Girlll you better put that Summer’s Eve down right now! You all had so many questions about vaginal health and we brought the best of the best to answer them all. Dr. Heather Irobunda is an Obstetrician Gynecologist based in Queens, New York who shows women, specifically women of color, that you can feel safe and supported by your gynecologists (not creeped out or shamed). Listen to hear answers to most asked questions about vaginal health that you NEED to know.
What we cover:
- What age should you start going to the gynecologist?
- What age should you get your first gynecology exam?
- How often should you get pap smears?
- How to advocate for yourself at the gynecologists appointment
- Best tips to advocate for pain management at the gynecologist’s office
- You’re not crazy for having a painful experience with IUD insertion
- How to pick a gynecologist that’s not a creep
- Should you be cleansing your vagina?
- Are yoni egg’s useful?
- Do we need products to balance vaginal pH?
- How to know if hormonal birth control is right for you
- Can you get pregnant while on birth control?
- What to do if you get yeast infections after using sex toys
- Postpartum vaginal health
- Changes in sex during menopause
- What to do if you have recurring bacterial vaginosis or yeast infections
- Which brand of lube you should have
- Should you use water based or silicone based lube?
Resources mentioned in this episode:
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So Heather, you have so many resources for women's health on social media and it's a really smart way to make a lot of this information more accessible to people. So what made you start putting out this information online?
Cause I feel like, especially for doctors, I like, I feel like they're just always busy running around . It seems like they don't have time for anything. So it's really cool that you're able to like integrate social media into your work. Yeah, so I mean, it is busy, so I feel like I'm wearing like five hats, but for me it's really important because I feel like oftentimes all of this information is gate kept.
Right. In a, in a weird way. Right. So I. We all should know how our body functions. We all should know like what a period is, what ovulation is, just what is considered normal, what's not. And a lot of times we don't get that from like, you know, sex ed or health ed in school or from your parents cuz your parents don't know, you know, things like that.
And so I just. That I shouldn't be holding onto this information. I should make it accessible. And more and more my patients were coming in saying, oh, I saw that my favorite influencer or someone, um, said that she had endometriosis, or she's having issues with her periods, or she's pregnant and I wanna know more information.
And I'm like, well, maybe I should give this information to people where they're actually finding information, which is online. Yep. Sure. Makes sense. Are you also, are you also on TikTok? Oh, I'm on TikTok. Which is funny because it's like a whole struggle torque situation. I'm all like, let me shake my one butt cheek and tell you about your period.
It's like a hot mess. I gotta do Enjoy it. Yeah, I enjoy it. So it's like, it's serious, but. As in I'm giving you good information, but a lot of times it's like I'm following whatever trends. I'm just having a good time. You're having fun with it, and that's what's most important. Exactly. Yeah. I think that's great.
Okay, , we have so much to cover and we figured we get started with the basics. Mm-hmm. . So number one is, cuz I have a friend actually who's never been to the gynecologist. How early that happens. Yeah, that happens. That happens. Yeah. How early and often should someone be seeing a gynecologist? Okay, so the way how we like to look at it is that your first gynecology appointment, if possible, should not be an appointment that you're actually gonna be getting an exam.
Hmm. So the recommendation is for those of you guys who have children or, or those of you who are younger, maybe in high school or whatnot, is that we actually want you to go to the gynecologist as a teenager, not for a checkup. Sorry. And that's my dog, cuz she loves to be in the business. But, um, not for our checkup.
Not that you need to like, have someone examining you that's not important. But to come to see us. To get to know us, um, we can go over what normal things are like in terms of your periods, if you're having any pain, what to expect. And we want one appointment like that in your teenage years. But your first exam should be around age 21, unless you're having issues before then.
Okay? And that's when you get your first pap smear. Okay. And then what about the frequency of pap smears and any other test that we should be getting? Every time I go, I'm honestly hearing something different. Five years, three years, one year. Like what is the, the updated recommendation? Right, and so this is where it gets confusing because what's funny is that like I trained not that long ago, but quite a few years ago, and they were changing the recommendations almost yearly in terms of the pap smear guidelines, just because pap smears are screening tests for cervical cancer, and we've learned so much information about it over the last few decades because we've done so many pap smears and so we know kind of what the process is.
For things to develop from slightly abnormal cells to cancer. So we know that we were being very, very aggressive in our screening before. So now what we recommend is if you're under the age of 30, that and you have, um, a normal pap smear, you don't need to come in to get one until three years. So like every three years under the age of 30, if it's normal and we're not actually testing for HPV V, which is a virus that some strains.
Make you at increased risk for cervical cancer. We don't screen for that until after age 30 because we know that under age 30, most of us are very, very much able to clear that infection on our own without any sort of intervention from a doctor. So that's the reason why we screen every three years and we don't screen for H P V after age 30.
It's every five years. and we do screen and as if we screen for HPV as well. So that's if it's normal, if it's abnormal, it depends on what the abnormality we see in the cells are, because there are a variety, different types, like about 10 different types of abnormalities we can see from being like, Almost normal to like very, very concerning, like cancer.
And so depending on what we see with those, we'll determine what interval or what timeframe we'll be screening for and what we're screening for and what we do. Okay. And then aside from the pap smear, I feel like that's kind of the go-to test. Are there like other tests after 21 that people should be getting regularly or is that the main one?
Oh, so even before 21 and before 21, you don't necessarily need an exam for it. But a lot of times after age 21, we do the testing with an exam just because it's like we're already down there and it doesn't really. Increase the amount of time of the exam. Like usually a lot of times the same swab you do for the pap smear can do it.
But things like sexually transmitted infections, so things like, um, what we swab vaginally for are things like gonorrhea, chlamydia. We also check for another STD called, UM, trichomonas, or trichomoniasis is the, um, infection. Uh, there's also blood tests that we do, like h i v, hepatitis B, hepatitis B, syphilis, all these things you should be getting checked out, especially if you're.
Sexually active, and especially in the ages between 18 and 25, you're at higher risk for things like chlamydia and gonorrhea. It's actually very, very, um, prevalent in that age group. So we do recommend that when you're under the age of 21, a lot of times we can do that testing through urine. Um, like for battery and chlamydia, you don't even have to have a pelvic exam for.
Okay. Okay. Now, a lot of our listeners had questions about advocating for yourself in medical settings because I think, especially for black women, there's a lot of trauma related to going to the doctor's office, and it's really hard to communicate your needs effectively because it could just be like, very scary, very intimidating.
Um, so do you have any suggestions for like, how to get that conversation going or like things that patients can do to feel a little more c. So one big thing I like to tell people first off, is that sometimes we get stage fright, right? Because when there's a power dynamic in the room, like yeah, or, and even if you're just like a naturally shy person or whatnot, you just don't like to, you know, go out of your way or.
Yeah, I get it. Trust me, I was there before I was a doctor. Like I now have no shame. But before, like I used to feel kind of that same anxiety. I recommend writing your questions down in like your notes section of your phone or something like that. Like, or you know, a piece of paper or something like that.
Like know what you wanna say because sometimes like. Even if you had every intention on asking a question, you might just get overwhelmed by the situation and then forget what you wanna say. And so it's really important to write down the questions that you have and make sure that they're answered. Um, another thing is remembering that doctors are also humans.
I am a human being. That scary white dude who maybe your doctor is also a human. Remember that we are humans. We like, you know, go to the bathroom just like you do. We need to be hydrated, just like you do all of the same things. Um, we get scared as well. So I think remembering that is helpful. And then knowing that that doctor that you're, or you know, medical provider that you're standing in front of is not the end all be all.
Your medical care, right? So like even if you get an answer that you're not really comfortable with, or if you don't have the interaction that you feel like you should be, that person is not the only doctor that you can see, right? Even if you don't have insurance, even if you don't have good insurance, you know, even if you don't have money, whatever the case is.
You know, think that you're not entitled to anything better than what's in front of you because you know there may be another person in the practice, another provider that can, that you can talk to, that you relate with better. Even if there isn't anybody, there's patient advocates that you can contact if you're feeling like things are not going well, there's a head nurse, somebody in that.
Can help you bridge that gap. So just don't feel like all is lost if you have kind of an off interaction with the provider who's sitting in front of you. Yeah. Yeah, it's so frustrating and I think especially with like pain management, cuz like, you know, someone might go in for like a pap smear or in my case for an I U D and it was just like excruciating.
And I've had several situations where providers are like, Oh, you're fine. Or it's really not a big deal. It's almost over. Like they kind of disregard that pain. So what can patients do, like if, you know, if they're trying to seek some pain relief, like are there options available for some of these procedures that they can ask for?
Oh, so this is one of my favorite things to talk about because it's, trust me, I've had like the same exact situations. Like I had an I U D placed years ago. It was eye-opening to say the We . Yeah. And I was already, seriously, I was an OB G Y N resident, right? And I was like, oh, you know, I put these in. I know they're not fun.
And I, and I've always been honest with my patients. It's not a breeze. Like this is not pleasant. That's good. Like, you know? Yeah. Like cuz I feel like that it's just wrong to not be very upfront about that. And yes, some people are going to be okay, but like most of us, It's not a pleasant experience. Right?
So one big thing I always tell people too is that if you have any history of like a traumatic, um, experience, like not only with like within an exam, like a GYN exam, but in general anything regarding kind of your genitals, that's something you may want to broach. If you feel comfortable just being just, and you don't have to go into details about what happened, you can just say, listen, I've.
A few bad experiences when it comes to exams or procedures, and I'm very nervous and anxious about what's going on here. And then a lot of times there's things that people can offer you depending on what they have available. Um, sometimes it can be like local an and local anesthetic, so that would be, um, like actually like injecting, like lidocaine in the area to see if that helps.
Sometimes it's a topical anesthetic. Sometimes they'll have you take some. Um, it's, I don't think it helps that much, but for some people it does, like taking like some ibuprofen or some sort of medication before that. Sometimes people offer things like, um, nitrous, which is like laughing gas with. It depends on, unfortunately your insurance coverage sometimes, and also the facility that you're in, if they're equipped to take care, you know, to give you some sort of an.
But having that conversation and asking them what they can do to help you opens a lot of doors and it sh and unfortunately it should be guided by us as the providers. Like we should be leading that conversation instead of patients like we should be the ones to say, Hey, like, so you're getting a procedure and this may be like anywhere from not that bad to, oh my God, this is the worst thing I've ever experienced in my life.
And. , here are some things that we can offer you to make it better. Because I've had patients tell me, like when I'm like, okay, like I can put some numbing medication in the area and stuff like that. They're like, oh, just do it. And I'm like, are you sure? And they're like, yeah, and, but that was their choice.
You know what I mean? Yeah. I think unfortunately we don't offer that choice very often and. And then we tell people, oh, like this shouldn't be that bad. And then you're wondering if you're crazy for having such a horrible, painful experience when it's like very, very common as someone who puts IUDs in all the time, where it's like, that is not a pleasant experience.
And what, I'm a person who had one too and it wasn't a, a pleasant experience. So I think really, Trying to ask what options you have for pain control. Um, also knowing that you can stop the procedure at any time is important. It is your body. You still have agency over it. You still have autonomy over it.
You should not feel like you can't say no, and you can just, like, you can say no in sexual encounters or outside of an exam room. Outside of a hospital, you are able to say no. Especially if you're doing something that is completely elective, like getting a pap smear or getting an I u D or whatnot, like you do not have to complete that.
Yeah. Oh my gosh. I just feel like we need more of these conversations because this is honestly the first time I'm even hearing this. Like you can say no or um, advocating for yourself cuz I've also had horrible experiences and this is kind of a random. Observation. I don't know if it's a question, but most of the time my bad experiences have been from men gynecologists who try to tell me like, oh, it's no big deal.
It's not painful. Or when I say, you know, actually, I know myself and I'm gonna have a hard time with this. They offer, offer me like an ibuprofen or something that's laughable. Um, and also a lot of these men, Are creepy. I'm sorry. Like I don't, I've had like these male gynecologists who I l later look and see.
They have like these very creepy, like these old white men, like very creepy reviews. And I'm not saying that's always the case or it's just inappropriate comments or. I don't know. It just seems like a violation, the whole thing. How do you, uh, as someone who is a gynecologist, and maybe I'm, this is reaching, but like, how do you decipher who is a creep?
or not? . , I mean, that's a great question. . It's really hard, but it, it actually, it's very interesting you say that because I feel like. Kind of what guided me into gynecology in a way. So when I was in between my first and second year of med school, right? I kind of always have been interested in like, you know, reproductive health, things like that, just because I didn't know that much about it.
So it was like the thing, but I, I think like, Scared me the most and I felt like a, and then I got very interested in it, but I had a really like awful experience, um, in between my first and second year of med school when I was doing my basic training for the military. So I was in a military gynecologist as well.
Like your girls been a lot of places. . But . Um, like this, this totally told me. Our system is broken for GYN and we need to fix it because I was randomly selected during my basic training to get a pap sear. Who the hell does that? Like who randomly selects people to get like, I was not due for one, but the army took like 20 of us who were at basic training that year and was like, you have to get a pap sear.
We own your body. Whatever we go to. Clinic and we're all lined up in front of exam rooms like one, like one next to the other. And we're told to go in undress from the waist down, sit on this like exam table and put on a sheet. I was on my period and my periods are epic. I talk about my periods on my stories all the time because I like to overshare about my bodily functions.
But um, yeah, so my periods are heavy. They're just. Wild experiences. And so I was like in the th like second day of my period or something like that, and I'm like, and I pull one of the assistants assigned. I'm like, Hey, I'm on my period. Like I have a tampon in. Like, I don't wanna take it out. Like, until we're like, ready to do the exam, do you still wanna do the exam?
They're like, yes, we can still do the exam. You need to take it out. Like everything off and out. And I'm like, I'm bleeding. Like how long am I gonna be sitting here? They're like, oh, it's gonna be. An hour and a half later, he was sitting on a bed, like bleeding all over over the place. Oh my God. And I was like so embarrassed.
So like just, I couldn't get up cuz I was afraid that I was gonna put like leak blood all over the floor. And then when I came in, like when the like doc came in, he was this like old white man and he was, and I was like, I'm so sorry. Like I know that there's like a lot of blood and like whatever. And he was like, Oh, don't worry.
It's fine. It's probably not that bad. And then as soon as I put my legs up, he was like, oh, it's soupy in here. And I was like, oh, badly. And I like wanted to cry. I was like, this is actually, oh my God, the worst experience ever. And I was like, no one should ever experience that. No one should ever deal with that.
Like we have to do better. This is. Not any way that any person should be treated. No woman, no man, no. No one should be treated like that. And so it's like, and it was creepy and it was, and it was weird and it was messed up. And I just feel like, you know, we have to do better. But in terms of figuring out whether someone's a creep or not, I mean, Google Review.
Yeah. Question Mark . Good place to start. . Good place to start. Not after asking around the question mark, but sometimes you know, you end up in situations and then also too. Yes. A lot of, unfortunately, gynecology has been male, a male dominated like medical field for a long time, which is weird and. Makes no sense.
But there's also a lot of women who carry on the work of the patriarchy in our field because I heard some of the most awful, um, comments about. Kind of how people react to pain or experiences or birth or whatever from female gynecologist where it's like, I don't know how she got pregnant if she can't tolerate it like a pelvic exam, because I would hope that her partner's penis is bigger than da, da da da, da.
Where you're like, that's really awful. Because one thing I like to remind people who get really upset, they're like, I'm so sorry like that I'm not handling this well. Girl and like, and they're like, they're, you know, doing, they, they're okay with having like intercourse and they don't have any problems with that.
And I'm like, girl, we don't have like the stadium lights on, your legs up. Right, right. Two people in the room that you don't know. Right. And throwing instruments in there. Usually if you're having a sexual encounter, it's, we, we set the. Sometimes dinner's involved. , why ? Yeah. You know, it's not like this experience where it's very sterile and cold and bright even.
Mm-hmm. Mm-hmm. . Yeah. Ugh. I'm just disgusted. Um, . Sorry. Yeah. I would hate story cause that's true. true. And it's so personal. It's so true because it's true. And so many people have similar stories or worse stories. Messed up. Yeah. Yeah. And it's sad because it shouldn't, it, there should be the utmost sensitivity involved with, uh, GYN care and I just feel like.
There's not. Um, but I, I appreciate doctors like you who are changing things and making it just much more approachable and comfortable. Um, okay. I wanna switch gears a little bit and talk about cleaning your vagina. Um, so another favorite topic of, I know , right? So my, um, friend, her mom would always say A healthy vagina cleans itself.
Having said that, smart woman. Smart woman, right? Smart mom. . There's so many. And so my friend will always say that she's like a healthy vagina. Cleans yourself. It cleans itself, but there's so many products everywhere. You go left and right and they're talking about, oh, you should use this or that, or Deodorized, whatever.
What are your thoughts on that? Hello, capitalism y'all. Everybody's trying to make a coin, right? Yes. Every single body, everybody's trying to make a dollar. Okay? And that's where that stems from. It's like, Soap is not a bad thing in general, right? In general life soap, soap is really not a bad thing in terms of washing most parts of your body, right?
But nothing should go inside your vagina because yes, it cleans itself. Usually if we go in there and do anything, like in terms of trying to cleanse it, um, it revolts because it doesn't like to be bothered. It likes to cleanse itself. And if there's something that's concerning you about the smell or the feel of the vagina, you probably need to see a doctor instead of going to the feminine care aisle or whatever they wanna call it.
The thing is though, healthcare is expensive, right? And so it breeds kind of. Culture of, let me see what I could do myself, , because I don't want to necessarily spend the time, money, or, um, be shamed or have a bad experience in a gynecologist's office. So let me see what I can do for myself in these aisles.
And unfortunately, most people do more harm than good in these aisles because it's not necessary. And then the other part of it, So the inside's, the vagina and then the outside's. The vulva. Right. And like, especially, and I noticed this is something that I actually talked about with one of my, um, dermatologist friends who actually is a black woman as well.
And we were talking about kind of in general how we as folks of color, especially black folks, um, We get really aggressive sometimes with, um, the cleanliness of our skin in our bodies. like, and it's not a bad thing, but it's sometimes we do harmful things to ourselves in the name of cleanliness. And then it makes you wonder where that comes from, right?
Like, why we. Feel like unless we literally scrub the top layers, not layer layers off of our skin, or put something that's really strong on our bbar, near our vaginas, or in our vaginas, do we feel like we're clean, right? Like, because, um, the joke that we all like tend to have is like, oh, white people don't like, you know, they don't wash their legs.
They don't do this. Right? They don't do that. But sometimes they're not dealing with some of the skin conditions we are that we do because we use these harsh chemicals and these harsh practices to cleanse ourselves. Like what is that? Like what? Like I feel like somebody needs to like dig deeper, but.
Honestly with the Volvo on the outside, right? All you need is like a very light cleanser and all these pH balanced, whatever. It's all hoopla. Bs, . It's bs. Y'all Like your body knows how to balance its own pH, and if it's not doing so, it's because there's usually an infection. that is causing it to be imbalanced.
And you know what? You don't need a cleanser. You need antibiotics, girl. Like you need antibiotics. It's not a cleanser that's gonna fix that. And then on the outside, like people don't realize your vulva is very, very sensitive skin. It's like baby skin. As I say. I'm like, please, like if there's a smell that happens, it's not time to get.
You know the strongest cleanser in the world to fix that, it's actually, you have to go more gentle because it's your body's way of telling you that something is out of whack and it just needs a res like to chill, right? Yeah. And usually either just water and if you need an antibiotic or an antifungal, you can get that or something that's unscented.
Doesn't even lather up like that. And yes, do some of those, um, cleansers in that feminine aisle, do that maybe, but. A lot more expensive than like, some, like cil, which is cheaper than most of them. And it'll not only cleanse their, it'll cleanse your whole body. Um, and it's, you just really wanna stay simple and base like, like very clean.
And I feel like. All of these multicentered things, summer Agil, and I know I'm gonna get blamed for this. Some other ones out there that are also owned by, I hate do it. Well, I, I have it in my bathroom, but you know, I, I fell into the trap of capitalism. What I have to say, , . Cause I, I know water is best, but I'm like, chow.
Let me, lemme support Buck business. Lemme go little. Listen. I almost did too. That's why I say I'm not about that. I'm never above it. But the thing that I say though, This, I say this stuff with an asterisk, right? If it ain't bothering you, I'm not coming for you. Hmm. So if you use it and you're fine, I love that journey for you.
I, I'm happy. I'm not gonna tell you to change it, but if you come to me and you're having problems, I'm gonna tell you what you gotta do, what you gotta change. There we go. You know what I mean? Yeah. And it's simple. It's like, cuz people are like, well that doesn't work for me. And I'm like, I'm just telling you.
Or like, or I haven't had a problem using any of these products and I'm like, I'm just telling you what will work for probably 95% of the population and the, and, and the product that some peop some of these people are using will work for about 50% of the population, maybe even less. You know what I mean?
I have to go by what I know, like will work for most people. Yeah. It's so interesting with the. The black people and the cleanliness because mm-hmm. it. There's, you will. Reamed or like you're black card revoked. Okay. Like whenever I tell my friends I don't use a washed cloth, they are like grasping their pearls.
Sometimes I do, but like I, it's not my default. I grew up with one. I know. I know, I know. But or anything like with cleanliness, they're . I, I can go on and on. The dog, the, this, the that. Like I'm not having dinner at your house. Um, but it's interesting cuz it's like, yeah, where does that come from? Where it's, we just had, uh, a black dentist on our podcast and she was talking about.
How, um, people like to brush their teeth, like they're scrubbing a burillo pad and it's actually all about soft brushing. And I'm like, oh wow. Why are we so aggressive with the clinic? Yes. Something to think about because there's no one who's cleaner than a black person. True. But at the same time, yeah, we take so much pride in that, but it's sometimes it's not really helpful because we also suffer from things like dry skin and all of that.
Um, exactly. Yeah. So speaking of all these gidgets and gadgets, um, my same friend group, , we had a bachelorette party and one of them brought these yoni eggs. Um, and we were talking about
Dr. Heather's, like out here. I, I know y'all slide. Just want me to slide off my chair. Don't show . So is the yodi eggs, like they're pa vag steaming the yi pearls like. Okay. Ba based on your face. I'm, I'm hearing that , this is not a good idea, which isn't my first time hearing that it's not a good idea. So tell me It's really not okay.
Y'all like, there are a few things that I'm like, you really just like, if you like I am again, I'm like, choose your own adventure. I'm here for you for the ride. Like, and, and I won't even like come for you unless you want me to come for you. Like if you want, if you want that energy, I can give it to you, but I don't normally, I don't lead with that.
I lead with things happen. You gonna do what you gonna do. . And we live. And we learn, right? And it's like I've done a whole bunch of messed up things. We can get into that another point, but especially pre like med school where it's like witch cha, witch chave, . But those yoni Ooh, chow. I have seen some things.
I have seen some things. I've had to fish them out. Y'all. I've had to. Yeah. Cause people put em in there and they're like, I can't get em out. And I'm like, oh my god. And they're like, and I'm like, I have a cell. It hurts. Whatever. And so I've had people come in for like emergency appointments where us go and fish 'em out.
Um, people who get raging, infect, like of all of the things that I have, um, like seen people get infections from some of the yoi, post yoi infections. Wow. Are like, they're, it's yeast in back in bacterial vaginosis or bb, but they are rough. Like it, it. Not, not pleasant. Um, and then like, I don't know if you guys have seen those ads, especially like, I mean, they're all on Instagram and stuff where they're like, look at all of the toxins that have shed from my, like, vagina.
No. And I'm like, and it's like pieces of flesh, right? It looks like, and I'm like, yu. That is not toxins. That is actually like the top layer of the inside of your vagina, like coming off in an inflammatory reaction, oh my God. Like that's not good. Like . That is not like a, not what should happen. So it's like you're not relieving yourselves of purging yourselves of any toxin, toxins, relieving yourself with any toxins.
There's claims that like the yoni pearls and stuff like that. Um, are good for things like endometriosis, fertility, um, fibroids, all of that stuff, which a lot of black women we suffer from. And cuz like one big thing that we need to know, especially fibroids and fertility issues, we're actually, we have a higher rate of infertility than.
Our white counterparts, we have a higher rate of fibroids than our white counterparts. We don't know how bad our endometriosis is because it's so underdiagnosed. Mm-hmm. in our community. So we're trying to self-medicate a lot. Right? Yeah. And so yoni eggs are used for our yoni pearls. And they're just, they, they will not treat those things because what's in those, those herbs that are in there just have not been shown to be helpful for those things.
And instead, a lot of times people are having chemical reactions in their vaginas to it, and it's not, it's not good. And like the best case scenario out of it is that it won't harm you and that you just spent the. Um, the worst case scenario is that it can cause you to have some, like chronic pain, infection, things like that, and vaginal steaming.
This one is interesting for me because like, again, people put herbs in, I say herbs and spices in there, right? , and it's like, mm-hmm. . Again, these herbs and spices, often essential oils, all of that stuff most times. Like irritant to there because like they cause allergic reactions. But even if you were just gonna use a steaming pot of water, right?
Just make sure you don't put your vagina back close to it because people have gotten burnt before. From it and things like that, from the steam. But typically it's not going to harm you if there's no like chemical irritants in there. But it may be helpful for pain relief, like if you're having your period, or like if you're someone who like suffers from chronic pain, but it's not really.
Like gonna do anything magical, like, you know, it's not gonna cure your fibro, it's not gonna cure your chronic pelvic pain. It's not gonna do those things. But you, there, you, you have to weigh the risk because there's a possibility that you can harm yourself by doing it. I, I just, I just usually think there's other ways.
Yeah. Yeah. And I mean, in my mind, the idea of steaming, I'm just thinking like moisture and yeast infections, basic, basically . So that's the other part of it is that it's like a lot of times people end up with yeast infections because anytime you kind of alter that climate down there, The vagina and boba your genitals.
They're very picky. Like they are just not happy unless you just kind of leave them alone, let them do their thing, and then make little adjustments here and there as you need to. Mm-hmm. . Mm-hmm. . We also got a lot of questions about hormonal birth control, and I mean, you know, this is, I feel like this has always been a hot topic.
Oh yeah. How do you address safety concerns? Because there's just so many, um, claims about hormonal birth control and like the possible effects that it can have for short, short term, and long term. So how do you navigate those conversations? So what I think is being very open and honest, right? I think one of the big issues, kind of, of both extremes of this slide, like kind of like the medical extreme and the like pseudoscience extreme is that like everybody thinks that there's like one truth or one answer that I don't think is, and I don't think there that's actually true.
Like birth control is a very personal decision or like hormonal contraceptives cuz you can use them for. Reasons. There's a lot of, um, diff people react to them different ways, right? And people need them for different things. And I think the issue is, is that, like from the medical side, right? Is that we don't necessarily address that when we're talking to patients about putting them on these things or suggesting it, right?
So a lot of. Docs will say, like, you come in, you're like, my periods are really weird. Like, you know, I don't have regular periods. I just need, you know, like, and I'm having pain too. Like what should I do? And they're like, here's this pill. You know, it's birth control so you won't get pregnant too. Yay. And like it's gonna solve all your problems and that's it.
And they send you home and then you get you, if you. Like, you know, thinking about it a little bit, you leave the packet and you're like, I can get blood clots and I can get this and cancer and blah, blah, blah. What the hell? . You know what I mean? And then like, cause that's my favorite thing where it's like, cause my favorite thing is like, when I even tell my patients what, like, kind of like all of the things and then they go home and get the packet and then they read it and then they come back and they're like, and I'm like, girl, I told you what was , what, what you were gonna see.
Like, so sometimes even when people are getting it, they're. Like digesting everything you're saying. Um, I think it's very important to be very honest, right? And say like, Hey, you know, let's look at what your goals are. Like your goal. Is your goal, like not having kids right now is your goal. Like, you know, you have.
P c o s, polycystic ovarian syndrome and like you're not having regular periods and like maybe we saw some abnormal cells in the lining of your uterus and like, we need to address this. This is why we're doing it. But these are possible side effects and this is the rate of these side effects. Because I think what happens on the other side, kind of like the pseudoscience side is that.
Side, like kind of like the rate of side effects happening is blown up more than it is where it's like, yes, birth control pills increase your risk of clots. Right? But it's not so high that we feel like it shouldn't be authored and it's way lower than getting pregnant. Right? So it's like if the option is like, let everybody just get pregnant versus.
Like be on birth control pills. If we're like looking at, let's say clots, right? It's actually safer to be on birth control than it is to get pregnant. Cuz you're more likely to get a blood clot from being pregnant than being on birth control. Or let's say, um, something like breast cancer, right? You're like way less likely to get breast cancer on like birth control pills.
Like, you know what I mean? Then like, you know, not so like there's a lot of times. We're not like there's the proper equivalence is not being, is not being looked at on kind of like the way extreme side of being like birth controls are really, is really bad. And then in terms of like some of the things where people have like changes in their mood or changes in things like that.
I think acknowledging that that's a thing is important because I feel like doctors play that down. They're like, no, it's probably not the birth control. And it's like, yeah, it really could be. And my, and what I say is like, let's take you off and see what happens. And if it gets better, then it was for you, it was for the birth, it was the birth control.
And that's fine, and you don't need to be on it. But for other people, they don't have those issues and they do well. So I feel like people who need to realize it's an individual situation. And you have to weigh your pros and your cons, and not everything is gonna be perfect. Medications are not perfect, and as long as you know what you're getting yourself into, it's okay.
But the problem is, is when like no one's being really honest about it. Yeah. I love that approach. Mm-hmm. , because yeah, I feel like that way you can make an educated choice on things. Cause I do think, like for many of us we're started on birth control at a very early age. We don't even understand what the hell's going on.
Yeah. And it's like, oh, you have acne, you know, you have. Period suck. Let's put you on birth. And we don't really even understand like what the underlying cause is. And you know, for some people they're on birth control for decades and then Yeah. You know, and, and this is like really all they know. Um, for someone who's like, okay, well I wanna, you know, consider maybe getting pregnant, do you recommend like allowing some time off of the birth control so the body can adjust?
Is there a recommended timeframe or is there, are you just like, okay, just get off and start. I usually say if once you get off birth control, I can't guarantee you that you're not gonna get pregnant or right away. Mm-hmm. , it happens way more than people think , because those people don't really actually talk about it.
That's another thing. People who have issues with stuff tend to be the loudest, right? Oh yeah. Let's think about it. Google reviews. Yo, come on. Like are you gonna write a Yelp review for something that was okay? No, unless you're one of those people who has like, you know, who's like the expert yelpers or whatever, who like make a coin out of just saying stuff.
Right? But if you're like a normal person who just goes on Yelp and, but then you had a really either great experience or you're like, oh my God, I used to tell people, or I had a really awful experience, you're gonna put that on Yelp. But if it was just like, you know what, that was fine. You're not usually gonna say it, right?
And so the people who have a hard time getting pregnant after birth control tend to talk about it, right? But sometimes because also there's like stigma behind like unintended and unplanned pregnancies, people tend not to say, Yeah, you know, I really wasn't trying to have this baby right now, but you know, I got off of birth control and then it just happened, and it happens a lot more quickly than some people would think.
So I always say, Hey, you can try to say you're giving yourself time, but if you're not on any form of birth control and you're waiting for it to kind of flesh out your body, there's a possibility that you can get pregnant in that time that you are waiting for it to flush out your body. Meaning that, um, there probably wasn't really an issue to begin with.
And so that's, that's the reason why we say once you come off of birth control, all bets are off. Like you can totally get pregnant and something people need to understand is. Like when you get put on birth control initially, like when you're a teenager or whatever, when you're having like acne issues maybe, or irregular periods, it could be a sign of an underlying issue like P C O S or something like that, that you don't even know about at that point, and maybe you weren't tested for.
So when you are on your birth control, do an okay whatever, and then you come off of it and now you're having trouble. It may not have been the birth control that's causing your issue. It's that underlying condit. that the birth control was treating that is now presenting itself. Okay. And that's what I like to tell people cuz I love to do this fact-finding mission with my patients, where it's like they come to me, they're like, I've been off my birth control for six months.
I haven't had a period. Right. What's going on? The birth control broke me. And I'm like, think back 15 years ago, right when you were like, when your mama took you to the doctor and then all of a sudden you have these pills you had to take every. What was going on in the first place that they put you on that pill.
And sometimes people have to really think about it and they're like, yeah, I remember I wasn't getting my period very often. And I'm like, aha. And then we start doing tests and I'm like, you have P C O S. Mm-hmm. That is why you haven't had a period in six months and you can't get pregnant. Mm-hmm. . Yeah. Ooh, so much to think about.
Well, We have a fire round. These are also questions people submitted and . Um, we have, let's, do you have like seven more minutes? I have seven more minutes. Okay, let me set my timers, set timer for seven minutes. No pressure. . Sorry, I'm like pressure. Quiet on this. Sounds like yes, 10. So this, it's not, it's not.
We'll just take a deep breath. Um, no big deal. Okay. So we're just gonna ask you a bunch of questions. We have seven minutes and we have like 10 questions. So we have basically 30 seconds per question. Okay? Okay. Menstrual cups, safe or not safe? Definitely safe. I use one. Okay. I, it's not gonna hurt you. Okay, great.
I keep getting yeast infections after using sex toys, tips. Wash your toys. Y'all Wash 'em, wash 'em, wash 'em, wash 'em, rinse 'em off. Really well. Is there a type of soap? Is it the Ceil again? Yeah, I would do Ceil or some sort of disinfecting wipe, but then wash it with CIL after. Mm. What can be impacting the smell of my vagina?
Lots of things. Dehydration usually is the biggest culprit though. Mm-hmm. . So drink your water. Ladies, drink up. Oh, that's a good one. Interesting. Um, yeah, remember the dentist was saying that that can also cause like the bad breath, so Yeah. Yeah. It's dehydrations a big one. Okay. What's a normal level of discharge?
Is there a way to decrease discharge? Let your body do what she's doing like and there is no normal level, normal for you. May not be normal for me. So let her, let her breathe. Let her discharge, yeah, it's okay. Okay. , what are, what are these? You're doing great. You're doing great sweetie.
Okay. What are tips for postpartum badge? Um, so moisturizing, so it, your vagina can get really, really dry. So like, if you wanna get back on the horse, do any sort of penetrative intercourse or things like that, lubricants are your best friends. Like, please, please, please. Do that. If you're really close postpartum and you had any sort of kind of trauma to the area, there's um, peri bottles, which is basically sporting water there when you're peeing or anything like that, that's more helpful than using like toilet paper.
Oh, uh, okay. Um, quick follow up, sorry. Um, like a mini bday. Like a mini bday. Mini bday. When you say moisturizing, do you mean, um, using like an over-the-counter? Moisturizer or you said lube too. Tell me more. Like is there a brand you recommend and is a lube just for sex or is it for the moisture during the day?
So they actually have vaginal moisturizers you can, that are like right next to lube. Um, and any pharmacy or anything like that, those you may feel like if you're feeling dryness, like throughout the day, like, but especially with intercourse, lubricant will be your friend postpartum. It's dry because of your hormonal state.
It's not you. You're not broken. You don't hit your partner, maybe, I don't know. But hopefully you don't . And it's not that. It's literally your hormones are making you dry. So if it's something that bothers you when you're not having intercourse, there's vaginal moisturizers that you can find over the counter that are right next to the lubes.
Um, and then there's actual lubricants that for, for intercourse or any sort of play. Hmm. Okay. Speaking of dryness, what are some badge changes to look out for as we get older? So bad changes as you get older, um, you might notice the labia gets smaller. You may notice that the, um, you do get Dr. Um, sex may become a little bit more, um, uncomfortable.
So you would need a lot more lube, lube, lube, blue lube. You may see changes in your libido. Some people, a lot of people see lessening or lowering of their libido, but some people actually see. Small, small portion of people, but it happens. Um, but those are the biggest things. Hot flashes, night sweats, things like that.
But in terms of the vaginal area, it's usually dryness and you may see str light gets smaller. Yeah. What are signs your menstrual blood, or sorry, what are signs with your menstrual blood flow that indicate something is. When you are soaking more, if you use pads, soaking more than a pad an hour. Um, if you're passing huge clots, if you feel dizzy, lightheaded with your periods, things like that.
Um, if you're using a menstrual cup, if you have to change it out multiple times a day cuz it's filling up. Um, If you're skipping periods, if you're having, um, spotting in between periods, anything like that or things just changed from what it used to be like. So let's say you used to have a period that lasted three days.
Now it's eight days. Come see us, we'll check you out. Okay, good. Uh, reoccurring yeast or yeast infections or bacterial vaginosis? What should I do? Go see a doctor. Honestly, it's going to be a journey. Hold on. Sorry. You guys here, sorry. Yeah, it's gonna be, yeah, it's gonna be a journey. It's not gonna be something that can be fixed immediately, and so just understand that you will need to be patient, but it's a need to have a close relationship with your doctor about to treat.
Okay. Because it sucks, and I'm sorry that you're going through it, but it's gonna take a while for it to go away. Yeah. What are some fertility tests that every woman should. Um, so I recommend if you are not having regular periods or you're over the age of 35 and then trying for six months or longer to get pregnant and haven't been able to the test that you can get, and I will rapid firely tell them, um, offer you.
Follicular stimulating hormone lutin. Hormone estradiol, which is estrogen. Um, they should check your hemoglobin A1C to see if you have diabetes or something like that, or P C O S. They should check your progesterone and, um, Depending on where you go, a m H, so anti hormone, those are like kind of basic ones.
They should check to see what's going on with your fertility. Also, an ultrasound can help as well just to see if there's anything going on, like vibrates and his cell pen, Agram, H S G, that checks to see if your tubes are blocked. That's kind of the basics of your infertility workup. Amazing ovarian. Are they common?
Do they impact certain people more than others? So variant cyst are very common, and actually it's a result of you ovulating what that little egg doesn't burst out so that that cyst or follicle grows and grows and grows and grows. Fills up with fluids, sometimes blood. A lot of times it just causes pain.
And then if it twists, if the over a twists on itself, that can be a surgical emergency. But for most people, they just kind of come and go as they will. Obviously, if you're having any pelvic pain or concerns, again, come see us, we can help you out. Last question, and that was amazing. Um, brand of lube. Do you have a favorite and does it have to be water based?
Um, water. Is good in general, but like, um, you can also, it depends on what kind of player you're using. So like doing, so like for example, if you're doing something that's going to take a while or for some people say for like anal sex, using silicone based loop, it's better. Um, but you don't wanna use silicone based loop on silicone toys, which are most of the toys out there.
You need water-based loop cuz you will ruin your silicone-based toys. Brands of. There's a lot astroglide. I actually used to have a relationship with them. I don't, but I still recommend them cuz they're good. Um, and then just basically anything that doesn't have glycerin in it. Cause glycerins like sugar and yeas like yeah, sugar.
So yeah, stay away from that . You did so good. Yay. That was amazing. Yay. That was the, oh my gosh. God, you killed it. You killed it Killed. That was fun. Yes. You're so amazing. It's stuff I like to talk about all day. So this morning. Aw, good. Yeah. So tell us, like for our listeners who wanna learn more about you, I know you said you have a podcast which you might start recording for again.
So like, where can people find you and stay in. I'm on Instagram, TikTok, Dr. Heather Ida md. That's my handle. My podcast is Dr. Heather's advisory cervix, like the cervix that is at the top of your vagina. Okay. Cause I'm a gynecologist and I some episodes that are already good, it's like just lots of just basic GYN stuff that I think is relatable.
And I'm probably gonna start it up again soon. So, um, yeah, check me out. Love it. Amazing. Thank you Dr. Heather. Thank you. Yay. Awesome. That great. You such a great interview. Such a natural. I know. Not all. That was fun. Good. You're your listeners had great questions. Oh yeah, they really did. Yeah. They were so excited about this one.