June 29, 2023 • 29 mins
Listeners asked, we answered! From mismatched socks at a gynecologic exam to UTIs after sex - here is a Q&A episode just for you. Thank you for listening and asking!
DM @gynandtonicpodcast or email gynandtonicpodcast@gmail.com with more questions and we'll get back to you soon.
*This is not intended to be personal medical advice but general information. We always advise speaking with your provider to find out what's best for you*
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:03):
Hi, i'm Sarah, And I'm Sarah, ja, and this is Gin
and Tonic.
Speaker 2 (00:07):
Welcome back to Intamin Convos with your besties
.
You're okay.
What are you doing now?
Speaker 1 (00:18):
There's my orange wine.
My only French I've retained ishow to say certain words with a
French accent.
No, please, sarah is not fluentin Italian.
If everyone was wondering,she's a prodigy.
Speaker 2 (00:36):
I can say ten words in Italian, but I'm one week
less than a week four.
Speaker 1 (00:41):
Yeah, you're such a diligent student, you're
actually very inspiring.
You get something in your headand you just go right at it.
I love that about you.
I'm trying to find happiness.
How's it going for you, though?
I'm still figuring it out, i'mjust kidding, i'm happy Me, too.
I spontaneously cried at worktoday.
It was like having a perfectlypleasant conversation with
(01:05):
people that I love and thencried for their reasons.
So it's one of those days, guys, but we are going to answer
questions.
Woo, woo.
I actually really love when yousay woo in our episodes.
It's my favorite.
Speaker 2 (01:21):
Did I ever tell you the best compliment a guy ever
gave me?
What was it?
That I could be a cartoon voice?
You are a cartoon, but I was soflattered I was like this is
better than anything any man hasever said.
Speaker 1 (01:30):
And somebody's like what the I'm like that's really
cute.
Speaker 2 (01:33):
I could be a cartoon voice.
Speaker 1 (01:34):
That's very novel, especially when you're talking
that voice for your joking andyou'll say things really fast.
It's very fun and funny.
You'll be like, oh my God, i'mso sorry, what are you doing?
I love your cartoon voice.
(01:56):
Okay, this is going to be ashorter episode so you can go
back and listen to the last oneif you needed more of a fix.
But you all wrote in some greatquestions and we want to answer
them.
Speaker 2 (02:08):
Okay, shall we do it.
Pregunta número 1.
Speaker 1 (02:12):
Shall we go for it, yeah.
Speaker 2 (02:14):
Alright.
So my OV advised againstfertility testing before trying
to conceive.
I want to know my clock.
Speaker 1 (02:20):
Okay, love this question because I feel like
there's so much information andall these new resources out
there about getting fertilitytesting.
There's all these new companiesthat have like home testing or
this kind of startup mentalityaround initial testing of things
, and I think that, in general,more information is better, but
(02:45):
talking to someone who can helpyou interpret that information
is the best.
So when people talk aboutfertility testing, i think they
mean different things, but thetruth is we just like don't have
great information to predictsomeone's fertility, like we
actually don't know how to tellyou how long you have to get
(03:07):
pregnant by being exposed tosperm.
We just don't know that Youknow.
What we do know is how your bodymight react if you had to do
IVF or things like that.
We have better means ofpredicting how your body might
respond to that.
So I think that your doctorprobably didn't want you to do
it, because maybe you're in anage range where we have no good
(03:30):
ways of predicting it.
But for some people it doesmake sense, like, depending on
what your family planning goalsare and what your other medical
history is, that you might besomeone we're having some of
that information sooner mightpush your hand in terms of doing
something more.
So I don't know.
Did I answer the question?
Speaker 2 (03:50):
Yeah, well, essentially it's like I think a
lot of these online companiescan be empowering, but I think
they have to be interpreted witha grain of salt because they
can be falsely reassuring.
So it's like you have tointerpret them carefully and,
like Supra just said, thenumbers are actually more
helpful in understanding howwell you'll respond to IVF
(04:12):
treatments if you need it.
That's what they really helpwith, which is kind of seems
ironic.
And why are we getting it forfertility testing?
Speaker 1 (04:21):
Yeah, i feel like the lab that has gotten the most
attention is something called anAMH or an anti-malarian hormone
, and people use that kind of asa substitute for fertility.
but really like, just like yousaid, sarah, all it's really
been tested to show is howsomeone who suffers from
infertility reacts to IVFmedication, like how well your
(04:46):
ovaries can be stimulated inthat very specific scenario and
it also has to be interpretedbased on your age.
I had a friend who did one ofthese modern fertility tests and
then was told it was all normaland didn't worry about it for a
few years and it showed me hertest results later and I was
like that wasn't normal.
You know you should have beencounseled that you needed to
have a conversation with thedoctor.
(05:08):
So I think they're just.
They're good in some cases, butdefinitely helpful to have a
doctor relationship that you canhave you at with or like
hopefully you can have aconversation with the doctor
where they understand your goalsand you guys can come to a
decision about whether or notit's meaningful.
Speaker 2 (05:24):
Yeah, i had a friend whose number was low and she had
no problem conceiving it as twochildren, so I think it can be,
can swing either way of the pen, whatever that pendulum swing.
Speaker 1 (05:37):
Sarah and I were both in the war elite today so we're
trying to answer your questions, but also, we are tired, and so
good luck to you for listening.
Okay, sarah, out of my annuals,a listener wrote in do you
judge me for wearing mismatchedsocks?
Oh my god, i would be judgedall day, every day of my life.
How prepared does my huja needto be at an annual exam?
(06:02):
What do you think, sarah?
Speaker 2 (06:04):
People apologize all the time, like as we're getting
to that, like I'm just so sorry,i haven't shaved.
It sounds like neither have Isince New Year's.
I'm not part of her.
I haven't shaved.
Speaker 1 (06:15):
I am partner and he said he loves me anyway.
So there we go.
Speaker 2 (06:19):
But people apologize all the time, like I actually
don't care at all.
Speaker 1 (06:23):
Also, i cannot remember, like I do not register
it.
Like I could not tell you whatanyone's huja looks like unless
I documented it in a note.
is like an abnormal finding.
Yeah, like, do not comment onhair, like nothing of the sort.
Speaker 2 (06:38):
Yeah, we don't care about grooming status at all.
And more people will say likeoh, you know, i didn't shave my
legs, or even like we don't.
I don't bitch that stuff at all.
Speaker 1 (06:51):
Okay, i'm laughing because we took notes on these
questions and Sarah wrote maybedon't go four to five days
without shower right, yeah, well, people like I did shower this
morning I was like that's okay,but like is it been a few?
Speaker 2 (07:02):
like been in shower yesterday, yeah.
Speaker 1 (07:04):
I mean, you don't have access to shower, it's
totally fine.
But I think the general conceptis like overall, good hygiene
is good, you just don't need todo it for us.
Speaker 2 (07:13):
And we've literally seen everything.
There's very little that cansurprise us.
Like you know, we've had visitsfor moving foreign bodies from
the vagina.
Speaker 1 (07:25):
Which is also one of my greatest fears that I left in
a tampon.
Really, yeah, you never havethat fear.
Speaker 2 (07:33):
No.
Speaker 1 (07:34):
Oh, i'm constantly afraid I have something.
Speaker 2 (07:36):
I'm just like so psychotic about it.
Speaker 1 (07:38):
What do you mean?
What does that mean?
like every night you like feelaround me and turn on things
there.
Speaker 2 (07:43):
You have like a journal.
Speaker 1 (07:45):
I tampon in tampon out, but I'm not sure it does
have a journal.
Well, i know probably.
Speaker 2 (07:50):
Well, i know I have an IUD, so I have been using
tampon in like nine years.
That's true, but those visitsare really fun actually Finding
it?
Speaker 1 (07:57):
Yeah, because you're like hurry The patient's so
mortified, but I'm like this isfun.
Because it's like quick tricks.
You're like oh, we got you.
We're like our picture comes inall the way.
Speaker 2 (08:08):
My discharge has been smelling abnormal for weeks.
Something's wrong.
Speaker 1 (08:13):
That is satisfying Where you're like.
well, this is it.
This is it.
Now we won't have a problemanymore.
Speaker 2 (08:18):
It's because you left your diva cup in for three
weeks.
I have you had that.
Speaker 1 (08:21):
Yeah, i went to A diva cup too.
I gotta try out this diva cupstitch.
It hurt.
Oh, you tried it.
Yeah, whatever Like, just sitin the back.
Maybe I need to see a blowerspecialist.
Speaker 2 (08:34):
It's because Eric and my cousin swears like that.
I was like mm-hmm, i evenlooped it up.
Okay, you did, yeah You'relooping everything.
It's because I have pelvicfloor dyslexia.
I can't relax.
Speaker 1 (08:49):
We'll work out later.
Speaker 2 (08:50):
I'm too high, strong, okay, you want to loop?
Speaker 1 (08:52):
Okay, where are we with our specialist?
Okay, so yeah, we don't care,be comfortable.
Speaker 2 (08:56):
We've had, you know, humans like stool on us, pee on
us, bleed on us retreat for anouttakes.
Speaker 1 (09:02):
Last time I peed in my mouth.
Speaker 2 (09:04):
Oh god, yep, it's happened On labor delivery, not
at a GYN visit, oh No.
Speaker 1 (09:12):
Well, the labor delivery was like into my mouth,
but otherwise it was on my face.
Speaker 2 (09:17):
Really Yeah, but you know what?
Speaker 1 (09:19):
I couldn't even tell you who.
Like I don't remember who Ijust remember the sweet nurse
walking over and like patting myface Which is how much we
associate these things with youspecifically like literally zero
.
Speaker 2 (09:33):
Okay does it matter if I?
Speaker 1 (09:34):
have my period on my pap Sarah.
Speaker 2 (09:36):
Someone wants to know In general, no, i will let the
patient know.
there is a possibility thatwhen we do the pap smear, that
there will be too much blood,obscuring them from seeing the
cervical cells.
So remember pap smear is thecervix at the end of the vagina.
So if you think of the vaginalike a tunnel, at the very end
of the tunnel is like a donutshaped organ.
(09:57):
We use a brush literally tojust brush the cervix.
Like this I'll brush it in myforehead Just to pick up cells.
We swirl them in a little jarof fluid and then the
pathologist like identifies thecells.
But if there's too many redblood cells they don't have a
harder time.
But in all honesty, whensomebody's on their period we
just brush the blood away andthen do the pap smear, but on
(10:21):
occasion a handful, likeliterally just a handful of
times a year.
It will say insufficient orobscuring blood.
Speaker 1 (10:28):
It's very uncommon And then you just have to do it
again.
Yeah, and also at the cytologylab where they read it, they
have a reagent they put on it toget rid of the blood.
So they also try to minimizeany effect that has.
But my, i have my friends whotold me there are doctors
automatically canceled theirappointments because they were
on their period, which I wouldnever do.
That I wouldn't do that either.
Speaker 2 (10:50):
That's odd.
Okay, am I too old to freeze myeggs?
When does the age interval foregg freezing Guys?
Speaker 1 (10:57):
Did you?
Speaker 2 (10:58):
This is such a sad question.
You guys do we not answer thison episode one?
Come on.
Speaker 1 (11:03):
But it's sad so we should answer again One I always
I had a big problem with usingthe word old because you're not
old.
Our bodies just do differentthings at different times.
Speaker 2 (11:15):
Normal Sarah's old, but the rest.
Speaker 1 (11:19):
Sarah's young.
Sarah has young, beautiful body, including your eggs.
But yeah, our bodies just dodifferent things at different
times.
So We also live longer than weused to.
We do things at a differenttime in our lives and our
reproductive systems have notcaught up.
So, like I hate like the wordGeriatric or I refuse to write
(11:41):
advanced internally, but I'mlike it's not advanced.
It's not advanced.
Being 35 is not advanced.
Speaker 2 (11:46):
That's like.
anyway, I won't write perStereolization oh, I hate that.
Speaker 1 (11:52):
I hate what.
Am I?
a cow, Yeah what?
Speaker 2 (11:56):
Yeah, I'm a contraception.
Speaker 1 (11:59):
Anyway.
So you're not old, regardlessof what I'm about to say, but I
will say that Ideally you woulddo it before 37 and really, if
you're thinking far ahead, i'dsay like 33, 34 is a great time,
but before 37, at 37, ourfertility really does decline a
good bit.
(12:19):
After 40 declines a lot.
So many REI doctors, who arethe ones who do freeze your eggs
, won't do it after 40.
There are always exceptions, soit might be worth having a
conversation if you're after 40and that's something that's
still of interest to you.
That doesn't mean there areoptions like you can.
If you really do want to have ababy and be pregnant, you can
(12:40):
do donor egg.
There are other things that youdefinitely can do, but I would
say, because just 40 is thenumber to be thinking ahead too,
Remember as we get older.
Speaker 2 (12:52):
Well, no, sorry advance.
As we become geriatric as myphone talks, wears off.
You three Minds extends to six,seven months.
Speaker 1 (13:08):
Sarah, it's been a year.
Speaker 2 (13:09):
Yeah, it just people how your forehead won't move.
I think it's.
I think it's because I've beenusing my robot.
Monotone face with more youhave.
Oh.
Speaker 1 (13:21):
You like, trained yourself not to use your
forehead.
I just give people dead face.
I've been doing that too, likethis is how I smile now.
Speaker 2 (13:29):
I don't even smile.
I can't risk the wrinkles.
Speaker 1 (13:31):
I'm just kidding, i'm not kidding, we're doing well
with this aging process.
Hey, we're with you.
Oh god, like kept talking aboutBotox.
And then Adam, which I've hadBotox once.
No shame, though I honestlyreally want it again.
I've had it multiple times.
Um, and Adam, poor Adam, who'slike, looks very young for his
(13:53):
age.
My fiance was like I think I'mtalking like no, i don't have my
craziness from off my face.
It's perfect.
Speaker 2 (14:02):
Okay, oh, wait questions.
But I just want to say, and thereason we don't recommend doing
it too, too much later in life,like late 30s, is because
remember, you have fewer eggsand the eggs that remain are
Generally less like like higherchance of being genetically
abnormal, abnormal.
So it's just you're gonna endup doing more cycles if you're
(14:24):
not gonna be as successful andretrieve as many good, healthy
eggs late.
Later on, later on versus a 33,34 year old or somebody younger,
then that's the reason behindit and those eggs that are
Genetically abnormal or lesslikely to form an embryo
implants.
Speaker 1 (14:41):
You're just less likely to get pregnant.
Yeah, okay, okay, yes.
So this these are listeners whoclearly listen to our lecture
called an electric Young person.
Speaker 2 (14:53):
Yes young woman who submitted.
Speaker 1 (14:54):
I'm just kidding This person wants to know what are
things that can go wrong withegg freezing.
Can I lose my ovaries?
Speaker 2 (15:01):
Well, So remember, when you're doing your egg
freeze, you're essentially,essentially when you're having a
regular cycle, not egg freezingyour body is sending hormones
to your ovaries to make oneSuper egg that you ovulate most,
most people just ovulate See myhands.
Speaker 1 (15:20):
I'm like People just saw my armpit hair.
I don't know.
Provence, when I'm really ourPeruvian tearless.
Speaker 2 (15:29):
We are like minimal hair.
Speaker 1 (15:31):
Oh, indians are all about it.
I love you know.
I don't know why, cuz it's hotthere, but we didn't not for
lack of hair.
I'm barely shave, anyways,that's true.
Anyways, okay, what was thequestion?
Speaker 2 (15:44):
Oh, yeah, so remember , every month you literally just
you know Superproduce one egg.
But when you're going throughan egg freeze cycle or IVF,
they're trying to super producemany eggs at one time, and so
your ovaries, you know, grow insize by 10 times.
They get to the size ofgrapefruits.
(16:04):
And so the risks in this is youend up producing a lot of fluid
in your belly And your eggs areso big that they could
accidentally turn on themselves.
That's called ovarian torsion,and so that could be an uncommon
risk, but a theoretical risk,and that's a surgical emergency,
you would know, because you'dbe in a lot of pain, you'd be in
(16:26):
a lot of discomfort, you'd becrouching over, very
uncomfortable.
So that is theoretically a riskand if it did happen it's a
surgical emergency.
Other things You know duringyour procedure, when they're
actually retrieving the eggs,they put a vaginal probe, while
you're asleep, into the vaginaAnd then the probe has a needle
attached to it, a very smallneedle that Punctures the the
(16:47):
top of the vagina and entersinto the abdomen and then
punctures the ovary to kind ofaspirate, suck out The eggs.
In doing so there's somebleeding.
That happens.
In general, the bleeding isminimal and you'll feel a little
discomfort, but in some casesit can be a lot, and then you
can have bleeding in yourabdomen and that might require
surgery or a procedure.
Speaker 1 (17:08):
These are uncommon.
Yeah, i'd say, all these thingsare super rare And the past.
Speaker 2 (17:13):
They would really pump up the hormones and people
would get admitted for being toohyper stimulated.
This doesn't happen as much asbefore, it's just super uncommon
.
Speaker 1 (17:22):
Now There's so much more like careful decision
making, better understanding ofhow much medication everyone
needs We're just better atmedicine, basically.
So, everything comes with risk,but in general, egg freezing is
really safe.
Speaker 2 (17:34):
Okay, okay, so I had no issues conceiving the first
time and couldn't, but now can'tget pregnant the second time.
Why?
Speaker 1 (17:45):
So crappy.
It's so tough when you'retrying to get pregnant and you
have trouble, especially whenit's unexpected.
We would call that secondaryinfertility.
So, and again, i hate the wordinfertility Really.
I write like fertility concerns.
Speaker 2 (18:00):
I write difficulty conceiving.
I do that too, actually.
I write difficulty conceiving.
I just feel like it's so cruel.
Or it's kind of like whenpeople write they failed their
glucose test and pregnancy.
It is failed.
I don't write for it, i justsay did not pass.
Speaker 1 (18:15):
But okay, so we call it technically, called it
secondary infertility, althoughif Sarah and I are not there
we'll probably try not to saythat word to you.
But that's basically when youhad one pregnancy where you got
pregnant spontaneously And thesecond pregnancy you weren't
able to for over a year, or insome cases, six months,
(18:36):
depending on the situation.
And there are a lot of reasonsthat can happen, although often
we're just not sure.
So reasons can be issues withthe structures in your body, so
scarring in the uterus, scarringon the tubes that don't allow
either the egg to get into theuterus via the tube or don't
allow for implantation, don'tallow for the sperm to join the
(18:58):
egg.
So that can be it.
Some people experience what wecall premature ovarian failure,
which basically is kind of likean early menopause, like your
eggs and ovaries just startacting like they're going
through menopause in an ageperiod, in your 30s.
Speaker 2 (19:15):
That's super, uncommon Super rare.
Speaker 1 (19:17):
And then there are genetic abnormalities.
So some people have geneticabnormalities in the mom and the
dad if it's a cisgender coupleand the combination of those
genes together predisposes themto things like miscarriages, So
that's possible too.
also really rare.
And then some people just haveunexplained infertility.
(19:38):
In general, about 10 to 20% ofpeople who have infertility have
unexplained infertility, whichbasically means all of your
testing is normal, We don't knowwhy.
We just have trouble gettingpregnant And in those cases they
have the most success doing IVF.
Speaker 2 (19:56):
And your doctor can do some of this work up for you.
but if you're having regularcycles and you're still not able
to get pregnant, with regularcycles meaning you're ovulating,
your ovulation predictor kitsare positive and all your
testing is normal, there's verylittle your OBGYN is actually
going to be able to do for you.
So I tell my patients that thisis happening.
We can either do your work upat a fertility center I can do
(20:18):
it for you but again, we'll getto the fertility center, it's
just there's not anything I cando for you.
Speaker 1 (20:23):
And when Sarah says nothing I can do for you.
She just means in general islike not the world but just we
would refer you to someone whodid three more years of training
than we did in fertilityscience.
Okay, so someone wants to know,sarah, how long they have to
wait after getting their IDremoved to get pregnant?
Speaker 2 (20:45):
Um nothing, it's just get it popping.
Speaker 1 (20:48):
Yeah.
Speaker 2 (20:50):
Because, remember, when you have the IUD, the way
it works is it's a local effect,meaning it's just really having
hormonal effects in your uterus.
It's not like the pill or depotor the implant where it's
tricking your brain andaffecting all of your hormones.
It's really a local effect.
And so what?
most people are still ovulatingwhen they're on the IUD
actually.
So when you remove the IUD, youmay have a delay in your period
(21:14):
coming back, but it's usuallynot because you're not ovulating
, but it's because the IUD hasreally thinned out the lining of
the uterus And that's whypeople don't bleed while they
have an IUD.
But I've had people getpregnant without even having a
period because they're stillovulating.
Speaker 1 (21:28):
Yeah, There's no hard and past guidance about it.
I often recommend people waituntil one period only because we
date pregnancies from your lastmenstrual period, so if you get
pregnant before that period,it's hard to know when your
pregnancy started, but notdangerous to get pregnant sooner
.
Speaker 2 (21:47):
And some people do stop ovulating when they're on
the IUD, usually in the firstfew years after insertion, but
so those people might have alittle bit of delay in return of
, you know, population andfertility.
But in general most people canconceive the same way as the
general population without anIUD does.
Speaker 1 (22:07):
Okay, And this leads to another question via listener
Can an IUD affect my fertility?
And the answer is no, it doesnot affect your ability to
appropriate at all.
Get the IUD out, have yourbabies get at it.
Yeah, the only thing I would sayis that, because a lot of
people stop having a menstrualperiod when they have an IUD,
(22:30):
sometimes you're not as aware oflike natural changes in your
cycle.
So if you are someone withreally irregular bleeding or if
you're just going through otherchanges, you might not be keyed
into that as quickly because theIUD is masking what you would
be doing without hormones, butthat's still really rare.
Speaker 2 (22:51):
And then do I have to urinate after sex?
Speaker 1 (22:54):
Sarah says yes, she says she has to urinate
immediately, otherwise she's UTIcentral.
Speaker 2 (23:00):
But nine UTIs in my early 20s.
Speaker 1 (23:03):
Nine.
Oh my God, that's so rough,Sarah.
Wait, how do you know nine Youcounted.
Speaker 2 (23:09):
Yeah.
Speaker 1 (23:10):
So you kept again a journal or what.
You counted only, so I was like, today was UTI number five.
Speaker 2 (23:16):
I was like does my urgent care?
was like oh God.
I was like I just went to bedafter I couldn't get on
no-transcript.
Speaker 1 (23:25):
Okay.
So basically the concern is forhaving recurrent UTIs, which
means you either had two UTIs ormore in six months or three or
more in a year, and some peopleare really prone to this, other
people not as much.
When you look at big studies,actually peeing after sex was
not a consistent thing.
(23:46):
That stopped UTIs.
But some people it matters morethan others And I'd say the
risk is low, like it's not thathard to pee after sex.
So we often encourage it,especially for people who are
prone to UTIs.
But evidence is out whether itreally makes a difference.
Sarah doesn't believe me.
Speaker 2 (24:03):
Okay, because think about this When you're being
intimate with somebody, you knowall the fluids you produce
lubrication and that fluid youknow your vaginal opening is
literally right next to yoururethral opening.
Speaker 1 (24:16):
Okay, sarah's going to do another study, another.
Okay, she's not biased at allon what the results will be, but
so far the studies don't agree.
Well, that matters foreverybody.
Speaker 2 (24:25):
The anus is really close, to you know.
Speaker 1 (24:28):
I'm just saying the holes are close.
Okay, yeah, so this is anotherthing.
a lot of people talk aboutdirection, of wiping front to
back to what you were doing backto front, were you really?
I actually I've like recentlymessed it up and I tried to
counsel someone to do it back tofront and they were like wait,
(24:51):
you mean front to back?
And I was like yeah, i do meanfront, i don't think I even
wiped.
Speaker 2 (24:57):
I just like blot.
Now I'm afraid I'm messed up.
Speaker 1 (25:02):
You're right.
That's why you blot, i blot,okay, i support you, okay, but
so front to back is better.
But again, the research is out,whether or not it really
affects your.
UTI risk.
The big controlled studiesdon't really show that it makes
a difference, but no harm indoing it And it could make a
difference for you, things thatdo matter, that have been proven
(25:25):
.
You're crying?
No, i just whatever evidencebased whatever is.
Drink lots and lots of water,like two to three liters of
water.
Avoid things like spermicidereliant, other methods of birth
control.
It's like those are like twothings that matter.
And then if you are someone whorepeatedly gets infection,
(25:45):
sometimes your doctor might putyou on an antibiotic for right
after sex.
That can help.
Or if you're someone aftermenopause, sometimes things like
estrogen crink can matter.
Speaker 2 (25:56):
Big fan of that Okay good We're on, the sir and I are
aligned.
Speaker 1 (26:01):
Okay, Sarah, who needs an anal pap?
I actually want to know thisbecause I don't know.
Okay, okay.
Speaker 2 (26:07):
So anal pap smears are, in reference to screening
for anal, pre cancer, kind oflike cervical.
The reason we get pap smearsit's of our cervix.
We're screening it for cervicalcancer.
So there are certain parts ofour bodies that we can
fortunately screen for cancer,meaning we can do things to
detect it early, like breastcancer, colon cancer, cervical
(26:30):
cancer.
So for things that are causedby HPV or affected by HPV the
cervix, the vagina, the vulvaand the anus you can sometimes
detect those early with certaintests, like cervical cancer
screening with pap smears.
And so if somebody has a historyof abnormal pap smears and
(26:52):
there's different degrees,there's low grade abnormalities
and high grade abnormalities ifyou have a high grade
abnormality of the cervix, youshould get an anal pap smear.
Or if you had a high gradeabnormality of the vulva or the
vagina a lot of people thescreening for that is a little
bit different.
It's mostly oh, i saw a mole orsomething abnormal on the vulva
(27:13):
, biopsie it Okay.
so it's really only diagnosedin the moment.
But if you had high grade ofthe vulva, of the vagina or the
cervix you should be doing ananal pap smear.
Speaker 1 (27:24):
And it's okay, and we were talking about how often
men, which there are a billiondifferent societies, a billion
different suggestions, but noone has really agreed upon
anything But probably, if you dofall under one of those
categories that you mentioned,you should start yearly and then
have a discussion with howoften.
Speaker 2 (27:43):
Yeah, And there's so many different societies and
they're going to finally come upwith one standard census And
actually an anal pap smear iseasier than a cervical pap smear
.
Speaker 1 (27:52):
Because you don't have to have anything stuck in
the anus.
Well, a brush Except for thebrush, but the brush is
different Device.
Speaker 2 (27:57):
It's a Q tip.
It's not the brush that theyuse for the pap smear, that's
cervical pap smear And you don'thave to put an instrument in
the anus.
It's literally just you moistena Q tip, you put it into the
anus about four, seven, likefour to five centimeters.
It's really not that bad.
Speaker 1 (28:12):
I was laughing because of your hand.
Speaker 2 (28:13):
I'm sure It's really not that bad.
And then you just go, you knowa little into the anus and then
you swirl it out.
It's really not that bad, swirlit out.
Speaker 1 (28:21):
Yeah, i hear it, you hear it.
Okay.
And then what all do I needswab for STDs.
You got to swab every holeyou're using Yep, mouth, vagina,
anus, all of it Okay.
And then there's also bloodtesting that you can do, so But
do you swap all the other?
holes Like I should, but Idon't always, but sometimes I do
(28:45):
.
There's a lot of oral chlamydia, like a lot.
I know, yeah, and no one everswaps for it.
So, yeah, you should get it allswabbed.
If you're, you know, puttingthings in your mouth, then put
this brush in your mouth too.
Well, okay, i got to go swabmyself.
Then you want me to swab you?
To be decided, we'll decidelater.
(29:06):
All right, those are all thequestions.
So if anyone has more questions, feel free to DM us on
Instagram.
We're at Jin and Tonic podcast.
Jin's spell GYN.
You can comment in our YouTubesame name And that's all.
(29:27):
We'll get back to you.
Thanks for the questions, loveyou.
I'll see you in the next G.
Hi, i'm Sarah, And I'm Sarah, ja, and this is Gin
and Tonic.
Speaker 2 (00:07):
Welcome back to Intamin Convos with your besties
.
You're okay.
What are you doing now?
Speaker 1 (00:18):
There's my orange wine.
My only French I've retained ishow to say certain words with a
French accent.
No, please, sarah is not fluentin Italian.
If everyone was wondering,she's a prodigy.
Speaker 2 (00:36):
I can say ten words in Italian, but I'm one week
less than a week four.
Speaker 1 (00:41):
Yeah, you're such a diligent student, you're
actually very inspiring.
You get something in your headand you just go right at it.
I love that about you.
I'm trying to find happiness.
How's it going for you, though?
I'm still figuring it out, i'mjust kidding, i'm happy Me, too.
I spontaneously cried at worktoday.
It was like having a perfectlypleasant conversation with
(01:05):
people that I love and thencried for their reasons.
So it's one of those days, guys, but we are going to answer
questions.
Woo, woo.
I actually really love when yousay woo in our episodes.
It's my favorite.
Speaker 2 (01:21):
Did I ever tell you the best compliment a guy ever
gave me?
What was it?
That I could be a cartoon voice?
You are a cartoon, but I was soflattered I was like this is
better than anything any man hasever said.
Speaker 1 (01:30):
And somebody's like what the I'm like that's really
cute.
Speaker 2 (01:33):
I could be a cartoon voice.
Speaker 1 (01:34):
That's very novel, especially when you're talking
that voice for your joking andyou'll say things really fast.
It's very fun and funny.
You'll be like, oh my God, i'mso sorry, what are you doing?
I love your cartoon voice.
(01:56):
Okay, this is going to be ashorter episode so you can go
back and listen to the last oneif you needed more of a fix.
But you all wrote in some greatquestions and we want to answer
them.
Speaker 2 (02:08):
Okay, shall we do it.
Pregunta número 1.
Speaker 1 (02:12):
Shall we go for it, yeah.
Speaker 2 (02:14):
Alright.
So my OV advised againstfertility testing before trying
to conceive.
I want to know my clock.
Speaker 1 (02:20):
Okay, love this question because I feel like
there's so much information andall these new resources out
there about getting fertilitytesting.
There's all these new companiesthat have like home testing or
this kind of startup mentalityaround initial testing of things
, and I think that, in general,more information is better, but
(02:45):
talking to someone who can helpyou interpret that information
is the best.
So when people talk aboutfertility testing, i think they
mean different things, but thetruth is we just like don't have
great information to predictsomeone's fertility, like we
actually don't know how to tellyou how long you have to get
(03:07):
pregnant by being exposed tosperm.
We just don't know that Youknow.
What we do know is how your bodymight react if you had to do
IVF or things like that.
We have better means ofpredicting how your body might
respond to that.
So I think that your doctorprobably didn't want you to do
it, because maybe you're in anage range where we have no good
(03:30):
ways of predicting it.
But for some people it doesmake sense, like, depending on
what your family planning goalsare and what your other medical
history is, that you might besomeone we're having some of
that information sooner mightpush your hand in terms of doing
something more.
So I don't know.
Did I answer the question?
Speaker 2 (03:50):
Yeah, well, essentially it's like I think a
lot of these online companiescan be empowering, but I think
they have to be interpreted witha grain of salt because they
can be falsely reassuring.
So it's like you have tointerpret them carefully and,
like Supra just said, thenumbers are actually more
helpful in understanding howwell you'll respond to IVF
(04:12):
treatments if you need it.
That's what they really helpwith, which is kind of seems
ironic.
And why are we getting it forfertility testing?
Speaker 1 (04:21):
Yeah, i feel like the lab that has gotten the most
attention is something called anAMH or an anti-malarian hormone
, and people use that kind of asa substitute for fertility.
but really like, just like yousaid, sarah, all it's really
been tested to show is howsomeone who suffers from
infertility reacts to IVFmedication, like how well your
(04:46):
ovaries can be stimulated inthat very specific scenario and
it also has to be interpretedbased on your age.
I had a friend who did one ofthese modern fertility tests and
then was told it was all normaland didn't worry about it for a
few years and it showed me hertest results later and I was
like that wasn't normal.
You know you should have beencounseled that you needed to
have a conversation with thedoctor.
(05:08):
So I think they're just.
They're good in some cases, butdefinitely helpful to have a
doctor relationship that you canhave you at with or like
hopefully you can have aconversation with the doctor
where they understand your goalsand you guys can come to a
decision about whether or notit's meaningful.
Speaker 2 (05:24):
Yeah, i had a friend whose number was low and she had
no problem conceiving it as twochildren, so I think it can be,
can swing either way of the pen, whatever that pendulum swing.
Speaker 1 (05:37):
Sarah and I were both in the war elite today so we're
trying to answer your questions, but also, we are tired, and so
good luck to you for listening.
Okay, sarah, out of my annuals,a listener wrote in do you
judge me for wearing mismatchedsocks?
Oh my god, i would be judgedall day, every day of my life.
How prepared does my huja needto be at an annual exam?
(06:02):
What do you think, sarah?
Speaker 2 (06:04):
People apologize all the time, like as we're getting
to that, like I'm just so sorry,i haven't shaved.
It sounds like neither have Isince New Year's.
I'm not part of her.
I haven't shaved.
Speaker 1 (06:15):
I am partner and he said he loves me anyway.
So there we go.
Speaker 2 (06:19):
But people apologize all the time, like I actually
don't care at all.
Speaker 1 (06:23):
Also, i cannot remember, like I do not register
it.
Like I could not tell you whatanyone's huja looks like unless
I documented it in a note.
is like an abnormal finding.
Yeah, like, do not comment onhair, like nothing of the sort.
Speaker 2 (06:38):
Yeah, we don't care about grooming status at all.
And more people will say likeoh, you know, i didn't shave my
legs, or even like we don't.
I don't bitch that stuff at all.
Speaker 1 (06:51):
Okay, i'm laughing because we took notes on these
questions and Sarah wrote maybedon't go four to five days
without shower right, yeah, well, people like I did shower this
morning I was like that's okay,but like is it been a few?
Speaker 2 (07:02):
like been in shower yesterday, yeah.
Speaker 1 (07:04):
I mean, you don't have access to shower, it's
totally fine.
But I think the general conceptis like overall, good hygiene
is good, you just don't need todo it for us.
Speaker 2 (07:13):
And we've literally seen everything.
There's very little that cansurprise us.
Like you know, we've had visitsfor moving foreign bodies from
the vagina.
Speaker 1 (07:25):
Which is also one of my greatest fears that I left in
a tampon.
Really, yeah, you never havethat fear.
Speaker 2 (07:33):
No.
Speaker 1 (07:34):
Oh, i'm constantly afraid I have something.
Speaker 2 (07:36):
I'm just like so psychotic about it.
Speaker 1 (07:38):
What do you mean?
What does that mean?
like every night you like feelaround me and turn on things
there.
Speaker 2 (07:43):
You have like a journal.
Speaker 1 (07:45):
I tampon in tampon out, but I'm not sure it does
have a journal.
Well, i know probably.
Speaker 2 (07:50):
Well, i know I have an IUD, so I have been using
tampon in like nine years.
That's true, but those visitsare really fun actually Finding
it?
Speaker 1 (07:57):
Yeah, because you're like hurry The patient's so
mortified, but I'm like this isfun.
Because it's like quick tricks.
You're like oh, we got you.
We're like our picture comes inall the way.
Speaker 2 (08:08):
My discharge has been smelling abnormal for weeks.
Something's wrong.
Speaker 1 (08:13):
That is satisfying Where you're like.
well, this is it.
This is it.
Now we won't have a problemanymore.
Speaker 2 (08:18):
It's because you left your diva cup in for three
weeks.
I have you had that.
Speaker 1 (08:21):
Yeah, i went to A diva cup too.
I gotta try out this diva cupstitch.
It hurt.
Oh, you tried it.
Yeah, whatever Like, just sitin the back.
Maybe I need to see a blowerspecialist.
Speaker 2 (08:34):
It's because Eric and my cousin swears like that.
I was like mm-hmm, i evenlooped it up.
Okay, you did, yeah You'relooping everything.
It's because I have pelvicfloor dyslexia.
I can't relax.
Speaker 1 (08:49):
We'll work out later.
Speaker 2 (08:50):
I'm too high, strong, okay, you want to loop?
Speaker 1 (08:52):
Okay, where are we with our specialist?
Okay, so yeah, we don't care,be comfortable.
Speaker 2 (08:56):
We've had, you know, humans like stool on us, pee on
us, bleed on us retreat for anouttakes.
Speaker 1 (09:02):
Last time I peed in my mouth.
Speaker 2 (09:04):
Oh god, yep, it's happened On labor delivery, not
at a GYN visit, oh No.
Speaker 1 (09:12):
Well, the labor delivery was like into my mouth,
but otherwise it was on my face.
Speaker 2 (09:17):
Really Yeah, but you know what?
Speaker 1 (09:19):
I couldn't even tell you who.
Like I don't remember who Ijust remember the sweet nurse
walking over and like patting myface Which is how much we
associate these things with youspecifically like literally zero
.
Speaker 2 (09:33):
Okay does it matter if I?
Speaker 1 (09:34):
have my period on my pap Sarah.
Speaker 2 (09:36):
Someone wants to know In general, no, i will let the
patient know.
there is a possibility thatwhen we do the pap smear, that
there will be too much blood,obscuring them from seeing the
cervical cells.
So remember pap smear is thecervix at the end of the vagina.
So if you think of the vaginalike a tunnel, at the very end
of the tunnel is like a donutshaped organ.
(09:57):
We use a brush literally tojust brush the cervix.
Like this I'll brush it in myforehead Just to pick up cells.
We swirl them in a little jarof fluid and then the
pathologist like identifies thecells.
But if there's too many redblood cells they don't have a
harder time.
But in all honesty, whensomebody's on their period we
just brush the blood away andthen do the pap smear, but on
(10:21):
occasion a handful, likeliterally just a handful of
times a year.
It will say insufficient orobscuring blood.
Speaker 1 (10:28):
It's very uncommon And then you just have to do it
again.
Yeah, and also at the cytologylab where they read it, they
have a reagent they put on it toget rid of the blood.
So they also try to minimizeany effect that has.
But my, i have my friends whotold me there are doctors
automatically canceled theirappointments because they were
on their period, which I wouldnever do.
That I wouldn't do that either.
Speaker 2 (10:50):
That's odd.
Okay, am I too old to freeze myeggs?
When does the age interval foregg freezing Guys?
Speaker 1 (10:57):
Did you?
Speaker 2 (10:58):
This is such a sad question.
You guys do we not answer thison episode one?
Come on.
Speaker 1 (11:03):
But it's sad so we should answer again One I always
I had a big problem with usingthe word old because you're not
old.
Our bodies just do differentthings at different times.
Speaker 2 (11:15):
Normal Sarah's old, but the rest.
Speaker 1 (11:19):
Sarah's young.
Sarah has young, beautiful body, including your eggs.
But yeah, our bodies just dodifferent things at different
times.
So We also live longer than weused to.
We do things at a differenttime in our lives and our
reproductive systems have notcaught up.
So, like I hate like the wordGeriatric or I refuse to write
(11:41):
advanced internally, but I'mlike it's not advanced.
It's not advanced.
Being 35 is not advanced.
Speaker 2 (11:46):
That's like.
anyway, I won't write perStereolization oh, I hate that.
Speaker 1 (11:52):
I hate what.
Am I?
a cow, Yeah what?
Speaker 2 (11:56):
Yeah, I'm a contraception.
Speaker 1 (11:59):
Anyway.
So you're not old, regardlessof what I'm about to say, but I
will say that Ideally you woulddo it before 37 and really, if
you're thinking far ahead, i'dsay like 33, 34 is a great time,
but before 37, at 37, ourfertility really does decline a
good bit.
(12:19):
After 40 declines a lot.
So many REI doctors, who arethe ones who do freeze your eggs
, won't do it after 40.
There are always exceptions, soit might be worth having a
conversation if you're after 40and that's something that's
still of interest to you.
That doesn't mean there areoptions like you can.
If you really do want to have ababy and be pregnant, you can
(12:40):
do donor egg.
There are other things that youdefinitely can do, but I would
say, because just 40 is thenumber to be thinking ahead too,
Remember as we get older.
Speaker 2 (12:52):
Well, no, sorry advance.
As we become geriatric as myphone talks, wears off.
You three Minds extends to six,seven months.
Speaker 1 (13:08):
Sarah, it's been a year.
Speaker 2 (13:09):
Yeah, it just people how your forehead won't move.
I think it's.
I think it's because I've beenusing my robot.
Monotone face with more youhave.
Oh.
Speaker 1 (13:21):
You like, trained yourself not to use your
forehead.
I just give people dead face.
I've been doing that too, likethis is how I smile now.
Speaker 2 (13:29):
I don't even smile.
I can't risk the wrinkles.
Speaker 1 (13:31):
I'm just kidding, i'm not kidding, we're doing well
with this aging process.
Hey, we're with you.
Oh god, like kept talking aboutBotox.
And then Adam, which I've hadBotox once.
No shame, though I honestlyreally want it again.
I've had it multiple times.
Um, and Adam, poor Adam, who'slike, looks very young for his
(13:53):
age.
My fiance was like I think I'mtalking like no, i don't have my
craziness from off my face.
It's perfect.
Speaker 2 (14:02):
Okay, oh, wait questions.
But I just want to say, and thereason we don't recommend doing
it too, too much later in life,like late 30s, is because
remember, you have fewer eggsand the eggs that remain are
Generally less like like higherchance of being genetically
abnormal, abnormal.
So it's just you're gonna endup doing more cycles if you're
(14:24):
not gonna be as successful andretrieve as many good, healthy
eggs late.
Later on, later on versus a 33,34 year old or somebody younger,
then that's the reason behindit and those eggs that are
Genetically abnormal or lesslikely to form an embryo
implants.
Speaker 1 (14:41):
You're just less likely to get pregnant.
Yeah, okay, okay, yes.
So this these are listeners whoclearly listen to our lecture
called an electric Young person.
Speaker 2 (14:53):
Yes young woman who submitted.
Speaker 1 (14:54):
I'm just kidding This person wants to know what are
things that can go wrong withegg freezing.
Can I lose my ovaries?
Speaker 2 (15:01):
Well, So remember, when you're doing your egg
freeze, you're essentially,essentially when you're having a
regular cycle, not egg freezingyour body is sending hormones
to your ovaries to make oneSuper egg that you ovulate most,
most people just ovulate See myhands.
Speaker 1 (15:20):
I'm like People just saw my armpit hair.
I don't know.
Provence, when I'm really ourPeruvian tearless.
Speaker 2 (15:29):
We are like minimal hair.
Speaker 1 (15:31):
Oh, indians are all about it.
I love you know.
I don't know why, cuz it's hotthere, but we didn't not for
lack of hair.
I'm barely shave, anyways,that's true.
Anyways, okay, what was thequestion?
Speaker 2 (15:44):
Oh, yeah, so remember , every month you literally just
you know Superproduce one egg.
But when you're going throughan egg freeze cycle or IVF,
they're trying to super producemany eggs at one time, and so
your ovaries, you know, grow insize by 10 times.
They get to the size ofgrapefruits.
(16:04):
And so the risks in this is youend up producing a lot of fluid
in your belly And your eggs areso big that they could
accidentally turn on themselves.
That's called ovarian torsion,and so that could be an uncommon
risk, but a theoretical risk,and that's a surgical emergency,
you would know, because you'dbe in a lot of pain, you'd be in
(16:26):
a lot of discomfort, you'd becrouching over, very
uncomfortable.
So that is theoretically a riskand if it did happen it's a
surgical emergency.
Other things You know duringyour procedure, when they're
actually retrieving the eggs,they put a vaginal probe, while
you're asleep, into the vaginaAnd then the probe has a needle
attached to it, a very smallneedle that Punctures the the
(16:47):
top of the vagina and entersinto the abdomen and then
punctures the ovary to kind ofaspirate, suck out The eggs.
In doing so there's somebleeding.
That happens.
In general, the bleeding isminimal and you'll feel a little
discomfort, but in some casesit can be a lot, and then you
can have bleeding in yourabdomen and that might require
surgery or a procedure.
Speaker 1 (17:08):
These are uncommon.
Yeah, i'd say, all these thingsare super rare And the past.
Speaker 2 (17:13):
They would really pump up the hormones and people
would get admitted for being toohyper stimulated.
This doesn't happen as much asbefore, it's just super uncommon
.
Speaker 1 (17:22):
Now There's so much more like careful decision
making, better understanding ofhow much medication everyone
needs We're just better atmedicine, basically.
So, everything comes with risk,but in general, egg freezing is
really safe.
Speaker 2 (17:34):
Okay, okay, so I had no issues conceiving the first
time and couldn't, but now can'tget pregnant the second time.
Why?
Speaker 1 (17:45):
So crappy.
It's so tough when you'retrying to get pregnant and you
have trouble, especially whenit's unexpected.
We would call that secondaryinfertility.
So, and again, i hate the wordinfertility Really.
I write like fertility concerns.
Speaker 2 (18:00):
I write difficulty conceiving.
I do that too, actually.
I write difficulty conceiving.
I just feel like it's so cruel.
Or it's kind of like whenpeople write they failed their
glucose test and pregnancy.
It is failed.
I don't write for it, i justsay did not pass.
Speaker 1 (18:15):
But okay, so we call it technically, called it
secondary infertility, althoughif Sarah and I are not there
we'll probably try not to saythat word to you.
But that's basically when youhad one pregnancy where you got
pregnant spontaneously And thesecond pregnancy you weren't
able to for over a year, or insome cases, six months,
(18:36):
depending on the situation.
And there are a lot of reasonsthat can happen, although often
we're just not sure.
So reasons can be issues withthe structures in your body, so
scarring in the uterus, scarringon the tubes that don't allow
either the egg to get into theuterus via the tube or don't
allow for implantation, don'tallow for the sperm to join the
(18:58):
egg.
So that can be it.
Some people experience what wecall premature ovarian failure,
which basically is kind of likean early menopause, like your
eggs and ovaries just startacting like they're going
through menopause in an ageperiod, in your 30s.
Speaker 2 (19:15):
That's super, uncommon Super rare.
Speaker 1 (19:17):
And then there are genetic abnormalities.
So some people have geneticabnormalities in the mom and the
dad if it's a cisgender coupleand the combination of those
genes together predisposes themto things like miscarriages, So
that's possible too.
also really rare.
And then some people just haveunexplained infertility.
(19:38):
In general, about 10 to 20% ofpeople who have infertility have
unexplained infertility, whichbasically means all of your
testing is normal, We don't knowwhy.
We just have trouble gettingpregnant And in those cases they
have the most success doing IVF.
Speaker 2 (19:56):
And your doctor can do some of this work up for you.
but if you're having regularcycles and you're still not able
to get pregnant, with regularcycles meaning you're ovulating,
your ovulation predictor kitsare positive and all your
testing is normal, there's verylittle your OBGYN is actually
going to be able to do for you.
So I tell my patients that thisis happening.
We can either do your work upat a fertility center I can do
(20:18):
it for you but again, we'll getto the fertility center, it's
just there's not anything I cando for you.
Speaker 1 (20:23):
And when Sarah says nothing I can do for you.
She just means in general islike not the world but just we
would refer you to someone whodid three more years of training
than we did in fertilityscience.
Okay, so someone wants to know,sarah, how long they have to
wait after getting their IDremoved to get pregnant?
Speaker 2 (20:45):
Um nothing, it's just get it popping.
Speaker 1 (20:48):
Yeah.
Speaker 2 (20:50):
Because, remember, when you have the IUD, the way
it works is it's a local effect,meaning it's just really having
hormonal effects in your uterus.
It's not like the pill or depotor the implant where it's
tricking your brain andaffecting all of your hormones.
It's really a local effect.
And so what?
most people are still ovulatingwhen they're on the IUD
actually.
So when you remove the IUD, youmay have a delay in your period
(21:14):
coming back, but it's usuallynot because you're not ovulating
, but it's because the IUD hasreally thinned out the lining of
the uterus And that's whypeople don't bleed while they
have an IUD.
But I've had people getpregnant without even having a
period because they're stillovulating.
Speaker 1 (21:28):
Yeah, There's no hard and past guidance about it.
I often recommend people waituntil one period only because we
date pregnancies from your lastmenstrual period, so if you get
pregnant before that period,it's hard to know when your
pregnancy started, but notdangerous to get pregnant sooner
.
Speaker 2 (21:47):
And some people do stop ovulating when they're on
the IUD, usually in the firstfew years after insertion, but
so those people might have alittle bit of delay in return of
, you know, population andfertility.
But in general most people canconceive the same way as the
general population without anIUD does.
Speaker 1 (22:07):
Okay, And this leads to another question via listener
Can an IUD affect my fertility?
And the answer is no, it doesnot affect your ability to
appropriate at all.
Get the IUD out, have yourbabies get at it.
Yeah, the only thing I would sayis that, because a lot of
people stop having a menstrualperiod when they have an IUD,
(22:30):
sometimes you're not as aware oflike natural changes in your
cycle.
So if you are someone withreally irregular bleeding or if
you're just going through otherchanges, you might not be keyed
into that as quickly because theIUD is masking what you would
be doing without hormones, butthat's still really rare.
Speaker 2 (22:51):
And then do I have to urinate after sex?
Speaker 1 (22:54):
Sarah says yes, she says she has to urinate
immediately, otherwise she's UTIcentral.
Speaker 2 (23:00):
But nine UTIs in my early 20s.
Speaker 1 (23:03):
Nine.
Oh my God, that's so rough,Sarah.
Wait, how do you know nine Youcounted.
Speaker 2 (23:09):
Yeah.
Speaker 1 (23:10):
So you kept again a journal or what.
You counted only, so I was like, today was UTI number five.
Speaker 2 (23:16):
I was like does my urgent care?
was like oh God.
I was like I just went to bedafter I couldn't get on
no-transcript.
Speaker 1 (23:25):
Okay.
So basically the concern is forhaving recurrent UTIs, which
means you either had two UTIs ormore in six months or three or
more in a year, and some peopleare really prone to this, other
people not as much.
When you look at big studies,actually peeing after sex was
not a consistent thing.
(23:46):
That stopped UTIs.
But some people it matters morethan others And I'd say the
risk is low, like it's not thathard to pee after sex.
So we often encourage it,especially for people who are
prone to UTIs.
But evidence is out whether itreally makes a difference.
Sarah doesn't believe me.
Speaker 2 (24:03):
Okay, because think about this When you're being
intimate with somebody, you knowall the fluids you produce
lubrication and that fluid youknow your vaginal opening is
literally right next to yoururethral opening.
Speaker 1 (24:16):
Okay, sarah's going to do another study, another.
Okay, she's not biased at allon what the results will be, but
so far the studies don't agree.
Well, that matters foreverybody.
Speaker 2 (24:25):
The anus is really close, to you know.
Speaker 1 (24:28):
I'm just saying the holes are close.
Okay, yeah, so this is anotherthing.
a lot of people talk aboutdirection, of wiping front to
back to what you were doing backto front, were you really?
I actually I've like recentlymessed it up and I tried to
counsel someone to do it back tofront and they were like wait,
(24:51):
you mean front to back?
And I was like yeah, i do meanfront, i don't think I even
wiped.
Speaker 2 (24:57):
I just like blot.
Now I'm afraid I'm messed up.
Speaker 1 (25:02):
You're right.
That's why you blot, i blot,okay, i support you, okay, but
so front to back is better.
But again, the research is out,whether or not it really
affects your.
UTI risk.
The big controlled studiesdon't really show that it makes
a difference, but no harm indoing it And it could make a
difference for you, things thatdo matter, that have been proven
(25:25):
.
You're crying?
No, i just whatever evidencebased whatever is.
Drink lots and lots of water,like two to three liters of
water.
Avoid things like spermicidereliant, other methods of birth
control.
It's like those are like twothings that matter.
And then if you are someone whorepeatedly gets infection,
(25:45):
sometimes your doctor might putyou on an antibiotic for right
after sex.
That can help.
Or if you're someone aftermenopause, sometimes things like
estrogen crink can matter.
Speaker 2 (25:56):
Big fan of that Okay good We're on, the sir and I are
aligned.
Speaker 1 (26:01):
Okay, Sarah, who needs an anal pap?
I actually want to know thisbecause I don't know.
Okay, okay.
Speaker 2 (26:07):
So anal pap smears are, in reference to screening
for anal, pre cancer, kind oflike cervical.
The reason we get pap smearsit's of our cervix.
We're screening it for cervicalcancer.
So there are certain parts ofour bodies that we can
fortunately screen for cancer,meaning we can do things to
detect it early, like breastcancer, colon cancer, cervical
(26:30):
cancer.
So for things that are causedby HPV or affected by HPV the
cervix, the vagina, the vulvaand the anus you can sometimes
detect those early with certaintests, like cervical cancer
screening with pap smears.
And so if somebody has a historyof abnormal pap smears and
(26:52):
there's different degrees,there's low grade abnormalities
and high grade abnormalities ifyou have a high grade
abnormality of the cervix, youshould get an anal pap smear.
Or if you had a high gradeabnormality of the vulva or the
vagina a lot of people thescreening for that is a little
bit different.
It's mostly oh, i saw a mole orsomething abnormal on the vulva
(27:13):
, biopsie it Okay.
so it's really only diagnosedin the moment.
But if you had high grade ofthe vulva, of the vagina or the
cervix you should be doing ananal pap smear.
Speaker 1 (27:24):
And it's okay, and we were talking about how often
men, which there are a billiondifferent societies, a billion
different suggestions, but noone has really agreed upon
anything But probably, if you dofall under one of those
categories that you mentioned,you should start yearly and then
have a discussion with howoften.
Speaker 2 (27:43):
Yeah, And there's so many different societies and
they're going to finally come upwith one standard census And
actually an anal pap smear iseasier than a cervical pap smear
.
Speaker 1 (27:52):
Because you don't have to have anything stuck in
the anus.
Well, a brush Except for thebrush, but the brush is
different Device.
Speaker 2 (27:57):
It's a Q tip.
It's not the brush that theyuse for the pap smear, that's
cervical pap smear And you don'thave to put an instrument in
the anus.
It's literally just you moistena Q tip, you put it into the
anus about four, seven, likefour to five centimeters.
It's really not that bad.
Speaker 1 (28:12):
I was laughing because of your hand.
Speaker 2 (28:13):
I'm sure It's really not that bad.
And then you just go, you knowa little into the anus and then
you swirl it out.
It's really not that bad, swirlit out.
Speaker 1 (28:21):
Yeah, i hear it, you hear it.
Okay.
And then what all do I needswab for STDs.
You got to swab every holeyou're using Yep, mouth, vagina,
anus, all of it Okay.
And then there's also bloodtesting that you can do, so But
do you swap all the other?
holes Like I should, but Idon't always, but sometimes I do
(28:45):
.
There's a lot of oral chlamydia, like a lot.
I know, yeah, and no one everswaps for it.
So, yeah, you should get it allswabbed.
If you're, you know, puttingthings in your mouth, then put
this brush in your mouth too.
Well, okay, i got to go swabmyself.
Then you want me to swab you?
To be decided, we'll decidelater.
(29:06):
All right, those are all thequestions.
So if anyone has more questions, feel free to DM us on
Instagram.
We're at Jin and Tonic podcast.
Jin's spell GYN.
You can comment in our YouTubesame name And that's all.
(29:27):
We'll get back to you.
Thanks for the questions, loveyou.
I'll see you in the next G.
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