ramble [Music] [Applause] [Music] welcome to best friends back all right the show where two high school best friends try the best friend thing again i’m stevie wynne levine and i’m making homemade fad and today we have a very special guest who’s going to be talking with stevie and i about what’s going on downstairs we finally get to talk about vaginas i’ve been waiting for so long it hasn’t been a part of every episode up until now yeah but we’re talking about it with facts this time with an actual doctor so hey we’ll get into that there’s been no fake news when it comes to me talking about vaginas thus far but i’m excited to get into uh some of the questions that we got from the friends listening that they wanted to submit and ask a gynecologist and i actually i did some last minute preparation for today’s episode um i went to a wnba game last night [Laughter] which i feel like is really putting me in the right mindset have you ever been to a wnba game no well i can’t say i have let me just say the bulk of the attendees and i’m gonna say the players are all lesbians logan is dying laughing because i was i mean you could assume that right i would assume that they’re women i thought you were women women they are okay fine they’re women but also i’m i was getting a lot of gay vibes in the audience i didn’t realize it was like a cultural event in that particular way and i dressed like dressing going to a sporting event i’m always like i don’t know what to what to project here because you know i’m not a big sports person and like which team is has which color on and where do you sit and like how do you act and so i just dressed like i what i was wearing to the studio um yesterday i wore to the game and then when i got there i was like oh this is like a lesbian scene situation so you just wished you looked prettier i wish i looked prettier i was wearing a cowboy hat what the hell you were wearing a cow i would hate to be the person sitting behind you at the time no no okay if it was like a play or something i i would not wear a cowboy hat but because you could wear a running event yeah yeah because it was this warning of it i was like oh people can wear whatever they want and like people are gonna be up and down eating nachos drinking stuff and so that part was fine i’m just saying next time i go to a wnba event i will be dressing for the girls and the gays that are are there but that’s all i’m saying is that’s the energy i’m bringing to today’s episode is wnba audience energy i’m channeling it okay and i’m god and i’m here to project that perfect perfect i’m so excited i’m so excited yeah you sound it now that i know what page we are both on we can proceed with this um the energy i’m coming into this episode with is i just opened an email from my mother uh she sent an email to all of the children in this family my sister my younger brother and myself in all caps saying whose bill is this who’s bill yeah she gets uh we’re all still on the family plan oh yeah oh the day you get kicked off is gonna be a bad one i’ve been there and somebody somebody had some overage charges so she who was it who was it i don’t know i don’t know we’re gonna offline about this okay it’s you it’s obviously you a little bit later but speaking of overcharges i am so excited to introduce my sister my gorgeous talented beautiful older sister dr nas i don’t call her that i call her just nas but people lovingly refer to her as doctor so dr nas i ask if that’s if that’s what she went by that’s a thing yeah so my sister is like she’s honestly every immigrant family’s dream daughter because she was you know she was all the responsible things smart beautiful but she also went to so much school okay so much school she went to duke undergrad as you know we had we had a couple of a couple of uh visits there ourselves medical visits yes duke medical school harvard business school ucsf for her residency i mean she’s done a ton yeah and she she’s an ob gyn now practicing in the dc area and she’s the most popular person at any party we go to because everybody’s like i got an ailment so even though her specialty is like women’s health i mean she can advise you on a wide range of things from like i got some pediatrics to geriatrics pediatrics to geriatrics is that a phrase like in the community or did you just coin that it just rolled off my tongue yeah yeah good for you yeah so do you want to say hi nas sure hi can i just mention stevie that nagin was the one who tried to get me kicked out of the family plan two years ago okay why i am a mother to four twins and then one day out of nowhere nadine turned to me and was like it’s time for you to like get off mommy and daddy’s plan god family and i was like where the hell is this coming from is this a mandate from you or i just don’t think that you can have multiple generations on a family plan but i was like where is this coming from like my [ ] business yeah also like don’t you get a bigger discount the more people that are on the family plan i don’t think we don’t know we haven’t been looking at that bill well let me tell you you don’t want to get bumped off the family plan so i i say like at least until the girls are 18 years old stevie are you and your sister on the family plan no that’s what i’m saying i recently was bumped off and because my parents were like hey this uh company i forgot who it is has a senior discount but you guys aren’t allowed on it bye oh it was a rude awakening to my mom okay let me tell you so when my parents age out that’s oh my god no they’re there they’re they’re gonna get the boot i think unless they listen to this podcast they’re not gonna they’re not so i gotta say i gotta share something a little bit funny a little bit ironic about what nas does so growing up i actually from the age of five i wanted to be a gynecologist i’m sorry what you didn’t even put a tampon in until you were a grown-ass adult what do you mean i’m just okay tell me why you wanted to be a gynecologist was this like a playing with barbie’s thing no oh i really actually didn’t like playing with barbies i it was i think it was i just liked children i liked babies if i could sorry i so an obstetrician delivers babies yes and so i’m an obstetrician gynecologist just to clarify so i actually i really is more educated than i am no i wanted that because i i asked nikki and i was like is she an ob gyn an obstetrician a gynecologist are those things the same thing so like can we just start there for a second because i don’t even know that sure so we usually abbreviate it as ob gyn or ob gyn when you have an ob gyn that means they do obstetrics and they do gynecology so obstetrics has to do with everything related to helping people through their pregnancy delivering the baby and taking care of that person postpartum gynecology has to do with everything else that would affect someone like their menstrual problems fibroids menopause contraception counseling family planning so i’m a generalist i’m a generalist i do ob and gyn okay so i was a stupid five-year-old and i said i wanted to be a gynecologist but really i wanted to be that’s not what i was saying you wanted to deliver babies you wanted to like work with babies exactly okay and nas and nas growing up wanted to be a neurosurgeon oh what’s very funny is that she ended up becoming the obstetrician gynecologist and my very first hired acting role i played a neurosurgeon i played a neurosurgeon wow all i could say is pretty interesting that you know i never thought of that well wait how did you go from wanting to be a doctor for up here brain to a doctor for down here i’m gesturing for those listening i’m gesturing and you can picture where i’m gesturing well i realized that i i love surgery and i also love the practice of medicine and being able to see people in clinic and take care of them over a longer course of time and i realized actually when i was in business school that what i loved the most was taking care of people in especially when it comes to talking about vulnerable subjects i think there’s a lot of depending culturally depending on how you grow up there can be a lot of shame or a lot of misunderstanding i don’t think our schools do a great job at all and i loved that i could be hopefully a person who can provide people comfort and education and a feeling of safety when discussing these types of topics i can’t tell you the number of people in my life that have reached out to my sister to ask questions about their own personal things so like they’re not even her sister’s patie my sister’s patience but like i think they’re at least 50 to 100. it’s okay okay which brings me to a medical question that i have just recently experienced well i mean i guess i just said it was me but let’s say one person was going to eat a piece of toast this morning and maybe that piece of toast had some mold on it questionable it might have or might not have had mold but then somebody was like oh [ ] it i’ll eat the piece of toast at what point can i expect diarrhea death or nothingness wow that’s okay so sorry this is the this is amazing because stevie i thought only iranian people did this but you just did what a lot of iranian people do which is they know she’s at ob sh they know she’s an ob gyn but they ask her a question that has nothing to do i know but i but you said that was okay and and and also i broadly feel as if if you’ve had that much schooling you could tell me if my moldy toast is going to kill me or not you sound like my dad thank you i also really enjoy everybody loves raymond everyone loves reading everybody loves raymond yes he’s like don’t you think this is important to know to be a good doctor i’m like dad there’s a lot i have to know and some people know things about the other parts of the body far better than i do so i would direct that question to your primary care provider oh so google it was what you’re saying you should be fine i mean if you get a little diarrhea you’ll find it i mean yeah a little diarrhea never hurt anyone right cleanse cleansing um okay but we have real real questions yeah i’d be i’d love to answer them real questions okay sorry okay i thought there was a really great first question for you this comes from um one of our listeners they say i am a uterus owner and over the age of 18 but haven’t been to the gynecologist yet out of pure fear can you describe what a first gyno visit is like to help me get rid of my fear sure so first of all i think anytime you’re going to a gynecologist someone should take the time to talk to you first and you’re going to go in they’re going to ask you your medical history especially if they’ve never seen you they just want to get a sense of who are you what are the things that we need to be thinking about and so part of that medical history is just medical conditions you have if you’ve had any surgeries if you have a uterus what are your periods like because periods are a vital sign um and tell us a lot about your gynecologic health so what are your periods like how often do you get them how heavy are they um are you sexually active and if you are with whom and what kind of protection you use we ask these questions to get a sense of your risk for sexually transmitted infections and to we’re not trying to be invasive or intrusive in our questions we’ll ask if you’ve ever been pregnant we’ll ask about medications you’re on allergies you have family history um some social history which so that sounds like a lot of questions okay do you want me to go into detail or not what i’m saying is it sounds like in the first appointment there are lots of questions to establish your history and so it’s just like a one-on-one conversation do you expect your patients to have all of the answers because even as you say this i’m thinking like i don’t even know if i know all the answers to these questions and is that okay that’s totally fine i think it’s helpful a lot of people don’t necessarily know their family history they haven’t gone and asked the questions and as a as an ob guy and i want to know do you have a family history of ovarian cancer breast cancer uterine cancer colon cancer and a lot of people don’t know that so i say go ask your family if you can and tell me later send me a message then you’re going to so after you establish talking to someone another thing that i like to ask people is have they had any history of sexual physical verbal assault or abuse because i think that’s really important one for me to know i need to know if i need to help someone right then and also i’m about to do potentially do a really intimate exam and i would like to help put that person at ease and there’s something we use in medicine called trauma informed care and that means just taking the time to make sure someone feels safe and that you are preparing them for the exam that you’re about to do so once we go through the questions i asked to do an exam sometimes people are already undressed and wearing a gown other times we let them get undressed and then we do for people who have breasts we do a breast exam and then if someone needs a pap smear or has or doesn’t need a pap smear but is having concerns like abnormal discharge painful sex painful periods we might do an exam and an exam would entail doing what’s called a speculum exam um using a speculum which negan called a duck bill like a few years ago it’s like your sister’s a [ ] gynecologist like can you please use the right term i mean it’s descriptive i i feel the same way and i’m also literally talking about it and i think she needs to think hard about what she’s done and correct herself you’re right i should have called them salad tongs excuse me so we’re gonna use a speculum which is an instrument that opens that goes in the vagina and opens up around the cervix because for pap smear we’re screening the cervix so that for that first visit if you’re over 21 will want to do a screening pap smear we can talk about why why 21 versus 18 like what’s the yeah yeah so the professional guidelines um american college of obstetrics and gynecology us preventative task force um there’s there are a few others american cancer society i think don’t call me on that one well but we have national guidelines that tell us when we should start screening and we used to do it at 18 or whenever someone was sexually active and we realized that we’re actually over screening a lot of people got it so now the guidelines are that no matter when you start being sexually active that you can start your pap smears at age 21. okay because those screen for cervical cancer so you’re saying you don’t have to start pap smears until you’re 21. right but you may still have questions about your sexual health or sure your body um your reproductive organs things like that before then and so at that point are you supposed to talk to your primary care provider which at that point is like your pediatrics yeah yeah like what at what point are you supposed to have your first gynecology appointment like what would you recommend there’s no right answer right so if you have a good like a pediatrician is going to be able to answer some of your basic questions but if i have a 14 year old or 16 year old who has really awful periods or has yeah and has questions about it then i’m happy to see that you’re happy to see them or they should see you i think i’m happy to see them and they should see if their pediatrician can’t answer their questions or their primary care provider can’t answer their questions then they should be referred to see an ob gyn who can really help dive into those questions even more and then we even have pediatric adolescent gynecologists so people who do even more training to understand because anatomy and physiology of the pediatric population is different from that of an adult population so we even have those specialists available in some places but this is all to say sorry that i hope that this person who has concerns about their first visit one let your provider know i think it’s so like i don’t expect anyone to be thrilled to come and see me no one wants like we all hate getting yeah right we know that i’m sorry we all hate you but we like you [Laughter] also can we talk about the lighting in the gynecologist office like do you go for soft light do you uh what is your office like do you uh yeah what’s the ombuds because like i will tell you like a a fluorescent light when you got your legs just spread open to the to to the elements the lighting i feel is important but it feels like a neglected element of the gynecology experience so i would love to make this another topic that we address at some point but like oh she’s trying to get herself another episode this girl is hustling for a job it’s a gynecology lighting episode exclusively you just you don’t have like i i think you have to divorce a lot of times the architecture and design of the clinic from the individual who’s providing your care because and there are wonderful there are like kind body tia health they are new companies that are really focused on the experience so there’s there’s like this burgeoning group of clinics that are opening up that really focus on the experience yeah that of course that’s important yeah that’s not what we’ve traditionally focused on so so you’re gonna get fluorescent lighting in my eyes i promise you you will get a five-star experience speaking of five-star experience i think a lot of people also have a fear of going to the doctor going to see their ob or their gynecologist because of the grooming stuff so somebody submitted this amazing question which i’m so excited to hear your answer to so the question is before a gyno visit i always have to weigh the risk of mega bush versus a possible razor burn and grown hair situation how concerned should we be about grooming the area before an office visit that’s what they called the uh george w bush presidency era it was called also the mega bush era sorry i don’t care i don’t i do not remember what your vulva looked like i see so many i do not remember so i don’t want anyone to have to worry about grooming if you if you if you like to wax or you like to trim and shave and you do it before your your visit great if you don’t like to do it don’t do it just for me okay but have you seen anything have you seen anything wild yeah i want to know like what is i mean have you paid attention to the hairstyles even though you don’t remember them of course and you’re not judging anyone like what is the truth what are the trends yeah what is what is the current grooming trend yes are we on cosmo yeah yeah are we trying to get oh i’m on something but it’s not cosmo but is there have you noticed the trends changing from med school days yeah to now i wouldn’t know or like pandemic come on doctor come on don’t [ ] us here like we’re trying to get what is is is are people doing the rachel down there i don’t know i don’t a little shag yeah is that the truth yeah um i think i haven’t noticed as many brazilians thank god oh thank god so so the more natural i think like like trimming okay also i will say we do recommend like like waxing and shaving can irritate the skin more and it can cause cuts that can lead to like little tiny infections or razor burns so like trimming is the best way if you ever have a surgery a gynecologic surgery or you’re going in for a c-section we’re going to tell you to trim okay you’re bringing it back to a medical place i appreciate it i respect what you’re doing you asked for a doctor i know but i think it’s very important we all know that the natural look is in okay but you know what i was just on a beach and i don’t think the natural look was in because the bikinis are getting smaller oh yeah yeah yeah so what i’m hearing from you is that it’s actually like un potentially unhealthy to be doing extensive waxing and shaving right so like maybe string bikinis are actually a threat to our public health i mean i don’t it depends if your skin gets irritated if if if your skin gets irritated and every time you’re doing that you’re coming in with razor burns or like ingrown hairs then yeah you shouldn’t do it but if you’re fine and that’s what you like keep doing it and what do you do about those ingrown hairs when you have them you take a loofah and when you’re in the shower you scrub the dead skin off and you have to do it pretty regularly but you shouldn’t sit there popping them you can introduce more bacteria all right wow are you all happy no can we please move on no i’m not very good wait wait i learned that from the lady that i went to go get waxed from i did not learn oh my god do you want her to come on she can tell you honestly i think that that might be more up stevie’s ally hey don’t talk about my alley [Music] well before we get into the rest of the episode there’s a word from our sponsor 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quick breakfasts lunch snacks desserts and more and zach and i love hello fresh because it gives us like a little date night activity it means we have something to do at the end of the day we haven’t had to like work really hard for the meal but it’s like 30 minutes of of time that we have just chopping away yeah we love it we love it so much yeah and i’ve found that you can uh still grip onto a knife with shrivel fingers and chop things up so that’s been good go to hellofresh.com best 16 and use code best16 for 16 free meals across seven boxes and three free gifts that’s hellofresh.com best16 and use code best16 for 16 free meals across seven boxes and three free gifts hellofresh america’s number one meal kit all right so when you’re in these um in these rooms now when you’re doing your exam you’re wearing a mask right when you’re doing like a pap smear right yes since the pandemic we always wear masks but i will say pre-pandemic we did not it’s interesting even when you were doing a pap smear i wear gloves uh-huh why why would you wear why would what did you think would happen if they didn’t wear a mask you thought something was going to come like flying out into there i don’t think something’s going to come flying out but we do we did get a lot of questions about odor oh and so the questions around odor are like generally like why do some vaginas have a strong scent and others don’t right so lots of questions about what smells mean um and when when it’s problematic and when it’s totally natural and so i’m wondering as a doctor when you’re doing an exam and somebody comes to you saying like smells kind of strange to me are you actually smelling them wow i wish i’d known these questions before i agreed to come on wait wait no but this is an example of a question that like i wouldn’t i’m not sure how i would be articulating this cannot be the sound bite that we use oh my god i thought you were just gonna leave it at like and what do the different smells mean and what’s natural and everything i didn’t know you were i didn’t know that’s i didn’t understand that that’s where it was gonna go but like now i’m i’m really into it now i really wanna know so the two questions about how do you assess smell and then do use and then what does smell mean okay so there’s different types of one i think people given i just have to put this out there like there are stupid washes out there that are designed just for the vulva and vagina like vagisil does this you go to target and there’s just like feminine cleaning products which are [ ] really like no one should be investing money in those things i think if you want if you want to use soap um to clean your vulva then you can use a hypoallergenic soap a non-scented soap or not even use soap water is fine you don’t need a wash in that area and you certainly shouldn’t douche because that’s actually really unhealthy now when it comes to smells i think as a result of all of this we have made people people feel a lot more um sensitive to the different odors of a vagina than they would be totally some owner is is normal like and it depends on have you been sweating um it can depend on where you are in your cycle like the type of discharge you have and so there are certain odors that are characteristic of um certain vaginal either inflam inflammation or infection so like something like bacterial vaginosis is going to cause the vaginal discharge to have a very strong fishy odor that’s very characteristic and actually one of the ways a healthcare provider can assess for it is by doing a whiff test that’s all i’m going to say about it yes that makes a lot of sense to me not in the presence of the patient you don’t oh but oh you take it how do you do it with oh that makes a lot of sense okay got it you collect the discharge you put it on a slide and you take it somewhere and you add some yeah i see you could cut out a whole step though if you just no you can’t because you have to add some reagent to the discharge to do it okay okay anything else you wanna suggest in my practice i’m i’m i’m surprised that you didn’t ask her this question like in your private life like like like girl you smelling vaginas like i feel like you would have gone there like this is i’m glad that you waited i you preserved it you set it up in a way that seemed legitimate and then you just and then you and then you did it i honestly i don’t i actually don’t know where the line is with my sister because she is very comfortable exactly so then you’re telling me like don’t ask me is this like a weird question no i just assume that you’re that your audience like really wanted to know i think they wanted to know about the what what a smell like the smells are i don’t think they wanted to know i believe that was a tack-on question of like do you smell yeah don’t fault our audience fault yeah i don’t i want to say i don’t judge anyone yeah except your sister except your sister but okay but what i learned what i learned from this is that smells are normal you should not be using feminine wash products to clean not in my opinion not i have to say this is not medical advice you learned it from your waxer again yes all my medical training i learned from the waxer that i saw for a brief amount of time in san francisco oh and here’s another thing it’s like maybe this myth more more people know this is a myth but i remember you telling me now is that like the whole idea that eating pineapple would make you smell better down there is total [ ] i thought that was a like a jizz thing oh yeah i think i was talking about like i was she’s like yeah actually that is interesting no it’s not true but it’s a long conversation with certain males in our life who had this false belief that you can say it you can say it our little brother oh when he was really young he asked her okay that is a totally different episode and i’m very interested in that when we have your brother on i’m going to leave with that opening question my sister and my brothers um their conversations and their history of like talking about sexual health is long and so interesting and it starts in a pf changs i do feel like i feel like i do need to bring this up so i remember my sister was i think you you were in medical school at this point now and my little brother was in middle middle school the entire family was at a pf changs okay my grandfather was there oh no but he doesn’t speak english oh yeah my grandfather who doesn’t speak english so okay that we were having this conversation but castra um was going through sex ed and my sister was quizzing him um and so they were quizzing him on all these questions and then she’s like okay three common stds in the pf jinx the waiter comes by he’s like ma’am like what would you guys like to order they’re like mongolian beef and he’s like chlamydia what else would you like crispy honey chicken syphilis and then the last one gonorrhea and this waiter is like in the middle of the greensboro north carolina pf changs the entire restaurant if the public school system isn’t going to teach them i will yeah wow so i think um we can we can take it back to some of the questions that our friends asked which is a little bit in line with maybe some of the questions i’m asking but is there such a thing as a patient’s questions going too far and then where are patients not going far enough i certainly don’t know what the line is with my doctor i think you have to keep in mind that it’s still a professional relationship okay and so i think there is no if i don’t ever want people to feel like they have a stupid question or one that’s inappropriate and if it and i think we all don’t have the right vocabulary to ask something yes yes and so i think that’s totally fine like say it the way you’re experiencing it and we will help you like figure out what it what it’s about so no i don’t think there’s but but i do think i mean any time when you’re if you turn the question around and you ask the doctor like have you experienced this or um sometimes i i think i remember one patient was like like you know when something is happening and this happens like haven’t hasn’t that ever happened to you before i’m like we’re not here to talk about me oh we’re here to talk about your and i’m and and there’s some times where i think it’s appropriate to show that like it’s something that we’ve all gone through and other times from like let’s let’s take this professional but i think you just have to think like if this if this is truly a medical question you should feel comfortable asking it yeah i guess that the conf like the gray area with you is probably i mean you’re talking to people about their sexual history or what they’re going through sexually and that oftentimes is very awkward for people to talk about and so i think that’s probably where the line question comes up is like you know how how much am i going to share in what way yeah what’s relevant and that is again i think if the provider is asking you questions then and you feel like it’s relevant you can say it also if you feel like the providers asking questions that aren’t relevant and it’s making you uncomfortable you should say that too like oh can you tell me why you like you need to know that um i think this is true for several of our like trans and non-binary patients if they feel like the questions are are not necessarily relevant then they should be able to say that but oftentimes if it’s being asked it’s to understand like okay again assessing your risk and what things that we need to think of i will say like a lot of times people take pictures of their discharge or their bleeding and they’re like oh i have a picture you want to see and if it’s discharged i usually don’t need to see but it’s okay if you take pictures yeah i’d be like what a slide show because it’s like over time and yeah or like if you’re going to get your hair cut and you have a picture of rachel um but what you’re saying though is that like there’s not a line in terms of if you feel like you’re you’re talking openly with your doctor to share pertinent information your doctor’s not gonna unless you cross over until like personal towards them territory or you know like you’re not gonna be like whoa that was wildly inappropriate that you told me about that particular experience as it pertains to your health or like no i can’t believe you showed me that photo like there’s not the the patient shouldn’t be concerned about really crossing a line with you because it would have to be pretty wildly inappropriate for you to you know have some kind of reaction so like i guess what i’m saying is you know what i mean i was like yeah yeah okay we are this is as an ob gyn a lot of the topics i talk about can be very sensitive and very personal and people have said i haven’t been able to talk to anyone about this or this is the first time i’m bringing it up so i want to invite the conversation and i never want people to feel judged it might be that we have to redirect the conversation yeah right that often happens a lot more where it’s like okay i don’t need to know about all the other health stuff i need i have like 15 minutes with you and i really need to figure out and in your mind it might be that it’s all connected it’s about the moldy bread yeah i was thinking the same thing like if you go in for your pap smear stevie in three months don’t bring up the moldy bread can i bring up the lighting you want to bring in your own lighting i think all i’m all i’m saying dr nas is there are some gels that you can invest in i’m not talking about you know vaginal gels lube i’m talking about lighting gels and they’re you know inexpensive they bring a warmth to the room if mythical wants to send me some lighting gels okay here’s the thing i feel like this is a good sponsorship opportunity well we’ll do what we will see sponsoring who and then and then if you could just place um oh you know what we’ll do here’s what we’ll do our key art for bfba we’re gonna make a nice print for you we’ll mat we’ll mat it frame it it can go in one of your exam rooms in that exam room we will put gels over the lights so you get the warmth but you’re reminded yeah listen to best friends back all right new show every friday yes perhaps by perhaps by mythical that’s my movie yeah we did have some questions though about reproductive rights about some options that people have because you know we are just in a dumpster fire right now this country of of all kinds of rights being being uh taken away from us left and right and there are questions about more right than left but sorry what people’s options are for a safe abortion especially maybe when abortions are banned in their state what do you have for us because you’re not you’re currently not practicing in a state where abortions are banned is that correct correct and i think people are scared because in my state i practice in virginia and there is concern that there is some legislation that they are going to try and propose to limit um our ability to perform safe abortion so yeah i think this is i mean as an ob gyn and an individual who strongly strongly believes like the whole one of the main reasons i became an ob gyn is because i believe in the reproductive rights of everyone and and that means supporting people through pregnancies that they desire and supporting people through pregnancies that they don’t desire it’s really um important to me that people understand where they can go for resources so one of my favorite websites is i need an a dot com and um what it does it asks you for your age your zip code and the week since your last period so just in general anytime you see a ob gyn you should try and know the first day of your last period even if you’re not pregnant but just there that’s what we measure your periods by the first day of your last period so that’s a great website i need an a.com to go see one to get a sense of if abortions are um legal in your state and where you can get them depending on how far along you are what really scares me is that there are states that have proposed legislation but it hasn’t passed yet so a lot of people because you see headlines and you see headlines about the legislation people assume that they can’t get care but they can’t so so i need an a.com is going to help them just like figure out if it’s still legal in their state and then other resources there’s an amazing organization called the national abortion federation and they have a hotline that can help people with financing and referrals and their website is prochoice dot org backslash patience backslash naf dash hotline so if you just look up nav hotline naf people can find a hotline that they can call to get a sense of where they can get access and where they’re where the resources are there’s another website called three for freedom dot com and three for freedom.com tells you how to take control of your reproductive future by either getting birth control emergency contraception or medication abortion pills and for people who live in states where they cannot get safe legal abortions there we do currently have a way of getting the medication abortion pills shipped from outside of the country to them but it does take some time that’s something i saw a lot on on social media people posting tons of stuff about abortion pills and that wasn’t something that i was aware of before so in 2020 pills accounted for 54 of all u.s abortions so i think that’s really important to know that abortions can be safe with medication and that in our country 50 of them were done with medication and there’s a lot of different organizations that are offering medication abortions via telehealth there’s two other websites i want people to know safe to choose.org and that’s safe the letter the number two choose dot org and they have abortion counseling and then aidaaccess.org and when i talk about abortion counseling it’s that sometimes people are confused the decision is not an easy one it might not be straightforward for them and we have what’s called options counseling and people who are trained to ask you questions that will help you decide what is right for you because what is right for you is not necessarily right for someone else and these are not people who are making the decision for you or trying to bias you i just want to say it’s really scary to google how to get an abortion because the internet is rife with misinformation and there are these entities called crisis pregnancy centers that look really beautiful if anything looks if a website i mean stevie you were talking about beautiful lighting if you see beautiful graphics on a website related to abortion you should be a little wary if it looks too good to be true you should be a little wary crisis pregnancy centers are these clinics that are set up in states and often times there are more crisis pregnancy centers than there are abortion clinics and they offer they lure you in with free ultrasounds free testing and what they are they are designed to bring people into the clinic where you talk to anti-choice individuals who sometimes like when you read accounts of these centers sometimes they have a grading system is this someone who’s going to definitely get an abortion so we need to work even harder to try and convince them out of it is this someone on the fence or is this someone who’s already like decided to continue the pregnancy and we don’t need to worry about them so these centers are funded by organizations that are anti-choice they don’t always have professional ultrasound technicians and they and they hide all of this they’re just not disclosing it and so you have to read the fine line and just and see because at least in california and i don’t know about other states but when i was in residency this is something that we actually went and um asked the legislative state legislature to change in california they are required to put on their website that they do not perform abortions and i don’t know that if that is the case in every state that’s why i need an a dot com is such a great resource because they’re going to vet those for you okay so that’s a good way to always just cross-check to validate if you have a place in mind go to that website and that will help you know if that’s a legit place to explore your options okay that was insanely helpful i feel like you know we’re focused on rightfully so the politics of the entire situation to get things changed but at the same time there’s you know people out there who actually really need to take action and don’t know how to do it and so all the sites that you listed are ones that i haven’t seen on social media that are actually um super helpful so thank you for for walking us through that and i know i mean on the the political side of things you know one thing that we’ve done over at mythical is donate to uh abortion funds i don’t know if there’s more information that you have on that particular front but but the one that we uh we’ve donated to is uh called wrrap women’s reproductive rights assistance project there are so many wonderful organizations out there that are doing really important work with reproductive justice access to full reproductive services including abortion i would go to planned parenthood there’s a center for reproductive rights if you go to any of these websites you will find a list of other organizations one is a rather new one it’s called prowess protecting reproductive rights of women endangered by state statutes but they are aiming to be a floating health clinic dedicated to offering a full scope of reproductive health and wellness services including contraception and surgical abortion a floating clinic so this is like a like one of those gambling boats in new orleans you know oh like legitimately floating like on floating on water or floating the like floating around floating around the country in a in a i don’t know this is not a float in a parade this is floating in water it’s like a cruise ship it is going to be especially in southern states that have been most affected by the trigger laws that have banned abortion this will be um a boat where people can potentially get um abortion services i mean talk about something mythical could sponsor that sounds great get we need our photo on on the boat i think nothing better than having two white men on a boat for women oh i thought you were talking about us i was like wait a second you mean best friend’s back all right i said we need our photo i mean what is it what’s that um that bravo show under oh oh oh deck below deck oh my gosh i’ve heard so much about below deck oh this is like a below below deck if you know what i’m saying yes [Music] switching gears a little bit um i would say that at least 50 of my friends are talking about putting their eggs on ice right we’re like approaching our mid-30s many of my friends don’t have children um they’ve determined that they think they want them um and so they feel compelled to do something about it but they’re just they’re just not sure kind of like what to do next or whether whether it’s really worth the investment because it is so freaking expensive to do any of that it’s like at minimum like fifteen thousand dollars i think ten to fifteen ten to fifteen thousand just to start so what’s your advice to people who who think they want children but aren’t quite ready to do it i think you should talk to your ob gyn about it um and get some information from them i think it’s a great thing to think about one of the questions i try and ask my patients when they come in just for us a preventative visit is what are your plans for future fertility and some people we might say like i definitely know i don’t want children great i think i want them but i’m not ready to think about it for another three to four years or i think we are going to want to start in a year or two i think if people want to are thinking about deferring their fertility whether it’s for professional reasons or they want to be partnered when they go through the process and they don’t have someone then it you know uh it depends on several factors it depends on your medical history do you have anything that we think is going to be a barrier to you getting pregnant in the first place previously there was a study that showed there was a discussion i would say that that may be the sweet spot for freezing eggs was around the age of like 34 or so but that doesn’t mean that someone in their 20s shouldn’t get their eggs frozen i think it depends on how many if you are thinking about having children how many you think you might want to have when you’re ready to get started if you’re working at a company that provides benefits then that might be something that you are more excited to think about than if you are having to do it on your own sorry really it’s the idea of working at a company that has benefits i just feel like that is a huge benefit if your company is going to pay for it my gosh but even then it’s not necessarily right for everyone because one of my former um co-residents and a fertility specialist at ucsf did a big study that showed that satisfaction rates for people who underwent egg freezing were really variable and satisfaction of what i mean there can be a lot of emotions involved with this process and people felt really dissatisfied with the process because even though you were taking a preventative step you might be really disappointed if you didn’t get the number of eggs that you thought you would or not enough of them were able to be frozen totally it’s a two to three week process it does take a toll on your body and it can take a toll on you emotionally and it is so wonderful that we have it available and and that people can take advantage of it i think it’s such a amazing progress we have in science but that doesn’t mean it’s benign right like just in the past two weeks i’ve seen two people in the emergency room who had some complications related to the procedure so i think you just need to go in with it with an open mind that it’s not just like two weeks later and i have like my eggs on ice and everything’s great it it kind of like for some people there it can suck i am not discouraging people from it i’m saying inform yourself before you do it and the way you inform yourself is you first start with the conversation with your ob gyn and then you would go see a reproductive endocrinologist and infertility specialist and rei and they’ll walk you through the process rei sorry yeah not not the story that that’s it it’s interesting to me because like i mean i i think my friend group is mostly uh you know a lot of dudes and gay women who aren’t necessarily talking about this particular process so i know i know nothing about this like i don’t even know like if you freeze your eggs you’re saying like 34 is the is the age but like then how long do you freeze your eggs for and like what what what’s the maximum age for like a healthy pregnancy like nakeen when you’re talking about all your friends who are probably around 34 talking about this like what is their like general expectation for the process like i don’t want to have kids now but maybe in a few years i want to have kids or like i i just don’t know it’s a lot of it’s a mix of women who are either single and they know they want children but they want to do it with a partner or for professional reasons and personal reasons they’re just they have a partner but they don’t want children yet but they are worried that when they do want to have children it will be hard for them because they will be in their upper 30s so the thought is like can i get some like younger eggs which is which is legitimate reason right we know that the risk of miscarriage goes up the risk of chromosomal abnormalities goes up so and you can do it at various stages you could freeze your eggs at 38.39 is it going to be as easy as if you did it when you’re 28 most likely not but you can still do it so i think if you think you’re going if you’re 28 and you think you’re going to be partnered and ready to have your kids in the next seven years you’re probably going to be fine without freezing them and if you’re trying to get pregnant and you’re less than 35 and it’s been a year of trying and you haven’t gotten pregnant you should go talk to your doctor because that would be a reason to look into it like a reason for the infertility potential infertility so i think if you think you’re going to have all your kids by the time you’re 35 you might not need to freeze your eggs but if you have any questions don’t talk to me go go see a doctor yeah good we should have put that at the top of the podcast do not reach out to dr nas on instagram for medical questions and her handle is okay so we also had a question about iuds and it was if you have an iud and use a period cup can it really suck out the iud is this real i’ve never wha like is that how high suction first of all i gotta say i’m i’m scared of a of a period cup but it’s like the like la lesbian thing to do uh i mean we’ve talked about scented tampons on the show before we’ve talked about the progression from pads i just like i haven’t gotten myself to the period cup uh comfortability place but i had no idea that like i mean how much section are we talking about in this cup yeah so there’s actually been studies that have looked at this and i wouldn’t tell someone that because you have an iud you can’t use a menstrual cup and also like if you’re using a hormonal iud chances are your periods are going to get a lot less so progestin only iud your periods are going to get a lot less so maybe you just need like a period thimble the copper iud is going to cause you to some most a lot of people have heavier more painful periods but they have found that um there was one study in the green journal that found that 30 of menstrual cup users with expulsion reported it during their removal of the menstrual cup because it does have a little bit of a section so i just think you have to be a lot more so now can you say that can you say that smart sentence and a dumb way for us so um so what it means is that when you’re removing the cup it creates a little bit of a section and that is when you are most at risk of pulling the iud so it’s true it’s real then it could happen yes it could and it doesn’t mean you can’t use one it’s just that you should be more aware that that could happen yeah i you know here’s the thing i have a friend who is a proponent of menstrual cups and she has a garden and at one point i was consuming something from the garden no no and no she informed me that she fertilizes her garden with blood from her period cup oh i thought this is going somewhere else that’s where i thought it was going where did you think it was going i mean do you know how much [ ] is in the ground yeah okay yeah maybe like the full realizer yeah so i guess maybe i shouldn’t have asked you the toast mold question i should have led with if i’ve consumed my friend’s period menstrual your garden am i going to be okay you’ll definitely be fine over under 50 chance of death i also think it’s fine i just don’t want to hear about it as i’m consuming something i agree you know yeah i mean it’s kind of weird it is odd and again the la lesbian scene she did recently tell me she stopped doing it because uh of the mess and which that also brought my heads to a different place too because i’m just thinking like the trail between the bathroom and the garden you know the bloody trail is what they call it oh yeah bloody trail of 2021 gosh wow um we had another really good question didn’t we you we had a lot of really good questions and and sorry we can’t get to all of them okay so the question is would you recommend that a not sexually active trans person with a vagina vulva and uterus who is taking hrt testosterone continue to see an ob gyn or would you recommend seeing an ob with a specialty in treating trans men if that was available i need an ob checkup and i’m worried about feeling uncomfortable or dysphoric because the whole procedure feels so awkward and invasive i think it’s it’s hard to specifically answer your question but it depends on where you are geographically sometimes you can tell from a profile of an ob gyn if they are going to be open or allow you a judgment-free zone to be seen i think we definitely have a ways to go in our field in making trans and non-binary people feel more comfortable and providers are learning i myself continue to learn how to be better and i think one thing you can look for is just do you feel comfortable with your provider and it might be that you ask the first visit that you just want to talk and that means you’re open to coming back for another visit for either an exam or more of a discussion but it’s it’s kind of hard on the internet to always figure out who’s going to be helpful and not because even though like i do think there are some ob guides who are really good at helping take care of trans patients without having a specialty without having a specialty exactly um because they’ve incorporated incorporated it into their practice and they have been reading up on it and know what to know how to make their patients feel comfortable and i think other providers even though they are well intentioned might not know and those slips in the vocabulary that they use and the way that they perform the exam might not make a trans person feel comfortable there are definitely specialists though which is an amazing thing depending on where you live i mean i just did a quick search and there are several organizations that really call out the fact that they they do trans health um so you can choose to go there but i do think i’d like to think that you’re going to be able to find an ob gyn that is going to be able to help you and then can tell you if there’s certain things that they need another specialist to help you with right i can at least say i’m going to help you navigate this and i’m going to support you and we’re going to do this together um so you don’t have to do it alone that makes a lot of sense you’re so good oh man you have answered a ton of questions this has been helpful i think the most important one that we could end on is just generally like how do you think being um my sister has made you a better doctor we actually got that question from the audience i do use negan as an example when i’m talking to certain patients interesting like when i talk about choices for contraception i will say something like what works for me did not work for my sister and i say that as an example to show you that like just because i love something and i might be telling you that i think it’s really good and that it might not be good for you are we talking about the nuva ring i’m talking about the next one you got it so yeah you have definitely in you have definitely enhanced me being an ugly guy think in this sense in the sense that like when you called it a duck bill i have started saying to my patients so this is called a speculum and it’s important to know what this is called you have helped give me the lens of a patient and then when you stick it in you go quack quack quack quack i feel like i feel like we’ve really matured like better people today i think the quack quack joke is really a demonstrative of uh of that maturity but in all honesty thank you so much for being on the show it really i think that we did actually learn a lot i’m really happy that we got to answer some very specific questions from people that might not have the access to someone to ask these questions to even if some of your answers came from your waxer so thank you for spending your time with us and uh we know you’re you have to run to a meeting so uh thanks for thanks for being a little thank you i love you thoughts and prayers about the phone bill bye it’s totally nasa’s fault no it’s not totally weird do not boot me off bye wow that was one of my that was one of my favorite episodes that we’ve done thus far honestly um and and surprisingly not because it was all about vaginas but because your sister is an actual delight um but a good one i will say last week you promised me and the the friends listening that you would share your awkward moment of the week so i am primed and ready to receive your awkward moment and dispense helpful information as i am about to tell you this i’m feeling really awkward so i mean this is a good one it’s a good time to process and move on okay um okay so i went to a baby shower and what a great baby shower right yep is that a wedding shower i’m sorry i was at a baby shower and of course there was the the kind of pregnant woman of honor that was there a necessity so there was also a lot of other pregnant women okay so that sets the scene then i’m sitting down i’m talking um to a new person i don’t know she’s wearing this kind of uh you know those prairie dresses that are in fashion now with the high high waistline that’s like right under your boobs yeah she was wearing one of those and it was tied so it had some oh no it was kind of it was kind of puckered and i know having just made a comment to somebody else about how many pregnant women were there i looked at her and i said oh my god are you are you fertile too are you fertile too okay i had a drink so you didn’t say like when are you due you decided to go with are you fertile too let me just tell you what happened okay i look to my right i’m telling my friend like well so many pregnant women here then i turn my head 25 degrees this woman walks up and i see her this dress and i’m like oh my god are you fertile too and she looks at me and as she looks at me i’m like what the [ ] did i just say is that also what her face says wait what did she say what cause that’s on her face she looks at me and she says what yeah and i say i said no are you in floral too oh yes girl yes i said are you in floral too and she’s like oh yeah that’s what i thought you said yeah it’s a really popular pattern you don’t need my advice here that that is amazing like okay so i have when i played soccer i don’t know i’m bringing this up multiple episodes in a row i would fall asleep at night and i would play the game back in my head and like [ ] i could have done done differently differently i love that you didn’t have to sleep you just did it are you fertile too to are you in floral two i am you need to go into poetry songwriting like improv how it was within seconds and i but but as i said it and she was like oh yeah that’s what i thought you said of course in my mind i’m like no you know what i said you’re just playing along listen she was in a prairie dress she doesn’t know what you said dying inside and i still am mortified because there were other people around us and we just go back to what we were doing but did other people hear you the next day i saw my friend and she was like so i have to ask you a question yesterday did you ask that girl if she was fertile i was like yes and she’s like i saw you recover it that was a beautiful recovery but yeah i definitely heard you say fertile wow i i honestly i think that you got yourself out of this one i think your choice of phrasing at first was so awkward and weird that it became less awkward because she didn’t really understand what you were asking and then the recovery was amazing so i think you have nothing to be worried about i think that you completely got yourself out of that i got myself out of it but don’t [ ] comment on people’s pregnancies like they need to tell you first what did like i i know this but i had to i had to i was my body was like moved to say something and i was wrong well i think it had to do with the the the vibrations in the room being caused by all of the concave stomachs around you forced your brain yeah yes that for two years yeah yeah yeah yeah are you fertile oh my god are you fertile too all right well thank you for sharing i feel like you’ve done a great job i like how you tied thematically into this episode uh it worked out well yeah all right that’s it for this week thanks for listening to best friends back all right speaking of thematically tied things uh i don’t know if you’ve heard but a hot dog is a sandwich because i did like a hot dog thing in a in a wiener thing that was my video in the special five part podcast series josh nicole finally in the debate once and for all is a hot dog a sandwich and they’ve brought on a just like a wide array of experts everyone from like a philosopher to a business person to to discuss is a hot dog a sandwich it’s going on right now and every wednesday so go check out a hot dog is a sandwich on apple podcast spotify or wherever you listen to your podcasts and you can catch brand new episodes every friday of this show best friends back all right make sure to follow so you don’t miss an episode if you’re enjoying the podcast leave us a review and five stars you can follow at mythical pods on tick tock for clips to share with family and friends you can follow me at negen and stevie everywhere at stevie w levine that was such a like uber driver thing to say and five stars and of course you can hear me every monday through friday on good mythical morning with rhett and link at youtube.com slash good mythical morning i’ll see you there [Music]