring, or ask your doctor for an IUD or implant removal at any time. If you use birth control to help manage a medical condition like PCOS, be sure to discuss it with your doctor before you stop taking your birth control, Dr. Kiley notes.And remember to use a backup method of contraception right away, such as condoms or spermicide, if you’re not planning to get pregnant, Dr. Sridhar adds.If your doctor determines your birth control is the root of your side effects, here’s what to consider.So, you’ve brought your robust symptom journal to your doctor, and the two of you end up determining that your contraception is likely causing your symptoms. Now what?
Peeing yourself at inopportune times (or really any time) can, understandably, be upsetting and anxiety-inducing. If you have stress urinary incontinence (SUI), seemingly harmless activities—like laughing during dinner with friends, having sex, or sneaking in a quick workout—can be potential triggers for a dreaded dribble (or gush) of urine. In these moments, weakened or damaged urinary muscles put excess pressure on the abdomen and bladder, which causes the sphincter muscles—circular muscles in the urethra that control the passage of urine—to open briefly, allowing a bit of pee to trickle out. With SUI, pressure is caused by “forceful” activities like sneezing, coughing, laughing, or exercising. Unfortunately, you can’t exactly predict when a case of the giggles or climbing a few stairs may trigger leakage—and that can impact how you live your life or even start to make you feel anxious about when your next “accident” will strike.That said, SUI isn’t something you just have to live with—and you deserve to feel at ease in your own body. Here’s what you should know if you’re dealing with this, and what you can do take back control of your life (and your bladder). 1. More people experience SUI than you might think.About one in three people with vaginas experience SUI at some point in their lives, according to the Urology Care Foundation, and it can happen at any age. SUI occurs when the pelvic floor muscles—a hammock-like group of muscles that support the bladder, rectum, and uterus—become stretched, damaged, or weakened, or when your urethra—the tube that transports urine from the bladder out of the body—can’t fully close, or both.One reason people with vaginas are more likely to have this issue is that their urethras are much shorter compared to people with penises. (People with penises can still experience SUI, but it’s much less common.) Having a shorter urethra generally translates to having less muscle power, which means any damage or weakness in the area can make it more difficult to control your urine flow, according to the Office of Research on Women’s Health (ORWH). Another big reason people with vaginas are more susceptible to SUI: pregnancy and childbirth. Having a baby can weaken the pelvic floor muscles responsible for holding organs in place, like the bladder, and can press on or injure the nerves that signal the activity to release urine.2 For older people, menopause may also be a culprit, as hormonal changes are thought to affect the pelvic muscles, which can lead to incontinence, per ORWH. In any case, “incontinence is not ‘normal,’ or ‘just a part of aging,’ or a ‘par for the course if you have babies,’” Dr. Reynolds stresses. “It’s very common—probably more common than most people think—but too many people suffer in silence about it.”2. SUI doesn’t just affect people who’ve given birth, though.“Childbirth is simply one contributor or risk factor,” Miranda Harvey, DPT, OCS, director of education at The Academy of Pelvic Health Physical Therapy, tells SELF. Less obvious risk factors include chronic obstructive pulmonary disease (COPD), allergies, and constipation, which can all cause repeated and forceful coughing or straining that can weaken those pelvic muscles over time, she says.
When the push notification declaring that the Supreme Court intended to overturn Roe v. Wade popped up on my phone, I felt like a lot of people did: incredibly afraid for my future. I’m a trans man, and I’ve been on testosterone for half a year, but I knew I wasn’t immune from an unwanted pregnancy. After taking a moment to cry, I googled, “tubes tied near me.”I got a tubal salpingectomy, the removal of both my fallopian tubes, in late July. It was a procedure I had wanted for years, but the need for it had suddenly become immediate and urgent.In the aftermath of the Dobbs decision access to contraception will become even more important for anyone who is concerned about their reproductive health, including trans men, transmasculine people, and non-binary people. Of course, there are tons of birth control options out there—but not all transmasculine folks want to deal with daily reminders to take the pill or weekly swaps to re-up their birth control patch. On top of that, frequent visits to your ob-gyn’s office or the pharmacy present their own challenges, especially when it comes to facing possible stigma from health care providers and grappling with the effects of gender dysphoria.That’s when long-acting reversible contraception (LARC) and permanent contraception (sterilization) can be helpful options, because they’re basically set-it-and-forget-it methods. To help you make sense of it all, SELF spoke to three experts about what transmasculine people should keep in mind when looking into LARC and sterilization.One big thing before we get into it: None of the methods of birth control we’re covering in this article provide protection from sexually transmitted infections (STIs). For that, you’ll need to use a condom or another barrier method. Okay, here’s what you need to know:I’m a trans guy on testosterone. Can I still get pregnant?Despite popular misconceptions, taking testosterone is not a reliable form of pregnancy prevention. Even if your period has stopped or you have been on testosterone for a while, you may still ovulate, which means you can still potentially get pregnant. If you want to avoid getting pregnant, you should consider birth control.Can transmasculine folks on T use hormonal birth control methods?Yes! According to Holly Cummings, MD, MPH, a Pennsylvania-based ob-gyn who specializes in transgender gynecologic care, trans people on testosterone can use any form of birth control, even if it contains hormones. Because the progestin in hormonal birth control, including in certain LARC options, is unlikely to hinder the effects of testosterone, you should feel free to choose whatever birth control method feels like the right fit for you. That said, Dr. Cummings tells SELF that if you aren’t comfortable using hormonal birth control or have had negative experiences with certain hormonal methods, you have other options (more on that shortly).What are my options for long-acting reversible contraception?When providers talk about LARC methods, they’re typically talking about intrauterine devices (IUDs) and the birth control implant, Mary Jane Minkin, MD, a member of SELF’s medical review board and a clinical professor of gynecology, and reproductive sciences at the Yale School of Medicine, tells SELF.
Regardless of whether you get care through your college, a local Planned Parenthood clinic, or another provider who isn’t associated with your campus, you’ll also probably want to know how your provider handles information you might like kept confidential, like prescriptions for birth control, says Dr. Lincoln. For example, even though you have a legal right to medical privacy, your parents might get statements that show you visited an ob-gyn if you go through their insurance for the visit. Dr. Lincoln says you can ask your provider what types of information the insured party might get in the mail and notes that a Planned Parenthood or campus-based clinic is more likely to be discreet.If you live in a dorm, your resident assistant may also have some answers to your questions about your school’s sexual-health services, including those that are specific to the LGBTQ+ community. For example, at least 149 colleges and universities offer insurance plans that cover hormones and gender-affirming surgeries for transitioning students, according to data collected by the non-profit Campus Pride.And even if you aren’t sexually active at the moment, it’s a good idea to get familiar with the health care services you have available so that you feel comfortable using them if and when you need them. If you have a vagina, it’s particularly important to have a provider to speak to when you suspect that you have an infection, such as bacterial vaginosis, a yeast infection, or a UTI, because you’ll want to get speedy treatment.3. If you want to avoid pregnancy, decide on a contraception plan.Using a condom during sex can significantly reduce your odds of getting an STI or becoming pregnant—with perfect use, they’re effective at pregnancy prevention 98% of the time. But user error is common: In a 2017 analysis of contraceptive failure published in Perspectives on Sexual and Reproductive Health, condoms had, on average, a 13% failure rate over the span of one year. In other words, if you’re having the kind of sex that can lead to pregnancy, ideally, you’ll have a backup method of birth control.Choosing a birth control method can be daunting, though, since there are so many options available, says Dr. Lincoln. Your best bet is to do a little research beforehand so that you have an idea of what method would work best for you. “It’s important to go to legitimate sources, and not TikTok, which can scare you off just about every birth control option,” Dr. Lincoln says. She points out that experiences with birth control that you might see on social media are pretty much like online business reviews, where people only share “if it’s really awesome or really horrible.”Dr. Lincoln recommends FindMyMethod and Bedsider.org as sites to consult as you start your research. Once you’ve compiled a list of pros, cons, and potential side effects for a few birth control options, you’ll be more empowered for a conversation with your provider.4. Understand when to get tested for STIs.STIs can be an unfortunate part of being sexually active. That’s true even if you aren’t engaging in penetrative sex of any kind. If body fluids like saliva, semen, or vaginal secretions are getting swapped, your risk of infection will never be zero, Kristen Mark, PhD, a professor of family medicine and community health at the University of Minnesota Medical School’s Institute for Sexual and Gender Health, tells SELF.
Madeline Brewer earned a 2021 Emmy nomination for her portrayal of Janine Lindo on The Handmaid’s Tale (which returns to Hulu for season five on September 14). While viewers have watched Janine survive one trauma after another in Gilead, the show has also revealed some of the character’s backstory prior to becoming Ofwarren, including the safe and legal abortion she underwent at a clinic before giving birth to her son, Caleb. Since the Supreme Court overturned Roe v. Wade, millions of people across the US have lost their reproductive freedom. This terrifying shift moved Brewer to share via a June Instagram post that she also had an abortion offscreen at age 20. Here, she tells SELF her abortion story in full, as told to writer Samantha Vincenty, and she explains why she’s never regretted her choice.I grew up in a historically white town in New Jersey that was pretty conservative at the time; it had 13 churches within a 2-square-mile radius, so when it came to the residents’ views toward reproductive health, interpret that as you will. But my own parents were very “choose your own adventure” about religion. My mom is one badass feminist, and she instilled a lot of that in me. My view on abortion was always “whatever you need to do for your body.”That said, when I was growing up, I never saw a single TV show in which a person made this decision and the doctor was supportive, in the way we portrayed Janine’s experience on The Handmaid’s Tale. Both onscreen and in the world around me, abortion was a whispered word.I was 20 years old when I got pregnant; at the time, I was attending acting school in Manhattan while living in Queens. I was an emotionally guarded person back then with no clue of who I was or what I wanted, really. All I knew was that I wanted to be an actor.Like so many people, I didn’t even realize that I’d become pregnant until weeks afterward. My boyfriend and I had used a condom the last time we’d had sex. I’d missed a period, but that wasn’t unusual for me: I was in college, stressed out, and dancing five days a week, so my body was already going through a lot.By strange coincidence, I booked Orange Is the New Black on the same day that I got pregnant. Two weeks later, after the greatest night of my life filming my first TV show, I was mugged on the streets of Queens while walking home from the studio. I remember being frightened for my life. But to be honest, I was generally scared of everything in those days. When I look back at myself on that first season of Orange, I think, God, that girl was so lost. And it was during this time that I had to make this huge life decision to terminate a pregnancy.
Kelly Ripa has always been pretty frank, especially when it comes to sharing the scoop about her relationship with her husband, Mark Consuelos. And based on a recent story the 51-year-old talk show host revealed, which is in her forthcoming memoir, Live Wire, her honesty isn’t going to let up anytime soon. Excerpted in Haute Living, Ripa writes about a time she passed out while having sex with Consuelos—and she didn’t even realize it until she woke up in the emergency room. That’s how she found out she had ovarian cysts.An ovarian cyst is a sac filled with fluid that can form on or inside the ovaries. They’re pretty common, and about 8% of people who haven’t hit menopause will develop a cyst large enough that needs treatment, according to the Office on Women’s Health. When an ovarian cyst ruptures, you may not feel anything at all—most tend to be small, so they don’t always cause noticeable symptoms. It’s not totally clear what, exactly, made Ripa pass out, nor if or how her cyst burst. However, the bigger a cyst grows, the bigger your risk of feeling some pretty serious—and maybe very sudden—pain. You may also experience an intense feeling of pressure, major swelling or bloating, and nausea or vomiting, among other unpleasant symptoms. Not all ovarian cysts need treatment, but some may need to be surgically removed. “My eyes shift between the fuzzy images on the screen, the remnants of my ovarian tormentor, and Mark happily snacking away,” Ripa writes, per the excerpt. “Sex can be traumatic I think, and yet one of us is completely undaunted. There he is, happily munching on the saltines now and ordering a second apple juice. Mark could be at a movie, or a spa. Instead, I’m flat on my back wondering when the other two cysts will burst.”The ordeal occurred shortly after the birth of the couple’s first son in 1997, and Ripa joked about the outfit Consuelos dressed her in to take her to the hospital. When she came to, she was wearing a leotard, red Manolo Blahniks, and her husband’s sweatpants. Luckily, it seems like Ripa recovered and now laughs about it; although she thinks the entire situation, particularly her “costume,” as she called it, is “still baffling.”Ripa also dished some details about working with Regis Philbin, her thoughts on aging, and her relationship with her three children in Live Wire, which is out September 27. In an Instagram post from April, she stressed that she put a lot of herself into this book. “My husband said writing a book is like giving birth,” Ripa wrote in the caption. “He’s never done either. Although it would be like giving birth, if giving birth lasted 18 months. A labor of love nonetheless.”Related: