SEX SLANGS AND QUESTIONS FOR MY OBGYN | EP. 06

Dr. Lehua Perry and Dr. Cass Nakasone drill down on the top 10 questions women are afraid to ask their OB.  Dr. Cass also gets the 411 on sex slangs.  What the heck is a falcon punch WHY a rusty trombone?

Transcript

SPEAKER_04 0:00

Do you know? I don't even know. Can we say these words on like the podcast like vagina? Sure. I mean, we just talked about butts for half an hour. I think we're okay. Normally at baseline, every woman has discharge. I don't think that's a well-known fact out there. The 10 things I'm too embarrassed to ask my OB. Is my vaginal odor normal? I wish men had to go through something, right? Because men don't go through. Yeah, we we do have- They even took away rectal exams now, you know?

SPEAKER_00 0:28

Yes. I'm very, very happy.

SPEAKER_04 0:30

Can we give you something? We get mammograms, our boobs get squeezed. You know? Like we have vaginal exam. That's not fun. It's like a thing that they donkey punch each other. Why do I call a donkey? I don't even know. Why?

SPEAKER_00 0:45

I don't know. I have no idea.

SPEAKER_04 1:01

Hello again and welcome to our podcast from the inside out. Um Dr. Nakasone is here. Uh we are gonna talk about a very interesting subject today.

SPEAKER_01 1:14

So today, our our um our how should I say our spotlight will actually be Dr. Dr. Lehold Perry, who's gonna talk to us about the top 10.

SPEAKER_04 1:25

Well, the top I'm gonna kind of first go into it. Uh we're gonna talk about some what I call the self-cleaning oven. And then we're gonna move into some questions that people have, the top 10 questions that I'm too afraid to ask my OB.

SPEAKER_01 1:40

Okay. Or too embarrassed to ask my OB.

SPEAKER_04 1:42

Yeah, too embarrassed.

SPEAKER_01 1:43

This is uh I'm gonna be all ears because I I have obviously no idea.

SPEAKER_04 1:47

But jump in anytime. This is very like a chill topic, but super important because um I'm talking about vaginitis today.

SPEAKER_01 1:56

Okay. And can you tell everyone what vaginitis is?

SPEAKER_04 1:59

You know, I don't even know. Can we say these words on like the podcast? Like vagina and sure.

SPEAKER_01 2:04

You can't you okay. These are I was just wondering. Right. But I'm like wondering what the if we get if we get whatever, I guess. Uh I do we get like censored? I have no idea.

SPEAKER_04 2:15

I don't either.

SPEAKER_01 2:16

Yeah. No? Oh, okay, okay. They will let us know.

SPEAKER_04 2:19

I mean, we just talked about butts for half an hour. I think we're okay.

SPEAKER_01 2:22

But I think these are all medical. They really are. They're they're they're not uh bad words or anything. Not at all. These are true words.

SPEAKER_04 2:29

So they are, and the words we everybody should be using.

SPEAKER_01 2:32

So so for the audience, what what is vaginitis?

SPEAKER_04 2:36

Vaginitis, okay. So this is something that I see is probably my most common reason for coming in. Um, I see this maybe I would say like it's about 50% of my day usually is just vaginitis. Um, so I call the vagina a self-cleaning oven. Okay. Um what is we'll start with what is vaginal discharge, okay? Because basically we're talking about discharge. I know gross, ill, sorry, but it's not gross at all. But what is vaginitis? Yeah. Okay, well, I'll go with vaginal discharge first and then we'll go with vaginitis. Okay. Um, so vaginal discharge is like a fluid that's kind of made by the cervix and the the glands of the vagina.

SPEAKER_02 3:22

Okay.

SPEAKER_04 3:22

And basically, every woman has discharge.

unknown 3:26

Okay.

SPEAKER_04 3:27

Okay, men out there. It's not gross, it's not weird. Every woman has discharge. Okay. And you're supposed to have discharge because it's normal. Okay. So normally at baseline, every woman has discharge. I don't think that's a well-known fact out there. I don't know, right?

SPEAKER_01 3:44

And it and and I'm sure it it varies in terms of discharge.

SPEAKER_04 3:47

It is there's a very large range in what is considered normal as far as discharges.

SPEAKER_01 3:52

Some people could be drier, some people could be way more than a few. Correct.

SPEAKER_04 3:56

So it discharges between a person to person.

SPEAKER_01 3:59

Okay.

SPEAKER_04 3:59

So it's either you can have a watery discharge, you can have a thicker discharge, it can be pasty or like thick, depending on hormonal changes.

SPEAKER_00 4:07

Okay.

SPEAKER_04 4:08

Usually it's kind of like a whitish kind of color. It's that's fine. Um, it removes dead cells, it removes bacteria, it provides moisture, and it maintains like a very balanced environment in the vagina. So we like discharge. Um, but it I guess it's not a well-known fact that you're kind of supposed to have it.

SPEAKER_00 4:28

Okay.

SPEAKER_04 4:29

So um, what is vaginitis? Okay. So vaginitis is like an abnormal discharge. So um it's inflammation or infection of the vagina associated with symptoms like itching or burning, um, dyspyrunia, which means painful intercourse. A lot of times um it will have an odor that's not your natural order, so it's very fishy in nature.

SPEAKER_01 4:54

I I think for the audience, um, it's uh anything that ends with itis, vaginitis, usually refers to some kind of inflammation.

SPEAKER_03 5:03

So yeah, we don't like the itis.

SPEAKER_01 5:06

Yeah. Iritis is inflammation of your iris.

SPEAKER_04 5:10

Iris.

SPEAKER_01 5:11

Yeah.

SPEAKER_04 5:11

Iritis.

SPEAKER_01 5:12

Yeah, but there's no such thing as penis itis. Yeah. As far as I know, there's a I'm sure there is. No, there I'm sure there is.

SPEAKER_04 5:25

Yeah. Anyway.

SPEAKER_01 5:26

Anyway.

SPEAKER_04 5:27

So yeah, this is one of the most frequent things that I see, reasons for a visit. So um basically, we're just gonna talk about symptoms, diagnosis, and like how we treat vaginitis. Okay. And this is for just a disclaimer, this is for non-pregnant people and people without HIV, because both of those things change the um treatment of vaginitis.

SPEAKER_01 5:48

Wait, wait, sorry, say that again.

SPEAKER_04 5:49

Pregnant people and HIV.

SPEAKER_01 5:51

Okay.

SPEAKER_04 5:52

Um, those things change the way we treat vaginitis.

SPEAKER_01 5:57

Why why why is that?

SPEAKER_04 5:58

Why is pregnant we can't use the same medications. Medications. No, no, not necessarily. Sometimes we can.

SPEAKER_01 6:03

But then HIV too. And this is mostly to protect the baby. Is that why?

SPEAKER_04 6:09

Yeah, well, we need to treat it. We can treat it, but we just have to treat it in a different way. So this what I'm talking about is just non-pregnant individuals and non-immunocompromised individuals.

SPEAKER_01 6:20

Okay, what what's uh I'm I don't know enough about the HIV and uh vaginitis relationships. Like what's what's it's a different treatment again.

SPEAKER_04 6:28

It's a different treatment because they're not they're immunocompromised heavily, right? So it's just a different treatment. So this is just like the normal Sally Joe that comes in.

SPEAKER_01 6:38

Okay. Yeah. Okay, so we're not picking on Sally Joe.

SPEAKER_04 6:42

No, I'm sorry. I didn't know I just picked any name out of a hat. I'm sorry, Sally. I was gonna say Joe Schmoe, but that's not a woman. Yes, you know, so can I use Joe Schmoel? True. Sorry. Okay, no Sally Joe. Anyway, there are okay, so there are the three most common things that we talk about when we talk about vaginitis, okay? One is bacterial vaginitis. Okay, that's the most common. The second is like a yeast infection that causes vaginitis. And then also the third most common reason is trickom trichomoniasis. So we call it trick.

SPEAKER_01 7:18

Okay.

SPEAKER_04 7:19

Okay.

SPEAKER_01 7:19

Okay, so I'm really trying hard not to have a. I'm sorry. I will I will try to remain as professional as possible.

SPEAKER_04 7:28

Yeah.

SPEAKER_01 7:29

Yeah.

SPEAKER_04 7:29

So, you know, we we talk about estrogen being very important to the vagina. Okay. Uh, estrogen is very crucial in keeping the vagina very happy. Okay. So usually you'll see um all of these vaginitis kind of things coming up in the reproductive years because we have a lot of estrogen there.

SPEAKER_02 7:46

Okay.

SPEAKER_04 7:47

But it helps to keep like the flora and the bacteria all happy. Okay. And then our vagina is at a pH of less than 4.5 usually.

SPEAKER_01 7:59

Okay.

SPEAKER_04 7:59

Did you know our pH? We have a vaginal pH that our vagina is happy.

SPEAKER_01 8:03

I remember learning about this at one time.

SPEAKER_04 8:05

Yes. So, you know, it it it keeps um estrogen helps to just keep the vagina very happy.

SPEAKER_00 8:13

Okay.

SPEAKER_04 8:13

Um, and have the good bacteria kind of flourishing.

SPEAKER_00 8:16

Okay.

SPEAKER_04 8:17

Okay. And so they're and keeping the vagina in a very ecstatic environment. So like bad things can't grow as much. So you won't find vaginitis that much. You can't it it's rare, but you do see it, but not as often as like a reproductive year, but you can see it in the younger girls and the really old ladies, but older ladies.

SPEAKER_01 8:36

I think also, just for the audience, a normal or a neutral pH is seven.

SPEAKER_04 8:42

Yes.

SPEAKER_01 8:42

Okay, so just so that the audience knows, seven is like neutral.

SPEAKER_04 8:48

Yes.

SPEAKER_01 8:49

Right? I don't know if for those of you who have been.

SPEAKER_04 8:51

Oh, thank you for explaining this.

SPEAKER_01 8:52

I have never taken chemistry or anything like that, but there's seven is neutral.

SPEAKER_02 8:56

Yep.

SPEAKER_01 8:57

If you go higher than seven, it becomes more basic, okay, or alkaline. So you for those of you who have bought water from Costco, for example, the uh a new fat or what rage is you buy alkaline water. So you notice that the water's pH at Costco or nine or wherever you're buying it is about nine.

SPEAKER_04 9:16

Nine, yeah.

SPEAKER_01 9:16

Okay, so that would be basic. So anything below seven is more acidic. So a four point, what do you say? Four point five is actually quite acidic.

SPEAKER_04 9:26

It kind of is. Thinking about that, right? Like on the on the pH.

SPEAKER_01 9:29

I'm surprised that doesn't burn people.

SPEAKER_04 9:33

I mean, it's not to that point. Yeah, it's not to that point. Like vinegar is like a what, maybe like a one or something. I don't know.

SPEAKER_01 9:38

I don't know, but I I'm shocked, I'm actually surprised at how low that is.

SPEAKER_04 9:42

It's a very low acidic environment, but for a purpose, because you know, certain good bacteria ther thrives there, and then in acidic environments, you don't get as much bacterial growth, right?

SPEAKER_01 9:53

Yeah.

SPEAKER_04 9:54

If you think about it. So, yeah. So we'll talk about the big bad BV. So this is bacterial vaginosis. Okay. It's the number one reason why we would have vaginitis. It's the most common um cause of abnormal discharge.

SPEAKER_01 10:08

And did you say that this takes up 50% of your maybe? I would say 30 to 40 percent.

SPEAKER_04 10:13

I would say 30, 40 of my visits.

SPEAKER_01 10:18

Oh, okay.

SPEAKER_04 10:19

Yeah, people always come in, which is great. We want people to come in if you have a a different sort of discharge, if it's smelly, if it's stinky, if it's itchy. You know, women are very in tune with their bodies, and so when something's off, and it can be really uncomfortable. Uh okay.

SPEAKER_01 10:35

But that high.

SPEAKER_04 10:37

Yeah.

SPEAKER_01 10:38

This is this this makes me very happy that I'm in orthopedics. Oh, thank you.

SPEAKER_03 10:42

Really?

SPEAKER_01 10:42

Yes.

SPEAKER_03 10:43

I don't know. I don't, I don't know if I could do what you do.

SPEAKER_01 10:47

I love what I do. I don't, yeah, see, and that's why people pick different specialties. That is true. They say that in uh we were just talking about this. OBGYN is probably like 75 to 80 percent female.

SPEAKER_04 10:58

Yes.

SPEAKER_01 10:59

Orthopedics is probably the opposite. Opposite, right? With uh a low women. Like we're actually trying to get more.

SPEAKER_04 11:06

Do you guys have a percentage? Like how many women's pretty low though.

SPEAKER_01 11:09

I I can't imagine. I I would imagine it's like engineering. Engineering schools, like at Caltech, and at least when I was there, it was like a uh six to one boy to girl ratio. Wow, just because girls generally don't like they don't go into certain specialties.

SPEAKER_04 11:23

It's just well, that one's very physical, you're especially super physical, and like but we've been trying to get more. Also, the engineering mind is very difficult for people, you know, people just everybody gravitates to a different specialty depending on what they're using. Like, I'm not good with math and physics, like it's not a good idea.

SPEAKER_01 11:39

I would not be good with vaginitis.

SPEAKER_04 11:41

Oh, yes, so we're in the perfect fields for ourselves. So, yeah, so people come in. Um, the most common um kind of symptoms that people come in with bacterial vaginosis, um, or we call it BV, people will come in saying, Hey doc, I have a different sort of discharge. It's very watery, um, thin, kind of grayish sometimes. And the most common thing I hear is it smells like fish. So it's like a fishy, stinky discharge. Okay. That is usually BV right off the bat. Okay. Um, we can diagnose it in many different ways. Some do still old school, where we do a swab and then we put it on a microscope and we look at it in the office and we're looking for certain cells. Um, but most times nowadays we just do a little swabby swab, okay, send it off. But you can kind of tell just uh on the exam the type of discharge, and if there's like a malodorous discharge, and you can just kind of tell. But that's how we diagnose it. And then um we can treat it with some just some oral metronidazole, or you can do some inserts. Okay, and uh you can do that for a few days.

SPEAKER_01 12:51

Sorry, what what what are the inserts just for people who um they're metronidazole inserts. Meaning like you put the pill into the vagina, so it's like a suppository. Oh, okay. Yeah, into the vagina.

SPEAKER_04 13:01

Yeah, yeah. All the way up there.

SPEAKER_01 13:03

Yeah, just to make sure because some people want to hear suppository, they might think that they stick the pill in their butt and it'll cure their vagina.

SPEAKER_04 13:10

So there's rectal suppositories and then there's vaginal suppositories.

SPEAKER_01 13:13

So just that that's I think we should be clear about that.

SPEAKER_04 13:15

Yes, thank you. Thank you. So there are some people though that you treat BV and then it just keeps coming back.

unknown 13:21

Okay.

SPEAKER_01 13:22

And how, sorry, how does this how does this happen?

SPEAKER_04 13:25

Oh, yeah, so BV, sorry, it's not a true infection, but it's a change in the normal microbiome like we were talking about.

SPEAKER_01 13:32

So then there's an imbalance of one bacteria that uh overpopulates. Overgrowth. Uh compared to the other flora. Yes, there's a normal flora that every woman has.

SPEAKER_04 13:44

That certain things can change that flora, right?

SPEAKER_01 13:48

But whatever it is, say the pH goes off for a little bit or whatever, and one bacteria becomes dominant when they should be all living in harmony. Yes. Got it.

SPEAKER_04 13:56

We are not in harmony. Got it. Yep. So this one is not a true infection, but it's just a little overgrowth, you know?

SPEAKER_01 14:02

Do you happen to know? I'm just curious, like, what what are like what's like the top three, I don't know, types of bacteria that live in the female.

SPEAKER_04 14:14

Oh, we have tons though. Okay, what we have like the uh it really does. I don't know the uh the specific name of it. There's like lactobacilli blah blah blah.

SPEAKER_01 14:23

Okay, so yeah. So lactobacillus is the one that uh I I remember.

SPEAKER_04 14:28

Yeah.

SPEAKER_01 14:28

Right?

SPEAKER_04 14:29

Yeah, yeah. There's all these these different um But different types of bacteria. Like the top bacteria, but there's tons of lactobacteriums.

SPEAKER_01 14:38

Which is really interesting.

SPEAKER_04 14:40

It's super interesting because there's a lot of all, you know, good bacteria that we think of bacteria we think bad. Yeah, but in this in the vagina and the gut, good, right? Because they both kind of help with the keeping everything really nice and the balance correct. Yeah. Um yeah, so sometimes you we treat the BV and it keeps coming back.

SPEAKER_00 15:03

Okay.

SPEAKER_04 15:04

Um, so there are some things that we can treat as far as like what we call suppressive therapy. So if you have like three or more episodes a year, um, we can give you those inserts kind of twice weekly for a good 16-ish weeks, and then you can kind of we can kind of see it kind of saves off any more infections.

SPEAKER_01 15:23

And the these inserts are they more they're not antibacterials, are they just sort of more It's a metronidazole, you know?

SPEAKER_04 15:30

So it's not an antibiotic. It's not right.

SPEAKER_01 15:33

Yeah, it's it's does it help sort of restore the normal pH? It kind of does. I it does so that the body will self sort of get back to its normal. I see. Oh, interesting.

SPEAKER_04 15:45

But they've done studies. Um, I recommend it usually, but they've done studies which didn't show uh any kind of improvement, but on um on like probiotics, okay, taking like a vaginal probiotic to help, you know, restore the good bacteria and the pH and everything down there. But all the the evidence-based studies don't show that they make a difference, that they really make a difference. But I find like the people with recurrent BV, if they take a probiotic, there's really no harm in it. Again, this is not medical advice, but there's really no harm in taking the probiotic. So, you know, if that's something that you struggle with having recurrent vaginitis.

SPEAKER_01 16:26

And this probiotic is an ingestible form.

SPEAKER_04 16:28

You can have a pill, there's pills, okay, or you can eat things like yogurt with active cultures, you know, like the activa. That's special, yeah. Really? Mm-hmm. Yeah, but active culture yogurts really help with all of the really I thought that was more of a just a I I thought that though that was limited to more of gut stuff, but there's there's a gut one, and then there's actually if uh I tell my patients you have to look for something called like vaginal probiotics.

SPEAKER_02 16:57

Oh, really?

SPEAKER_04 16:58

So it says either vaginal health or women's health. Yeah, those are specific to the vagina.

unknown 17:04

Wow.

SPEAKER_04 17:05

So I I tell my patients to look for something called the women's health or vaginal health um on the bottle and make sure that it's specific to the vaginas.

SPEAKER_01 17:17

And you can find this in like Safeway or Foodline or whatever.

SPEAKER_04 17:20

Yeah, usually more of the health food stores, but a lot of my patients get it on Amazon.

SPEAKER_01 17:25

Oh, okay. Yeah. Wow, I didn't even know that something is.

SPEAKER_04 17:28

And there's like there's different numbers. There's like um millions or billions, usually they go for the higher number of things, but you know, only recurrent kind of stuff, I tell them. Yeah, you know, maybe it's a good idea. Or you eat some more yogurt, you know, get that good bacteria in there naturally too. Yeah. Um, new there's a new recommendation with BV, though. So when we found out that people keep getting BV amongst each other, well, they found that in monogamous relationships, we s we kept seeing, like, you know, you're in a monogamous relationship, but you keep getting this BV. Is there something going on like between the partner? So now they've done a study. Um, it was actually a randomized control study, and they looked at um treatment of just the the female versus treatment of the female and their partner. And what they found was the recurrent BV rate went way down if you treated the partner too. How do you treat the so basically we get the metronidazole and so the partner also gets metronidazole, but now it's recommended metronidazole pills plus a topical cream.

SPEAKER_01 18:43

Thank God. I thought you were gonna say the the guy had to stick the metronidazole in the cream.

SPEAKER_04 18:46

I wish. I wish something men had to go through something. I wish men had to go through something, right? Because men don't go through Yeah, we we do have they even took away rectal exams now, you know? For the prostate.

SPEAKER_00 19:02

Yes, I'm very I'm very, very happy.

SPEAKER_04 19:04

Can we give you something? We get mammograms, our boobs get squeezed, you know? Like we have vaginal exams. That's not fun. It's not fun, yeah.

SPEAKER_01 19:14

I actually uh picked my primary care physician um by looking at the size of their fingers because I thought that you know, since I was getting older, that this was gonna happen. But happily jokes on you! Yeah, happy to report, happy to report that apparently we don't need to do rectal digital rectal exams anymore.

SPEAKER_04 19:30

Yes, everybody's happy.

SPEAKER_01 19:32

Yeah, I'm very happy about it.

SPEAKER_04 19:33

Except the ladies. I'm like, can you? I'm just joking. I can you give the men something that's uncomfortable? There's nothing, even the chlamydia now. Remember, like they got to like stick a q tip way back when. Yes, but now it's just the shishi test, right? So it's like anyway. But yeah, so recurrent partner, uh recurrent um concurrent sexual partner therapy is now a thing. Wow. Uh so if your partner and you and you notice your partner keeps getting BV, it's a good idea for your partners to be treated. To be treated as well. So it's a topical uh cream for the men uh that you put on the penis twice a day, and then it's a metrodizole pair.

SPEAKER_01 20:16

That's kind of interesting because then that means that this this chemical compatibility kind of between people is is kind of a real thing.

SPEAKER_04 20:25

It's a real thing, right? And I've seen patients who have had recurrent BV or recurrent yeast infections with the same partner, and then they have a different partner, and then yeah, because maybe you know the the whatever the pH or whatever the bacterial flora on each individual person either jives or doesn't, yeah.

SPEAKER_01 20:45

That's really interesting.

SPEAKER_04 20:46

I wonder, right?

SPEAKER_01 20:46

Maybe it's the universe telling you that maybe maybe not such a good idea.

unknown 20:52

Yeah.

SPEAKER_04 20:53

Or, you know, you just gotta work harder for that person.

SPEAKER_01 20:56

I guess.

SPEAKER_04 20:57

Okay, so the second uh other type of vaginitis we're gonna talk about is trichomoniasis, and so we call it trick. Um this is a std.

SPEAKER_01 21:07

Okay, yeah. So this one is so this can be this can be uh acquired by performing tricks.

SPEAKER_04 21:15

Yes. Yeah, so yes, I think there's some uh vernacular out there on the right.

SPEAKER_01 21:21

We should put we should put the name of this on there because the the trick that uh you're talking about is TR.

SPEAKER_04 21:26

T R C H. Not trichomoniasis, right? Yeah. So it's a protozoan species that actually infects us, and um, it's the most common non-viral S T S T D in the United States. Um this, you know, if you have more partners or uh lower socioeconomic status or douching, those are all risk factors for trick. Um most people, half of them are asymptomatic, and half have this like weird discharge that's going on. Sometimes you can have um bleeding or abnormal bleeding. Or bleeding after sex. Um trick. So of note, trick is kind of different. So usually, you know, like chlamydia, if you have a STD, you come in, you kind of know who you got the chlamydia from, somebody who you just had intercourse with. Trick is different, it can be a long-term infection. Um, so it's not like you just because you tested positive from trick that this is the partner that necessarily gave it to you. It can kind of stay in there for a while. Yeah. So it's it doesn't mean it's a a newly acquired infection necessarily. Trick can kind of live there for a long time. Because you can be asymptomatic with it.

SPEAKER_01 22:41

So you can be asymptomatic with it and then what like several months later. Years, months, years develop the symptoms symptoms, yeah.

SPEAKER_04 22:51

Or sometimes we just do like a routine swab and it comes up, you know. Yeah, very interesting stuff. Um, this one you can have like maybe a green-yellow discharge, bubbly discharge. Um, we do a swab to detect it. And again, it's uh treatment is metronidazole again. Um, this one, your partner, I mean, you should be tested with it three months after as well. Okay, and then let's talk about the last one is candida or yeast. Okay. Yeast is very popular here in Hawaii, I would say. You know, because we have a warmer environment, people go swimming a lot in their bathing suits, go surfing, you know, and so the pH of the vagina kind of can change with that.

SPEAKER_01 23:36

So, really, a lot of these uh like this candidate or the what candida and at least bacterial vaginitis, yeah, really has a lot to do with the uh pH environment.

SPEAKER_04 23:46

It does.

SPEAKER_01 23:47

So I again because you I'm assuming you have a little bit of candida in your vagina anyway.

SPEAKER_03 23:54

Probably, like you know, just on our skin, it's around a small amount, right?

SPEAKER_01 23:58

And then when the when the pH changes to the point where the candida can thrive.

SPEAKER_04 24:02

Yeah. Well, candida is yeast is a fungus, it's a fungus, right?

SPEAKER_01 24:06

It's a fungal infection. But it likes warm, moist, and yeah, but I would imagine you have to have some of it on.

SPEAKER_04 24:12

Probably, yeah. Like we all have we probably have some yeast everywhere, right? Like even dogs in their ear, you know, that kind of stuff. Yeah. Um, so this is the second most common b uh cause of vaginitis after B V. Um, this one everybody comes in with itching, usually. Uh, it can be asymptomatic, but usually, women, when you get a yeast infection, you know, because it is itchy and it's an itch you cannot scratch. It is up inside, it could be out on the outer side, on the outer vulva. Um, it could be all over. It could also kind of infect your UTI and your urine too.

SPEAKER_01 24:52

Sorry, again, I'm embarrassed. I didn't really know this, but they said that yes, Candida is a normal uh normally found on and inside humans as part of the natural microbiome. So I think when your pH goes off and they can thrive, you get you get that okay.

SPEAKER_04 25:06

Yeah, yeah. So this one, women, if you've ever had a yeast infection, you know out there it's a white, clumpy, it looks like cottage cheese. Um, and it's just a burning and itch that you can't scratch. And it is the most awful thing. Um there are creams and stuff over the counter that are available that are actually pretty good. There's a monostat, which is a vaginal suppository.

SPEAKER_02 25:32

Okay.

SPEAKER_04 25:32

Um, and there's different days that you can you can do like a five-day, a three-day, one day. Um, they are kind of expensive, so some people don't use them if they, you know, because they're like 20 something bucks sometimes. Yeah. And um usually we can give you a single pill at the OB office if you come on in. But you know, we'll do a swab again, diagnose it. Um, this one also can be recurrent. Sometimes you can have recurrent infections, and we just give you like a weekly fluconazol for three to six.

SPEAKER_01 26:05

And this is the this this one. Um, I think the other thing is that it's very common when you get antibiotics. So you get treated with antibiotics for another reason. Yeah, because it messes up the balance. Yes, yeah, where it kills the bacteria, but then your fungus is free to but with that, all the good stuff goes away too, right?

SPEAKER_04 26:24

Yeah. So just the balance is throw anything that throws it off. But also with um Canada specifically, it's very important you air her out. You know, make sure that you only have certain soaps that are like dye free, fragrance-free. You want to use like cotton underwear or no underwear, air her out, you know.

SPEAKER_01 26:46

Yeah, I see.

SPEAKER_04 26:49

But it'll go away in a few days. But man, it is just the most uncomfortable thing ever for a lot of ladies. Men have no idea.

SPEAKER_01 26:57

Well, men have jock itch.

SPEAKER_04 26:59

Yeah, yeah, yeah. But that ain't nothing. I I guess so, but it's not like on the inside, right? Like true, but that's itchy, but like it can be quite sore. Maybe to compare it, maybe it's like for you guys to have like an itch in your butt up inside that you can't scratch.

SPEAKER_01 27:17

Oh, I see. Yeah, yeah, I see, I see it makes a difference, yeah. Like way up in there, and you're like, And again, getting back to please don't try to scratch it with this.

SPEAKER_04 27:25

Don't scratch it.

SPEAKER_01 27:26

Yeah, don't scratch it with this.

SPEAKER_04 27:27

But you guys don't have yeast in your butts. You guys have nothing. You guys are jock jock itch.

SPEAKER_01 27:32

Yeah.

SPEAKER_04 27:32

Um anyway. So a lot of um yeast infection has to do with hygiene. So keeping everything clean. Like if you're going surfing, if you're going to the beach, just change out of your wet stuff as soon as you can, you know, die free things.

SPEAKER_01 27:49

Do you guys recommend um I've seen lately, and I haven't really looked into this, but I've seen things where they say that, oh, uh, women should sleep without underwear.

SPEAKER_04 28:00

I've seen that. I've seen that.

SPEAKER_01 28:01

I'm guessing it's sort of that way.

SPEAKER_04 28:04

I would just suggest anything breathable, you know. So cotton is actually the best. But you know, if you're gonna wear a thong, it's kind of like going without underwear. If you're gonna go with like those really like silky things or not people wear a lot of lyra or like the spandex, you know, yoga pants. Yoga pants, those kind of jeans, those kinds of things really kind of keep all that in. And like I said, it likes warm, moist environments.

SPEAKER_01 28:32

So so what what what you're saying is that thongs and such like things are actually highly recommended.

SPEAKER_04 28:37

Um, I wouldn't give out that medical advice, but you know, cotton actually, you know what? I I gotta say it. The most recommended thing is the granny panty with cotton. I'm sorry, I'm sorry to say it. But she breathes.

SPEAKER_01 28:51

I see. But I I I I still I think that probably um most men would be very, very um supportive of the thong idea.

SPEAKER_04 29:02

Yeah, you know, just because uh I mean there's certain women that you know it's crazy.

SPEAKER_01 29:07

Safety though, for safety and for your health. This is what it should be for for your health. I recommend the granny panty.

SPEAKER_04 29:14

That is what I recommend the biggest granny panty you can find, ladies. Okay, yeah, anyway. Um oh, that leads to our questions. Okay. Um, the 10 things I'm too embarrassed to ask my OB. And one of the most common questions I get is Is my vaginal odor normal? Or even vaginal discharge? Is it normal? I have people come in. I have discharge, is that normal? Yes, very normal. Um, but what is normal for you if you go outside, what is normal for you? If you have anything stinky, anything smelly, anything itchy, um, anything that's way different color that it's different for you, then I always say it's probably a good idea to come in and check.

unknown 30:07

Okay.

SPEAKER_01 30:08

So actually, would you say most healthy vajs um don't have really a strong odor or should not have a strong odor?

SPEAKER_04 30:20

Um, you know, it can have an odor. Yeah, but just like a body, you know, our bodies have like a it's not like a BO odor, but like, you know, it can kind of have a little smell, but not crazy.

SPEAKER_01 30:32

You would have to be, you would, I mean, I guess so the point is everybody's a little different, and you would have to know that there is a change from what is your normal normal.

SPEAKER_04 30:41

Yes.

SPEAKER_01 30:41

Yeah, got it.

SPEAKER_04 30:42

Yes, and even from like when you are a teen to 20s to 30s to 40s, that discharge can change. Like the amount can change.

SPEAKER_01 30:50

That makes sense because of the hormonal changes that occur with your body.

SPEAKER_04 30:53

The smell can change a little bit, but you know, you'll know when when the smell is not okay. Yeah, that's what I tell everybody. I'm like, you know, if it smells like fish, usually that's not how somebody normally smells, you know.

SPEAKER_01 31:08

You know, uh, I don't recall this, but can't candida, does candida have a strong odor?

SPEAKER_04 31:14

You know, it doesn't.

SPEAKER_01 31:15

It doesn't, right?

SPEAKER_04 31:16

No, not to me. It doesn't smell very strong.

SPEAKER_01 31:18

Um the bacterial ones very, very the bacterial the bacteria v the B V U can tell. Yeah, yeah. Those you can almost smell from across the room.

SPEAKER_04 31:27

And don't be embarrassed. When you come in, uh OBs, we're we're used to it. We we don't mind it. We like you to come in, we like you to chat. Um usually though the the yeast is more just the cottage cheese discharge and itching. Those are the two kind of number one things we see.

SPEAKER_01 31:45

Yeah.

unknown 31:46

Yeah.

SPEAKER_01 31:47

And I guess if you're embarrassed, if you're in the waiting room and the odor is very strong, yeah, nobody knows where it's coming from. So you can always look at you can always look at the person next to you and go like this.

SPEAKER_04 31:58

Usually though, the good news is you cannot smell it through your pants.

SPEAKER_01 32:03

Oh, that's good. Okay, that's good.

SPEAKER_04 32:04

Usually you have to kind of be got it. Uh bottoms down to kind of smell anything or see it, you know. Yeah, I've never really had anybody that said uh maybe here or there, but yeah. And it can usually, sometimes I have patients that get BV or things like that before their periods, you know. So it's kind of hard to tell if I have a smell from my discharge or a smell from my period. So that also we kind of check out.

SPEAKER_01 32:32

Can the BV actually self-correct? Like let's say yes, yes. Like let's say you're about to have it.

SPEAKER_03 32:37

You don't always need Yeah, yeah.

SPEAKER_01 32:39

You might have to have your, I mean, say you're about to have your period and your hormones are changing and whatever. pH changes a little bit, you get it for a little while, and then once your hormonal or your flora gets back into back into balance, yes, it goes away on its own.

SPEAKER_04 32:54

I've seen that too. Okay, so some people would say, Oh, last month I had this fishy odor, I had a weird discharge, and then it went away. Like, okay, because you know what? Self-cleaning oven again, right? Like we just we keep it. Our girls are smart down there.

SPEAKER_01 33:07

Yeah, so this is maybe another stupid question, but uh I I've heard that washing down there, like with a douche or something, is not healthy.

SPEAKER_04 33:18

It is not healthy.

SPEAKER_01 33:19

Okay, that's I think that's important.

SPEAKER_04 33:21

Thank you for bringing that up because our kind of mom generation that was very popular in like the the older generation.

SPEAKER_01 33:28

What is it called? Summer's Eve or something like that. Summer's Eve. It was like a uh some kind of a a douche. A douche douche, right?

SPEAKER_04 33:35

And basically what a douche is is you put kind of water up or some substance up to flush it. Some people use vinegar, yeah.

SPEAKER_01 33:43

You know, but again, you're damaging the normal floral.

SPEAKER_04 33:46

Yes, yes. So it's not helpful to douche or to try to do those things on your own. Uh-huh. Um, and if it self-corrects, great. But if not, always go and see your OBG by end. And we can take care of that right away. Okay. Yes. Um there are some other questions that people had that from I don't know if you wanted to. Oh, I so are they kind of similar to the ones that you've heard?

SPEAKER_01 34:13

Yes, I I've heard. So another looks like another real common question is does my vagina look normal? Does my labia and my vagina normal? Normal looking.

SPEAKER_04 34:24

Yeah. And I would say we see a lot all day long. And usually everybody is really normal. If it's abnormal, your OBG by N will definitely say something.

SPEAKER_01 34:37

But what would be like if it as far as just the looks, what would I don't know.

SPEAKER_04 34:43

Some people are just, especially the younger girls, you know, when you just start kind of I feel like we're really unaware of our bodies and not taught a lot about our bodies.

SPEAKER_01 34:52

Here's another thing that I also read was that how your your privates look like when you're younger will change based on the hormonal levels of. So like when you when you become reproductive.

SPEAKER_04 35:09

Like your labia?

SPEAKER_01 35:10

Yeah, it gets bigger or something, right? Or it changes. And then when you go through perimenopause, there's obliteration of that.

SPEAKER_04 35:18

Yeah. It's very interesting. So your your vagina literally changes. Um, so when you're young though, I get these questions a lot. Like, does it look normal? When you're kind of around your like sexual debut time, people are wondering, like, am I okay? Or does it look alright?

SPEAKER_01 35:35

And I've also heard that um I've also heard people having uh cosmetic surgery to remove like I guess some people uh the the um the labia is uh minora is it the minora that sticks out like you know.

SPEAKER_04 35:50

It could be either like you know, it could be that that portion. It kind of you could either have a asymmetric growth, yes, or it could just be larger. And I've had patients come in where you they want a labioplasty because it is large, either after kids or just the way God made you. Yeah, you know, and so one side actually causes pain and friction, you know, when you walk or sit. Um, so that's one reason why we would do a labioplasty. Um kind of looks like extra teriyaki one side.

SPEAKER_01 36:22

Yeah, so you know how people joke about all the roast beef, right?

SPEAKER_04 36:24

Yeah, yeah, yeah, yeah, yeah, yeah. I mean, it kind of looks a little bit, you know, it can have a little extra but uh and who does a labioplasty?

SPEAKER_01 36:33

Obis or plastic surgeons?

SPEAKER_04 36:34

You know, I do them, but um usually it's the plastic surgeons because usually if you want a labial plasty, it's most times they want other procedures as well done. Uh-huh.

SPEAKER_01 36:46

You know, so it comes with like the mommy makeover where you get the tummy tuck or the we'll um we'll uh actually have a plastic surgeon on one day too, um, who's already agreed to talk to us about the uh great about such things, um aging with grace and beauty, like you know, talking about um mommy makeovers, etc. Yeah, so um but I would say to women out there Stay tuned.

SPEAKER_04 37:08

Stay tuned. I would say to women out there, I wouldn't um worry too much about what it looks like necessarily. Men don't care. And then I would say um if it causes you pain or discomfort, then definitely let us know.

SPEAKER_01 37:25

Yeah, I would 100% agree. Right, like men, they don't nobody's like nobody's like, oh, that's right, yeah, you know, it's usually quite the opposite.

SPEAKER_04 37:36

It really is, like, you know. You know, yeah.

SPEAKER_01 37:38

I I I don't know of any guy that you know, I had a lot of people. That like inspects anything or any of my friends or anybody that that's ever said, oh, I I saw it and then I didn't want to do it. Come on.

SPEAKER_04 37:51

I mean, men don't men don't care. And our parts are kind of more hidden than men, really. So men care, I guess, about that sort of thing. But women really I don't think I don't think men, I don't think. I mean they're care about you know, men care about what they look like more than what women Yeah, I don't think But they don't care about what women.

SPEAKER_01 38:08

I have never heard of a guy tell me that that's that that's a turn off.

SPEAKER_04 38:13

No, and I've never heard of a woman say like he saw it and then and said like oh no thanks.

SPEAKER_03 38:20

Yeah, what meant to say no thanks.

SPEAKER_01 38:23

I didn't want pastrami sandwich today.

SPEAKER_04 38:25

No, it's never it never happens, girls. So you know what? She looks beautiful, she's good, don't worry about it. Exactly. If it's causing your pain, discomfort, let's say.

SPEAKER_01 38:33

I think that's probably that's probably good advice about all of you.

SPEAKER_04 38:37

What's that?

SPEAKER_01 38:38

Meaning the whole of you.

SPEAKER_04 38:39

You know, women are so self-conscious like women are so self-conscious about how they do societal construct about you know but I think But people are also very meaningful.

SPEAKER_01 38:47

But you know what the but you know what the thing is, it's women are most hypercritical of women.

SPEAKER_04 38:54

Yes.

SPEAKER_01 38:54

Guys are if you ask most guys, they don't care, yeah. Guys find right, yeah.

SPEAKER_04 38:59

100% it's women going after women.

SPEAKER_01 39:02

Women are the meanest to other women.

SPEAKER_04 39:04

Yeah. Let's not do that, ladies. Let's be nice. You guys because we all doing the struggle. All the ladies, we are struggling.

SPEAKER_01 39:10

You there's guys that will, there are guys that find, I mean, it's this true beauty is in the eye of the beholder, right?

SPEAKER_04 39:18

It really is, and there's a nut for every squirrel.

SPEAKER_01 39:20

There is a nut for every squirrel. That's a great saying.

SPEAKER_04 39:23

My dad says there is a nut for every squirrel. So don't worry, if that's not your nut, there is another nut somewhere else.

SPEAKER_01 39:31

You know, um, yeah, I have a story when I was uh working at this uh this clinic, and this guy, this guy came in.

SPEAKER_04 39:40

You were working there.

SPEAKER_01 39:41

Yeah, I was I was working there. This guy came in. Yeah, he was homeless. Oh, okay. He was like, not to be cruel, but he was obviously super stink, dirty, right?

SPEAKER_04 39:54

Yeah.

SPEAKER_01 39:56

And then at the end of it, we we were talking about treatment, and I I said something to him.

SPEAKER_04 40:00

Oh, he came in for something.

SPEAKER_01 40:01

Yeah, I said something to him, like, well, you know, because you know we knew you were homeless. We were like, well, you know, after you have this procedure or whatever, you know, you're gonna need someplace safe to stay.

SPEAKER_04 40:10

Like, do you have And clean?

SPEAKER_01 40:11

And clean, you know. I was like, you know, can you, you know, is there someplace or you know, do you have anybody? He goes, Oh, I'll just stay at my girlfriend's house. And I was like, Oh, yeah, yeah. I was like, wait a minute. I was like, I was thinking to myself, I didn't say this, but I was like, you have a girlfriend? Yeah, like this guy literally smelt like Oh no, they have pl yeah. This guy smelt like pea and feces combined, like doo doo, like you know, like he was nasty.

SPEAKER_04 40:37

Yeah, no, no, they you know, there there's a nut for every squirrel. Yeah, so that's when I realized that you know some people don't mind the hygiene thing, yeah.

SPEAKER_01 40:45

So that but I I guess but I put things into perspective, and I was thinking to myself, you know what, I I don't think I need to worry about um you know ever finding. I told my told my friends, don't ever worry about it. If this guy can find a girlfriend, you'll be just fine.

SPEAKER_04 40:57

But you know, it is hard to say, man. But it's true, it's hard to find a good man.

SPEAKER_01 41:01

It's true for women though.

SPEAKER_04 41:02

Men, you know.

SPEAKER_01 41:03

Yeah, men, yeah.

SPEAKER_04 41:04

Yeah, hard to train too. Once you train one, like you cannot, you know, why yeah to retrain another one?

SPEAKER_01 41:13

It's very hard.

SPEAKER_04 41:13

Yeah, that's why I just can stick with what I got. I mean, I love you. Anyway. What's the next question?

SPEAKER_01 41:24

The next question is um, should I shave before my visit?

SPEAKER_04 41:29

Oh, yeah. Shaving is a fun one. So, like the hair question, right? Like, you don't need to shave before you visit.

SPEAKER_00 41:37

Okay.

SPEAKER_04 41:37

From what I hear to our parents' age, like when you gave birth, they used to shave you before they gave birth. Did you hear that?

SPEAKER_01 41:43

No, I I didn't know that.

SPEAKER_04 41:45

I mean, that's a weird question to ask your mom, maybe not.

SPEAKER_01 41:47

But like my mom would tell me.

SPEAKER_04 41:50

My mom said they used to shave you before you gave birth. Really? Yeah, it's very interesting.

SPEAKER_01 41:55

But nowadays that it that was a practice before?

SPEAKER_04 41:58

I don't know. That's what my mom said. Like everybody got shaved, but we don't do that anymore. And in fact, shaving causes like a lot of microabrasions and can cause infection, especially before surgery. So, like C-sections and stuff. Please don't shave before your C-section. Yeah, it increases your risk of surgical site infections. Oh. Um, so that's why we clip, use the clipper. But shaving is kind of funny because it does cause a lot of itching, like when the hair grows back. So that's one thing that people come in for vaginitis for, but it actually is oh, the hair growing back after I shave.

SPEAKER_01 42:32

Okay.

SPEAKER_04 42:32

But you can have a lot of itching.

SPEAKER_01 42:33

Yeah.

SPEAKER_04 42:34

Because it's real itchy.

SPEAKER_01 42:35

Yeah, I would, I would, I would imagine. Yeah.

SPEAKER_04 42:37

So we we suggest either like wax. See, all the things women go through. Yes. I'm telling you, we suggest either waxing or laser hair removal, but you don't have to do anything at all before you come in.

SPEAKER_01 42:52

For to for your doctor's visit. For your doctor's visit. No, don't worry about it. Because you guys have seen it all.

SPEAKER_04 42:57

We've seen it all. And people are so embarrassed, which I understand. Yeah. But at the end of the day, we've seen it all. And there's no surprises. Rarely, I don't think you could surprise me with much these days. Okay.

SPEAKER_01 43:11

Well, what if what if somebody came and asked the question, um, how much um how much masturbation is too much masturbation?

SPEAKER_04 43:19

Oh. Well, when it affects like your quality of life, I would say that's too much, you know. Like you gotta go to work and you gotta do it appropriate places. Yeah, you know. Masturbation? Yeah. Yeah. Just like men.

SPEAKER_01 43:33

Oh, uh you know. Uh so it's a hobby.

SPEAKER_04 43:38

A hobby for men?

SPEAKER_01 43:40

I I I'm just I don't know.

SPEAKER_04 43:44

I don't know about men.

SPEAKER_01 43:46

It's a hobby.

SPEAKER_04 43:47

Sure, women, it is very common, and it's very normal. Let's normalize our bodies, let's normalize it.

SPEAKER_01 43:53

I would be willing to bet a thousand dollars that men will beat women a hundred percent.

SPEAKER_04 43:58

Yeah. I mean, we got tings too.

SPEAKER_01 44:00

Do you know? Yeah, men, it's we got places to men it's a it's a we cannot be doing that all day, but I mean, you know, yeah, yeah, it's healthy and it's normal.

SPEAKER_04 44:10

It is normal, so you know.

SPEAKER_01 44:12

So I I this is a really interesting one that I found on the internet. Oh, it's a what can I do? So here's another it's an embarrassing question, right? What can I do about embarrassing noises like uh like a uh vaginal fart, like queefing during sex or yoga?

SPEAKER_04 44:31

Okay, during sex, like we just said, I don't think anybody cares.

SPEAKER_01 44:36

Nobody cares, that's true.

SPEAKER_04 44:38

And there's a lot of noises going on.

SPEAKER_01 44:39

It's true.

SPEAKER_04 44:40

So I and I don't think your partner, if they're male, they don't care.

SPEAKER_01 44:44

Yeah, they don't care.

SPEAKER_04 44:45

And if you have a female partner, they know what's going on. So it's what it is. It's true, and it's not gonna ruin the moment. But what about yoga? Can you imagine being yoga? Well, okay, can I just be honest? Yeah, nothing against the yoga people. I mean, I love the yoga people, but they're very natural usually. So I've been in yoga classes where people rip one without any shame. Well, I guess that's and nobody cares there.

SPEAKER_01 45:14

Yeah, and all you gotta do is do a oh and then you're good.

SPEAKER_04 45:18

But don't you find don't you find they're more natural? Like the the yoga. True, true.

SPEAKER_01 45:23

I think they're they're very into holistic.

SPEAKER_04 45:25

Better out than in idea.

SPEAKER_01 45:28

So that's a good point, actually.

SPEAKER_04 45:29

I just feel like I've been in yoga classes and I didn't know how to react, right? Yeah, but there were people who just let it go and nobody reacted, and I was the only one going.

SPEAKER_01 45:40

Yeah.

SPEAKER_04 45:41

Hmm.

SPEAKER_01 45:41

That's maybe this is why guys don't go to yoga too much because if that happened, they'd be cracking up.

SPEAKER_04 45:46

You know what's the worst though? When you rip one in a hot yoga. Oh you know, like when you fart in a shower, more stink. I don't know why.

SPEAKER_00 45:55

Is that true?

SPEAKER_04 45:56

Why you know when you fart in a shower, it's more stink.

SPEAKER_01 46:04

Maybe.

SPEAKER_04 46:05

Have you ever done it? You should try it.

SPEAKER_01 46:06

I oh I'm I I'm sure I know, but I never I don't know if I have ever noticed if it's I don't know.

SPEAKER_03 46:13

Am I crazy? I feel like it stinks more than that.

SPEAKER_01 46:16

No, but you know what though? Maybe because you're in a maybe because you're in an enclosed hot environment. Yeah, you know what I mean?

SPEAKER_04 46:22

Which is hot yoga. Like when people fart in there.

SPEAKER_01 46:25

Yeah. Oh man.

SPEAKER_04 46:26

That's rough. But you know, I mean, God bless. Two zone. I know judge. Yeah, no judgment zone.

SPEAKER_01 46:33

Do you have to just keep repeating in your head, Namaste, Namaste?

SPEAKER_04 46:36

I'm like trying, trying hard. I know I don't go, I don't go there usually. Wow.

SPEAKER_01 46:41

Okay.

SPEAKER_04 46:41

Yeah.

SPEAKER_01 46:42

But yeah, that's my What other questions that people have? Really?

SPEAKER_04 46:44

You never farted in the shower.

SPEAKER_01 46:46

No, no, it's just stinking. I'm sure, but uh, it stinks all the time. So how but not more stink? I have no idea. It's like chambered. I I have no idea. Maybe it is. It's because you're in an enclosed space.

SPEAKER_04 46:55

Maybe I'm crazy.

SPEAKER_01 46:56

No, it's probably because you're in an enclosed space, I'm guessing.

SPEAKER_04 46:59

You think so?

SPEAKER_01 46:59

And you smell it more. Maybe because maybe the maybe the heat makes it rise faster.

SPEAKER_04 47:05

Oh, maybe that's what it is.

SPEAKER_01 47:06

Yeah. So it rises rising in a more concentrated fashion, right? Right? I'm guessing maybe.

SPEAKER_04 47:13

I don't know. You try it, you let me know. Yeah.

SPEAKER_01 47:16

But now you're gonna be like I I never thought about that. Yeah. Okay, um, what other what other uh questions have you did you have?

SPEAKER_04 47:26

I don't know. What else I got on there? What else I got on there?

SPEAKER_01 47:30

Um We we went over the vaginal discharge thing.

SPEAKER_04 47:33

Yeah, yeah. So discharge is is done.

SPEAKER_03 47:36

I think.

SPEAKER_04 47:38

Oh, okay, okay. Uh oh, should I shower before I come in? I say no. No need to shower. I mean, we appreciate, but no need. Yeah, what I say is we we smell the feet more than the vagina.

SPEAKER_01 47:52

That's a very uh you were you and I were talking about this before.

SPEAKER_04 47:55

Could you could you please uh well like the vagina's a little bit farther away from us when we're doing our exam. The what's near our face and our head is your feet. So I mean, you can keep your shoes on, you can take your shoes off. We don't care, we clean it every time, but you know, that's what we smell more than really. I don't know. That's what I I recommend. Yeah, that's for men out there, because my husband didn't know this before I had children. Yeah, because you guys don't come to the OB visit with us. Um on the the exam table, there are things called stirrups. Yes, and so these things pull out of the exam table, flip out, and that's where ladies put their feet. Yeah, and then your bottom is at the bottom of the bed.

SPEAKER_01 48:41

Yeah, so that's kind of the picture of what all all women who have gone to the OB know know that know about this.

SPEAKER_04 48:49

But men, I didn't realize because when they pulled that out and I was, you know, checking for when I was pregnant, my husband came in first time ever, and he was like, What are those?

SPEAKER_01 48:58

And I didn't realize that he never saw one, yeah.

SPEAKER_04 49:01

Men would never see it, right?

SPEAKER_01 49:03

Yeah, unless you're in the yeah, exactly. Yeah, unless you go to the appointments. Appointments. And I I think that's kind of I don't know if anybody really why would a guy because you can't stand there while your girlfriend is having an exam. It's weird, right?

SPEAKER_04 49:18

There are there are some partners that would like to be present in our clinic. We allow partners if you're pregnant or post-surgical. Yeah, but if you're like just an annual visit, we don't really necessarily because you have to talk about things that you may not want the other person to be around for. Very true. Yeah, yeah.

SPEAKER_01 49:37

So yeah.

SPEAKER_04 49:38

And then uh I always get the question should I come in if I'm on my period?

SPEAKER_01 49:42

Yeah.

SPEAKER_04 49:43

And that's okay. You can come on in. It kind of depends on how heavy. If the flow is like really strong and going, maybe not, but like you can we don't mind it. You can come in on your period, it's okay.

SPEAKER_01 49:55

What about um this is another question that I got was um, is it possible to lose a tampon?

SPEAKER_04 50:02

Oh, that's a good idea. That's a good question. It is not like in your belly, like it just goes somewhere and like lost forever.

SPEAKER_01 50:10

I I guess that's what they they mean by this.

SPEAKER_04 50:12

But uh the vagina is a closed kind of system. So what you have is you're outside, right? And then you have the vagina, and then you have the cervix, which is the opening to the womb. That's where a baby would be if you were pregnant.

SPEAKER_01 50:25

We should show the graphic on this.

SPEAKER_04 50:27

So the cervix stops anything from getting lost in the neverland. But I but you can lose one and forget. I've had a ver I've had a lot of people with retained tampons.

SPEAKER_01 50:39

Yeah, and actually it can lead to something that's quite toxic. Yeah, so uh, and that is that is probably one of the most scary Yeah, that I mean scary. Women that have that, they're like close to death.

SPEAKER_04 50:51

Death, because you get septic. Yes, like deathly septic from tampons. But how does one forget that you You know, sometimes it's just uh you can't remember if you took the last one out and you just put another one in and keep changing that one. That's a common story I get. Um, another one is uh I was drinking and I had my period and I don't I thought I took my tampon out and I and they didn't.

SPEAKER_01 51:20

Oh you know, but wouldn't they feel it?

SPEAKER_04 51:23

No, there's all there's not many nerve endings up in the in the upper cervical region in the vagina. There's not a lot of nerve endings. So that's why I tell people if you can feel the tampon, you're it's probably in the wrong place. Because usually when you stick a tampon up there, you don't really feel it. But you feel it like if it comes out or when you put it in, but you don't feel it up there. There's not a lot of nerve endings. So that's why people can use like diva cups. Have you heard of that?

SPEAKER_01 51:48

Uh is that the birth control?

SPEAKER_04 51:49

No, it's like a cup instead of a tampon, you put like a little cup up inside to catch the blood. Oh, and then you take the cup out, wash it, and then you can put it back up inside. So that's called the diva cup. Yeah.

SPEAKER_01 52:01

That works.

SPEAKER_04 52:03

It's for people who don't really want to use a tampon.

SPEAKER_01 52:05

Um it doesn't leak around the sides.

SPEAKER_04 52:08

I I I don't know. I'm you know, I'm not really like super familiar with the diva cup, but usually my patients that use it say it doesn't leak. It's very easy. They just pop the seal, pull down, and then wash it. Yeah.

SPEAKER_02 52:24

Interesting.

SPEAKER_04 52:25

Yeah, so that's the newest one is the diva cup for the periods. Um, people also use nothing, right? Like uh they have that period panty now that catches period panties? Yeah, so you don't have to wear a pad or anything, apparently.

SPEAKER_01 52:38

Like you just like a disposable panty?

SPEAKER_04 52:40

It's washable.

SPEAKER_01 52:42

Oh wow. So these are for these are for probably the yoga people.

SPEAKER_04 52:45

Yeah, yeah, yeah, yeah.

SPEAKER_01 52:46

Yeah, very natural, very natural, all natural.

SPEAKER_04 52:48

Yeah. But yeah, so tampons and anything in the vagina, unlike the butt, yeah, usually cannot get lost up inside unless you perforate it somehow. But it it can the some vaginas are longer and harder to get things out. So, you know, that can be a problem. But I always say if you really need to, you can get the help of your partner. But it might get a little, you know, go a little sideways because men just say, oh, yummy, you know.

SPEAKER_01 53:20

How this is another another question that I how long, like when you put in a tampon, how long does it how long do you keep it in there?

SPEAKER_04 53:28

Well, different ladies have different amounts of flow and then different things. You know, but we say it should be changed at least every six-ish hours. Oh, really?

SPEAKER_01 53:38

That frequently, I thought it was like once a day.

SPEAKER_04 53:40

No, it's six to eight hours. Like, we don't want you to leave that tampon in for very long.

SPEAKER_01 53:44

Like oh, I I didn't realize I thought it was like a lot of people.

SPEAKER_04 53:46

But usually usually if it's you're not on your light day, like you're changing it kind of more often, right? And some people are very like they just are very regular with changing it out. But some people have such a very light flow that they just leave it in, and then sometimes you can just forget about it. Yeah. But you don't want to leave it in there for extended periods of time, you know.

SPEAKER_01 54:07

What other embarrassing questions or things that uh well what what other embarrassing things have you actually seen?

SPEAKER_04 54:15

I mean, I've had a lot of people who are embarrassed by a lot of stuff. I'm not embarrassed. There's no judgment zone. If you have anything that you think is embarrassing, you can always ask.

SPEAKER_01 54:25

Yeah, I I don't think uh I don't think doctors that are in like that go into urology or OBGYN are embarrassed by much.

SPEAKER_04 54:34

Uh-uh.

SPEAKER_01 54:34

And I tell my patients it's the nature of the business.

SPEAKER_04 54:37

It's the nature, and I tell my patients, it's there's nothing that you can be embarrassed about. I talk about sex all day.

SPEAKER_00 54:43

Yeah.

SPEAKER_04 54:44

Every day. And there's nothing that really, there's nothing that I haven't been asked before. Yeah. You know? So there's nothing really on the embarrassing scale that's too embarrassing to ask your OB. And I'm sure every OB out there is the same way, you know.

SPEAKER_01 55:00

Yeah. And I guess after all, if you are their doctor, they should feel comfortable to ask you what.

SPEAKER_04 55:08

But you know, I get it. We only see you once a year, usually. Um, if you have a few problems here or there, it's kind of awkward to talk about with a stranger. Um, or if you're young, you know, and kind of unfamiliar with your body, I guess. It can be a little bit like daunting. But there's no judgment, no embarrassment. Come on in. Ask away. I did sex ed though at um few of the schools. I used to go around doing sex ed. Really? Yeah. That that was shocking. Those kids have some questions. Where did you do uh sex education at? Can I say which schools? Uh they're private, they were private schools. Oh, okay. Because you can't do publics, yeah.

unknown 55:47

Publics.

SPEAKER_01 55:47

Oh, I see. I see. I'm just curious what kind of questions. Yeah, I don't I don't I'm sure.

SPEAKER_04 55:53

I don't know if I could say those questions on air.

SPEAKER_01 55:55

Really?

SPEAKER_04 55:56

Yeah, I'll tell you later. Um I don't think you can say those things.

SPEAKER_01 56:01

Like, I'm now I really, really want to know.

SPEAKER_04 56:05

You just I uh I don't think I can say those things.

SPEAKER_01 56:09

Like, I can't imagine what you this is a Can you bleep me out?

unknown 56:13

I can.

SPEAKER_04 56:13

Yeah.

SPEAKER_01 56:14

If if it's like medically related, I think it's it's it's okay.

SPEAKER_04 56:17

I don't think we're talking about No, I don't think I can say it. But anyway, it has to do with like donkey punches.

SPEAKER_01 56:24

Donkey punches? What's a donkey punch?

SPEAKER_04 56:26

Right, uh dirty Sanchez's.

SPEAKER_01 56:31

I don't even know.

SPEAKER_04 56:32

Yes?

SPEAKER_01 56:32

Wait, wait, wait. Oh my god.

SPEAKER_04 56:35

Those those things I was like Wait a minute, what is a donkey punch? I'm I had to call Kleiner and I was like everybody else in the room.

SPEAKER_01 56:43

Can you bleep this out though later? Okay, wait, wait, if I I think it's what what is a donkey punch?

SPEAKER_04 56:50

So they were like, amiss, you know, right when we were having sex the other day, and I was like, How old are you? And he was like, Oh, I 16, you know, me and my girlfriend. I was like, bruh, this they're like very anyway. So he was like, So what? Is it okay, like if I donkey punch my girlfriend? And I was like, What is that? Yeah, he was like, You know what donkey punch is? I'm like, no, he's like, you literally say you literally, when she's about to come, you punch her in the face.

unknown 57:25

What?

SPEAKER_04 57:26

Why? I don't know, I have no idea. It's like a thing that they donkey punch each other. Why do I call it donkey? I don't even know. It's a donkey punch. That is not it is not. I think it's like at the SNM.

SPEAKER_00 57:42

I thought a donkey punch was you just punch him in the sun.

SPEAKER_04 57:44

Oh, you can the girl, the girl punches the guy, or the guy punches the girl.

SPEAKER_01 57:51

Right when you're about to why in the world to each his own, yeah? To each his own.

unknown 57:59

I don't know what a very sad.

SPEAKER_01 58:02

I know what I think I know what that is.

SPEAKER_04 58:04

Give a little tickle, tickle in their pickle, and then you put it over the girl's lip. You know.

SPEAKER_01 58:18

I think I know what that is.

SPEAKER_04 58:20

Put the doodoo.

SPEAKER_01 58:21

Yeah, that's what I thought.

SPEAKER_04 58:22

Make one mustache, yeah? One dirty Sanchez. Yeah.

SPEAKER_03 58:27

Oh, what was that again? Kleiner and I were talking about the rusty trombone.

SPEAKER_04 58:31

What is that with the thing?

SPEAKER_01 58:32

What is that?

SPEAKER_03 58:32

Philadelphia Steam Roll.

SPEAKER_04 58:34

Oh my god.

SPEAKER_01 58:34

Wait, wait, wait, wait.

SPEAKER_04 58:35

What is a- what they teach you about Kawaii? I know it. I know I know the rusty trombone. What is a rusty trombone? These are so new. It's been it's been such a long time. It's a long one. It's a long time. Yeah. No, there's all kind of I'm telling you. But anyway, kids got questions, okay?

SPEAKER_01 58:53

Yeah, but what now? I that I gotta look. I gotta find out. Look them up. Wait, wait, wait. What it's a rusty trombone and what?

SPEAKER_04 58:59

Philadelphia steamroller.

SPEAKER_01 59:01

Philadelphia steamroller.

unknown 59:04

I had a good one.

SPEAKER_04 59:05

I'm telling you, Cass. These kids nowadays. But you know, I always tell them, there's nothing embarrassing. And my face, when they asked me about the Donkey Punch, I was like, what? Yeah. And they're they're asking these questions in class, like.

SPEAKER_01 59:27

Oh, all I know is that the Philadelphia quote, Philadelphia steamroller does not have a recognized medical meaning. It does not appear in reputable medical or scientific references.

SPEAKER_04 59:37

Not reputable, no.

SPEAKER_01 59:38

So I'm I'm guessing I'll never find that term in the New England Journal of Medicine.

SPEAKER_04 59:42

We know people in low places, KCAS. He found it.

SPEAKER_00 59:56

That is an interesting way to say it.

SPEAKER_04 1:00:00

I mean, they these kids now, but I don't know how the kids do about this, right? Like how I don't know. Maybe I'm old school, but I don't know these terms, you know? But the Donkey Punch one, that one got me. I was like, bruh, don't be doing that. You're gonna get single real fast.

SPEAKER_03 1:00:20

Oh, so it's it's but you cannot have that face when you're talking to the kids, right? You have to be like, you have to be like, oh very professional. Um yeah, please don't punch somebody when you're going to orgasm.

SPEAKER_01 1:00:38

What did you say? It was a dirty trombone? What was it? Rusty. Rusty.

SPEAKER_04 1:00:43

Look it up on urban nickname. One rusty trombone. I remember I had to ask your brother about the rusty trombone and the donkey punch. I was shocked.

SPEAKER_03 1:00:59

Don't look up images! Yeah, this account will be flagged.

unknown 1:01:06

Oh my god.

SPEAKER_00 1:01:09

Is this what teenagers are making their girlfriends do?

SPEAKER_04 1:01:12

Yeah. I mean, and then you got the normal tea tea bagging and you know, the normal stuff, but like, yeah. I think it's a game with them though to try to make me visually. I think it's just a game, they all had those, but like six or seven of them. All asking me about these things. I think so, right? Like maybe and I'm like, come on. Better than that, dirty centiges, donkey punch, come on. So yeah.

SPEAKER_01 1:01:42

Well, I learned two new things today. You did!

SPEAKER_04 1:01:45

Yes, and you can use those yes, you can use those.

SPEAKER_01 1:01:49

Yes, actually, three new things today.

SPEAKER_04 1:01:51

Three?

SPEAKER_01 1:01:52

Yep. Oh, I've learned I learned what a Donkey Punch is. Yeah. Uh a rusty trombone and Philadelphia steamroller. Okay.

SPEAKER_04 1:02:04

Yeah.

SPEAKER_01 1:02:05

Um a dirty sandpad. I guess everyone in the audience can look that up on the Urban Dictionary to find out for themselves what exactly those things mean.

SPEAKER_04 1:02:12

Again, let's add that to please don't do this.

SPEAKER_01 1:02:17

But I guess I guess the rusty trombone is not dangerous.

SPEAKER_04 1:02:25

I guess.

SPEAKER_01 1:02:26

Except it's maybe not so hygienic, but it's not hygienic.

SPEAKER_04 1:02:29

That's the problem, right? Nobody wants E. coli anywhere.

SPEAKER_01 1:02:32

True. True.

SPEAKER_04 1:02:33

So I'm just saying, like the dirty sand. Nobody needs that. Don't put that by your mouth. Don't put that, don't put that anywhere. Nobody needs to get septic.

SPEAKER_01 1:02:40

I can't imagine there's a physician out there that would recommend or say that this is uh uh uh safe to do.

SPEAKER_04 1:02:49

An intimate partner violence is never the answer, okay?

SPEAKER_01 1:02:51

Yes.

SPEAKER_04 1:02:52

Unless you gotta have a good safe word. What that's just that's crazy. Yes. Anyway, I don't know how Ryan's gonna edit this, but that's yeah.

SPEAKER_01 1:03:04

Well, I think that's a good place to end our.

SPEAKER_04 1:03:06

I feel that is too. I hope that was very uh educational today.

SPEAKER_01 1:03:10

On the most embarrassing or questions that you're too embarrassed to ask your OB.

SPEAKER_04 1:03:15

Yeah. Um And vaginitis.

SPEAKER_01 1:03:18

And and and and vaginitis. And with that, you we ask you to like and subscribe. I guess it helps the algorithm.

unknown 1:03:27

Yeah.

SPEAKER_01 1:03:28

Uh we do you can leave comments for us, but because we are new to the I don't think people should. Yeah. Yeah. But you can know if that's a good idea. And if you do have questions, uh we will try to look them up and address them, maybe at some later episodes. Um but again, Dr. Lehu and I are are new to this We're very new. This this uh whatever, this media thing.

SPEAKER_03 1:03:51

Yes.

SPEAKER_01 1:03:51

So we're trying to figure out how to get to your questions and comments and how to address those, et cetera, and our and readdress things.

SPEAKER_04 1:03:58

Yes. But we'll figure it out.

SPEAKER_01 1:04:00

Yes, and please um yeah.

SPEAKER_04 1:04:02

Keep watching.

SPEAKER_01 1:04:03

But I I do I do think to today's episode was uh we did give some good solid advice. I think so. Of what not to do.

SPEAKER_04 1:04:11

Of what not to do. Yeah. Or just be careful.

SPEAKER_01 1:04:13

Or just be careful.

SPEAKER_04 1:04:14

Be careful out there, be careful out there.

SPEAKER_03 1:04:16

It's it's a rough world.

SPEAKER_01 1:04:17

Don't hurt each other and don't hurt each other and don't hurt yourself.

SPEAKER_03 1:04:20

Yeah, love each other, don't harm yourself or others. That's pretty much the basis of what we had to say today. Yes, yeah. So please subscribe.

SPEAKER_01 1:04:28

Yes, and thank you for joining us again. Thank you on From the Inside Out.

SPEAKER_03 1:04:31

Take care of each other.