Cynthia Nixon on Love, Sex, and Women's Health

The Sex and the City star talks about playing Miranda, her battle with breast cancer, her fabulous 40s, and her next role.

From the WebMD Archives

While it may be hard to believe, Cynthia Nixon insists that dressing up in fabulous threads and hanging out with your BFFs can actually be a dangerous job.

Nixon, whom we all recognize as Miranda Hobbes from Sex and the City -- the cable TV series and the movies -- is sitting by the window of a sushi restaurant in her Upper West Side neighborhood, where the server knows her well enough to bring tea before she requests it. She's wearing a long zip-up sweater over leggings, sensibly heeled clogs over striped socks, and dangly, delicate silver earrings. Her hair is a couple shades blonder than Miranda's, but still red enough to promote Sex and the City 2. Nixon is just back from seven weeks of shooting the movie sequel in Morocco, and she's talking about the hazards of her work.

For example, there's the TV episode from 2001 in which Miranda trains with her new love interest, "Marathon Man," and Nixon (not a runner) is directed in the scene to sprint -- without a warm-up. "I snapped something in the front of my hip," she says, "and every now and then it comes back."

The real peril, however, comes with standard SATC footwear. "The heels! It's hard, and it's long hours," she says, remembering her workdays in Morocco. "Wearing heels for 18 hours -- walking, running, on cobblestones, on sand -- and there's no breaking them in." But, she concedes, "they are very well-made shoes."

On Life As Miranda

Since the beloved HBO series debuted in 1998, we've watched Miranda grow from a hard-nosed law firm partner to a softer single (and then married) mom. As she moved into her 40s, she seemed to find peace and become more relaxed with herself and those she loved. But what we didn't know was that the beautiful, self-assured redhead was becoming more and more like the beautiful, natural blonde behind the script.

"When we started, Miranda was a very different person," Nixon says. "She used to be bitter, cynical, and mistrustful. I think she's grown up, gotten sure of herself, and learned to trust. Now she's a lot more like me." Nixon says Miranda relaxed after she found a guy who really loved her (Steve) and after she became a mother. Plus, all her years of professional ambition paid off. "She got where she was going. But she's not really happy there, so what does she do now?"

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Off the set, Nixon, 44, couldn't be mistaken for a SATC character. She dresses stylishly, but for comfort, not to attract paparazzi, and she's quick to admit she's a homebody. "I'm not a girl who likes to get dressed up and go out," she says. "I like to stay home and be with my girlfriend [Christine Marinoni] and my kids. I love going to the theater, but spending a lot of money on clothes -- that is not me."

Instead of getting excited about a to-die-for designer suit or drop-dead gorgeous jewelry, Nixon gets excited talking about the stack of boxes where she stores all her family's holiday supplies -- like the birthday box with the crown, noisemakers, and balloons.

As otherworldly as the SATC wardrobes might be -- the stars never wear the same outfit twice -- Nixon says neither the clothes nor the number of easy-on-the-eyes New York City bachelors is the most unbelievable part of the show. She says it's the fact that hard-charging, big-city professionals Miranda, Carrie (Sarah Jessica Parker), Samantha (Kim Cattrall), and Charlotte (Kristin Davis) manage to schedule lunches or brunches two to three times a week. "It's like, come on, who are we kidding?"

Cynthia's Support Network

Nixon, who grew up in the same neighborhood where she now lives, close to her mother, does have a tight group of girlfriends from grade school days. They have had regular meals together for the last 30 years, but a little less often than the SATC crew -- it's every New Year's Eve at a Chinese restaurant. As for presenting her personal issues to a table of friends for a vote, she's not that kind of girl either. "I get advice one-on-one, not by committee," she says. "There are friends you turn to for different things -- advice dealing with work, or your mother, or your kid, or decorating your home. And then there are friends I have a meal with and [find I] didn't even know what was bothering me until I talked to them about it."

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On Exercise Strategy

Nixon has a similar approach to her physical well-being, calling on experts for various needs. For strength training, she works with a trainer on weight machines, using a slow-burn method called Serious Strength. Nixon calls this the "PowerBar of exercise," because she says it's so effective in totally exhausting her muscles in just 20 minutes. She did it right after her son was born, when she had less than two months to get in shape for the Golden Globe Awards, and it worked wonders.

At least once a week she takes a yoga class and trains on machines at a gyrotonics studio, both of which she says helps her with core strength, balance, and flexibility. She says gyrotonics (a stretching and strengthening exercise in which users work with a trainer on equipment that moves limbs in circular motions) also helps her realign her posture and her gait. She gets a massage and visits her chiropractor once a week for tightness in her back and has been seeing an acupuncturist regularly since she was treated for breast cancer three and a half years ago. The acupuncturist, Nixon says, is like a friend who helps her figure out what's wrong when all she knows beforehand is that she's feeling a little "off."

Nixon is doing everything right. Marianne J. Legato, MD, professor of clinical medicine at Columbia University in New York, says regular exercise is critical for women in their 40s, and three days a week for 40 minutes is enough to do the trick. "Walk fast to work, two miles a day," say Legato, who is also adjunct professor of medicine at Johns Hopkins University in Baltimore. "Use the stairs instead of the elevator and walk instead of driving your car as often as you can."

Five Rules for Fit and Fabulous 40s

Nixon may not have her character Miranda's hairstylist, makeup artist, and wardrobe designer, but at age 44, she makes beauty through health and fitness a priority. Forty is a good age to take a step back and make sure you're doing everything you can for your physical well-being, says Legato, a women's health specialist. She offers WebMD her top health and wellness pointers for women in their fabulous 40s.

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Check up. Choose an internist or primary care doctor, and get a regular physical exam every two years before age 40 and every year after that. Too many women consign their care to their gynecologists until their first serious illness.

Get busy. Sex is a life-giving force that is important at all ages. It does not disappear when you hit 40. Your partners should be carefully chosen, and you should always have protected sex unless they are fully known. Also, don't assume that because you're over 40 you can't get pregnant. Finally, masturbation is normal and a healthy addition to your sex life.

Speak up. Let your doctor know if you're not going to take the medication or get the exam she recommends. We can't drag our patients to tests, but we'd like to suggest a list and be aware of what they're willing to do.

Keep it real. Do not choose a cosmetic procedure unless you're well aware of the risks and benefits of that surgery. And remember: People respond to charm more than appearance.

Work out. Regular exercise is shown to reduce the risk for heart attack, improve cardiovascular conditioning, relieve tension, keep weight down, and promote bone health by guarding against thinning of the bone, or osteoporosis. Core strength is important for balance. Many people fall because of weakness, and their walking is stiff and awkward. Exercise doesn't have to be boring; one of my patients does salsa dancing.

Cynthia's Battle With Breast Cancer

Although breast cancer is behind her, Nixon speaks publicly about it from time to time. She is frustrated by the controversial new mammogram guidelines released in November by the U.S. Preventive Services Task Force (USPSTF), which recommended routine screening mammograms for average-risk women to start at 50.

"It's just so horrible to me, because the main thing I have to tell these women is to get your mammograms and don't delay," says Nixon, who has received regular screenings since she was 35, because her mother had recurrent breast cancer.

Nixon's cancer was discovered on a mammogram when she was 40, but she says it was so small that doctors wouldn't have looked at it twice if they hadn't been able to compare it with images from the previous five years. Plus, the cancer was too small to feel in a breast exam.

"I don't want to be an alarmist and say we need to get mammograms at 22, but get them at 40, and get them every year," she says, "and earlier if you have breast cancer in your family." That's what the American Cancer Society officially recommends: a routine annual screening mammogram starting at age 40 for healthy women at average risk.

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The New Mammogram Guidelines

Nixon's surgeon, Paul Tartter, MD, echoes her concern, saying he was "flabbergasted" when he learned of the new guidelines. "One patient after another kept telling me that if she had waited until 50, [it would have been too late to be successfully treated]," says Tartter, senior attending physician at St. Luke's-Roosevelt Hospital Center's department of surgery in New York.

Still, it's important to put the USPSTF's new screening guidelines into perspective. The task force recommends "biennial screening mammography for women ages 50 to 74" and says the decision to start the screening before 50 should be an individual one, taking into account a woman's values about certain harms and benefits. Diana Petitti, MD, the previous vice chair of the task force, said in a statement last year, "So, what does this mean if you are a woman in your 40s? You should talk to your doctor and make an informed decision about whether mammography is right for you based on your family history, general health, and personal values."

Another area of debate is whether diet can be linked to breast cancer. According to
Tartter, who is also an associate professor of surgery at Columbia University's College of Physicians and Surgeons in New York, billions of dollars have been spent trying to verify that connection, but the results are inconclusive. However, he says patients with high body weight or those who gain weight after treatment have poorer outcomes.

Nixon, who has experimented with various levels of meat in her diet, has settled on a mostly vegetarian approach. She eats fish and eggs and uses beef and chicken broth when cooking soup or risotto. On special occasions she allows herself some prosciutto on pizza or a slice of bacon. But at home, she regularly prepares big salads, and Marinoni (a former education organizer and the stay-at-home mom of the pair) is the authority on cooked vegetables. She also makes uber-healthy (or "yucky," according to Nixon) morning juices that include carrots, kale, apple, red Swiss chard, and ginger, plus the occasional beet greens and spinach.

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Have Sex Like Miranda

When asked what sex tips Sex and the City's Miranda might offer, Nixon quips that her tough attorney character might ask her sexual partners to sign a contract. Legal documents and joking aside, Nixon says that a decade ago, Miranda's advice might have been, "Look out for yourself -- take care of yourself first."

It would be tough to argue that Miranda's sex stories are the most titillating among the four friends. In the first SATC movie, for instance, a distracted and exhausted Miranda rushes Steve through sex (pleading to just get it over with), and the next morning over breakfast, her girlfriends are horrified to learn that the last time Miranda had sex before then was six months ago.

But today, Nixon says, Miranda is much softer, and by the end of SATC, her sex life looked like it might be improving. So here are three tips Nixon says today's Miranda would offer in a conversation about sex:

  • Be safe. Use a condom.
  • Don't be shy. Follow your impulses.
  • Be as present as possible, and if that scares the other person, get out of the bed.

Coincidentally, Nixon says she would also personally give this same advice. As for No. 3, Nixon says this applies to all parts of a relationship, not just in the bedroom. If you can't be yourself, she says, the relationship's not right. Get out.

What's Next for Cynthia Nixon?

The worldwide promotion for SATC2 will continue into the summer, but once that's over, life will return to a more relaxed pace for Nixon, her children, Samantha, 13, and Charles, 7, and Marinoni, 43, whom Nixon calls the kids' "other mom." (They have been engaged for a year -- Nixon shows off her ring -- and would like to get married, but New York has not legalized same-sex marriages.) The two occasionally weekend at their house on Long Island, but usually stay in the city, hitting a museum, going to the park, or hosting friends for a slumber party.

Nixon says she isn't sure what her next acting job will be. She has been offered roles in a number of plays, but either the timing of the production or the character she would play wasn't quite right. "I love working, but I was a child actor, and for the first 10 years of my career I was in school," she says. "So anytime I wouldn't get a job, I'd be disappointed, but I'd also think, 'Ahh, I'm not going to have to be in school and working.' There was always an upside to not getting the job. I still feel very much like that. If there's a wonderful job, that's great. But if not, and I'm home, that's great."

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The actor often reflects on an article she read years ago in The New York Times Magazine about a ballerina she says was "of a certain age" with two children. "When she was young, it was all about pushing herself, rehearsing 12 hours a day, getting her leg higher and back straighter," Nixon says.

"At a certain point, she hit her peak and decided to completely shift her regimen because -- like the women [in SATC2] -- she was where she wanted to get to. Instead of trying to get her leg higher, she just needed to support it and cushion it and make it stay as long as it could. She was dancing to stay limber and for longevity."

Nixon, too, is beyond the pushing-it-to-the-limit phase of her life. She doesn't want to be more famous, more rich, or more skinny. "I have enough of those things," she says. "I could have more, but I have enough."

In the new movie, Miranda, Carrie, Charlotte, and Samantha are making similar appraisals of their lives. They realize the goals they worked so hard to achieve brought them to a place that wasn't the utopia they'd imagined. "There are complaints and adjustments to be made," Nixon says. "What do we do when we've got to where we're going? How do we enjoy it? How do we stay there as long as possible?"

Nixon seems to have figured it all out for herself. For her, the answer to "What next?" isn't picking another path or running up a different mountain. "Maybe," she says, "mountains are not for me."

WebMD Magazine - Feature Reviewed by Louise Chang, MD on May 26, 2010

Sources

SOURCES:
Cynthia Nixon.
Paul Tartter, MD, senior attending physician, Department of Surgery, St. Luke's-Roosevelt Hospital Center, New York; associate professor of surgery, Columbia University's College of Physicians and Surgeons, New York.
Marianne Legato, MD, professor of clinical medicine, Columbia University, New York; adjunct professor of medicine, Johns Hopkins University, Baltimore.
Agency for Healthcare Research and Quality: "Screening for Breast Cancer."

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