April 13, 2025 • 27 mins
How much period pain is normal? Does my weight impact my cycle? And why oh why do we get period poos?!
In Mamamia’s brand new podcast Well, co-hosts Claire Murphy and Dr Mariam discuss everything you need to know about periods and bust a few myths along the way. Plus you’ll learn about the existence of a sperm graveyard and whether there is a ‘right’ way for your vagina to smell.
Well is a podcast about the taboo, the annoying, the embarrassing and the scary. We cover the concerns you’re probably considering seeing a doctor about, from insomnia to weird periods to how to prevent dementia. The full body health check for the Australian woman - dropping every Thursday - wherever you get your podcasts.
Coming up - we delve into endo, PCOS, depression, ADHD and burnout.
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For more information on periods and a pain and symptom diary, Dr Mariam recommends the Jean Hailes website.
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CREDITS
Hosts: Claire Murphy and Dr Mariam
Senior Producers: Claire Murphy and Sasha Tannock
Audio Producers: Scott Stronach and Jacob Round
Video Producer: Julian Rosario
Mamamia acknowledges the Traditional Owners of the Land we have recorded this podcast on, the Gadigal people of the Eora Nation. We pay our respects to their Elders past and present, and extend that respect to all Aboriginal and Torres Strait Islander cultures.
Information discussed in Well. is for education purposes only and is not intended to provide professional medical advice. Listeners should seek their own medical advice, specific to their circumstances, from their treating doctor or health care professional.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:11):
You're listening to a Muma Mia podcast.
Speaker 2 (00:14):
Mamma Mia acknowledges the traditional owners of the land and
waters that this podcast is recorded on.
Speaker 1 (00:20):
Hey there, I'm Claire Murphy from Mamma MIA's brand new
health podcast, Well, hosted by me and doctor Mariam, a
brilliant GP and advocate for women's health. Well is a
podcast about the taboo, the annoying, the embarrassing, and the scary.
We cover the concerns you're probably considering seeing a doctor about,
from insomnio to weird periods to how to prevent dementia.
(00:43):
In this episode, we do some period mythbusting like how
much pain is normal? Does my weight impact my cycle?
And why do we get period poos.
Speaker 3 (00:58):
Hi.
Speaker 1 (00:58):
I'm Claire Murphy and welcome to Well. This is your
full body health check. I've been a journalist for nearly
twenty years, the past six of those hosting mmamea's daily.
Speaker 3 (01:08):
News podcast, The Quickie.
Speaker 1 (01:09):
So I have asked a lot of questions of a
lot of experts about a lot of things related to
women's health.
Speaker 3 (01:16):
But now I want to know more.
Speaker 2 (01:18):
And my name's doctor Marriam. I'm a city based GP
and our staunch advocate for all things women's health. I'm
also a twin mum to toddler boys, which is why
I'm always tired. I'm so happy to be here.
Speaker 3 (01:35):
Let us tell you why we're here.
Speaker 1 (01:37):
Well is about addressing the taboo, the annoying, the embarrassing,
and sometimes the scary. We're going to cover concerns that
you're probably considering seeing a doctor about, from insomnia to
weird periods to how to prevent dementia. The difference is
we're going to give you the tools that you need
to make sure that you are seen and heard by
(01:59):
your healthcare professionals, and we won't charge you once your
fifteen minutes is up. First up, we're going to take
you to med school. This is where we're going to
share something fascinating that we've learned in the process of
making this podcast.
Speaker 3 (02:10):
Then it's into the.
Speaker 1 (02:12):
Checkup, where we'll explore a health topic in a stack
more detail. We'll speak to a specialist who when we
need their expertise, and then finally it's the quick consult.
We head off to the doctor's rooms where we solve
a dilemma on any health topic as submitted by you today.
In the check up, We're going to be putting a
spotlight on periods, like can weight loss injections actually help
(02:33):
with a particular menstrual issue? Why is period poor thing?
And when do you actually need to go and see
your doctor? But first we're hopping off to med school.
Speaker 3 (02:43):
Welcome to med school.
Speaker 1 (02:45):
So this is where I'm going to share something that
I've found out recently which will equal parts freak you
out and fascinate you. Have you heard about the sperm graveyard?
Speaker 4 (02:54):
Now?
Speaker 1 (02:55):
Look, I came across on my social media feed at
a doctor in the US which explained apparently the sperm
that is ejaculated inside of you, obviously when your partner
is not wearing a condom, and which does not end
up fertile the egg, which like is millions of them. Marian,
(03:15):
can you please explain to us where they go?
Speaker 2 (03:18):
So when a man ejaculates, it's thought that two hundred
to three hundred million sperm and to the vagina that's
a lot of sperm.
Speaker 3 (03:27):
That's a lot.
Speaker 2 (03:27):
And I like to think of the vagina as like
the ultimate Ninja warrior course, right, It's designed with lots
of boogie traps to kind of kill the sperm before
it gets to the egg, so we're not welcoming it in.
We're not a well, no, yeah, the vagina's not very welcoming.
So there's things that the sperm has to get through,
like the pH so a lot of the acidity of
(03:47):
the vagina will kill the sperm. There's a cervical mucus
in which some of the sperm will get trapped in,
and then the body identifies the sperm and rightly so
as foreign invaders, so will send these white cells to
kind of shoot them away. And then for the sperm
that does make it through the fallopian tube, and at
this stage, that's thought to be about two hundreds so
(04:09):
you can imagine two hundred to three hundred million, and
you've got two hundred sperm remaining. The rest have just
died from exhaustion because sperm is quite lazy that do
not surve. So the sperm's traveling along one we hope
will fertilize the egg, and then the rest are thought
to just keep swimming along. And so the fallopian tube's
(04:30):
actually not attached to the ovary, so there's these like
finger like projections called the fimbria, and so it can
actually exit out of the fallopian tube into your abdominal cavity.
Speaker 3 (04:40):
And this is what I've heard is referred to as
the sperm.
Speaker 2 (04:42):
That's right, So like, if you have a visual you
can just imagine like this just like falling into your
abdominal cavity.
Speaker 3 (04:49):
But do not be alarmed.
Speaker 2 (04:51):
Enzymes break that sperm down and it's reabsorbed for nutrients
for the body.
Speaker 3 (04:56):
What happens after we absorb it? Like are we using that?
Speaker 2 (04:59):
But if you think about it, sperm is like microscopic.
You can't even see it, so like it's so so tiny.
Speaker 3 (05:04):
It's yeah, you know it's there.
Speaker 1 (05:06):
No, we are going to actually put that video of
the sperm graveyard up on our socials too, if you
want to go and check it out. Later in the
section we are referring to as the quick consult, Alice
asks us whether her vagina smells right. But next in
the checkout, we're gonna do some period myth busting, because
even though we think we know everything about our menstrual cycle,
(05:26):
trust me, we do not.
Speaker 3 (05:31):
It's time for the check out, all right, let's.
Speaker 1 (05:35):
Get into it today. We are period myth busting. I've
seen videos in my social media feed claiming that your
period blood says something about.
Speaker 3 (05:44):
Your overall health. Is that true?
Speaker 2 (05:47):
Not necessarily like a core bullshit for some of it.
So there's like variation in the color of your period
through your menstruction cycle. At the start, it tends to
be heavier, it's brighter because it hasn't had a chance
to oxidize. And then as your period progresses you've had
some of the tissue sitting in there, it's reacted with
the oxygen. You might pass clots, and it might be
(06:08):
darker brown or even a close with black color. The
color variation that's completely normal. But the signs that you
know would prompt you to see a doctor would be
if it was like a gray or an orange tinge,
that might suggest an underlying infection. A light pink might
suggest iron deficiency. There's not really a strong link, but
(06:30):
it might, and especially if that's something new for you
or there's been a change, then that might warrant a
doctor review. But no, I wouldn't say, you know your
hormones fluctuate throughout the cycle. I wouldn't say it's indicative
of estrogen and progesterone de efficiency. There are a lot
of hormonal health coaches online. Unfortunately, so always check your sources.
(06:50):
The only hormonal advice I would take from would be
an endochronologist, to be honest.
Speaker 1 (06:54):
Yeah, so it's not like looking at your Wii and going, oh,
I'm dehydrated.
Speaker 3 (06:57):
Yeah, no, it's okay.
Speaker 2 (06:58):
Or your cervical mucus.
Speaker 3 (07:02):
I'm not sure.
Speaker 1 (07:02):
How comfortable I am checking out my cervical mucus, but
maybe for the sake of this podcast, I might have
to start. I also saw an post from someone who
said they were a nutrition scientist, but they claim that
taking vitamin D supplements can actually help with period pain.
Speaker 3 (07:20):
Is that true?
Speaker 2 (07:21):
So there is some evidence that it can help period pain,
though in a lot of the trials they were using
really high doses, so well above the recommended range of normal.
Vitamin D Toxicity is very rare, but I would just
advise anyone who wanted to take vitamin D get your
levels checked. If you're deficient, definitely start treatment, and always
(07:44):
speak to your doctor before you're starting any supplementation. A
lot of these medications can interact with other medications, and
you know, some medications, if they're used outside of that
recommended range, can cause toxicity. Although vitamin D is very rare,
in that regard, you should always speak to your pharmacist
or doctor. When should we be worried about a period?
What would not be normal is you've noticed a change
(08:06):
in the pattern of your peeriods who it's starting to
become more erratic, it's irregular, you're bleeding in between your periods,
you're bleeding for a prolonged time, like for more than
eight days, you're bleeding after sex, or there's significant pain
with your period that's not being relieved with simple over
the countermedications and it's disrupting your quality of life, or
you're just concerned for any reason about your period. That's
(08:30):
more than enough reason to see a doctor.
Speaker 1 (08:32):
And as we know, one in seven women in Australia
are diagnosed with endomeytriosis, which often means heavy, painful periods.
And that's something we'll be exploring and talking about in
more detail in our next episode.
Speaker 3 (08:45):
How much blood is normal?
Speaker 2 (08:46):
The average loss is thought to be about thirty to
forty meals, which is six to eight teaspoonfuls.
Speaker 1 (08:53):
Why are we're measuring in tea spoonfuls? Can we not
measure via a menstrual crap or something like at least
something we use it. No one's poised over the loo
with a tea spoon.
Speaker 2 (09:01):
But we define heavy menstrual bleeding as any bleeding that
impacts your quality of life in any way. So if
you feel like, you know, you having to change your
pads or tamp on every hour, you're leaking through your
periods more than eight days, you're passing large clots, which
we say more than a fifty cent piece, then there's
signs that something's happening. You should see a doctor.
Speaker 1 (09:22):
Okay, what are my options if I do have or
I'm prone to having really heavy periods.
Speaker 2 (09:30):
So if you do have heavy periods, I would really
encourage you to speak to your doctor because there could
be underlying causes contributing to the heavy period. We also
want to ensure that you don't have iron deficiency as
a consequence of the heavy mental bleeding as well, which
is awful. Get iron deficiency or me too.
Speaker 3 (09:49):
I feel like everyone I know now has an I.
Speaker 2 (09:51):
Dis and I always say, like, you know, iron supplements
and iron infusions, they're kind of band aid solutions. So
you want to kind of address the root cause, and
if that's heavy mental bleeding, then figuring out why you're
having it and stopping it from happening is really important.
So the first thing to just definitely see a doctor,
you know, and get the appropriate investigation. But while that
(10:13):
is happening, doctors should be giving you medication if that's
something that you want to reduce that blood loss. And
there's non hormonal options. The non hormonal options are something
we call transaxamic acid and that stops the blood from clotting.
That's actually quite effective in reducing blood loss. Anti inflammatories
are also shown to reduce blood loss and they also
help with the pain. You can take the two of
(10:34):
them together. They're most effective to start a day or
two before your period and you continue them for about
three days during your cycle. The hormonal options are and
the first line for all heavy menstrual bleeding is the
IUD and that is ninety five percent effective at twelve
months in reducing heavy menstrual bleeding. It's really effective and
(10:55):
it helps keep that endometrium nice and thin. And there
are the progestin only pill and combined oral contracepti pill.
They're actually quite effective as well. Obviously, you know there's
side effect profiles and you know preference to the patient.
So that's the option to discuss with your GP on
what you would feel would be best suited to your life.
And for the patient to have really heavy mental bleeding
(11:18):
that's affecting their quality of life, they've trialed everything. We've
excluded underlying causes that would warrant a referral to a kinecologist,
you know, for more extensive investigations and potential surgical options
if that's something that the person wanted to do.
Speaker 1 (11:32):
Okay, so that's cover off on bleeding. But what about pain?
Speaker 2 (11:36):
So pain you subjective, right, So what might be painful
for me might not be painful for you. But what
we do consider normal for periods is period pain that
isn't affecting your quality of life generally. You know, you
get the peak of the pain in the first two days.
If you have a bit of pain, you take over
the counter medications like parastamol or anti inflammatories. You're still
(11:57):
able to go about your day. It's not impacting your
work or extracurricular activities. That's normal. As soon as it's
I am having to take days off work, or you know,
it's impacting relationships or you're just staying at home lying
in bed, that's no normal.
Speaker 1 (12:12):
Here's a question, if things are all happening around my uterus,
why do I get pain in my lower back.
Speaker 2 (12:20):
So we blame that all on the prostic lands, and
so prostic lands ands are released during menstruation and that's
what causes the smooth muscle to contract. So the uterus
and the spine are in close proximity, so you get
that radiation in the pain. We also, like a physiotherapist
was telling me that the hormones also loosen your ligaments,
which makes you more prone to like injury, So which
(12:42):
is really interesting.
Speaker 1 (12:43):
It's interesting like the Western Bulldogs AFLW team have just
started doing something around so they've customized training around their
players mid cycles because of that very fact, and they're
wondering if you know a lot of their players are
getting acl injuries because of that kind of stuff too,
So that is really interesting.
Speaker 2 (13:00):
Yeah, So it's thought maybe it's causing some like spinal
instability and that could be a cause of the back
pain as well. But importantly, the back pain could also
have a root cause. You might have an underlying condition
like endometriosis, fibroids, or dinomyosis which is causing that referred
pain as well. So important. If it's like quite severe,
doesn't feel normal, definitely, see it's octor Like if you
(13:22):
are throwing up from hain, Yeah that's normal.
Speaker 3 (13:24):
That is not octod Okay.
Speaker 1 (13:32):
This is something that we've been having a lot of
conversations about, especially in the last couple of years, is
what period products are actually healthy to use, because there's
been a lot of fear around potential chemicals in things
like pads and tampons, and then you know, menstrual cups
came along, and so what realistically is healthy Because I
know some of those studies around the heavy metals that
(13:53):
were in tampons, the research wasn't done in a way
that actually those heavy metals would even make it into
your body or bloodstream. So it was just a big
scary thing that wasn't really a thing. Can you give
us some explanation around that?
Speaker 2 (14:05):
So I think it's actually been great that this has happened.
There's not a lot of studies on tampons and pads, and.
Speaker 1 (14:14):
What is wild is that they did start using blood
on those products until very recently with fluids, but not
actual menstrul blood.
Speaker 2 (14:21):
And it's crazy, you know, I think this spotlight has
kind of forced like okay, and rightly, so females have
a right to know what they're inserting into, right and
if you know they there's potential toxins and chemicals that
could potentially cause harm later. And it's we don't want
to be fear mongering either. I think costs and affordability
(14:42):
accessibility is really important. And if you can only afford
tampons and pads, that's what you're going to use right now.
There is not enough evidence to suggest that they will
cause harm. But like I said, those studies are really important,
so we just kind of wait and watch. In the
intranim there's like menstrual cups, there's underwear. There's this period underwear,
which is fantastic. Yeah, I've ordered some. I'm waiting for
(15:05):
them to arrive. I'm excited to give them a try.
I think it's important that like organic doesn't always mean
free of chemicals as well. So if I had any advice,
it would be just to go for the fragrance free options.
Speaker 1 (15:18):
There's one in America that's been getting a lot of
airplane on social media. It's like confused with menthol Like
can you imagine the burn of a pad that has
menthol on it.
Speaker 2 (15:28):
Your vagina is not a flower. It doesn't need to
smell a certain way. Yeah, that's just that's crazy.
Speaker 1 (15:35):
Okay, next we're going to talk about something like this
is like it's a bit gross, yeah, but it's a
common thing for most of us. Yeah, please explain to
me why period poo is a thing. And if you
don't get period poos, it's literally like the week before,
it's like your guts go crazy and they're like just
wanting to expel everything in there.
Speaker 3 (15:58):
What is happening?
Speaker 2 (15:59):
You feel like it's colonoscopy prep.
Speaker 1 (16:01):
It is almost as if you've done prep estly.
Speaker 2 (16:06):
I say that they should schedule all colonoscopies for females, right.
Speaker 3 (16:09):
That makes it act.
Speaker 2 (16:10):
Yeah, So basically the understanding is it's all goes back
to prostagland and so they're released, they cause the uterus
to contract, they act on the smooth muscle. They also
act on the smooth muscle of the bow, so causing
the bow to contract and then comes your period poop.
Hormonal fluctuations with progesterone also play a role, so we
know when progesterone is high and more likely to be
(16:33):
constipated and that's generally before your period, and then when
it drops, the period poop comes, so it's been held
back for a while, and then the contractions as well.
It's all happening. And we also know that the progesterone
rise before the period is like kind of what triggers that,
you know, like craving for those sweet and carbi foods.
(16:53):
So we're eating crappy fit We're eating crappy foods and
that's what causes those I don't know if you get
those pesky period farts that just smell My husband knows.
He're like, you'll be like, yeah, it's coming. It's common.
So if I have general advice for females who you
know is bothersome for it's generally keep up your fluid intake.
(17:15):
If you're losing a lot of fluids. You want to
replace those electrolytes. Eat food high in fiber, you know,
fruit and vegetables. You want to avoid stimulants like coffee,
processed food, chili, try to avoid those processed foods. But
if you need it, just eat it and you'll have
a pesky fat here and there.
Speaker 4 (17:31):
That's fine. We're all human.
Speaker 3 (17:33):
We also need to be happy. Yeah, sometimes that means chocolate.
Speaker 2 (17:36):
There's also some evidence which suggests that the fluctuations in
hormones affect your neurotransmittens like serotonin, you know, the feel
good hormones and when they're low, you want to eat
trying to make myself so and then yeah, so you
know you eat a cheeseburger or a big mac, and
you know you feel good for that little period and
(17:57):
then and then were we pay for it later with
the pesky farts.
Speaker 3 (18:01):
With the pesky fats?
Speaker 4 (18:03):
Fun?
Speaker 3 (18:04):
Can other things be impacted by your period? Down there?
Speaker 1 (18:07):
So, for example, we've had a stack of women ask
about UTIs and many of them have said they get
a UTI right after their period finishes.
Speaker 3 (18:15):
Could that be connected?
Speaker 2 (18:16):
Yeah, So the fluctuations in the hormones, So when estrogen
rises and estrogen drops, so we know when estrogen rises
you're at increased risk of thrush and when it drops,
your at increased risk of ut eyes right, fun, fun fun, Yeah,
And the hormonia of shifts have massive impacts on your
mood and quality of life. You know, people with PMS
and the more severe form PMDD that can impact obviously
(18:40):
you know, relationships, your work and everything around you. And
we also know that the rise in prostaglandins, especially at
day two, can cause significant cramping and that can cause
you to miss like extracurricular or sporting. And the hormones
also affect your temperature, right, and that temperature effects can
disrupt your sleep. So there's especially people with PMDD, they
(19:03):
can suffer from like insomnia, like yeah, and it' and
that sleep deprivation has that knock on effect as well.
And then the skin changes, you know, for people who
get like hormonal acne and dry skin. So yeah, it's
not just all about the blood. It's it's it's good
effects everywhere.
Speaker 3 (19:20):
Fun.
Speaker 1 (19:21):
Yeah, Okay, does your weight impact your period and your cycle?
Speaker 2 (19:26):
It does so definitely. So changes in your body weight,
whether you're overweight or underweight, can impact your menstruation cycle.
So if you're underweight or your exercise intensively, you may
have an underlying eating disorder. We find that there's an
estrogen's efficiency and that can cause irregular or absent periods
as a result. And then we know that people that
(19:48):
are overweight, they're more likely to have heavy menstrual bleeding,
irregular periods, more likely to have underlying conditions like polycystic
ovarian syndrome, and sometimes they might not ovulate at all,
and that's generally because extra fat produces estrogen, which can
disrupt that cycle.
Speaker 1 (20:03):
I got said this article via Instagram about how PMDD,
which you've mentioned a couple of time, which is like
extreme pms that people who have been taking these new
range or not new, they've been around for a while,
but they're kind of new to us range of weight
loss injectibles. So at GLP one agonists or semaglutide that
(20:25):
is actually been helpful for PMDD. What do we know
about that?
Speaker 2 (20:28):
So there's very limited evidence for that, and I would
definitely not recommend it to someone who has PMDD. We
have evidence for medication that we know that works. We
also know that some people report increase anxiety, depression, suicidal
thoughts with these medications, So you know, what works for
one or two people might not work for the general population.
(20:50):
We'd have to wait till proper studies are conducted, and
so I would always trial the medications which have been
tested and tried, and that's generally go with your doctor.
Speaker 1 (21:00):
Okay, how do we now take the things that we've
learned today to make sure that we're explaining to our
healthcare professionals what's actually going on with us.
Speaker 2 (21:08):
Some people will think that their pain is normal, or
their heavy flow is normal, or some people think it's
not normal and I've seen a doctor and the doctor's
dismissed it. And for those females, I'm really sorry, because
if you think it's not normal and it's affecting your
quality of life, then it fits those definitions. I strongly
encourage any person who feels that they have symptoms that
(21:30):
aren't normal that geneals is a fantastic website with a
lot of information, and they also have like a period
diary with a symptom tracker and for two cycles. I'll
just encourage females to like kind of plot what's happening
in terms of their flow, they're passing clots, the symptoms
that they're feeling, and take that information to the doctor
right because you're like, I've plotted this, I've done the work,
(21:52):
and write down all the questions that you have as well.
The worst part is when you leave a doctor's room
and you're like, crap, I had such an important question
to ask. And make sure you find a gp with
a special interest in woman's health. You shouldn't have to
suffer in silence. Get that period diary. That information is
so valuable, write down those questions, find that appropriate GP yeah,
(22:15):
and hopefully you get some answers.
Speaker 1 (22:17):
Next, for today's quick consult, we're actually going to be
heading into the doctor's office with our very own doctor Mariam.
We are going to get some advice on a dilimit
that Alice sent in to see if we can help
her with her slightly smelly problem. The doctor will see you.
Speaker 2 (22:31):
Now, just through here to consult room one.
Speaker 1 (22:35):
First of all, sing, this is our very first one.
Can you bring us into the consult room the way
that you would bring a patient into the consult.
Speaker 2 (22:42):
Right, definitely. So I always start by saying thank you
for waiting, because I'm always over time, and I apologize.
You've got to give every patient the time and attention
they deserve, and sometimes it's within fifteen minutes and sometimes
it isn't, so I apologize, but I always tell them,
you know, it might be you next that needs that
twenty or thirty minutes. So my patients are usually quite
(23:04):
grateful and they're happy to wait.
Speaker 1 (23:06):
So this is where you can have your health concerns heard.
So If you do have something you want to ask
doctor Mariam or any expert in the health space, make
sure you reach out to us. You can send us
an email well at mmamea dot com dotter you, or
you can leave a voice note. You can find a
link on how to do that in our show notes.
So at least recently reached out to us to ask
this question.
Speaker 4 (23:28):
I don't think much vagina smells right. It has a
sort of fishy smell, and when I wash it, I
notice only an hour or so later it smells bad again.
The other night my girlfriend commented that it tasted different
and I was mortified. Am I just not cleaning properly?
Could this be a sign that something is wrong? Joined
it to see a guyano or is it GP?
Speaker 3 (23:47):
Okay, Allie, thank you so much.
Speaker 1 (23:48):
That's a really tough question to put out there into
the atmosphere. So we really do appreciate you doing this.
But Mariam, what should you do?
Speaker 2 (23:56):
So I'd start by saying, you don't need to see
a specialist. Your GP should be your first port of
call and they should definitely be able to get to
the bottom of it. No pun intended. So basically what
we do is we gather a bit more of a history,
see if she's got any other symptoms, like bleeding in
between her periods, any vaginal discharge. Is it just the smell.
(24:16):
I'd want to get more of a history about her
cleaning her vagina. Is she using like fragrance products? Is
she inserting anything into the vagina?
Speaker 1 (24:24):
Because I see a lot of these around. They're like
there's wipes and douches.
Speaker 2 (24:28):
Yeah, you know, the vagina is self cleaning. You don't
need to use these products. And the fact that you know,
there's this expectation that our vagina should smell a certain
ways just absolutely stupid. And by using these things, we
can disrupt the pH balance of the vagina and it
can cause infections like thrush. So i'd want to explore
more of that with her and see if she's is
(24:49):
she overcleaning it or inserting it which potentially could be
causing We also want to exclude things like foreign bodies.
That's the thing, retain tampons. That happens.
Speaker 1 (24:59):
Yeah, Okay, I've had friends who've forgotten and it happens.
Speaker 2 (25:03):
It happens like females. We're busy people, you know, you
could just push the tampon in and it's pushed the
other one further at the back and you've completely forgotten
about it. And then you want to exclude infections like
bacterial vaginosis, thrush and STIs. So definitely first pot of course,
seeing a GP, they'd gather more of a history. They'll
do an examination and take some swabs, and they'll do
(25:26):
your cervical screening test. You can also do a self collection, now, guys,
that's a thing. So if you're late for your cervical smear,
please do it. It's so easy the self collection. Yeah,
and depending on what I find during examination, I might
commence treatment if I suspect it's bacterial vaginosis prior to
the results coming, and then follow up with the results.
Speaker 1 (25:48):
It might be so hard not to overclean when there's
a smell, yeah, because we all know the smell of
our own vaginas. And sometimes it's worse at times, like
we all know about swamp crutch after going to the gym,
or there's what's referred.
Speaker 3 (26:06):
To as cabin crutch.
Speaker 1 (26:08):
Like a long flight, it can get a little, yeah,
you know, steamy, and I've heard someone refer to it
as when you go to a nightclub bath.
Speaker 3 (26:18):
Oh my goodness, and it smells like hot muff.
Speaker 2 (26:22):
I love it, Oh my goodness.
Speaker 1 (26:23):
So like we know the times that it can get
a little bit much and it is really tempting to
then go in and like just do a super thorough clean,
but you reckon, like just be careful.
Speaker 2 (26:31):
Yeah, So you don't need those products, Honestly, just warm
water is more than enough. Like you don't need to
be aggressive, you don't need to like scrub and insert
soaps that it will just like cause more harm than good. Honestly,
that stuff is just marketed and it's in a way
unfortunately that makes us think of vaginas need to be
flowers and they don't. You know, it's normal to have
(26:53):
a natural odor here and there. That's you know, part
of our body at least.
Speaker 1 (26:56):
I hope that helped out. And maybe just pop over
to your GP and get a little bit of advice.
Speaker 2 (27:02):
Yes, definitely you need to see your GP.
Speaker 1 (27:04):
Yeah, thank you so much for joining us on this
very first episode of Well Again. If you have any
questions about what we discussed or any health concerns you
want us to look into, please shoot us an email.
It is well at mmmamea dot com dot au or
you can leave us a voice note as well. And
if you're interested in exploring these topics and more, make
sure you sign up to the Well newsletter. There's a
link to that in our show notes. And as always,
(27:25):
the advice you've heard here today is general and may
not suit your exact needs, so make sure you reach
out to your own doctor or health specialist to get
the info that is one hundred percent right for you,
and we'll see you for your appointment this time next week.
Speaker 3 (27:38):
Thanks Mariam Babe.
Speaker 1 (27:40):
Well is produced by me Claire Murphy, Our Group Executive
producer Georgie Page, and senior producers Sasha Tanic, with audio
production by Scott Stronik and Jacob Brown. We hope you
enjoyed this episode of Well. If you're after more women's
health news like this, Well is your full body health
check and drops episodes every week on a Thursday.
Speaker 3 (28:01):
Coming up, we.
Speaker 1 (28:02):
Delve into endo, pcos, ADHD, depression and burnout. There's a
link to follow us in the show notes.
You're listening to a Muma Mia podcast.
Speaker 2 (00:14):
Mamma Mia acknowledges the traditional owners of the land and
waters that this podcast is recorded on.
Speaker 1 (00:20):
Hey there, I'm Claire Murphy from Mamma MIA's brand new
health podcast, Well, hosted by me and doctor Mariam, a
brilliant GP and advocate for women's health. Well is a
podcast about the taboo, the annoying, the embarrassing, and the scary.
We cover the concerns you're probably considering seeing a doctor about,
from insomnio to weird periods to how to prevent dementia.
(00:43):
In this episode, we do some period mythbusting like how
much pain is normal? Does my weight impact my cycle?
And why do we get period poos.
Speaker 3 (00:58):
Hi.
Speaker 1 (00:58):
I'm Claire Murphy and welcome to Well. This is your
full body health check. I've been a journalist for nearly
twenty years, the past six of those hosting mmamea's daily.
Speaker 3 (01:08):
News podcast, The Quickie.
Speaker 1 (01:09):
So I have asked a lot of questions of a
lot of experts about a lot of things related to
women's health.
Speaker 3 (01:16):
But now I want to know more.
Speaker 2 (01:18):
And my name's doctor Marriam. I'm a city based GP
and our staunch advocate for all things women's health. I'm
also a twin mum to toddler boys, which is why
I'm always tired. I'm so happy to be here.
Speaker 3 (01:35):
Let us tell you why we're here.
Speaker 1 (01:37):
Well is about addressing the taboo, the annoying, the embarrassing,
and sometimes the scary. We're going to cover concerns that
you're probably considering seeing a doctor about, from insomnia to
weird periods to how to prevent dementia. The difference is
we're going to give you the tools that you need
to make sure that you are seen and heard by
(01:59):
your healthcare professionals, and we won't charge you once your
fifteen minutes is up. First up, we're going to take
you to med school. This is where we're going to
share something fascinating that we've learned in the process of
making this podcast.
Speaker 3 (02:10):
Then it's into the.
Speaker 1 (02:12):
Checkup, where we'll explore a health topic in a stack
more detail. We'll speak to a specialist who when we
need their expertise, and then finally it's the quick consult.
We head off to the doctor's rooms where we solve
a dilemma on any health topic as submitted by you today.
In the check up, We're going to be putting a
spotlight on periods, like can weight loss injections actually help
(02:33):
with a particular menstrual issue? Why is period poor thing?
And when do you actually need to go and see
your doctor? But first we're hopping off to med school.
Speaker 3 (02:43):
Welcome to med school.
Speaker 1 (02:45):
So this is where I'm going to share something that
I've found out recently which will equal parts freak you
out and fascinate you. Have you heard about the sperm graveyard?
Speaker 4 (02:54):
Now?
Speaker 1 (02:55):
Look, I came across on my social media feed at
a doctor in the US which explained apparently the sperm
that is ejaculated inside of you, obviously when your partner
is not wearing a condom, and which does not end
up fertile the egg, which like is millions of them. Marian,
(03:15):
can you please explain to us where they go?
Speaker 2 (03:18):
So when a man ejaculates, it's thought that two hundred
to three hundred million sperm and to the vagina that's
a lot of sperm.
Speaker 3 (03:27):
That's a lot.
Speaker 2 (03:27):
And I like to think of the vagina as like
the ultimate Ninja warrior course, right, It's designed with lots
of boogie traps to kind of kill the sperm before
it gets to the egg, so we're not welcoming it in.
We're not a well, no, yeah, the vagina's not very welcoming.
So there's things that the sperm has to get through,
like the pH so a lot of the acidity of
(03:47):
the vagina will kill the sperm. There's a cervical mucus
in which some of the sperm will get trapped in,
and then the body identifies the sperm and rightly so
as foreign invaders, so will send these white cells to
kind of shoot them away. And then for the sperm
that does make it through the fallopian tube, and at
this stage, that's thought to be about two hundreds so
(04:09):
you can imagine two hundred to three hundred million, and
you've got two hundred sperm remaining. The rest have just
died from exhaustion because sperm is quite lazy that do
not surve. So the sperm's traveling along one we hope
will fertilize the egg, and then the rest are thought
to just keep swimming along. And so the fallopian tube's
(04:30):
actually not attached to the ovary, so there's these like
finger like projections called the fimbria, and so it can
actually exit out of the fallopian tube into your abdominal cavity.
Speaker 3 (04:40):
And this is what I've heard is referred to as
the sperm.
Speaker 2 (04:42):
That's right, So like, if you have a visual you
can just imagine like this just like falling into your
abdominal cavity.
Speaker 3 (04:49):
But do not be alarmed.
Speaker 2 (04:51):
Enzymes break that sperm down and it's reabsorbed for nutrients
for the body.
Speaker 3 (04:56):
What happens after we absorb it? Like are we using that?
Speaker 2 (04:59):
But if you think about it, sperm is like microscopic.
You can't even see it, so like it's so so tiny.
Speaker 3 (05:04):
It's yeah, you know it's there.
Speaker 1 (05:06):
No, we are going to actually put that video of
the sperm graveyard up on our socials too, if you
want to go and check it out. Later in the
section we are referring to as the quick consult, Alice
asks us whether her vagina smells right. But next in
the checkout, we're gonna do some period myth busting, because
even though we think we know everything about our menstrual cycle,
(05:26):
trust me, we do not.
Speaker 3 (05:31):
It's time for the check out, all right, let's.
Speaker 1 (05:35):
Get into it today. We are period myth busting. I've
seen videos in my social media feed claiming that your
period blood says something about.
Speaker 3 (05:44):
Your overall health. Is that true?
Speaker 2 (05:47):
Not necessarily like a core bullshit for some of it.
So there's like variation in the color of your period
through your menstruction cycle. At the start, it tends to
be heavier, it's brighter because it hasn't had a chance
to oxidize. And then as your period progresses you've had
some of the tissue sitting in there, it's reacted with
the oxygen. You might pass clots, and it might be
(06:08):
darker brown or even a close with black color. The
color variation that's completely normal. But the signs that you
know would prompt you to see a doctor would be
if it was like a gray or an orange tinge,
that might suggest an underlying infection. A light pink might
suggest iron deficiency. There's not really a strong link, but
(06:30):
it might, and especially if that's something new for you
or there's been a change, then that might warrant a
doctor review. But no, I wouldn't say, you know your
hormones fluctuate throughout the cycle. I wouldn't say it's indicative
of estrogen and progesterone de efficiency. There are a lot
of hormonal health coaches online. Unfortunately, so always check your sources.
(06:50):
The only hormonal advice I would take from would be
an endochronologist, to be honest.
Speaker 1 (06:54):
Yeah, so it's not like looking at your Wii and going, oh,
I'm dehydrated.
Speaker 3 (06:57):
Yeah, no, it's okay.
Speaker 2 (06:58):
Or your cervical mucus.
Speaker 3 (07:02):
I'm not sure.
Speaker 1 (07:02):
How comfortable I am checking out my cervical mucus, but
maybe for the sake of this podcast, I might have
to start. I also saw an post from someone who
said they were a nutrition scientist, but they claim that
taking vitamin D supplements can actually help with period pain.
Speaker 3 (07:20):
Is that true?
Speaker 2 (07:21):
So there is some evidence that it can help period pain,
though in a lot of the trials they were using
really high doses, so well above the recommended range of normal.
Vitamin D Toxicity is very rare, but I would just
advise anyone who wanted to take vitamin D get your
levels checked. If you're deficient, definitely start treatment, and always
(07:44):
speak to your doctor before you're starting any supplementation. A
lot of these medications can interact with other medications, and
you know, some medications, if they're used outside of that
recommended range, can cause toxicity. Although vitamin D is very rare,
in that regard, you should always speak to your pharmacist
or doctor. When should we be worried about a period?
What would not be normal is you've noticed a change
(08:06):
in the pattern of your peeriods who it's starting to
become more erratic, it's irregular, you're bleeding in between your periods,
you're bleeding for a prolonged time, like for more than
eight days, you're bleeding after sex, or there's significant pain
with your period that's not being relieved with simple over
the countermedications and it's disrupting your quality of life, or
you're just concerned for any reason about your period. That's
(08:30):
more than enough reason to see a doctor.
Speaker 1 (08:32):
And as we know, one in seven women in Australia
are diagnosed with endomeytriosis, which often means heavy, painful periods.
And that's something we'll be exploring and talking about in
more detail in our next episode.
Speaker 3 (08:45):
How much blood is normal?
Speaker 2 (08:46):
The average loss is thought to be about thirty to
forty meals, which is six to eight teaspoonfuls.
Speaker 1 (08:53):
Why are we're measuring in tea spoonfuls? Can we not
measure via a menstrual crap or something like at least
something we use it. No one's poised over the loo
with a tea spoon.
Speaker 2 (09:01):
But we define heavy menstrual bleeding as any bleeding that
impacts your quality of life in any way. So if
you feel like, you know, you having to change your
pads or tamp on every hour, you're leaking through your
periods more than eight days, you're passing large clots, which
we say more than a fifty cent piece, then there's
signs that something's happening. You should see a doctor.
Speaker 1 (09:22):
Okay, what are my options if I do have or
I'm prone to having really heavy periods.
Speaker 2 (09:30):
So if you do have heavy periods, I would really
encourage you to speak to your doctor because there could
be underlying causes contributing to the heavy period. We also
want to ensure that you don't have iron deficiency as
a consequence of the heavy mental bleeding as well, which
is awful. Get iron deficiency or me too.
Speaker 3 (09:49):
I feel like everyone I know now has an I.
Speaker 2 (09:51):
Dis and I always say, like, you know, iron supplements
and iron infusions, they're kind of band aid solutions. So
you want to kind of address the root cause, and
if that's heavy mental bleeding, then figuring out why you're
having it and stopping it from happening is really important.
So the first thing to just definitely see a doctor,
you know, and get the appropriate investigation. But while that
(10:13):
is happening, doctors should be giving you medication if that's
something that you want to reduce that blood loss. And
there's non hormonal options. The non hormonal options are something
we call transaxamic acid and that stops the blood from clotting.
That's actually quite effective in reducing blood loss. Anti inflammatories
are also shown to reduce blood loss and they also
help with the pain. You can take the two of
(10:34):
them together. They're most effective to start a day or
two before your period and you continue them for about
three days during your cycle. The hormonal options are and
the first line for all heavy menstrual bleeding is the
IUD and that is ninety five percent effective at twelve
months in reducing heavy menstrual bleeding. It's really effective and
(10:55):
it helps keep that endometrium nice and thin. And there
are the progestin only pill and combined oral contracepti pill.
They're actually quite effective as well. Obviously, you know there's
side effect profiles and you know preference to the patient.
So that's the option to discuss with your GP on
what you would feel would be best suited to your life.
And for the patient to have really heavy mental bleeding
(11:18):
that's affecting their quality of life, they've trialed everything. We've
excluded underlying causes that would warrant a referral to a kinecologist,
you know, for more extensive investigations and potential surgical options
if that's something that the person wanted to do.
Speaker 1 (11:32):
Okay, so that's cover off on bleeding. But what about pain?
Speaker 2 (11:36):
So pain you subjective, right, So what might be painful
for me might not be painful for you. But what
we do consider normal for periods is period pain that
isn't affecting your quality of life generally. You know, you
get the peak of the pain in the first two days.
If you have a bit of pain, you take over
the counter medications like parastamol or anti inflammatories. You're still
(11:57):
able to go about your day. It's not impacting your
work or extracurricular activities. That's normal. As soon as it's
I am having to take days off work, or you know,
it's impacting relationships or you're just staying at home lying
in bed, that's no normal.
Speaker 1 (12:12):
Here's a question, if things are all happening around my uterus,
why do I get pain in my lower back.
Speaker 2 (12:20):
So we blame that all on the prostic lands, and
so prostic lands ands are released during menstruation and that's
what causes the smooth muscle to contract. So the uterus
and the spine are in close proximity, so you get
that radiation in the pain. We also, like a physiotherapist
was telling me that the hormones also loosen your ligaments,
which makes you more prone to like injury, So which
(12:42):
is really interesting.
Speaker 1 (12:43):
It's interesting like the Western Bulldogs AFLW team have just
started doing something around so they've customized training around their
players mid cycles because of that very fact, and they're
wondering if you know a lot of their players are
getting acl injuries because of that kind of stuff too,
So that is really interesting.
Speaker 2 (13:00):
Yeah, So it's thought maybe it's causing some like spinal
instability and that could be a cause of the back
pain as well. But importantly, the back pain could also
have a root cause. You might have an underlying condition
like endometriosis, fibroids, or dinomyosis which is causing that referred
pain as well. So important. If it's like quite severe,
doesn't feel normal, definitely, see it's octor Like if you
(13:22):
are throwing up from hain, Yeah that's normal.
Speaker 3 (13:24):
That is not octod Okay.
Speaker 1 (13:32):
This is something that we've been having a lot of
conversations about, especially in the last couple of years, is
what period products are actually healthy to use, because there's
been a lot of fear around potential chemicals in things
like pads and tampons, and then you know, menstrual cups
came along, and so what realistically is healthy Because I
know some of those studies around the heavy metals that
(13:53):
were in tampons, the research wasn't done in a way
that actually those heavy metals would even make it into
your body or bloodstream. So it was just a big
scary thing that wasn't really a thing. Can you give
us some explanation around that?
Speaker 2 (14:05):
So I think it's actually been great that this has happened.
There's not a lot of studies on tampons and pads, and.
Speaker 1 (14:14):
What is wild is that they did start using blood
on those products until very recently with fluids, but not
actual menstrul blood.
Speaker 2 (14:21):
And it's crazy, you know, I think this spotlight has
kind of forced like okay, and rightly, so females have
a right to know what they're inserting into, right and
if you know they there's potential toxins and chemicals that
could potentially cause harm later. And it's we don't want
to be fear mongering either. I think costs and affordability
(14:42):
accessibility is really important. And if you can only afford
tampons and pads, that's what you're going to use right now.
There is not enough evidence to suggest that they will
cause harm. But like I said, those studies are really important,
so we just kind of wait and watch. In the
intranim there's like menstrual cups, there's underwear. There's this period underwear,
which is fantastic. Yeah, I've ordered some. I'm waiting for
(15:05):
them to arrive. I'm excited to give them a try.
I think it's important that like organic doesn't always mean
free of chemicals as well. So if I had any advice,
it would be just to go for the fragrance free options.
Speaker 1 (15:18):
There's one in America that's been getting a lot of
airplane on social media. It's like confused with menthol Like
can you imagine the burn of a pad that has
menthol on it.
Speaker 2 (15:28):
Your vagina is not a flower. It doesn't need to
smell a certain way. Yeah, that's just that's crazy.
Speaker 1 (15:35):
Okay, next we're going to talk about something like this
is like it's a bit gross, yeah, but it's a
common thing for most of us. Yeah, please explain to
me why period poo is a thing. And if you
don't get period poos, it's literally like the week before,
it's like your guts go crazy and they're like just
wanting to expel everything in there.
Speaker 3 (15:58):
What is happening?
Speaker 2 (15:59):
You feel like it's colonoscopy prep.
Speaker 1 (16:01):
It is almost as if you've done prep estly.
Speaker 2 (16:06):
I say that they should schedule all colonoscopies for females, right.
Speaker 3 (16:09):
That makes it act.
Speaker 2 (16:10):
Yeah, So basically the understanding is it's all goes back
to prostagland and so they're released, they cause the uterus
to contract, they act on the smooth muscle. They also
act on the smooth muscle of the bow, so causing
the bow to contract and then comes your period poop.
Hormonal fluctuations with progesterone also play a role, so we
know when progesterone is high and more likely to be
(16:33):
constipated and that's generally before your period, and then when
it drops, the period poop comes, so it's been held
back for a while, and then the contractions as well.
It's all happening. And we also know that the progesterone
rise before the period is like kind of what triggers that,
you know, like craving for those sweet and carbi foods.
(16:53):
So we're eating crappy fit We're eating crappy foods and
that's what causes those I don't know if you get
those pesky period farts that just smell My husband knows.
He're like, you'll be like, yeah, it's coming. It's common.
So if I have general advice for females who you
know is bothersome for it's generally keep up your fluid intake.
(17:15):
If you're losing a lot of fluids. You want to
replace those electrolytes. Eat food high in fiber, you know,
fruit and vegetables. You want to avoid stimulants like coffee,
processed food, chili, try to avoid those processed foods. But
if you need it, just eat it and you'll have
a pesky fat here and there.
Speaker 4 (17:31):
That's fine. We're all human.
Speaker 3 (17:33):
We also need to be happy. Yeah, sometimes that means chocolate.
Speaker 2 (17:36):
There's also some evidence which suggests that the fluctuations in
hormones affect your neurotransmittens like serotonin, you know, the feel
good hormones and when they're low, you want to eat
trying to make myself so and then yeah, so you
know you eat a cheeseburger or a big mac, and
you know you feel good for that little period and
(17:57):
then and then were we pay for it later with
the pesky farts.
Speaker 3 (18:01):
With the pesky fats?
Speaker 4 (18:03):
Fun?
Speaker 3 (18:04):
Can other things be impacted by your period? Down there?
Speaker 1 (18:07):
So, for example, we've had a stack of women ask
about UTIs and many of them have said they get
a UTI right after their period finishes.
Speaker 3 (18:15):
Could that be connected?
Speaker 2 (18:16):
Yeah, So the fluctuations in the hormones, So when estrogen
rises and estrogen drops, so we know when estrogen rises
you're at increased risk of thrush and when it drops,
your at increased risk of ut eyes right, fun, fun fun, Yeah,
And the hormonia of shifts have massive impacts on your
mood and quality of life. You know, people with PMS
and the more severe form PMDD that can impact obviously
(18:40):
you know, relationships, your work and everything around you. And
we also know that the rise in prostaglandins, especially at
day two, can cause significant cramping and that can cause
you to miss like extracurricular or sporting. And the hormones
also affect your temperature, right, and that temperature effects can
disrupt your sleep. So there's especially people with PMDD, they
(19:03):
can suffer from like insomnia, like yeah, and it' and
that sleep deprivation has that knock on effect as well.
And then the skin changes, you know, for people who
get like hormonal acne and dry skin. So yeah, it's
not just all about the blood. It's it's it's good
effects everywhere.
Speaker 3 (19:20):
Fun.
Speaker 1 (19:21):
Yeah, Okay, does your weight impact your period and your cycle?
Speaker 2 (19:26):
It does so definitely. So changes in your body weight,
whether you're overweight or underweight, can impact your menstruation cycle.
So if you're underweight or your exercise intensively, you may
have an underlying eating disorder. We find that there's an
estrogen's efficiency and that can cause irregular or absent periods
as a result. And then we know that people that
(19:48):
are overweight, they're more likely to have heavy menstrual bleeding,
irregular periods, more likely to have underlying conditions like polycystic
ovarian syndrome, and sometimes they might not ovulate at all,
and that's generally because extra fat produces estrogen, which can
disrupt that cycle.
Speaker 1 (20:03):
I got said this article via Instagram about how PMDD,
which you've mentioned a couple of time, which is like
extreme pms that people who have been taking these new
range or not new, they've been around for a while,
but they're kind of new to us range of weight
loss injectibles. So at GLP one agonists or semaglutide that
(20:25):
is actually been helpful for PMDD. What do we know
about that?
Speaker 2 (20:28):
So there's very limited evidence for that, and I would
definitely not recommend it to someone who has PMDD. We
have evidence for medication that we know that works. We
also know that some people report increase anxiety, depression, suicidal
thoughts with these medications, So you know, what works for
one or two people might not work for the general population.
(20:50):
We'd have to wait till proper studies are conducted, and
so I would always trial the medications which have been
tested and tried, and that's generally go with your doctor.
Speaker 1 (21:00):
Okay, how do we now take the things that we've
learned today to make sure that we're explaining to our
healthcare professionals what's actually going on with us.
Speaker 2 (21:08):
Some people will think that their pain is normal, or
their heavy flow is normal, or some people think it's
not normal and I've seen a doctor and the doctor's
dismissed it. And for those females, I'm really sorry, because
if you think it's not normal and it's affecting your
quality of life, then it fits those definitions. I strongly
encourage any person who feels that they have symptoms that
(21:30):
aren't normal that geneals is a fantastic website with a
lot of information, and they also have like a period
diary with a symptom tracker and for two cycles. I'll
just encourage females to like kind of plot what's happening
in terms of their flow, they're passing clots, the symptoms
that they're feeling, and take that information to the doctor
right because you're like, I've plotted this, I've done the work,
(21:52):
and write down all the questions that you have as well.
The worst part is when you leave a doctor's room
and you're like, crap, I had such an important question
to ask. And make sure you find a gp with
a special interest in woman's health. You shouldn't have to
suffer in silence. Get that period diary. That information is
so valuable, write down those questions, find that appropriate GP yeah,
(22:15):
and hopefully you get some answers.
Speaker 1 (22:17):
Next, for today's quick consult, we're actually going to be
heading into the doctor's office with our very own doctor Mariam.
We are going to get some advice on a dilimit
that Alice sent in to see if we can help
her with her slightly smelly problem. The doctor will see you.
Speaker 2 (22:31):
Now, just through here to consult room one.
Speaker 1 (22:35):
First of all, sing, this is our very first one.
Can you bring us into the consult room the way
that you would bring a patient into the consult.
Speaker 2 (22:42):
Right, definitely. So I always start by saying thank you
for waiting, because I'm always over time, and I apologize.
You've got to give every patient the time and attention
they deserve, and sometimes it's within fifteen minutes and sometimes
it isn't, so I apologize, but I always tell them,
you know, it might be you next that needs that
twenty or thirty minutes. So my patients are usually quite
(23:04):
grateful and they're happy to wait.
Speaker 1 (23:06):
So this is where you can have your health concerns heard.
So If you do have something you want to ask
doctor Mariam or any expert in the health space, make
sure you reach out to us. You can send us
an email well at mmamea dot com dotter you, or
you can leave a voice note. You can find a
link on how to do that in our show notes.
So at least recently reached out to us to ask
this question.
Speaker 4 (23:28):
I don't think much vagina smells right. It has a
sort of fishy smell, and when I wash it, I
notice only an hour or so later it smells bad again.
The other night my girlfriend commented that it tasted different
and I was mortified. Am I just not cleaning properly?
Could this be a sign that something is wrong? Joined
it to see a guyano or is it GP?
Speaker 3 (23:47):
Okay, Allie, thank you so much.
Speaker 1 (23:48):
That's a really tough question to put out there into
the atmosphere. So we really do appreciate you doing this.
But Mariam, what should you do?
Speaker 2 (23:56):
So I'd start by saying, you don't need to see
a specialist. Your GP should be your first port of
call and they should definitely be able to get to
the bottom of it. No pun intended. So basically what
we do is we gather a bit more of a history,
see if she's got any other symptoms, like bleeding in
between her periods, any vaginal discharge. Is it just the smell.
(24:16):
I'd want to get more of a history about her
cleaning her vagina. Is she using like fragrance products? Is
she inserting anything into the vagina?
Speaker 1 (24:24):
Because I see a lot of these around. They're like
there's wipes and douches.
Speaker 2 (24:28):
Yeah, you know, the vagina is self cleaning. You don't
need to use these products. And the fact that you know,
there's this expectation that our vagina should smell a certain
ways just absolutely stupid. And by using these things, we
can disrupt the pH balance of the vagina and it
can cause infections like thrush. So i'd want to explore
more of that with her and see if she's is
(24:49):
she overcleaning it or inserting it which potentially could be
causing We also want to exclude things like foreign bodies.
That's the thing, retain tampons. That happens.
Speaker 1 (24:59):
Yeah, Okay, I've had friends who've forgotten and it happens.
Speaker 2 (25:03):
It happens like females. We're busy people, you know, you
could just push the tampon in and it's pushed the
other one further at the back and you've completely forgotten
about it. And then you want to exclude infections like
bacterial vaginosis, thrush and STIs. So definitely first pot of course,
seeing a GP, they'd gather more of a history. They'll
do an examination and take some swabs, and they'll do
(25:26):
your cervical screening test. You can also do a self collection, now, guys,
that's a thing. So if you're late for your cervical smear,
please do it. It's so easy the self collection. Yeah,
and depending on what I find during examination, I might
commence treatment if I suspect it's bacterial vaginosis prior to
the results coming, and then follow up with the results.
Speaker 1 (25:48):
It might be so hard not to overclean when there's
a smell, yeah, because we all know the smell of
our own vaginas. And sometimes it's worse at times, like
we all know about swamp crutch after going to the gym,
or there's what's referred.
Speaker 3 (26:06):
To as cabin crutch.
Speaker 1 (26:08):
Like a long flight, it can get a little, yeah,
you know, steamy, and I've heard someone refer to it
as when you go to a nightclub bath.
Speaker 3 (26:18):
Oh my goodness, and it smells like hot muff.
Speaker 2 (26:22):
I love it, Oh my goodness.
Speaker 1 (26:23):
So like we know the times that it can get
a little bit much and it is really tempting to
then go in and like just do a super thorough clean,
but you reckon, like just be careful.
Speaker 2 (26:31):
Yeah, So you don't need those products, Honestly, just warm
water is more than enough. Like you don't need to
be aggressive, you don't need to like scrub and insert
soaps that it will just like cause more harm than good. Honestly,
that stuff is just marketed and it's in a way
unfortunately that makes us think of vaginas need to be
flowers and they don't. You know, it's normal to have
(26:53):
a natural odor here and there. That's you know, part
of our body at least.
Speaker 1 (26:56):
I hope that helped out. And maybe just pop over
to your GP and get a little bit of advice.
Speaker 2 (27:02):
Yes, definitely you need to see your GP.
Speaker 1 (27:04):
Yeah, thank you so much for joining us on this
very first episode of Well Again. If you have any
questions about what we discussed or any health concerns you
want us to look into, please shoot us an email.
It is well at mmmamea dot com dot au or
you can leave us a voice note as well. And
if you're interested in exploring these topics and more, make
sure you sign up to the Well newsletter. There's a
link to that in our show notes. And as always,
(27:25):
the advice you've heard here today is general and may
not suit your exact needs, so make sure you reach
out to your own doctor or health specialist to get
the info that is one hundred percent right for you,
and we'll see you for your appointment this time next week.
Speaker 3 (27:38):
Thanks Mariam Babe.
Speaker 1 (27:40):
Well is produced by me Claire Murphy, Our Group Executive
producer Georgie Page, and senior producers Sasha Tanic, with audio
production by Scott Stronik and Jacob Brown. We hope you
enjoyed this episode of Well. If you're after more women's
health news like this, Well is your full body health
check and drops episodes every week on a Thursday.
Speaker 3 (28:01):
Coming up, we.
Speaker 1 (28:02):
Delve into endo, pcos, ADHD, depression and burnout. There's a
link to follow us in the show notes.
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