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📘 {{Tooltip|'''''{{Tooltip|Come as You Are}}'''''}} is a nonfiction guide to women’s sexuality by sex educator {{Tooltip|Emily Nagoski}}, first published in the {{Tooltip|United States}} in 2015 and issued in a substantially revised trade paperback on 2 March 2021.<ref name="OCLC879642467" /><ref name="SS2021" /><ref name="S&SAuthor">{{cite web |title=Emily Nagoski |url=https://www.simonandschuster.com/authors/Emily-Nagoski/434446538 |website=Simon & Schuster |publisher=Simon & Schuster |access-date=19 October 2025}}</ref> The book popularizes the {{Tooltip|dual control model of sexual response}}—the balance of “accelerators and brakes” (excitation and inhibition)—and explains concepts such as {{Tooltip|responsive desire}} and {{Tooltip|arousal non-concordance}} in a sex-positive, evidence-driven register.<ref>{{cite news |title=Why Are Young People Having So Little Sex? |url=https://www.theatlantic.com/magazine/archive/2018/12/the-sex-recession/573949/ |work=The Atlantic |date=15 December 2018 |access-date=19 October 2025}}</ref><ref>{{cite news |title='You're normal!' is science's battle cry in the fight for sexual liberation |url=https://www.theguardian.com/commentisfree/2015/apr/28/youre-normal-is-sciences-battle-cry-in-the-fight-for-sexual-liberation |work=The Guardian |date=27 April 2015 |access-date=19 October 2025}}</ref><ref name="SS2021" /> Written in an accessible, conversational style that mixes research summaries with anecdotes and exercises, it is supported by downloadable worksheets that extend the book’s practical tools.<ref>{{cite news |title='You're normal!' is science's battle cry in the fight for sexual liberation |url=https://www.theguardian.com/commentisfree/2015/apr/28/youre-normal-is-sciences-battle-cry-in-the-fight-for-sexual-liberation |work=The Guardian |date=27 April 2015 |access-date=19 October 2025}}</ref><ref>{{cite web |title=Come As You Are Worksheets |url=https://www.emilynagoski.com/come-as-you-are-worksheets |website=EmilyNagoski.com |publisher=Emily Nagoski |access-date=19 October 2025}}</ref> The revised edition retains a four-part, nine-chapter structure and updates examples and language; the outline used on this page follows the revised trade paperback.<ref name="Marmot2021" /><ref name="SS2021" /> The publisher promotes the title as a {{Tooltip|New York Times}} bestseller, and it has been widely covered by mainstream outlets since release, including {{Tooltip|WBUR}} and {{Tooltip|New York Magazine’s The Cut}}.<ref name="SS2021" /><ref>{{cite news |title='Come As You Are': Book Explores Old Lies And New Science On Women And Sex |url=https://www.wbur.org/news/2015/03/13/come-as-you-are-women-sex |work=WBUR News |date=13 March 2015 |access-date=19 October 2025 |last=Goldberg |first=Carey}}</ref><ref>{{cite web |title=The Way You Understand Your Sex Drive Is Wrong |url=https://www.thecut.com/2015/04/maybe-no-one-has-a-real-sex-drive.html |website=The Cut |publisher=New York Magazine |date=8 April 2015 |access-date=19 October 2025}}</ref>
== Chapter summary ==
🦠 '''8 – The runaway cell: new ways to address the killer that is cancer.''' In 2011, the {{Tooltip|National Lung Screening Trial}} randomized more than 53,000 high-risk smokers to three annual {{Tooltip|low-dose CT}} scans versus chest X-rays and cut lung-cancer mortality by roughly 20%, with about three fewer deaths per 1,000 people screened over ~7 years and a 6.7% drop in all-cause mortality. Not all screens help equally: the U.S. PLCO trial enrolled ~155,000 people from 1993 to 2001 and, amid heavy PSA “contamination” in the control arm, showed no prostate-cancer mortality benefit; meanwhile, the {{Tooltip|ERSPC trial}} reported a 20–21% prostate-cancer mortality reduction with routine PSA testing at the cost of overdiagnosis. Colorectal screening offers multiple lanes: {{Tooltip|colonoscopy}} quality is tracked with adenoma detection rate benchmarks, while a 2014 {{Tooltip|NEJM}} study validated a multitarget stool-DNA test that combines a hemoglobin immunoassay with assays for {{Tooltip|KRAS}} mutations and methylation of {{Tooltip|NDRG4}} and {{Tooltip|BMP3}}. Guidelines have shifted screening earlier—into the mid-40s—because incidence patterns changed, and flexible pathways ({{Tooltip|FIT}}, stool DNA, {{Tooltip|sigmoidoscopy}}, {{Tooltip|colonoscopy}}) let people match preference to risk. The thread through all of this is calibrated screening: hit the cancers where mortality moves and avoid tests that mainly uncover harmless disease. Layer in exposure control—don’t smoke, manage weight and insulin resistance, limit alcohol—and the baseline risk drops before any scan. Treatment is still improving, but the biggest wins come from catching lethal cancers sooner and avoiding the ones that never needed treatment. Make cancer a probability game you can influence—choose screenings with proven mortality benefit and reduce exposures that feed tumor biology. Optimize expected value by pairing high-yield tests (by age and risk) with long-horizon habits so fewer dangerous cancers gain a foothold.
🧠 '''9 – Chasing memory: understanding Alzheimer's Disease and other neurodegenerative diseases.''' The Finnish {{Tooltip|FINGER trial}} randomized 1,260 adults aged 60–77 at elevated risk to two years of diet, exercise, cognitive training, and vascular risk management versus standard health advice and improved global cognition—proof that a multidomain program can move the needle. A 2011 randomized study in ''{{Tooltip|''PNAS''}}'' added a tissue-level view: 120 older adults who walked briskly for a year increased anterior hippocampal volume by about 2% and boosted {{Tooltip|BDNF}}, shifting memory performance upward instead of down. Sleep connects the rest: rodent work from 2013 in ''Science'' showed that during sleep the interstitial space in the brain expands and {{Tooltip|glymphatic flow}} increases, enhancing clearance of metabolic waste including {{Tooltip|amyloid-β}}. Vascular health, insulin sensitivity, mood stability, and fitness all show up as levers that either protect synapses or accelerate decline. High-intensity intervals and heavy carries help the brain as much as the body by strengthening glucose handling, lowering inflammation, and preserving white matter “wiring.” Cognitive reserve is trained the same way muscles are trained: frequently, specifically, and with enough challenge to adapt. When labs and imaging are ambiguous, daily function—balance, recall, attention under fatigue—becomes the dashboard. Neurodegeneration is not one switch but a bundle of risks that can be pushed down together through movement, sleep, metabolic control, and targeted skill work. Build brain resilience by compounding small, repeated stimuli—endurance work, strength training, sleep regularity, and skill practice—that improve synaptic plasticity and reduce the toxic milieu that erodes memory.
== Background & reception ==
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