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Hey, hello ologites. So I put this in the show description, but I'm also adding it up top just in case you're driving a car, or your working a forklift, or you're freeding your chickens or I don't know, if you listen to on a high wire, you should not be reading text. This is just a pre roll linguistics alert. So in this episode, we talk about transgender healthcare and we touch on the history of the trans community in
the US. And when I recorded this episode, in considering the inclusion of trans women, I opted for use of the term women's health and women as gynecology is currently technically but antiquatedly defined. So I thought, okay, I'm making sure to include everyone who identifies as a woman. We are golden great. No, in so doing, I fucked up, and I overlooked and excluded non binary and trans men friends in that language, and I'm super, super super sorry.
I'm so sorry. Some really amazing and compassionate ologites alerted me to this, and I just want to say, I'm so so sorry that the language I used, like women, lady, lady machine made anyone feel unseen. Please know that trans inclusion was totally on my mind, but I'm just super embarrassed to have missed the mark and overlooked the non binary community and trans men community who also rely on gynecology for vital healthcare. I thought I had my basis covered,
and I did. I'm an idiot, So my ologites, each and every one of you, I see you, I love you, I care about you a bunch, and I will strive to do better when it comes to inclusionary language. As you know, I'm all about asking smart people dumb questions, and even when I think okay, I got this, I'll
do my best to just double check, triple check. So thank you for tipping me off to that that I could have been more in the loop about gender versus Jenny's and for your patients with me and with each other, just as we all learn new things and we evolve into an even more inclusive and better linguistically equipped society. Now, if you don't encounter it often, it may seem like, well,
what's the big deal? But I think these are some new and really exciting steps towards breaking down a lot of gender roles that hold all kinds of people back, from CIS to trans to non binary, Like wearing pants was illegal for half the population until that was challenged and reframed. So if you're dope that you don't have to drag a bustle on the subway or fit a petticoat into your Nissan CenTra, then we have some brave folks who said this sucks and it's impractical to think.
So likewise with gender and labels and the trans and non binary community for undoing some super stark gender expectations and roles that don't really fit anyone completely. So thank you, I see you. Let's all be super kind and compassionate to each other and keep our minds open to learning new things, whether it's about snake butts or be dancing, or the origins of the universe or another person's perspective. So learning shit is cool. I stand by that. Okay, Jino,
here we go. Oh hi, it's your guidance counselor aliy Ward, it's me. First things First, I think I have my contacts in the wrong eyes, but I'm just gonna go for this. I'm gonna change them later. Let's blaze through. OBG. Why not. Let's get into it. Vagina's talk about them. Maybe you have one, maybe you want one, Maybe you
love them, maybe you came straight out of one. They're everywhere, they're all around you, and they're pretty handy in terms of shooting out humans to continue the survival of our species. But how well do you know vaginas? How well do you really know them? It's kind of like when you've met someone a bunch of times at parties and you're like, oh my god, I love her, but you don't want to admit that. Like you've never had a real one on one and like you don't even text each other.
You've just hung out like a few times when people are drunk. So consider this episode just a deep ass dive into the world of vaginas, birth, women's health, mental health, self care, hygiene, all things that are happening in parts of your body that you only care about when they're causing you either great pleasure or great pain. So let's talk about gynecology first off, before we celebrate Croutch doctors, let's celebrate you. This engine of ologies runs total on
listener support. It's one hundred percent Indie, so your Patreon pledges keep it running from month to month. Thank you so so much for doing it. Patroons also get, in return to ask the ologists questions, and they get to walk around knowing that they're helping cocktail parties everywhere be way less vapid. So thanks to everyone who buys shirts and dad hats and pins and tots at ologiesmirch dot com.
You're totally helping to but mice tight. I get that you can also support so much by just subscribing and reviewing on iTunes, which is free. It takes two seconds, and I'm a creep and I read every review and this week's warmed my heart so much. It confused my soul a little bit TBH. Moneywalk says, just listen to the podcast on ichthyology, and I realized that Ali sounds very similar to Ellen DeGeneres. What could be better than listening to Dory tell you about fish? Do I sound
like Ellen de Generes? Yes, I am, that's me. Okay, back to gynecology. Now, before we dive into where babies come from, let's look at the birth of the word. So gynecology it means a science that deals with the health and diseases of women. It comes from a Greek word jina, which comes from Gwen, which has the same route. Are you ready for this as a queen Gwen, Queen Jine boom, so just think yes, her majesty y'all rfe jai. So let's bow to your queens with a discussion with
a gynecologist. Now, I had gone to Portland to record a few episodes beer Bees, and now this interview with a medical doctor who grew up in the Philippines, South Africa. She grew up in Argentina, the Netherlands all over. She's now based in Portland. She's been in obgyn since nineteen ninety seven and she's worked several medical missions in Ethiopia. She's a total badass. She spent an hour on a
Saturday morning getting peppered with questions for me. Now she arrived in my hotel lobby, I think a bit confused. I'm gonna be honest. I think she was like, what am I getting myself into? And I have a dear high school friend, Hypaul, and he had put us in touch. And I think she's like, who is this redheaded chick in a three star Portland hotel? And why am I
talking to her on a Saturday morning? And side note, I had booked it on a hot wire where they tell you like it's probably a Shardan or like a Marriott, and you're like okay, and then after you pay for it, they're like, psych, we gave you a creepy place that someone would stay if they're going through a divorce on a budget. So this amazingly brilliant doctor shows up and on the way to my room she offers that the place has a bit of a Motel six vibe, and
I was gently mortified. I was like, m girl, you are not wrong. Please forgive me. I have been foolishly caffish by hall wire Anyway, we got to my room, and she has the calmest bedside voice of anyone I have ever met. I imagine hone from literal decades coaching live human births. If a screaming rotisserie chicken made out of my own blood were to work its way out of an orifice, I would want someone with her calm,
intelligent disposition calling the fucking shots here. Likewise, if I found a rash somewhere delicate or needed my holes probed by imaging equipment, her voice, her coolness are goals. So she pulled up a chair and we chatted about what your gynecologist thinks of your bikini wax, unusual birthing strategies, self care, and even like warning, some super sobering statistics about assault, how you can help victims, how to wash yourself,
how to touch yourself, all kinds of great stuff. So feel free to recommend this episode to anyone who's a woman or whose life has been affected by a woman, which is like all of us. So please scoot just a little further down the table. It's just a little more. Okay, that's too much, okay for gynecologist doctor Philippa Ribbink, So here's your microphone, that's yours, and we just talked into it,
doctor Ribbink, Doctor Ribink. Was there a particular day where they're like, we can you can call yourself a doctor.
Now after you graduate from medical school. The day you graduate, you can call yourself doctor.
Did you no?
No? No?
Did it take a minute to like get settle in to your identity?
Yeah, it took a while. It took a while. I mean I did in residency, I think from day one, so that was a month after I graduated, so it wasn't didn't take that long, but yeah, it felt like I was acting in the beginning. Really, I didn't feel like a real doctor for quite a while. It actually took quite probably several years before I stopped feeling like I was acting.
That's really common though, in doctors, especially doctors with a lot of empathy. Is that feeling of imposter syndrome.
It's very common. Yeah, it's very common. I'm not quite sure why, but I did a lot of acting in college, so it kind of like I was okay with it, but I felt like I was.
Acting quick aside on imposter syndrome because I feel like so many smart capable people have it, including so many ologists that I meet. First, It's not a syndrome or a disease at all. It's just an experience identified by two psychologists, doctor Paulineklants and doctor Suzanne IIMs Now. They observe that many intelligent, high achieving people, especially women and people in ethnic minorities, tend to think that they are
not intelligent. It's common across so many fields, people like my Angelo in Cheryl Sandberg and even Tom Hanks being like man Man, I do not belong here. I suck. So a lot of people with imposter syndrome don't know that other people worried that they don't belong in the high ranks that they've achieved. But admitting and talking about
it tends to really help, if not solve the problem. So, by the way, the opposite of this is called the Dunning Krueger effect, when people of low ability think that they are the best, which can also happen in a lot of fields, such as, for example politics. As for imposter syndrome, no matter if you're a doctor or a dancer,
you may have felt like do I belong here? At what point did you kind of decide to nurture the medical side of your talents, if you are if you're also doing arts and acting, Like, was there a moment where you're like, I gotta choose.
I always wanted to be a doctor. When I was a little kid, I had I had I had a heart apperishon when I was a little kid, and after that, I always I kind of felt like, well, I have to do this when I grow up. And my grandfather, who I was very close to, was also a doctor, so I kind of wanted to be like him. And I always thought I was going to be a doctor. And then I went to college and I discovered acting and I loved acting, and then I thought, well, maybe
I'll be an actress in New York City. And then I was waiting tables in New York City and kind of thinking, wow, I don't really want to do this. And I was very good at science, so I didn't. In my last year in college, I was like, I need to rethink this. I need to do what I'm good at and applied to medical school and I got in and I ever since that, i've I'm I love medicine. It's just it's it's it's the only job I can
imagine doing. It's the only I don't think there's a lot of jobs except for maybe what you do, where you can really you can hear stories, people's stories. You can listen, you can you can get really intimate details about people's lives. And a friend of mine said, you know, I don't read literature because I listened to patients all day long, and you can't make up this stuff. You can't make up this stuff. The degree of kind of the views in people's lives you get as a physician.
Maybe not all physicians, maybe not if you're a radiologist or a pathologist, but as an OBGN or a family practitioner or an internist, it's amazing. I mean, it's an incredible privilege. You get to like listen to people's intimate details, and then you get to give them advice. I mean, you get to change people's lives, and there's very few jobs where you get to do that.
Do you think that there's something about psychology and stories that drew you to women's health in particular?
Probably? I mean I've always think I've always found there's also just something about women's health that's just it's so varied. What I do as an OBI Julane is so varied. I'm in general Obi Juane. So I get to deliver babies, I get to take people to ower, I get to do c sections, I get to do I get to know people for twenty years. And that's not you know, surgeons get to meet someone one day and take out
a gallbladder and then never see them again. And I get to see people whose kids I've delivered and then maybe I've taken that they're overari insist or I've you know, and I take care of their kids. I you know, I saw yesterday, I saw a patient who was a Katrina refugee who had nothing when she came here. Now are kid's going to go to college? I mean it's like I get to see these stories, and I don't you know, who gets to have that kind of inside view.
Even as a journalist, you're like, you know, you get to hear a story and then you're in another town. Yeah, so you don't get that. You don't get to know people on that level.
Did you find that when you were first starting out, was that kind of intimacy was that easy for you or did that did that become more easy more natural as you gained experience.
Yeah, I mean, I think it takes time to be comfortable with people telling you things that may be someone embarrassing and someone you know a little too much information or a little bit like, oh my god, I work with you and you do that. That's interesting. But I think that you know, it takes a while to ask the right questions as well. It takes a while to
ask questions about people's sex lives. It takes a while to ask and to learn how to do it without judgment and where people are actually comfortable and they're going to tell you details, they are important for you to know. If you don't ask the question, you're not going to get the answer, You're not going to look for the the you're not going to be able to make the diagnosis.
You know, there's people make silly choices sometimes when it comes to sex, and you don't you don't find out that they've made those silly choices until you've actually asked the really specific question. Or there make silly choices when it comes to drugs or other things. And again, you know, unless you're very specific and you learn how to ask questions very specifically without without judgment, and that takes quite a while I think that in the beginning, I wasn't that good at that.
Do you have to do a lot of guests work with women's health. Are there any cases that you feel like really confuse both you and the patient. I feel like as as a person with a vagina and someone who has friends with them, there's a lot of times women's health can absolutely confuse us and say why does this hurt? Why is this happening? And do you find that that that it's Sometimes diagnoses are difficult to make.
Yeah, I mean probably Pelvic pain is one of the hardest subjects for us all because people come in with complaints of pain, and there's so many different things that can cause pain in the pelvis because all these you know, there's so many different organs in the pelvis and all the nerves travel together, so you can have you know, you could you could have a hairline fracture in the tip of your you know, in the tip of your femur in that in your fhemeral head, and that could hurt,
it could make you hurt kind of in the mid line as if you've got, you know, something wrong with your ovary, and so the pain, all these pain fibers travel together. I've had people with atopic pregnancies on the left side and come in with intense pain on the right side.
Side note topic means out of place literally, and it refers to an egg instead of implanting in the uterus deciding to just like attach to your full opium too or elsewhere. So it was like moving into a new house, but setting up your bedroom in the driveway. It's like, is here good? No, No, that's not good. And sadly, topic pregnancies usually do not have a good outcome, and they can be super dangerous for both the fetus and the mom and they hurt a lot, sometimes in the wrong spot.
It's hard to locate pain just by where people point or people say it hurts on this side. And I've you know, I remember taking a patient to the ore because she had intense pain on the left side and she had a cyst on the left side, and she was postman a puzzle and she shouldn't have a cyst on the left over and we took out our ovary and she still had this pain on the left side.
And then I kind of scratched my head and didn't know what to do with her and send her to a friend of mine who's a fantastic physical therapist who's also a really fantastic diagnostician, and who just kind of figured out that she had started playing the flute and was hold her body. Really funny, what Emma's just contracting her left side of her body and that's why she had this intense pain on the left side. So there's all this. You know, people people hold their you know,
hold tension in their iliosois muscles. Huh, they'll hold tension in their muscles, So.
Come again, Okay, those are both part of your pelvic floor, which is kind of like a trampoline of muscles holding your bowel and bladder and uterus in the right spots. So this basin of muscles. Make sure your guts and gonads are well supported. Some of us don't even realize we've strained them, or don't even know we have them. We've never even thanked them once. If you're feeling bad about it, just do like a little keegel squeeze right now, like a high five, like boop.
They'll hold tension in some of their muscles and it will be and it will feel like pain from thereover it will feel pain from their dress and it's really referred pain.
Wow, I didn't even know that could happen. I can't imagine. You're like, I played the flute. Let's get this over yet here, Like who would have That's that's not something you're going to find in a medical textbook, Like.
No, definitely, it is just kind of you know, I mean, sometimes you can get it out through the history. You you know, you finding out what kind of work people do, whether they stand a lot, and sometimes people have a lot of women have had a history of sexual abuse, and a lot of times when you've been raped or you've been hurt, you'll hold you know, your body remembers the pain and it manifests itself later on in life, so in various different ways.
So, having practiced now over twenty years, have you seen any attitudes toward women's health or being their own advocates for their health, or their attitude it's toward their own sexual relationships change it all over the last couple decades.
Unfortunately, I think women are still somewhat mystified by their body more so than they need to be. I think there's a lot of information out there on the internet that's very helpful, but I don't know how many people are actually accessing it. There's an amazing website called oh my God yes about that basically talks about female sexuality. Uh.
Yes, I went to oh mygodyes dot com. Okay, so this is a site that raises money for women's sexuality research by providing in exchange informative, beautifully shot instructional videos behind a paywall. I was like, do I pay thirty nine dollars in the name of science to see what this is all about? And hell yeah, I used my business card and it did it. So let me just say, whoa, dude,
whoa whoa? Okay, it's this gorgeously shot catacomb of videos you can go down about orgasmic tactics such as edging, layering, signaling, orbiting, and it's just right up in there. You see it all. Honestly, the most striking thing was like, whoa. I have never seen someone that you'd work in an office with talking or doing sexual things on camera like this. There's like no performative moaning, there's no painful looking high heels or weird KOI eye contact with the camera. It's just women
teaching women how to use their anatomy for pleasure. Men might be thinking, like, you need a video for that. We don't need videos for that, because our bodies are human factories with a lot of real complicated parts. Most of sex ed that women get focuses on, like mechanics like periods, pats, tampons, ovulation, how to make sure dude does not put a baby in us when we don't
want one, et cetera, et cetera. As we learned about in the Sexology episode, most women don't come through just vaginal stimulation, and no one really talks to us about that because for a quarter of our fertile lives, we are busy hemorrhaging from are crotch. And that just got dropped from the pamphlets they give out in middle school. They're like, oh, yeah, I guess you could come to I guess if you figured it out.
I think it's kind of changing. I mean, I think the last year is very interesting to me because I think there's all these different you know, maybe because of the Me too movement, maybe because of reaction to the election, or there's there are many more TV shows that talk about female sexuality that very openly. So I think I kind of feel things are changing now, but I don't, you know, I don't know. I mean, there's still I see a lot of women with pain with sex. There's
a lot of great information out there about that. Women are coming very very mystified about it, and I really not. They don't know how to access information on the internet and how to find how to find the right sources. They come and they come in with a lot of shame. I'm a lot of shame, or they hear things like, oh, just continue to have sex because it will get better,
and they come in. By the time they come and see me, they've got they've had pain for so long that their muscles are completely tense, and it will take ages for us to kind of reverse what's happened. I think things may be changing now, but I in the twenty years I've been here, I haven't necessarily seen. You know, there are people that know how to access information and will from either books or from the internet, and know how to take what's you know, they know how to
separate the bullshit from the true information. And there's also people that just get mired in the details and then really come in with some really cookie concepts.
So do you find that people sometimes over google before an appointment and they're like, I think I figured this out, and you're like.
Well, yeah, people do. And again, sometimes people come in and they've googled things and they've really find they've found some stuff that I've never heard of, and they've really and they educate me. There's also people that come in and they've just really gone down a rabbit hole and they just are it hasn't helped them. So again, I mean, I don't know what makes people good at finding information and what makes people bad at it, But I you know.
Is there any book you think that every woman should read about her own health?
Like? Is this in Our Bodies Ourselves kind of a thing?
Is that say? Like is there a should there be a textbook?
There should be? And I think Our Bodies Ourselves is kind of outdated, and Joy of Sex is a kind of outdated. I mean I think there's Yeah, I think there should be something that's That's the thing about female sexuality is that they're so you know, it's finally being studied, it's finally being studied in a more kind of scientific way.
I remember textbook when I was in residency that talked about it was a surgery textbook, I talked about treatment for vulvar cancer and some vulvar cancers that are invasive that are spread. The treatment is removing the entire volva, including the clitoris.
Let's take a few quick sex for a quick rundown of the key players in a gynecologist eye line. Now, when you say vagina, such as in my vagina wants to text him, but my heart knows better, or I'm sorry I stole your brownie. Please do not kick me in the vagina. Friend. What we're probably referring to, you're right for this is a vulva, which is such a moist sounding word. But I am a grown ass woman, and I just learned one minute ago that the vagina
is just the muscular canal. That's your baby shoot. The vult is everything else external, including the pubic mound, the labia majora that's your burger bun. The labia minor there's your lettuce. The glitteris your pee hole, your vage opening. That's all your vulva. You've been calling it by its sister's name, vagina all this time, but it's like whatever I'm used to it. So, as she was saying in some cancers if they spread, they remove all or part of the vulva.
This surgery textbook said that after that, some woman will still achieve orgasm. And I read that and I tried to find the reference for this, yeah, and I could not. There wasn't a reference for it. It was just a statement in the textbook, but it wasn't referenced. So I kind of thought, where on earth do they get this information? And I kind of know where this information comes from
because I've worked with those doctors and they know. The patient comes in and says it's everything's still fine with your husband, and patient says, yes it is, and hence the conclusion that woman can still achieve orgasm, which is a lot of bullshit. Yeah, I mean there's no I never found a reference for that statement.
If things are fun for your husband, they must be fun for you.
So I think that, you know, finally there's people that are actually doing scientific research on female sexual pleasure on female bodies, and I think that's really important.
I think that's astounding that it hasn't been that it's such an afterthought, I mean to women's health in general. I mean, I feel like the focus is tends to be more on reproductive I feel like we prioritize making more babies rather than having more orgasms.
Probably, yeah, I mean I think it's all like, you know, who's telling the story, you know? I mean it's just like I think for ages, men have been telling the story. I think, finally women are telling the story. Women directors are directing movies and telling stories. There's TV shows that are you know, written by women, directed by women, and it's finally women are telling the stories. So I think we'll get more, you know, science kind of being spent
on issues that are important for women. I think we need more women telling stories. We need more women in science, We need more women asking questions. So, ladies, exactly exactly.
Did you gravitate toward gynecology because of your own interests in it? Necessarily?
Were you?
Were you kind of mystified by things and you thought this, if I'm mystified and I like science, maybe other people are. Or did you like the idea of delivering babies?
What was it?
Is? A rape pict a mactricod in college, So I think that kind of made me interested in women's health and them. Just in medical school, I mean, there were there there were two fields I loved psychiatry, but that happened to be because I did medical school in New York City and the psychiatric hospital was paying Whitney at Cornell, and it was just such a fantastic psychiatric hospital, and the psychiatrists were the smartest doctors I met, and it
was just fascinating. And then the second field I really loved was obi. It just obig in. I just absolutely fell in love with it. I really had no experience with delivering babies before I started medical school. I just like, I just fell in love with the field.
I'm so sorry that happened to you, by the way, that's.
I wasn't a rip victim, was a ripe victim advocates.
I thought, you said, I'm so sorry, advocate. Okay, so this is super embarrassing. But when she said rape victim advocate, I missed the advocate part of that sentence. So that was the most embarrassing and delicate conversational hiccup of my life. So thank you for witnessing it. I had never heard of a rape victim advocate, but doctor Rabink explained, I.
Went to the er to like be with rape victims. So they had a program that we they when you could be you could train to become a Rape Victim Act advocate and you were on call and if some if a rape victim went to the er, you would go with them and sit with them basically during the interview.
How did you get involved with that?
Oh?
No, someone there was a flyer up in my college. I went to a woman's college. I don't know.
That's dope.
It was cool, it was a thing, it was cool, it was good, a good thing to do.
In an ideal world, perpetrators of these violent crimes wouldn't do this. And we all know society has a long way to go in addressing our culture of violence. And unfortunately, I hear these stories from people I know a lot. Every woman seems to have had a sexual experience that should not have happened to her, or a near brush with one, and those stories are so common, They're incredibly common.
I mean, it's just it's astonishing how many women have been sexual assaulted, are raped. It just is astonishing and underreported as well. Underreported. I mean we used to say one and four. I think that's probably more one in two.
Wow.
God, that's.
I think. I'm hoping I'm hoping that women will start. This will start some kind of tide of speaking up. I feel like this even the last couple of months has been the first time that you really hear people speaking out about it. Because the repercussions are so so much. There's so much sharper for women than they should be ever, and they should be for any other victim of anything else. So for more information on programs to help support victims, one resource is rain dot org are ai n N
dot org, so check that out. So all right, in college, she spent some time being on call for volunteer work. What about now when it comes to being an OB? Are you is your life always? Are you always on call?
No? I'm in a group. I could never always be on call. That I mean, I don't I know that OB's used to do that, and I think they had wives that would like take care of their personal needs and we're somehow able to do it. I would never be able to pull that up. Now. I work in with a lovely group of physicians and we cover each other. And our group was actually the founders of my group really felt that in order for us to be good physicians,
we had to take care of ourselves. We couldn't take care of other people if we didn't take care of ourselves. So we from the very beginning that they the group, we never took call for ourselves twenty four seven. We always covered each other so that if you had a dinner date, you could go to your dinner date. You didn't have to cancel your dinner day just because someone was in labor. And patients, you know, our patients hear that from the you know, the first the day they
come in the door. You know, I work in a group. We take we cover each other for call. Whoever's own call is going to do your delivery, maybe maybe one of my wonderful partners. And you know, if you if that's not okay with you, then you need to find a different physician.
And when when you say taking care of yourself is, of course that makes you a better doctor. I think that's so interesting, especially when it comes to women's house. We don't take care of ourselves. What are the basic tenets of like making sure that you're not ragged and it's not affecting your body. I'm asking this for selfish reasons because I'm always ragged.
Get enough sleep when you can, don't drink too much alcohol. Have friends, do things with your friends, have family, do things with your family, go on vacation, you know, do things that have nothing to do with medicine. Go to the movies, read a book, learn a new language, do other things. And exercise. We all, like, everyone in my group has an exercise routine and we stick with it religiously.
It's so important. And eat healthy. I mean those are kind of I mean, they're basic things that everyone should do. Don't eat chunk food.
What's your exercise routine?
I go to yoga twice a week, and then I do this bizarre exercise called gyrotonics, and I take a private lesson with this Russian ball arena who tortures me. I'm Russian. I had to do this when I was a kid, and you have to do this?
What is it?
Does it involve a gyroscope?
No, it's it's kind of like pilates, but it's more three dimensional than pilates. It's an amazing core muscle exercise routine. A lot of what I do is bending over and holding my body in funny positions when I'm waiting for someone to deliver or.
Okay, I looked this up and it's not rotonics. It's technically gyrotonic, followed by an R in a circle like a registered trademark. Gwyneth Madonna. They're both into it. And videos I watched feature these super ripped Swan Lake types stretching cables around with such elegance they look like a live puppets doing this slow sweeping modern dance performance. It's also expensive, but there are group ons. If you're thirsty for abs, you're a gyro guino.
I'm a gyrog. I'm not like there's actually three gyrogyos in my group. We're a group. We actually thought about having a group retreat and doing a gyrotonics class.
You guys need T shirts and I run and I walk, so make sure it gets get some exercise.
Yeah, I think we need a like a women's health Bible, and that should be chapter one and then the rest of things, like what.
The hell does cervix? Okay, So cervix means neck and it's the lower part of the uterus that serves as an opening to your vagina. Now, I try to find a fun fact about a cervix that you would like, and it might be uncomfortable. So I'm just gonna sing it fast in case it's on comfy, so you can just tune out the words and grips the music if you need to. Okay, So your cervix has glands that make mucus and you can monitor it to figure out how fertile you are, and it's thicker and acidic when
you're less likely to get knocked up. But it's stretchy and clear like an egg white when you have more estrogen in my be ovulating, and that aspect of being stretchy, like, for instance, a mucus has a name, and the Internet says it's pronounced like this spin barkie hee. I'm sorry I did that to you. And also there's nothing less sexy than a robot describing your cervical mucus. Okay, let's
change the subject. This is a dumb question. But when people are going to the gynecologist and they're like, oh my god, I need to get a bikini wax, does any of that really matter? Because I feel like there's so many women I talk to who are like, oh man, I'm going I'm rogging this bush. Oh that's embarrassing. Does it get a colle just ever really care?
Actually, I actually tell everyone, don't shave. Oh okay, because hair is there for a reason. So where I mean, if you talk to all the vulvar specialists in the country, everyone's like, don't shave.
Really, Yeah, It's so cool that out there right now there are vulvar specialists, like real ones, and not dudes on spring break wearing shirts proclaiming that they're volvar specialists. They're not.
I mean, I see people coming with like nasty feilculitis because they've shaved or they've waxed or whatever, and I'm always like, you know, I also think the shaving has kind of made people so much more aware with what their vulvat looks like in their labya and like there's like so many people that think their laby are too long and that they need to be reduced or cut off and and I think part of that's because everyone's
shaving and so you can see them more. And there are so many different normal shapes of volvas, and the range is amazing.
And.
I think people have this idea of what that needs to look like that's really artificial. So there's all the plastic surgery that people are doing on their volva. I think part of it is the result of and part of the result. Part of it is the result of internet porn. Part of it is the result of everyone shaving and thinking that this is kind of what it needs to look like, and there really isn't a specific way that it needs to look like.
I was that was one of my questions that I was going to ask if you've seen in your practice, like with lybiaplasty has become more and more popular as we have more access to images that maybe are it has I mean, it's it's there's My practice is.
We're it was started by two hippies, so it's we've got a little more hipie dippy practice, although the two hippies have since moved on, and I do not like the Grateful Dead. So that's actually one of my interview questions.
That's so specific.
Like I said, no, I grew up with the sex Pistols, Oh my God.
So perhaps as a future gynecologist she was influenced by the sex Pistols seminal album never Mind the bullocks. Bullocks mean testicles in British slang, back to trimming or labya.
So not so much in my practice. I haven't you know, I occasionally have done labial plasties, especially in cases where like one labya is way longer than the other, or when there's so long that they're really rubbing and it's really uncomfortable, where when they are athletes, they just is a problem. So I've done labioplasts in those cases. I don't get that many requests for just purely cosmetic labio plasties. But I know physicians that are practicing elsewhere that are
you know, that's a big bulk of their practice. And there, you know, I know there's in New York there's a specialist of maternal fetal medicine, high risk e cetrics that left his specialty and all he does is labia polasties and he advertises on the internet the before and after picture and has all these stories from women that felt always felt horrible and felt that they were ugly and now they feel so much better. And I, you know, to me, it's just like there is no normal. You know,
let's let's talk about what's normal. Let's talk about the range of of what the volva needs to look like, and let's and I think what the only thing that makes me really hopeful is that we're starting to see more women's bodies that are slightly different in advertising. We're starting to see women's bodies on TV that are not the perfect model that whoever decided was the perfect model.
I'm hopeful that we're finally going to have some more except that women are finally going to learn how to accept their body the way it is right because I think that's them. That's what it's about.
I guess, and being an advocate for your own health is accepting your body as fine as it is. I think women have such a Women do tend to have a bit of an antagonistic relationship with their body because it's because of perfection standards. I mean, I know, I feel like every woman I know has something that they're No.
One likes their own boobs.
Yeah, it's like, really, it seems like.
Very few people really find that their rests are they're either too big, they're too small. There's no better lesson you could learn your daughter. Teach your daughter then love your body the way it is.
It's a lot cheaper, awesome, it's a lot cheaper than plastic surgery. Okay, let's pivot to have some iud chat intrauterine devices IUDs. They can last three to six years and be super effective in preventing pregnancy, so they interfere with sperm motility. They booby trap your cervical mucus to make fertilization harder. In some cases they poke your uterus to make you think you're already prayer so than an egg won implant. So that's very lay women's terms. They
also can deliver hormones. They can help with heavy periods like the marina IUD.
You know some people don't tolerate the marine IUD.
I was going to ask you about about iud's how much more common they're becoming, and if they're pretty painful if someone's considering one.
It depends on where you are, I mean on the coasts. I think they're a lot more painful. Right before the election, I think I was putting into IUDs a day. Really, these people are afraid they're going to use contraceptive benefits and they you know, an IUD in last five years or ten years, depending on what kind of valued.
Do you have.
We've always put in a whole, We've always put in a lot of valuds. I once did a review for a legal case from somewhere in the Midwest, and they you know, the patient was never offered an IED and
she presented with heavy bleeding. One of the first things we would do in someone who presented with heavy bleeding would be to offer them amber an id because it reduces menstrual blood loss and it's so effective that my you know, I worry about my residence getting enough experience doing hysterectomies because we don't do that many hysterectomies anymore. We use we use the IED.
When it comes to ovarian reserve and eggs, I feel like I know a lot of people who are waiting a little bit longer to have children. Maybe they're in their mid thirties, late thirties before they're considering starting a family. This is a maybe. Maybe this is a stupid question.
Maybe it's not.
If you've been on birth control preventing ovulation for a number of years, does that mean that you have more eggs or not? No?
Okay, I mean it's good to be on the birth control pill for many years because it decreases a chance of you developing endometriosis, So it suppresses endometriosis, so it preserves fertility. In that way, it doesn't preserve fertility in terms of a very reserved It's not that you don't have eggs. It's just that your ovaries become more unresponsive, So it doesn't it's not just the number of eggs you have left. It's more just the responsiveness of your ovary.
Do you recommend women who are waiting to have a family. Is there a time when you're like, get these puppies on ice?
You know, that's a good question. I mean, our college and the American College of Overduans just send out a whole I think it was last year that they send out a questionnaire where they asked all of us up to what extent we offer our women, our patients that are in their early thirties, up to what except we
talk about fertility preservation with these patients. And it's interesting because I think that what came out is that most of us, if we had a patient who presented with cancer and was going to get a whole body of radiation that was potentially going to destroy their ovaries, we would talk to them about preserving their eggs. And we don't necessarily do that in our patients that are thirty two, that are getting their second PhD and waiting to have
kids because of that reason, and we should. I mean, ever since that they that study, I have been asking people, what are your plans in terms of kids? Is this something you want? Something you don't want? I'm not you know, occasionally I've talked to people about preserving their eggs. The tricky thing in Oregon is that it's not it doesn't it's not covered under insurance. So it's pricey. Yeah, you know,
us a fair amount of money. And you know people that are students don't necessarily have an extra ten to twenty thousand dollars laying around to do that.
Yeah.
No, So that's that's the problem. I don't think people are quite aware of how quickly, how much age, how much infertility is caused by age.
So twenty or so years ago, the American Fertility Society wanted to launch an ad, very well meaning on buses that said, hey, ladies, start your families before you turn into a wizard crone paraphrasing.
You know.
They showed the ads to groups of women and everyone just was completely offended. Right, you know, there's it's it's hard to how do you tell women you know your clock is ticking without telling women go make a baby exactly. You know, it's it's hard, Yeah, it's hard, and the very you know, the the O site freezing has you know, we used to we used to not be that good at freezing, just unfertilized O sites. So now we've become
much much better at it. So it's an option. It's a viable option now for those that can afford it.
But early thirties is the time to think about it, maybe.
Yeah, okay, yeah, I remember twenties, early thirties.
I remember someone mentioning it to me when I was thirty four, and I was like, how dare you? And I was like, oh, yeah, okay, I see what you're talking about.
Yeah, no, I mean it's just fertility starts plumbing in our late thirties and different, you know, we're we're all a different curve. Some woman I've had a patient to conceive with IVF with her own eggs at forty five. But that's the exception to the rule.
Right, There's always someone that's like, I don't know, my cousin found out John accident was pregnant for forty eight and so anything's possible. And you're like, okay, whatever, good to know. Okay, have some rapid fire questions ok from listeners. But before we take questions from you, our beloved listeners, we're going to take a quick break for sponsors of the show. Sponsors. Why sponsors?
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Okay your questions. Carrie Steward wants to know what are obg rants doing to reduce the maternal mortality rate in the US and during a woman's pregnancy. How do obi's balance the mom's health with the baby sealth.
Well, in California, they took kind of control of the issue and they started investigating every maternal death and they came up with some really great algorithms and kind of protocols and approaches and on how to address postpartum hemorrhage, on how to recognize people at women at risk for preclimatic seizures. California maternal mortality rates have gone down ever since they started these investigating maternal deaths. Text As maternal mortality rates are have gone up, So I think it's
a state by state response. It has to do with access to care.
Texas maternal mortality rates are five times that of California, They're ten times that of some other developed nations, so access to good medical care as prevention holds true on a global scale as well. Staggeringly, ninety nine percent of global maternal mortality happens in developing countries. For me, as a non mom, I had kind of taken for granted the danger of childbirth. I mean, it's such a natural process.
And on top of that, we have phones that can scan our faces now, and talking robots and soap and missions to mars. I had thought like, Oh, we've totally kicked childbirth risk. I had no idea that the statistics were still going up in some parts of the country.
You know, and obstetrics, most things go fine most of the time, and occasionally things don't go fine. And when they don't go fine, they go south real quickly, and it takes a certain volume to recognize, oh, things are
going south. There's also, you know, a whole kind of changing culture, and for instance, in our hospital, the way we've empowered our nurses to speak up so that if there's one person in the room that's not comfortable with what's happening, we have certain words on how to say stop. I need I think we need to change this tactic. I'm uncomfortable with what's happening here, and this is what I want to see happen, and everyone in the room has a right to speak up. And by empowering our nurses,
we've also changed things. We're moving away from this model that the physician knows everything and is the captain of the ship. We're moving more to a team approach to medicine. And it's a much better approach. It's a much safer approach.
It and more natural to squat and have a baby than it is to lie down and have a baby.
It is, but you know, most of us don't have enough core muscle strength to actually do that. I mean, I've only had a couple of patients in my career that could actually hold their body up in a squad uh and push out a baby. One was one was exactly. One was this like Iron Iron. She was like competed in the Iron Man, and she was completely like Superwoman.
She was able to She's just trail running, squat, squat, keep this baby out squatting.
Most of us just don't have enough core muscle strength. I mean, it's it's different. We sit in chairs, we sit at desks, and and I've done some work in Ethiopia, and Ethiopian woman can actually squat and push a baby out because they don't sit on chairs. They sit on the floor. They work in the field all day long. They have good core muscle strength. We just don't have enough good core muscle strength to do that. Most of us.
Good to know.
I won't be squatting one out anytime soon, but I should work on my core sidebar.
I started looking up chairs that are like really fancy balancing ones, and some are like seven hundred dollars, which seems like a really gross way to mimic just not having a chair. So then I found an article that said one thing you can do is just sit on the floor more. It's free, and it has health benefits like improved posture, it strengthens your core, and according to this article, it also keeps you humble. And it's like, dude, it's Saturday night, I'm googling, why am I a slob
with atrophied abs? I got that last one covered. Rebeccaha wants to know when you say you've seen everything before, do you actually mean that or are you just saying that to make us feel better When you're like, oh man, I've seen everything knowing about it, or do you just say that.
I don't think I've ever said I've seen everything before. I've seen a lot, but I don't. I don't think i'll ever have seen everything. I never ceased to be amazed at what I see. No, I mean, life is messy. Life is just messy. We're all messy. We all are like make silly mistakes. I don't know. I really don't have a lot of judgment when it comes to people's behavior.
I don't. I mean, initially I think I was practicing non judgment, but eventually I just like, it's like, you know, there's so many different ways of living, and there's so many different ways of being I don't.
I don't, yeah, which is funny. That leads to the follow up question.
Katie Grant wants to know what's the most unexpected thing you have ever retrieved from a vagina?
And I don't know if you can answer that. Set of car keys, muffin.
I think across across and residency.
Oh, I hope it was ironic. No ouch, Yeah, that is not ergonomic at all.
Yeah.
Collette Eyers wants to know why am I so irregular despite having every single form of test all coming out normal, including the one with the long stick covered in a giant condom. I think she's talking about a transfaginal I'll say that are there negative effects on the body when periods are not regular? Or are there certain chemicals your body produces during menstruation that if you're a regular your body misses out on? She asks, is contraption a good
way to regulate your period? I believe she means contraceptual assumption, and that was probably autocorrect, But contraption. Maybe there's a contraption uterine cage. Yeah, what do you irregular periods? What's happening here?
It is normal for the period to vary familiar from you know, every twenty four days to every thirty six days. That's normal. That's still considered regular. Okay, So I you know some woman consider that irregular, you know, and some women are blessed with having a period every twenty eight days. And even when they're not in the birth control pilt, most women have slightly irregular periods.
Quick knowledge, drop about your red devil, your crimson tide, your leak, weak, et cetera. So Mensis comes from the Latin word for moon because duh. Both are twenty eight days, So of course the moon is a hollow orb that houses a period gremlin who controls us naturally. But fact check this. Several scientific studies have shown there's no correlation
between moon phases and mensis. It's a dang mystery. And to repeat the dock, most women have slightly irregular periods anyway, so the moon is not a conspirator in your ruined beach plants.
Skipping periods all together probably means she's not ovulating on a regular basis. And sometimes that's because you have polycysgovarian syndrome, and sometimes it's just do you have oligo aovulation, you're just not ovulating on a regular basis and you just skip a period once in a while. If you have really long intervals between periods and you don't, you know, you're menstr eight months every six months or so. The risk of that is that you're still making estrogen. The
estrogen is stimulating the lining of the uterus. You're not breaking down that lining of the uterus, and so you can get an overgrowth of the lining of the uterus, or you can get worse, a cancer of the lining of the uterus. If you don't, if you're still making estrogen and you don't have progesterone to kind of break down that lining once in a while. We usually say
you should have at least four periods a year. So if you're not having four periods a year, you should you should take progesterone to make yourself have a period four times a year. It's a little bit of an arbitrary number. I don't think any of us have ever studied that that's the right number. Right, the right number, and that's what's going to protect the lining of the uterus. I think if your periods are really really heavy, we're having a lot of in between your periods, you need
to get the lining of your uterus evaluated. And even if you've done it two years ago, you may need to do it again because it I've I've had patients developed and a mutual cancer that I've buy up sed every two years, and every time that that lining was negative, negative and low, and behold, now it's positive and they've got an mutual cancer. So if you continue to have what's what we would call unopposed estrogen, so estrogen to the lining of the uterus and not no progesterone a
kind of break down that lining of the uterus. Then you need to have the lining of your uterus evaluate it. If, on the other hand, you're having irregular periods because you're going into premature or varying failure and you don't have a lot of it estrogen around, that's and you just once in a while still kick out and you know, recruit a follicle and ovulate, then it's not. Then that's not as concerning.
So irregular periods could be nothing, or they could be a sign that your lading machine is about to retire from the game early, even when you thought you had a few innings left to play. Also, buckle up for a fun fact about how low f SH or follicle stimulating hormone can be an indicator of good ovarian health and some TMI about all wards gonads. I feel very vulnerable right now.
It depends on you, know, are you are you still making estrogen or your estrogen levels normal is your FSH normal, which is your forllicular stimulating hormone, which is the hormone your brain makes to tell your ovaries make estrogen. And as long as your fhilic stimulating hormone is less than ten, you're still making estrogen.
But you've got to get that checked on a certain day too, write no.
Yes, and no, like you know it. If it's less than ten on a random day, you're in good shape.
Yeah. Mine was one thirty five last it was checked.
But I you have premature, Yeah, sure you do.
But I didn't. That happened started happening to be in my mid thirties, and I just was like, oh, I travel a lot. I just it's irregular. And then they didn't figure it out until it was When it came back, they were like, there's a chart and you're off of it. And it was like, oh good, But yeah, I hadn't. I didn't even think that that was the thing. I think we kind of also do get fed, like as a career woman, like don't let anyone tell you that
you're losing fertility, you know what I mean. It's almost like a badge. It's fine, it's fine, it's fine. Like I'm an aunt, I'll get a dog probably baby seemed like a lot of work anyway, Fine, I am fine. See Mads wants to know how scary are pap test and obg ynn appointments, et cetera. She's like, I'm a young adult with a for guba I think she means in China, I mean, I think that's adorable, so.
Many different words for I know.
She's terrified of getting her bits checked out, So how scary are they she wants to know?
Well, first of all, we don't do pap says until people are twenty one, So okay, Uh, if she's been sexually active, it's I mean, it depends a little bit on whether you've been sexually active before. If she's never been sexually active, she doesn't actually need a paps mare. If she's been sexually active, if she's used tampons before, it really shouldn't be it shouldn't be uncomfortable. And how scary it is depends a little bit on how comfortable
she is with the physician. If she's uncomfortable with the physician, don't have them do perhaps.
I Nowadays they always have a nurse in the room as well.
Right, that's fairly new.
There's there. Yeah, there should be someone else in the room, whether it's a nurse or a medical systant nurse. Gabe.
Yeah, it's always just as a matter of you just gotta keep scooching. You think you're scooched to the edge of the table, and then they're like, can you scooch more? And you're like really, and you scooch and they're like just a little more, and you're like, damn, I gotta hang my butt off this thing for real.
That's true. Yeah, that's true.
Keep scooching. Lily Moss asks a question, is there an equivalent of vagino for trans women? Is it same doctors for sis women or is it a fairly new job thing that specializes in trans women's health.
There? You know, there's I see some trans women, but not that many. I actually see more trans men than I see trans women. Interestingly enough, there are.
Yeah.
Most trans women in terms of we'll have their vagina built by someone who specializes in surgery. That's a very specific surgery. Tends to be people that are plastic surgeons. Sometimes it's gerologists. There's different groups in the country that are known for their surgery. Some of our trans woman patients will go to Thailand because the surgery is a lot more affordable there. Marcy Bauers is herself a trans woman.
She used to be an over Juan. She specializes in gender reassignment surgery and she's located in the Bay Area. She used to be in a little town in Colorado.
So the town of Trinidad, Colorado became known as a hub for gender reassignment surgery. When this local surgeon, doctor Stanley Biber, had come back from being a medic in the Korean War and he was asked by a patient about the possibilit for this procedure, and he was kind of stumped. He's like, I don't know how to do that. So he wrote to some colleagues at John Hopkins and Stanford.
They sent some plans, like some sketches. Yeah, that's how we did it a couple times this way, and so in the late nineteen sixties he got really good at it. So this doctor in Colorado started practicing gender reassignment surgeries, and transfolks started moving to Trinidad, Colorado because his medical care was the best. So this doc kind of passed the torch to doctor Marcy Bauers. But when she left for San Francisco, Trinidad, Colorado became kind of a bit
of a ghost town. The mayor himself called it an abyss of nothingness. But recently, they turned an abandoned pepsi plant into a pot dispensary, and business in Trinidad is on the rise. So for several decades, Trinidad, Colorado served as this kind of beautiful, rare gem in the middle of the wild West, but care for transpatients is now becoming a little more widespread.
So there's a couple of there's sent to. San Francisco has a Center for Excellence and Chance Gender Health, hich Issue has a Center for Excellence and Chance Gender Health, And these centers kind of specialize in gender reassignment surgery, and those tend to be the places where people go.
Krista Traxer wants to know how many babies have you delivered and what's the longest you've ever seen a woman be in labor.
For I don't, actually, I didn't keep track of how many babies I've delivered. I've probably delivered over three thousand babies, but my god, I don't I didn't actually count them all.
That's so many babies.
Just based on how many years I've been in practice.
What's the biggest one. My sister had a ten and a half pound baby. It's like a turkey.
I helped. I kind of was supervising a midwife who delivered a thirteen pound baby. What that's like two babies, Yeah, the biggest one I've delivered. I think it was also close to thirteen pounds, but that was a C section. Oh, we knew that baby was going to be big, so we just felt like it wasn't going to be safe.
Yeah. Yeah, let's get out the sun roof there. Ohive, quick question? Why are some babies giant? So doctors don't call them giant babies, but rather LGA, which stands for large for gestational age. Any baby over eight pounds thirteen ounces, it's diagnosed with fetal macro somia, which literally means baby big body. And genetics can play a part totally, as can things like maternal diabetes, which kind of messes with
your insulin levels. But sometimes you just don't know. And my niece is now a lanky twelve year old, she's almost taller than me, but she will always be our beloved LGA fetal macrosomic giant turkey baby. What's the longest you've ever seen someone in labor for?
Oh, it can be it can be days, like real active hard labor, probably two to three days.
Ugh, But how what's the percentage of people they'd get epidurals, because that would be like Anesthscize me from the neck down, wake me up when this thing's over.
It's about seventy to eighty percent.
Yeah, is there any risk to them?
If you get an epidura very early in labor, before you're in active labor, it may slow down your labor because it's when you first get into active labor. It's probably a good idea to walk around because kids have big heads compared to our pelvis, and in order for the head to kind of fit down the pelvis, it needs to kind of rotate to find a way to
pass through the pelvis. Humans, when they evolved from being a four legged mammal to becoming bipedal, change the structure of their pelvis, and so their pelvis got a little smaller. In the meantime, heads got bigger.
Listen to episode two on Primatology if you want more details on our shitty head to pelvis situation.
And so hence, when the baby actually descends and leaves the body, it actually goes through these rotations to make its way through the pelvis, and those rotations work way better if you're actually walking. Oh, so that if you can walk for a part of active labor, your kit's more likely to descend and your labor is going to be a little bit faster.
Okay, get on that treadmill, do some breathing exercises. Yikes.
I mean, I've had people that wanted all natural deliveries and labored for twenty four hours and we're absolutely exhausted, and their muscles are tense and they're just not going anywhere in a hurry. And the epidural just allows all their muscles to relax and the baby descends and boom, they can deliver their baby and they're done. And Emmanuel, we get a lot of transfer from home deliveries, and
about half of those women still deliver vangeli. And these are women that the midwife is brought in that they thought could not deliver vangeally and all they needed was some pain control and a little bit of sleep, and they still have a vangile delivery.
So do you have anything about your job that you hate that just sucks or that it's difficult?
You know, occasionally the sleep deprivation gets to me. Yeah, it's tough. It's sometimes really tough to I mean, typically, if it's a delivery, I can I can rally. If it's a kind of a silly phone call, yeah, or sometimes it's stuff like you know, some hospital wants to transfer patient, and that kind of stuff irritates me, and it's like, you guys can take care of this. Why are you calling me at two in the morning about this? Or an er one of my patients has gotten an
ear somewhere in the air. Physician wants to just let me know that they've seen the patient. And I'm like, I'm so happy you're calling me at three to let me know that you've seen the patient and taken care of this patient, and you've just welcomed me up. I'm so happy about this.
Can you get back to sleep easily?
Or no?
If I get irritated, no, it's hard to get back to sleep. If it's a silly thing, then I get irritated, and then it's hard to get back to sleep.
But I know, what's your favorite thing about what you do?
I think it's still delivering babies. It's just such a beautiful thing. I mean, I didn't I never thought I would like that this would be the thing. I always thought eventually i'd stop doing them be and I just do two an and have an easier life. But it just is such a beautiful thing. I mean, it's just so amazing that we make these little human beings and they come out. It's just it's pretty cool.
I imagine. The patience vibe also is pretty great.
Yeah, it's great. I mean it's especially great if it's someone that i've you know, I delivered their other kids, and it's just that's it's kind of cool.
People give you a lot of cookies and baked goods, thank you.
Yeah, lots of different things I actually have gotten to like. One of my most beautiful bouquet of flowers was from a patient who I who just was complaining that her she just her discharge just didn't smell right, and it had been going on for a really long time, and I told her to stop using soap and or to stop using the antibacterial soap she was using, and the smell went away and she gave me it.
So with this.
Beautiful bouquet of flowers, it was like, ah, it's funny.
The discharge based gratitude exactly. She's like, you changed my life exactly, and my fluids exactly. So no anni bacteria soap.
Don't use any antibacterial soap, and don't use detergent soap in your body, and use very little soap in your body. Really, soap is really not that especially for your vola. Don't use If you can avoid using soap, you're better off.
What about vaginal steaming and douches?
Don't do right? Don't, don't, don't. One of the vaginal specialists in at Kaiser in the Bay Area did a kind of had patients kind of come up with slogans for her vaginal health clinic, and one of the patients came up with a clinic with it with a slogan, the vagina is a self cleaning oven. And it's so true. It's like the vagina will keep its own balance if you don't mess with it. If you upset the balance, the anaerobic bacteria which creates smell, are going to overgrow,
so the less. And the problem with soap is that a lot of soap has detergent qualities, so it's going to take away the oils, and the oils are one of the things that protect the skin. So if you take away oil from the skin, you're going to have more overgrowth of kind of bad bacteria as well. So the thing with the vagina is that, or with the vulva is that a lot of over the counter products
are irritating to the vulva. Like this product vegicill that people use for irritation is actually really irritated to the vagina. Most vaginal specialists will say, vegicill makes you ill.
BRB. I'm going to go drop a single called magicill makes you well.
And one of the vacilline is probably very safe. Coconut oil is very safe. Those oils are safe, but creams and lotions tend to not be saved. They tend to dry out the vagina and the vulva. A lot of over the counter products have something called propellin glycol in it, which five to ten percent of people get irritated from it's drying. Ky jelly tends to dry people out, so
most of us recommend against ky we. You know, either if you're using condoms, oils will dissolve the condoms, so you don't want to use an oil or a greasy substance when you're using condoms. But as an alternative, if you can use some of the silicon based lubricnts. But you don't want to get rid of the oils in the skin of evolving in the vagina because they're really there to protect you.
So stay hairy, stay oily, exactly, stay greasy, and stay hair words to Luba.
From the Gyro, from the gyro.
Exactly good advice, Thank you so and bidazzer a great thing. Oh, days are a great thing. But I have Japanese toilets should exactly why do they have them?
I know we should. They're a great thing.
Do you think the kind that are like aftermarket, like putting a spoiler on your toilet, but they are a day like the kind that just hook in.
They actually work? Fine? Okay, yeah, you have the days. I don't get up a day. I have a separate shower head.
That's treat yourself. I tried.
I tried to. It's if I have an old house. It's a it's a long story.
I know. I just don't understand why we have so much technology in our cars, but our toilets are just waterholes. I know, I agree.
I agree, no and all these and stay away from wipes too. That's my one other piece of advice is a lot of those wipes are drying too.
And they also make fat bergs in the sewers. Have you heard of that does?
Yeah? I saw that picture in the London sewer. You see it. There's a picture of these people working on this huge like blob that's like obstructing the London sewer. It's like as big as an elephant.
It's the grossest thing ever picture. Okay, google fat berg and send me the invoice for the psychotherapy. It's worth it. I will tell you that in one photo, a London sewer worker is holding up this greasy chunk that's about the eyes of a small marlin where he a fisherman. I was horrified. I was traumatized to notice he was not wearing gloves. He was just raw dog and his fat berg. My mind raced and raced. I was like, why does he hate himself? How is his brain not
capable of feeling fear? What is happening?
Why?
Why?
Why?
And I zoomed in on the picture and I was very relieved to see that his rubber gloves were just the same ruddy peach color as his skin. But that was a rough rough thirty seconds from a psyche. It's just like the only thing that could make I can't like. I just keep thinking of like Sisyphis having to push like a fat berg up a hill. It's just the grossest thing, a fat burg. It's a fat berg because it's yeah, I don't know, because it's grease, and wipes
just clog the grossest, it's so gross. This is all really good information. You go, thank you so much for doing this. Yeah, yeah, you're good. So don't flush those wipes even though flushable ones folks, when in doubt, put it in the bin as they say. Also, go easy on the detergent. Don't get a Brazilian wax for your
next pap. Your China's like no, no, what No. To find out what episodes are coming up next, you can become a patron for as little as a buck a month, y'all twenty five cents an episode, and then you can submit your questions to the ologists and I say your name and ask your question. If you want to wear an Ologies shirt or pin or tote or baby onesie, I don't know how old you are. Head over to ologiesmerch dot com. Take a look around to follow on social media. I'm Ali Ward with one L or at
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So?
Double check? Episodes coming up involve X rays, the science of hair, diabetes, Darwinism, so good stuff coming down the podcast Vagina for you. Meanwhile, ask smart people dumb questions because that's how they got smart in the first place. They love it. I want to say a quick thank you to Shannon Feltis and Bonnie Dutch for running Ologiesmarch dot com. You guys are amazing. And to Aaron Talbert and New Boston resident. How's Boston treating you? Hannah good
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Is it?
Thank you for sticking it out to the very end. And number one, I still haven't unpacked that Doffel bag. I'm looking at it right now. Should I unpack it while we're on I'm gonna unpack it while you guys are on Mike, Okay, let's see. Oh my god, why am I doing this this way? Okay, all right, here's the Duffel bag. This in my closet. I'm the list out. We have green card again. There's a tote bag in here.
Why woolf sweater, pajama bottoms, dirty sock that has a shark on it, jewort's T shirt, bikini, and a couple of wash glass because sometimes when I go on vacation, especially if I'm sharing like an Airbnb with friends, I'm bringing a couple of wash glass to wash my face so that I don't have to use dirty hand towels on my face.
Tip.
Okay, guys, I unpacked the double bag. No, I just have to throw these things on the laundry. Thank you for being with me through that. Another secret I'm gonna tell you really quick is another life pack. Sometimes if you see a group on and you didn't get the deal in time or whatever, you can call the place and be like, hey, I was just about to buy a group on and they're like, don't buy the group on, just come in. We'll give you that deal because groupon
takes a cut anyway. So sometimes the places like salons or gyms prefer you just pay them the group on rate, but don't do it through group on. So okay, this was this is a this is a weird secret patch. Thank you for making it through this thorny secret patch with me. Okay, borrebye pack a.
Germantology, hobbiology, crypto zoology, lithology, chology, meteorology andology, nathology, seriology, theology.
There you go boom, oh boy, oh boy. That's like two babies.
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