Adulting - #3 'Please don't shave your vagina people' with Anita Mitra

Episode Date: April 8, 2018

In this episode I chat with Anita @gynaegeek, who is a gynaecologist and we discuss all things women's health from PCOS to fertility. We also try to combat lots of the taboos and misinformation that prevent us from understanding ourselves from the inside out, such as the fact that what we call a 'vagina' is actually a 'vulva'- whoda thunk it. Hosted on Acast. See acast.com/privacy for more information.

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Gambling problem? Call 1-866-531-2600. Or visit connectsontario.ca. Select games only. Guarantee void if platform or game outages occur. Guarantee requires play by at least one customer until jackpot is awarded or 11 p.m. Eastern. Restrictions apply. See full terms at canada.casino.fandu.com. Please play responsibly. Hello guys and welcome back to Adulting. Today I have a very special guest with me. I have Anita here with me. Hello. So you may already follow Anita on Instagram as the Gyna Geek. Do you want to tell us a bit more about what you do? Yeah sure. So yeah so my name is Anita Mitra. My surname is the Greek word for uterus,

which is pretty cool because I'm actually a gynaecologist. So I work in London and I basically look after women when they're having a baby, when they're having problems with their periods, problems with their hormones, all that kind of thing. And I'm also involved in a lot of research, particularly about cervical cancer. and I also write a blog called gynegeek.com because I just basically realized that there was a lot of misinformation and confusion on social media and online so I decided to take matters into my own hands. Yeah definitely I think what you do is so interesting and so important I didn't know that back this morning though. Yeah I know it's a bit random isn't it? Yeah I love that so the reason why we're talking about this today on adulting is because I think as you said there's loads of misinformation but one of the most important parts about growing up

is not only really realizing kind of the external responsibilities you have like buying a house or getting a car it's also learning the responsibilities you have to understand your own body I think one of my most favorite quotes is your body's the only definite home you have to understand your own body. I think one of my most favourite quotes is, your body's the only definite home you're going to have forever, so you need to look after it. And as well, you need to understand it. This podcast isn't just for girls and women. I want guys to understand female health better as well,

because I think a lot of the problem is that we need everyone to understand it. Because if we can't talk about it openly, we can't solve a lot of the issues that go on. That's so true. I definitely agree with that. Because we we can't I think a lot of the problem you face is well I now just go on about periods all the time on Instagram to the point where I don't think anyone cares anymore um but I feel like especially when I was growing up you couldn't even speak about having a period you couldn't say the word tampon without going bright red so if you can't talk about those problems there's so many more issues related to female health that you can't even tap into yeah I totally agree I mean I remember when I was at school like if somebody um didn't want to do PE or something because they were having

like a horrible period their mum would like write a letter saying like so and so will not be doing PE today you're sincerely whereas like otherwise it would be like so and so is not doing PE today because she's hurt her knee so it was always this like unspoken thing. And I just think that that's just really crazy. I think it's changing. Oh, it's definitely changing. I was really naughty at school though because if it was a male PE teacher, we used to be like, we've got our period. When we didn't.

Oh, really? Just because they'd get so uncomfortable and we could just run away. I'd be like, it's like my time of the month. And they literally wouldn't know what to do. Which is bad like in either sense it's not great yeah and I remember the most embarrassing thing was if like your tampons fell out of your bag at school yeah are the worst it was just so mortifying and now I just don't care definitely yeah it's uh I yeah I think I don't know I'm not sure if the taboo is

changing or just like I just talk about it all the time and people can't really escape but I do feel like more and more people are talking about it so it's amazing that you for example talk about it on your Instagram and I saw you wrote something about menstrual cups the other day and I thought that was great because lots of people kind of like see this kind of thing and they're like oh I don't really know what that is I don't really know whether to ask my friends so it's great that people will just openly talk about it on social media yeah I completely it's funny because I agree with you I think everyone talks about it I think that's just I now talk about it so I'm like everyone talks about periods and the funny thing with the menstrual cup is I hadn't really thought

about them for years the first time I saw them I think in year seven we went to this like sustainable home some random woman's home somewhere in the countryside and she had like a compost toilet and stuff and then afterwards went to this museum and I remember they had moon cups because I think moon cups are brand isn't it and menstrual cups I think that's the first one I ever heard of yeah same and we were all like that is disgusting I'm remembering like I can't who would wear that that's so gross and I honestly hadn't thought about it until then until now I've got a bit more um environmentally awakened and kind of want to do my bit and now I'm fully converted I think that's also because we've just kind of like been brought up to think that periods are something that you don't talk about. So there's sort of something a bit disgusting.

And I mean, there's lots of countries in the world where women are actually shunned when they're having their period. Because it's kind of thought to be this dirty thing. And, you know, there's some religions where women are not allowed to go into um you know like a temple or whatever when they're having their period because it's like they're dirty so i think that we need to change that idea and then maybe menstrual cups might seem more acceptable yeah as well i mean i don't think that's the only reason but i think it definitely contributes. Yeah, I agree. So yeah, well, there's loads of things going on at the minute, like talking about periods and with change to do with like period poverty and stuff.

And have you heard of like Amica George's campaign? Yeah, absolutely. Free periods. And there's like bloody good period. In fact, for one of my book clubs, we decided to, everyone collect, which is annoying me now because I wish we'd collected menstrual cups, but everyone gave loads of sanitary towels and tampons and stuff to collect them for charity to give away, which is amazing. But it's weird because I had no idea about period poverty.

Yeah. Until I think like last year. I didn't even think about it. Yeah. It's a massive problem in the UK, actually, because I think a lot of people are aware that it's a problem in developing countries. And for example, I work with a charity called Raise the Roofoof where we basically supply reusable sanitary packs to girls in Kenya and we've shown that we've increased the school attendance and also participation in sport which is amazing and it's just something so simple that we take massively for granted but actually it's such a problem in this country because there

is actually a lot of poverty in the UK that kind of gets swept under the carpet like we're all aware that you know everyone likes to try and do things for charity in other countries but there's so much poverty here yeah and because we don't often you know do a lot of fundraising to raise awareness for that kind of thing I think that's why it maybe gets a bit lost um and so yeah there's a statistic so it's quite shocking but in the uk and there's a study that showed that one in ten school girls cannot afford to buy sanitary towels or tampons which is really like quite shocking when you think about it like we just pop around to like you know little waitrose and i say waitrose you know intentionally because it's just the irony of the fact that you know we can go to a shop like that and just pop in and buy a pack of tampons but they're quite expensive yeah you think about it

um and so if you are somebody who has a heavy period for example as well you could be spending like 15 20 pounds a month on um on sanitary wear and i think the other problem is it's coming all goes full circle so these girls not only they can't afford it but no one feels like you can talk about it and you don't feel like you have the ability to voice these problems about periods because it's so taboo so not only can they not afford it but they don't know who to go to who to speak to it's seen as shameful if you get your period and it's really bad because because periods are so unthought of i genuinely have never made the link to think women who are homeless obviously at periods you think they need food

and stuff but you just forget just periods are just so unspoken about I don't understand what it is so I actually carry like spare pads and tampons in my bag now and I give them to um women and then particularly down the road from here there's a lady who I always see um a homeless lady and I absolutely love her because she's so like she's so joyful every time I see her she's like hello um and I gave her some tampons the first time I was really scared I didn't know how she was going to react if she you know it's just yeah something I've never done before but she was literally so grateful it was amazing and so every time I see her now I give her some and I just carry them um rather than like giving money or

whatever that is such a good idea yeah um because maybe also it's something that they might not maybe prioritize to buy for themselves so yeah definitely i guess if you need to buy food or water like tampons doesn't come in straight away there's one good thing i think tesco's now pays tampon tax doesn't it for you yeah but that's the other thing like they're not taxable they are taxable jaffa cakes aren't but really yeah for cakes because they're apparently taxable. They are taxable. Jaffa cakes aren't, but... Really? Jaffa cakes? Because apparently cakes aren't... You can't put taxes on cakes because it's like for something to do with the war.

Wow. Yeah, I know. Isn't that crazy? I didn't know that. There we go, I learned something today. Yeah, I know. Jaffa cakes are tax-free. Ridiculous.

But not just periods. There's so many other things which are taboo, such as contraception, which we were having a little chat about earlier before. Because if you follow me on Instagram, you might notice that i'm trying out natural cycles um i need to did a post about this it's quite a controversial thing at the minute it's quite a hot topic because it it's the appeal of it is that it's it's non-hormonal which i think now that we're kind of coming out the woodwork women are taking more autonomy of their bodies and saying actually i want to be more in

control i don't want to be pumping myself with hormones. And for a while, we didn't feel like we had that voice. So these things coming out are great. But there have been kind of conflicting reviews. Yeah, so I think that, well, first of all, we are so lucky that we have so many contraceptive options. I have to say, that's the first thing that I've really begun to appreciate over the last few years because I so I work in a central London hospital um but we have quite a poor population so we actually see a lot of women who are coming um maybe having their like sixth seventh baby I've even had people who are having their 13th 14th and I think the other day one of my colleagues said somebody came and was having her 19th baby oh my gosh um and you know we kind

of sometimes think oh gosh like do you really how can you handle that many babies but actually what it is a lot of the time um is these women are not empowered to actually go and seek contraception yeah um they maybe don't speak english um maybe in their culture it's frowned upon to use contraception um but you know so they are getting pregnant um literally because they cannot access contraception this is women in central london in 2018 um so we are really incredibly lucky because it is quite dangerous to be having that many children for the woman. So yes, I think over the last few years, I've really seen a shift in people not wanting to use hormonal contraception, which is absolutely fine. But I do feel that there is a bit of misinformation going on um particularly in the

lay media social media as well and that's one of the reasons you know why i started this whole um instagram thing um because obviously every medication that you take has a risk so people are really worried about you know a lot of people are being fed this information that you shouldn't be putting um hormones your body. There are some risks from hormone contraception. So when we look at, you know, the pill is the most common kind of contraception. And I'm sure most people listening to this have either taken the pill or know somebody who has. So with the pill, the main risks are there's a slightly higher risk of getting blood clots. That's on the combined pill, isn't it? Yeah, that's the combined pill.

But then again, the risk of getting a blood clot during pregnancy, and particularly after delivering, is much higher than the risk of blood clots when you're on the pill. That's because your natural hormones are so much higher. Exactly, exactly. So it is something to take into consideration, but you have to think about what are the alternatives in that respect of what's the risk of a pregnancy itself? There's a lot of talk about the risk of changes to your mood.

So low mood and depression. A lot of studies are coming out at the moment. I think it's really, really interesting because there certainly are mechanisms whereby hormones can change your mood. But it's really difficult at the moment with the current evidence that we have to say that the pill actually causes depression. That's so interesting. Because I definitely wasn't depressed, but I found that when I came off the pill, I felt like a new person. And I didn't even know that the... I don't know because I didn't necessarily think I was going to attribute it to the pill,

but it just made sense to me that that is what had lifted my mood. And I don't think it was because I don't think I was like, I'm going to come off the pill now and I'm going to feel better. It was like a gradual thing. And I realised then that only the only thing that changes the pill. So I would be, it would be really interesting to see if there is any like correlation making an actual causal. Yeah.

And I think that, you know, actual causal yeah and i think that you know if you um if you feel that you're you're using hormonal contraception you feel your mood um isn't um as it was um it certainly is worth stopping it and seeing what happens but you can't guarantee it's going to have an effect but i think as well we need to have this um it needs to be okay to talk about mental health. And people should be aware that it can happen and that you shouldn't feel ashamed to go and talk to your GP or, you know, somebody at the family planning clinic and just say, I think this is happening because it's not in your head.

It can actually happen. And I think we just need some more awareness of that. And I think viewing mental health as well. I think some people think some people have mental health issues and other people don't. But mental health, it's everyone's got mental health. well, I think some people think, some people have mental health issues and other people don't. But mental health, everyone's got mental health. It's like a sliding scale.

You could dip into moments where you felt lower, where you felt better. And I think people go, oh, I don't have depression or that's not me. But I think that's one of the things that's weird, unfortunately,

is even the term mental health is quite funny because in itself, that's like a negative, but we all have a mental health. Yeah, that's a really interesting word we all have a mental health that's a really interesting it doesn't really make any any sense for that term but um the other thing which i find really funny and ironic is this you know they're talking about bringing out the male

pill okay yeah and they're like we're gonna have to spend years researching this because what we don't want is we can't have any side effects they were like men who've been trialing this have been reporting low moods anxiousness all this stuff that is literally every woman ever has been like, I've had this on, because I myself have tried about five different pills. Because I'm just, my mum was a nurse, I've got told I knew that I could go back and say I didn't get on with it.

Maybe some people didn't do that, but I registered with every pill that I tried that different things would happen. And that was just like, you knew there was gonna be some side effect, one might clear up your acne, one might give you acne, one might make you fat, one might make you lose weight.

And every single article about this male pill is like, we can't make it so perfect that there's no side effects. And it's so ridiculous because with women, they're like, take this, might give you acne, might make you gain weight, but, you know, at least you're not pregnant.

And with guys, it's like, guys, guys, chill out, it's fine. We are, we're going to get you this pill. It's going to be amazing. And I just don't know why. It's just never going to come out, basically, is it? No, and there's so much, like, funding trying to make it perfect. And I'm like, this is so sexist, obviously.

I know, exactly. Yeah, I don't think that one's ever going to happen. And even if, even if they made a male pill, I don't know if you'd trust, because that's the problem. Oh, I wouldn't trust anybody. No, and this is, I think, one of the things, like, within this podcast, I think it's so interesting, that and this is, I think, one of the things, like, within this podcast, I think it's so interesting

that as you grow up, you realise as a woman, you have, your life, your body is so much more of a scary thing than a guy because you're always going to be one that carries the baby. So no matter what happens,

like, I know that it's, if you got pregnant with someone, it would be both of your child, but you're the one that has to carry that. And that is literally, I think I've lived with, like, one of my biggest fears in life has always been getting pregnant.

I remember when I was like 16, I used to think I'd be pregnant, I wouldn't have even like had sex. I'm like, oh my God, I'm going to be pregnant all my life. And then I remember thinking now, I was like, oh my God, if I got pregnant now, I'd actually, I could have that baby, like technically, and nothing, it wouldn't be like I'd have to go into hiding and pretend it was like my mum's baby or something. I could actually fully have a baby. And that really scares me because I'm like I'm technically I think my

mum's generation everyone had a baby and I just don't know that I'm ready enough to handle that now but the concept that I could have one really really scares me but at least I have to think like think all those girls in Ireland where they don't have the because I'm pro-choice 100% um I'm sure I might get a bit of debate on that but I think that is something which as you grow up seeing your privilege and like like you've spoken about I didn't realize I knew there was lack of education on contraception but women falling pregnant that many times is just crazy I think that part of growing up is realizing that that's you have so much more than you realize if that makes sense yeah absolutely and i think it's interesting as well because you spend your whole teenage years

in your 20s trying desperately not to get pregnant and then there's suddenly this kind of wave of like when you turn 30 usually everyone's like oh my gosh am i going to be infertile and it's really interesting because i think that we do really ignore our fertility until the point that we want to use it. And that's also something I think really needs to change. And I think this is kind of like going back to the whole like contraception thing is that I think that we just always want to switch everything off and just ignore it. Yeah. And then suddenly hope everything's going to be fine when we want to use it. So one thing about going back to the pill yeah is that a lot of people are worried that the longer you use the pill um then it's gonna i used to think this affect your fertility and that's not

true actually um because you know if you miss one pill you can get pregnant um so it it just it's active for as long as it's in your system i used to look i remember being like looking up the half-life of a pill because i'd missed it by like so many hours yeah the best thing is not to miss any when i was at school i used to be on this combined pill i can't i think it was called i said no i've had sorrel so is that celeste that was it and i loved it because it made my boobs so big and me and my friends all went on it and we used to take it back to back you were allowed to the maximum you could take it was three months back to back before you had to have a breakthrough bleed we all want to talk about

breakthrough beads actually so we all used to take it and have absolutely gigantic boobs for like a month and then come off it and they just like for you because you have your how long is it a week break I haven't done it for so long yeah a week and then you go back on it again and start growing them again and we honestly thought this was the best thing in the world i had absolutely massive boobs it was just because of this pill but the other thing with breakthrough bleeds that's not that's a really interesting because a lot of people don't know that i didn't realize for ages it's not an actual period when you're on the pill is it absolutely so yeah it's called a withdrawal bleed um So it means you're withdrawing from the hormones essentially. And that is what happens naturally in your body.

But rather than withdrawing from your own hormones, you're withdrawing from the fact that you don't have the hormones from the pill that you've been taking. So yeah, a lot of people, I've heard people calling it a fake period. And so someone said to me once, they said, oh, since it's a fake period um and so someone said to me once they said oh since it's a fake period does that mean I actually were pregnant it doesn't matter whether it's a fake period or a real period if you're bleeding then you're shedding you're shedding so you're not going to be pregnant right um but yeah so what happens with um your normal cycle is that your hormones change throughout the month and you gradually start to build up the lining of your womb.

And then if you're not pregnant, the hormone levels drop and that's when you start having a period. So when you're taking the pill, you've got like a stable amount of hormone from the pill all month. You stop taking the pill for seven days and around the third or the fourth day that's when your period will start because of the fact that the hormone levels would have dropped sufficiently to make you start bleeding only reason it's not an official period is because it's not caused by natural hormone changes exactly right so that's why people call it a fake period right but it still is the same thing yeah so lots of people for example take it if they have um pcos so polycystic ovarian syndrome yeah i think we might touch on a bit later um and so i've heard i've heard doctors um saying to patients that you know take this it'll regulate your cycles and it really kind of breaks my heart when i hear that

because it's not true um the pill is not going to cure the underlying issue that is causing you to have irregular or maybe even no periods at all it's just putting your body into this kind of like full cycle because once you come off it that's what i read when you come off it was like if you have really heavy bleeds before when you come off the pill you're gonna get those same bleeds again yeah exactly and so it's um it is completely safe to take the pill if you have pcos and um i you know, it can be good from a safety point of view as well. Because if you have PCOS, you're not having periods as regularly. Can we quickly explain for people who don't know what polycystic ovarian syndrome is?

Because this is something I actually get asked lots about. I actually obviously have no grounds to talk about it. not a doctor or gynecologist but in within health and fitness a lot of people suffer with weight gain because of it so often it's a question i get asked so people who don't know so polycystic ovarian syndrome um is so it's a syndrome so it's a collection of symptoms and it's different in everybody so pcos in one person might not be the same in another person. You need three different characteristics. You need two of three characteristics to have a diagnosis of PCOS. So one of them is having irregular or infrequent periods.

So a regular cycle is anything between 25 and 35 days. So anything outside of that so it tends to be more on the longer side of things yeah if you're having a period maybe every two or three months that would be an irregular period then also having signs of having too much male hormones so it would be having acne or having excess hair or male pattern baldness as well and then the third thing is having lots of cysts on your ovaries now lots of people have scans for various reasons and they'll have their ovaries looked at

if you have lots of cysts on your ovaries but you don't have any of the other two symptoms you do not have polycystic ovaries about 40% of women will have a polycystic appearance of their ovaries because that's how you actually get eggs out of your ovaries is to make little cysts and then they rupture and then the egg comes out so a cyst is like a little fluid filled sack so yeah so if you have a scan and it says that you know the ovaries look polycystic don't freak out. You need to talk to your doctor,

but if you do not have irregular periods or signs of too much male hormone, you don't have PCOS. So lots of people who have PCOS may be overweight. Now, there's a massive debate about whether being overweight causes it or whether PCOS causes you to be overweight. Now there's a massive debate about whether being overweight causes it or whether PCOS causes you to be overweight and I don't think that anyone knows the answer and I don't think there is an answer actually. I think that as I said it's different in everybody but one of the reasons why it's associated with weight gain or just generally being a bit overweight is because

you get resistant to insulin. So insulin is one of the hormones that you need to produce in order to regulate your blood sugar. So this is where, I mean, this is one of the most fascinating things about the body, is that all your hormones are interlinked. So we all think that, like, your female hormones, so you've got oestrogen and progesterone, we all think that they're just like, you know,

your ovaries are just ticking away, no one else is having any input but you know your insulin can play a role your thyroid can play a role even stress can play a role in your female hormones because it sends signals all the way down the pathway from the brain to the ovaries so it's really important but so when you have ptos you make lots of testosterone um usually and so if you make lots of testosterone you usually don't ovulate so if you don't ovulate you're not making any progesterone so you've just got oestrogen okay so you might feel um you know you get a lot of pms type symptoms um and you might um feel that you well you're just you're not getting a period basically every month because of the fact you're not ovulating you're not making progesterone so

what happens is the lining of the womb builds up and then when you get a period it's usually quite heavy and quite painful yeah because you've had all that time for the lining to build up so that's why sometimes people who have PCcos are prescribed the pill so that you can um as i say it's not regulating your hormones but what it's doing is making sure that your body it's not making you ovulate it's just making those um estrogen and progesterone levels sufficient so that you will build up a lining but you'll shed it so in someone with pcs would you give them just the progesterone only pill no so give them the combined pill um so because the idea is that you actually want to induce a bleed um so you should ideally if you're not on the pill or if you're using the combined oh yeah because the progesterone only often you don't get that you don't exactly and that's fine

and that's safe that's something slightly different but the idea with pcos is that you want to make sure that people are having a bleed and shedding their lining because when you have pcos you have a slightly higher risk of getting an endometrial cancer so a cancer of the lining of the womb um you know later in life but i hadn't even heard that actually okay so it's um it's pretty common but not in people of our age it tends to be i'm sort of um 50 60 70s um and what it is is that because you don't ovulate you have a lot more estrogen acting on its own on the lining of the womb so it can get too thick and the cells start to become slightly abnormal so the idea of shedding them frequently is what helps you to prevent this so that's one of the rationales you know from my

point of view that's why i would want my patient to be on the pill if they wanted to and had pcos not to regulate any kind of right but when they stop taking the pill they'll be back to the same situation if nothing else in their body has changed and does it cause discomfort and pain or is that endometriosis that i'm thinking of now that's quite painful endometriosis is the one that typically is associated with pain um periods can be painful and you can get pain throughout the month but with pcos when you do get a period it often is um a bit more painful because the reason you have period pain is to try and squeeze everything out of the womb and so if there's more to shed you're gonna squeeze

more it's like when you like wring out like a cloth or something like that you're gonna give it a really good squeeze if it's really wet yeah if it's like just a bit damp you just squeeze it a little bit it's the same thing with your pill basically so for women with pcs there is like apart from taking the pill to maybe help obey the system help lower the symptoms a bit there's nothing really that you can do at the minute that we know of that will yeah so there's no tablet that's going to cure pcos that's um that's one thing to be quite clear about um you can in some women you can take something called metformin um it's a a drug that tends to be used for diabetes um and so that can

be helpful in women who are um overweight and are trying to um get pregnant want to be ovulating but again it's not going to be curing the underlying abnormality so for me the thing that I love to talk to my patients about is what they can do for themselves yeah I'm more than happy to prescribe medications if that's where we get to but the Royal College of Obstetricians and Gynecologists quite clearly states in their guidelines for PCOS that lifestyle intervention is the first line of treatment. So it's things like looking at your diet. So for example, are you having loads and loads of sugar? You know, I think sugar has been really vilified over the last year or two, hasn't it? On social media and just in newspapers and things. if you're you know as i mentioned insulin

resistance is a problem if you're feeding your body loads of sugar it's going to be going haywire interestingly actually off coming off that going the other way um we're talking about this is we're obviously talking about hormones and one of the things that i think we've spoken about before is what people don't realize is when you are the foods that you're eating really affect your hormones in that women especially really need to eat fats for hormone production. Oh, definitely. And I get girls messaging me saying,

is it normal to lose your periods? A lot of people who do, well, I mean, there's a big difference, it's kind of a bit like what you're saying, there's a big difference between health and fitness. The fitness industry and the health industry are not the same thing. Yeah.

So being, you might see these people that look absolutely amazing, really shredded, look like they're the fittest of the health industry are not the same thing yeah so being you might see these people that are absolutely amazing really shredded look like they're the fittest of the fiddle but they won't necessarily be healthy and the unfortunate distinction is with social media you see that so frequently in line with like a healthy lifestyle that you start to believe that that's the outcome of a healthy diet or a healthy attitude towards nutrition when it's really not so I wanted to ask you about because I think you've had an experience where you dieted and lost your period yeah I think this is like something that's really unspoken about so I know that a lot of people who are like health and

fitness bloggers sorry health and fitness bloggers on Instagram don't have regular periods and so this happened to me um and I didn't have a period for three years essentially um because I was completely over training I was completely under eating um and I barely slept and was really stressed how old were you when this uh I was 26 so you'd done you'd done your medical degree yeah so I'd finished medical school I was working I must have been 27 then so I'm 32 now so a lot of people don't know how old I am so I'm 32 yeah you do look really young I just realized I asked you how old you were then I was like it's not gonna make a difference I didn't hold you on that no but so like no I think it does um because I'm I wasn't that young when it happened and I think that's something really

important to be aware of because I get a lot of patients who come to see me and they feel really stupid to say like, oh, I haven't had a period. And then we kind of talk about the reasons why it might not be happening and they feel really stupid. But, you know, I was a doctor. I was 27 years old and I had no insight for about two years. Did you think anything was up?

Were you like, shit, I should be on my period? I didn't realise to start with um because I was so busy um and I just was moving house and I was like oh hey tampons oh I haven't used you for a long time really and I knew I wasn't pregnant yeah so I was like oh that's weird and then I just kind of threw them in a box and didn't really think about it and the other thing is if you are on a pill that stops you getting a period such as like the progesterone pill you might be so low body fat because i actually don't know people ask me when you competed did you lose your periods but i was on um sorrel so i didn't have periods anyway yeah so i don't know you don't know yeah i mean they came like when i then came off it i

had them very regularly but i have no idea if when i competed like almost two years ago now i could have not had them because i was down to like 14% body fat yeah exactly so that's a massive issue so um I was doing loads of HIIT training um literally like five or six times a week it was and I was obsessed I was really really obsessed I had a massive problem I realize now in retrospect like looking back but at the time I just thought like oh I'm so like fit and healthy I think when everyone gets into fitness you get so I was like that I was like how the hell did I push myself to do that like now I'm supposed like health fitness is my job but I wouldn't train more than five times a week yeah I couldn't do it yeah I don't know how I did loads no I used to train like twice a day yeah I don't know I mean I don't know how low my body fat was at that point I mean I was I was never like super shredded but

I mean I was just put yourself under so shredded but I mean I was just put yourself under so much stress pretty like I mean you could see like my arm muscles like popping when I wasn't flexing yeah when I had my arm like hang down by my side which you definitely can't now but um you know I mean I don't think necessarily low body fat was the reason for me but the reason that low body fat um for women can stop your periods is that you know you make um you make oestrogen in your body fat yeah so if you're not if you don't have as much fat you can't make oestrogen um so that's one reason why um overtraining will do it but then yes i was super super stressed so when you're stressed your body gets signals in the brain and it basically is like, right,

okay, let's turn this off. We are too stressed to be having a baby right now. And so it just, it just shuts everything down because the signals to make your female hormones in your ovaries come from the brain. And a lot of people don't realize that. And that's why also um having um sort of like problems with um like anxiety or yeah just being super super stressed will actually stop your periods and how is it dangerous to lose your periods is it so because then the other thing

is you'll get girls who do compete and they write about it quite openly within if you follow like proper bodybuilders and they don't seem to think it's like a problem and on the other end of that you'll get other people who are maybe like vegan extremists who think like it's good to get rid of your period which is something i read recently and i could not believe and it's someone loads of followers i went to his and she was like i was about to hear her accent that's such a amazing thing to do but she was basically like get so good you get rid of the toxins so you don't have your period and it's this just really weird idea that like your period's something unhealthy and that you should get rid of it because it's unclean. Yeah I'm glad you brought both those things up because I have something to say on both. So first of all let's deal with the people who are

losing their period because they're competing. No one knows whether it's unsafe but um the kind of like gut instinct um in the reproductive health community is that it it probably isn't a good thing um because your your period is stopping because your body's realizing something's not right so you're maybe not eating enough your body weight is too low you're overtraining and you're really stressed so um the problem with that is that you're not going to be making much oestrogen so oestrogen isn't just for your um ovaries and your womb it basically one of the main things it does is um keeps your heart healthy and keeps your bones healthy so during that phase when you're not having your periods you're not making as much

oestrogen and so your bones can actually become quite weak well this is like because when women become menopausal that's why it's really good to see weight training isn't it to help exactly but when women are menopausal you more higher likelihood of like osteoporosis and stuff like that exactly and so you've got that phase where you're not um you haven't got as much oestrogen and no one knows whether you can actually recover that phase in time so if it's only a short period then you know it's probably okay but you know a lot of people it might be a very prolonged period and we don't really know um and it could potentially have a problem for future fertility as well because if you're not able to get your cycle um coming back and you're you're then not going to

be ovulating that could lead to a problem the thing that you mentioned about veganism um i do not have a problem with people being vegan i'm part-time vegan that's absolutely fine um the only thing about it is that you can get quite a lot of nutrient deficiencies if you don't do it correctly so if you want to turn vegan be my guest but please do seek um some kind of professional advice because um so yeah people i've read as well people saying that you know um veganism stops your periods because you don't have any toxins so first of all your period is not to get rid of toxins in your body and that's going back to the whole thing that it's not a dirty thing yeah um the reason your period stops is yeah you're probably becoming undernourished and your body's saying uh we're not

really getting much in terms of nutrition so let's just cling on to anything we've got yeah that's why your period will stop if you become well it won't automatically but if your period stops and you've changed something about your diet or your lifestyle you've got to look at yeah that as being the cause and that's something to be um slightly alarmed about so I think it's really irresponsible that people are saying that it's a healthy thing when you become vegan because it's not healthy at all no, what I just find really

sad is that we obviously your period is a thing that's so natural, it's like one of the most it literally happens to everything, like every female animal has a period is that right? Mammal? as as i'm aware i mean i have it's been a while since i but what i mean is the sad thing is that people are pushing their bodies to such extreme limits and that's such a point of privilege to be able to i don't know i have a really weird thing about food where i think it's so sad that like i know that you probably see stuff like this

all the time but you know when you see those stats and it's like there's people starving there's this happening and then where you have women literally starving themselves with and then making themselves sick which is like something I used to do but just this idea when you look at the world like on a broader scale it's just so sad that we put our bodies under such distress when we have such a point of privilege and we have to eat right and kind of do you know what I mean that for me I really find difficult to but I think that that's kind of like what has become you know this perception of like a healthy lifestyle is gone a bit OTT and you know everyone wants to like train like an athlete well if you're an athlete you probably spent the rest of your

time when you're not training eating and sleeping yeah so it's kind of like if you're working you know nine to five job and you know maybe you've got other responsibilities like you know other hobbies and kids or whatever you know it's not the same as being a pro athlete but a lot of like six hours a day exactly and a lot of workouts are being promoted as that and you know there's so many people these days doing marathons and like triathlon has become like a you know a saturday afternoon hobby um we're like really pushing ourselves to the limit and i think that that is one of the problems and when i was um not having a period people were like oh my god you look incredible and i was getting so much positive

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is health i completely agree and i think there's nothing that you do as you you'll grow up you have to unlearn things i remember when i was younger i used to genuinely this is so sad but i used to be like i wish i had the strength to be anorexic that sounds so awful when i was younger i literally used to want to be able to not eat i used to, I used to be so jealous of people that didn't like food because I just didn't understand how you could lose weight. And I thought that that was kind of like the be all and end all. And now I love being healthy and I like being fit, but I also understand that I perpetuate another new type of ideal,

which is this really athletic body. And I'm nowhere near as lean as I used to be, but I'm still like in quite good shape. But the problem is, what we're doing is that that there's and I know I'm part of this problem it's really difficult because I don't want to be but we put so much focus on on women's bodies and so much stress that you'll there's this is really awful but there's these like gossip sites that are really nasty that write about like bloggers they never really like that means I'm not famous enough but they've written about my friends and stuff and these people write things like she's

supposed to be a fitness blogger and she doesn't even look lean. When people are still like, look absolutely unbelievable, they're just not like 12% body fat. And we've now got to the point where it's gone the complete other way. And because it's under health and fitness and people are like, muscly, everyone thinks it's like healthy. But all it is, it's just thin-spo disguised in another body. And it's so unhealthy and it's really difficult because you have the pressures of it's really there's no definitive

form of health some people could be a size 6 and absolutely tiny and eat the world and other people don't and it's just women's bodies

are put under so much pressure for so many reasons and what we've got to understand is that you need your fat like women store more fat I have girls all the time asking me like

how do you get that bottom bit of belly fat and I'm like you literally one it's gravity that's why it goes to the bottom of your belly it literally is pulled down like by gravity like there's nothing you can do and you need to store more fat because you're a woman like there's already so much pressure on women's bodies before you've even got to being like we're open to talk about periods and pcs and stuff yeah and i think part of growing up is realizing that you're more than what your body looks like you really need to take care of your you're so programmed to have more fat and you know like a few weeks ago I was in the gym and this woman came up to me and she's like I'm so glad that even you have back fat and I was like I just like jumped down

from like the chin-up bar and like for me now like I'm not bothered about aesthetics I'm more like okay so how many chin-ups am I gonna do today or like how much am I going to squat um but I just couldn't believe she said that to me because if she said that to me a few years ago I probably literally would have gone home and like been like right gotta get my fitness pal out and gotta cut those calories and like I would have really been affected I just couldn't believe that she said that to me and um it just really really shocked me but we are programmed to to have more fat than men. That's just how we are. But it's so funny because I used to be,

I used to have a massive thing about back fat. But it's obviously probably even not fat. It's just like wearing a sports bra, they like to dig in. Yeah, exactly. That was like one of my biggest concerns. I always used to hide it. And then if there was a picture with it in, I'd have to like repose it.

And now... You probably had back fat because your boobs were so big from the pill. Yeah, probably. I mean, when I was training, even even now like even when I was really lean I always had like you just can't not squidge some people don't but do you know what I mean and I remember I used to write then I'd be like went through this phase of being almost like fake body positive which is just really being real and I'd be like oh my god I don't mind like you can see I've got my back fat and now I just don't say anything I just put up videos where you can see different bits like wobbling so the other problem is, and I just put up videos where you can see different bits of me, like, wobbling.

Because the other problem is, when people then do put up photos or, like, show something, they then have to, like, point it out. And, like, I don't think you are being that body positive, because you've had to be, like, I'm a, like, it's almost like, I know it's there, I'm going to tell you it's there. Just to point out that, like, I know, so you can't say anything.

And the more you just get used to seeing women's bodies just being what they're like. Exactly. I think we also need to stop thinking about health and fitness as an aesthetic thing. And start thinking about it as a functional thing. So as I said, like how many chin-ups can you do? How much can you squat, for example.

But also as the fact that you're looking after your body because you want it to function for as long as possible in the future because you know that that's one of that is the reason isn't it to stay healthy is because you want to lead a healthy active lifestyle for the future so for example I've sort of touched upon the fact that you know women can get thinner bones when they go through the menopause so one of the reasons why I love women to um do strength training and you don't have to go to the gym I just have to say you know I like going to the gym that's my kind of morning meditation to be quite honest with you but yeah you know a lot of people think you have to go to the gym you don't there's loads of workouts you can do at home but what you need to be doing is you need to be doing

something that is loading your muscles and your joints because that's how you build the strength in your bones. And you want to build strength in your bones so that in the future when you're like 65, 70 and you trip over by accident, you don't end up with a broken wrist. Because the reason is we stop producing estrogen which means we stop producing testosterone as well, right? Because men don't have as much risk. Did I get that wrong? No, yeah, you're right. Men don't have as much risk. Is that, was that, did I get that wrong? No, yeah, you're right. Men don't have as much risk, but their hormones are completely different. We still, you still produce testosterone when you go through the menopause. But yeah, women are just at a higher risk

and also a higher risk of heart disease as well. And so, you know, that again is why you're doing it. You want to be able to run around with your children, your grandchildren. You want to be able to go out, walk your children your grandchildren you want to be able to go out walk down the road all those kind of things I think that we need to start thinking of that as the reason why we have a healthy lifestyle not because we want to look good in a bikini now and the other problem is people see health and fitness is such a like black and white dichotomy that oh someone's fat so they're unhealthy and someone's thin

this just doesn't work because there's probably people out there like sniffing cocaine and smoking cigarettes and drinking wine do whatever they're doing and they look great and they you could think they're really healthy but there might be someone for instance with some kind of um polycystic ovary syndrome or maybe a hyperactive thyroid or something like that which might make you carry a bit more weight who eats really well and trains really hard and actually lives a very healthy lifestyle yeah and i think people don't realize that we attribute literally think we can just see everything and you really really can't you don't know exactly someone's healthy just by looking at

them but that's why i always i get a lot of patients who come like for example with pcos um and they're like oh you know um my my GP said that I need to lose weight. And it's like, well, okay, fine. But, you know, losing weight may help you to start ovulating and it may help you to regulate your hormones. But I never make that the focus. I just say, I always say the best thing you do is don't think about what you're going to lose, think about what you're going to gain. Exactly. don't i always say the best thing you do is don't think about what you're going to lose think about what you're going to gain so do this my clients i'm like think about how much better your mood's going to feel how much more volume of things you can eat because you can eat more if you're eating

better exactly and and think about how much stronger you're going to get whereas everyone puts the focus on losing the weight and i think the minute you have a negative connotation as subliminal as it might be it's just negative your brain really does think like that if you make everything a positive and like what am I adding to my life by doing this rather than how much weight can I lose kind of like what goodness are you going to give yourself because when you start to change your um you know what you're eating in that way it's more fun you're more likely to stick to it but you're always going to be adding something that's good yeah um and it's kind of you know switching things and just you know making sure that you're

adding something better um and it's the same with exercise as well because you know a lot of people say like what's the best exercise for hormones so first of all when i went to see my gp um i'm not criticizing gps at all i totally respect them but when i went to see my gp when my um periods had stopped she was like oh what what exercise do you do and i was like oh well i lift weights and i just started weight lifting at that point actually um and i was like yeah i'm such a badass check me out lifting weights and she's like well that's why your periods are stopped women shouldn't lift weights um so lifting weights on its own will not stop your periods i want to go back to the point about gp so i think this is something really interesting that a lot of people

might find there's areas where if you specialize in something or if you're gp you don't know certain things so like a lot of people might find. There's areas where if you specialise in something or if you're a GP, you don't know certain things. So a lot of doctors will say they don't know much about nutrition. And when you go to the GP, they actually don't know that much about female health is something that I found. And as you say, that's not a slight on GPs. It's just that they're a general practitioner. It's not their kind of role. And I think what people don't realise is that you can go to sexual health clinics and gum clinics which are free and they're everywhere if you want advice which you might find more helpful than actually going to your GP and only getting 10 minutes and only being able to talk about

like one thing and I think there's a bit of a stigma about going to a gum clinic. I think a lot of people find that they think it's, oh yeah, I used to work across the road from a gum clinic and it's so funny, everyone used to do this like slight glance over their shoulder and I was used to want to like high five them and be like yeah go on you be really responsible but I thought that might put people off more what makes me laugh so much about like sexual health clinics is you can go there for the pill and I remember going at uni once to get the pill and everyone's making each other as if to think like oh my god I wonder what you think of me but you're all in there yeah exactly so everyone is there and it doesn't matter what you're there for and you should really be going to get, but you're all in there. Yeah, exactly. So everyone is there, and it doesn't matter what you're there for.

And you should really be going to get, especially if you're having sex, you should be going to get regular check-ups and just make sure that, you know, you know what's going on down there and everything. But it's so funny because you just all get so worried about it. I don't know if that's a British thing, though. I just feel like we're just so embarrassed about everything. I don't know. Maybe we should go on an international tour and see what the vibe is

in other sexual topics. Yeah. I know that in, like, in Denmark and Scandinavianavian countries they have a lot more relaxed approach to sex and talking about sex it's so important to go and you know um if you think about for example chlamydia is the most common um sti in the uk but in women 70 are asymptomatic so you won't know you've got it yeah um and in men it's about 50 percent um who don't have any symptoms so there's plenty of people that have chlamydia and don't realize it because so people i ask people all the time it's a standard question for my patients have you ever had a

sexually transmitted infection and they'll mainly say no and then i say okay when did you last get tested oh i've never been tested yeah I think the thing is with this, so I agree, this is a complete thing, so we actually used to go, like, at uni, you just go and get tested just to make sure, like, on the regs, you've just got to know. Yeah. And I think what happens with loads of people,

it's so shameful, everything's, it's so embarrassing, because you can't talk about sex, everyone's like, I'm just not going to find out. So then everyone, everyone will end up getting something, because no one's getting checked. Exactly. And it's really bad, and you should just go even if you think there's a I'm a bit of a hypochondriac though so I love going to the doctor or to any just for anything I just always

think I'm dying I'm always self-diagnosing it's very bad and I said actually I say this and then I'll get my friend who's like you're wasting it just as money so I promise you don't get that much but I just do always think I'm dying or something like that but yeah I think not enough people feel that they're able to talk about it or that or that they're too embarrassed or they just don't want to know so I always say to people that you're not sleeping with one person you're sleeping with every person that they've ever slept exactly and then everyone's like oh that's disgusting and well it's unfortunately that's how Germans get shared. Yeah. So there's nothing shameful about going to get checked. And, you know, I know someone who got chlamydia,

one of my friends at medical school. And when she found out, she's like, oh, yeah, I know who gave it to me. And he just looked so clean and he smelled really good. Oh, my God. But it's so true because the other thing is you might have just slept with one person. But as you said, so I think there's this idea,

and I hate slut-shaming anyway, because I don't think the word slut should be a thing but this idea especially if you're a girl or someone or something like that and you feel like if you got an sti you'd be or people judge you but the thing is it's so true you don't know who you've slept with you both might both just slept with like one other person who both slept with four other people who slept with 20 people it doesn't matter it's like i think it's something that just needs to be spoken out more and people should just go and get regularly tested and not be i think it's part of your responsibility when you get older to realize that you've just got to do these things yeah and it's it's so important because you know if you have undiagnosed um stis and chlamydia really is um one of the most troublesome um it can cause massive problems

yeah it can cause you to have problems with fertility. And also it can kind of cause scarring inside your pelvis. And so it can cause a lot of pain as well, chronic pelvic pain. So it's just something that it's better to just find out. You can take some antibiotics and it will go. There is a chlamydia screening program and it's for 16 to 24 year olds because that's the commonest age. And so it suggested that you should get screened every year or every time you change partner.

So, you know, there is there are things out there and it is accessible, but you need to actually go and do it. And then after that age, then, you know, everybody when you're changing partner or just, you know you think, I haven't been for ages, you should go and get checked. We normally say you should leave about two weeks from the episode of unprotected sex so that you don't get a false negative. So a false negative means that the test comes back as negative, but you do actually have a disease.

So yeah, definitely go and get an STI check. And if I see you, I'll just smile. I won't high-five you so on the topic of periods which is my fave so if you guys follow on Instagram you might have seen that I posted that I just started using a menstrual cup and I it has revolutionized my life and I know this sounds really first of all I was quite excited I genuinely was excited when I when I got it because I'm really excited to see what happens me like when's my period yeah I was like waiting I showed everyone I showed my housemate who's a guy he was like got it because I was like I'm really excited to see what happens when's my period yeah I was like waiting I showed everyone I showed my housemate who's a guy

he was like what's this I was like oh well this is my new menstrual cup and he was like oh my god you're so it and my boyfriend I've literally told everyone which is really fun I actually make a point of like telling the guys that I know just about stuff because then they just kind of get used to it and then they're just like because I said something in front of someone the other day

in front of my housemate and they're like oh my godid he's like i literally know her cycle now she just tells me all the time i'll be like i'm pmsing today all out and stressed but yeah with the menstrual cup i was so interested so this might be a bit tmi but you don't have a tmi never tmi but you don't know when you've got a tampon and how much you bleed like you can't see that. So I was actually fascinated that over the course of my cycle, you can see how it changes. And like tying that into kind of natural cycles and stuff, you don't need an app to look at your body, there is ways that you can start to tune in with yourself. So you know that you're coming to the end when it gets a bit darker, and a bit thicker, and at the beginning, it's just like a lot thinner and maybe brighter. But what is really

funny, I think, because in films and stuff, stuff and what guys I think guys think you literally like gush blood yeah and then it's like a waterfall but if you see the size of these cups they're like it looks a bit like someone said to me which is quite funny because I love eggs it looks like an egg cup yeah it's kind of like the size of it like a rubber egg cup and it doesn't like fill up or anything no and it's really because I just think I just had no idea and now that I've used it I now think like tampons are actually quite grossed me out a bit like the idea of it and also apparently they're actually they have chemicals in them which you don't they're not like natural things they might not be that great for the your yeah there's not a lot of evidence to support that like there's not a lot of scientific

evidence um I mean you know Gwyneth paltrow and her goop website she's always going on about you know how like tampons cause cancer and all that's kind of jazz oh my god i haven't seen that but you know and you know obviously there's no conflict of interest because she's selling organic tampons oh i see if you want to use organic tampons that's absolutely fine but i don't think anybody should be made to feel that they're doing something wrong to their body. Some people say that they find they're less irritating because sometimes tampons can cause you to feel a bit itchy and irritated. So yeah, by all means, switch to an organic one if you fancy it. But to be honest with you, I think that you shouldn't be...

I think there's like an orthorexia around health products. And no one should be made to feel that they're doing something wrong by using a non-organic tampon. You know, probably walking down the street in London. Like Oxford Street, isn't that one of the most polluted streets in the world? I think that's probably worse than using a normal tampon, to be honest. I just thought that was interesting because I just hadn't heard that before. But it was more that for me, I was like, the thought of it actually just sitting there and like I don't know I just suddenly thought that I must when it's cleaner it's cheaper and it's reusable so there's just like so many posts to it and I

haven't had to I do I have heard that people have difficulty putting them in in fact a few women who commented on my post were like I tried it tried one years ago I didn't get on with it so I don't know if maybe they've been because it's sadly they've come back in fashion now 100% like I feel like you didn't hear about them for a bit and then now Yeah I remember when moon cups first came out and I remember seeing them advertised in the toilets at uni and I was like what is this thing

anyway I mean I I have one now and I was a bit, I have to admit I was a bit surprised at how much you have to be kind of like really into like getting up there when you use it. Um, cause you have to like, you have to do some kind of like origami to put it up there, but it's really easy and there's loads of videos online. Um, and it's, it's really not as difficult as it sounds. Um, but yeah, you have to be happy to kind of like put your fingers, um, inside your vagina to put it in. Um, and then you kind of like push

it gently in and then it just of like push it gently in and then it just like releases and you know sometimes people might feel they're not opening properly inside but actually they will kind of like throughout the day get a bit sucked up and opened up just by the pressures inside yeah vagina but taking it out the first time I took mine out oh my god I literally nearly like gave myself a hysterectomy because I was like I was like this is hurting so much and I was literally pulling because it makes it can make a vacuum on your cervix and so I was probably pulling my uterus out basically um like a plunger yeah because I thought you just pulled the like the little knob in on the end yeah um but no that that pulls your insides out so don't do

that guys so what you need to do is you do again need to put your fingers inside your vagina and you kind of um i mean it might not be the same for everyone maybe this is just my grabby service yeah but you need to um you need to kind of like break the vacuum so what you do is you like squish the sides of the cup together again and you'll kind of gently you'll feel the vacuum break and then you pull it out um also thoroughly recommend doing it in the shower the first time um because you can end up with a bit of a mess i feel really awkward about this but basically i'm not trying to boast but i'm like really good at it like you're like a menstrual cup pro i literally i got it i put it in i'm massive because i got sent it by the company and i I mastered it, and I'm like, oh my God, I love it. And they're like, did you, like, it's quite difficult to put it in,

and I was like, no, let's just fold it and put it in. And then again, I don't mean to boast again, but I have really strong pelvic floors. I've spent, like, a lot of my life doing Kegel exercises. I'm doing mine now. Yeah, I do it all the time. I always do it in queues, and then you're, like, looking at people. I literally just, like, kind of push it out.

You get different sizes. Yeah. So that can affect how um how it fits and also i think a lot of them these days are a little bit thinner so that you know it's made of like a silicon type stuff and i think that um how thick the silicon is probably um affects it but i mean i really think that it's an awesome thing to try i took one on a trip um and it was amazing because you know normally you're kind of like oh how many tampons am I going to need for the trip yeah um don't have enough pads where am I going

to like stash them or whatever and it's just so easy so I mean I'm a massive advocate I get a lot of messages from people asking me if they're safe um there's absolutely no evidence to suggest that there's any um safety issues with them at the moment maybe that will change i don't know you do still need to make sure that you are emptying it and cleaning it um every um six to eight hours um so tampons can cause something called toxic shock syndrome um and it's caused by a particular kind of bacteria that can grow but um that i've definitely read at least one case study where it has happened with a menstrual cup um so it's just really important whatever you're using to just make sure that you change it you're changing it yeah and then you have to like wash it probably and sterilize it afterwards yeah so um hot water yeah um and yeah

talking about sizes because this is what some people ask me so basically the one that i have they said that you get like one for under 16 who haven't had sex one for under 25 that haven't given birth vaginally and then over 25s who have given birth that was like the three sizes they have obviously there'll be some scope for like variation there absolutely but that's like the basic so like what if you've had a child or whatever that is like a different size that would work for you because it's not going to say the same for everyone yeah and that's just to do with the changing the size of your cervix yeah but i mean even people who've never had a baby can have a slightly bigger cervix.

Yeah. You just have to try it and see. Also, a couple of people asked me before about whether you can use it with a coil. And I've read on some of the instruction leaflets it says no. Because it could pull it out. But this is the thing. I'm just not really sure how you're going to pull the coil out with the menstrual cup. I mean, I remove coils quite often.

I love it. It's so satisfying. But I just... I really don't understand how you would manage to do it with the... Can you explain to me quickly how you put a coil in? Because I'm so... This is why I won't get a coil. Because my friend had it done and they put it in wrong.

Okay. And then she bled for like three months and all of our friends are like, I'm never getting the coil. Oh, there's so many horror stories about coils but they can be amazing. There's two different kinds of coils. So there's a hormone coil and then there's a, yeah it's called a marina and there's two other kinds

that are out in the UK now called JADES and Kylena. They're a little bit smaller but they only last for three years rather than five. No, so they're also hormone coils. They're a little bit smaller, but they only last for three years rather than five. No, so they're also hormone coils. Oh, okay. They're just a bit smaller.

And then there's the copper coil, which doesn't have any hormones. So that one's getting really popular. How does it work as a contraception? Yeah. So it basically, the copper is toxic to the sperm. Oh my God, really?

That's sad. It causes a bit of irritation so that if there was like some kind of uber sperm and he managed to get through and fertilise an egg, the egg would not be able to implant. So that's how it works. Oh, so not only does it like, if it kills the sperm,

it kills the sperm or just puts them off? Yeah. And then if it does get in, you can't implant either. Exactly. So that's how it works um and it can also be used as emergency contraception a lot of people don't realize that the copper coil only not the hormone call the copper coil you can use up to five days

um after having unprotected sex um it's very very effective um but uh yeah so it does make your periods a bit heavier though which is why a lot of people don't like it you get parents on the copper coil yeah you get periods on the copper coil they're often a bit heavier though, which is why a lot of people don't like it. You get periods on the copper coil. Yeah, you get periods on the copper coil. They're often a bit heavier and a little bit more painful. And that's the commonest reason to ask to have it removed earlier. I think one of the reasons that people are embarrassed to go to talk to a doctor about something that's going on down there is because they're not really sure to say where it is.

Yeah. We do really misuse the word vagina um the vagina is literally the most people have shaved my vagina you haven't please don't shave your vagina people um yeah i don't know how you get a razor in there anyway be quite painful yeah it would um but no that's just the inside and yeah you're right the vulva's the outside i did a youtube video about this um a while ago did you yeah just kind of explaining all the different parts and because sometimes i get people who come and they're like oh i've got a problem and it's and they try and like give me this explanation and i just kind of say like should we just have a look yeah and it's definitely not where i think

it is and that's not their fault it's just that we are not good at using the proper words yeah i just don't think you're educated and like enough about it either like in school and things exactly it's not really talked about and i think that's something you have to learn you just gotta go out and and learn about these things and with like so that's part of growing up and i'm trying to bring this back to other things we're just getting so into talking about vaginas and vulvas i need to bring it back bring it back notes but yeah so part of growing up as well we said this like thinking about having a baby and i was just saying to anita kind of offer that i now would imagine myself having a baby quite maybe a bit later in life than say like my mum's generation

would have done and and i've like there's so many things i want to do and i think a lot of women are more career women now and they want to spend a bit more time working before they decide that they want to take time off to have a child but in terms of fertility I don't really actually know what my options are or there's even these companies that are trying to incentivize women to freeze their eggs which is really problematic um I think just because it makes you feel like you have to like you're kind of in because it's really expensive to do that isn't it yeah so expensive yeah and so like, you're kind of in, because it's really expensive to do that, isn't it? Yeah, so expensive, yeah. And so, like, if they're saying that, you're kind of like, it's off, you really can't refuse.

I think, because, as I mentioned, I'm 32, and, you know, most people have, the average age, actually, in this country to have your first child is 30. And most of my friends have got children, a couple of them got two, and one of my friends is actually pregnant with her third baby.

And I think a lot of my friends actually pregnant with her third baby um and i think a lot of my friends when they turned 30 they were like oh shit we need to start having a baby because there is this kind of like i think people get quite frantic um and there isn't really a reason to become frantic but um i think a lot of it is born through the misinformation around so first thing to be quite clear about is that fertility is not declining okay it's just that we're choosing to have children later um and i think it's really interesting because you were discussing in the um the podcast with your mum about like how financially our generation is completely different to our parents so i think one of the reasons is

career but another reason is that we're not as financially stable as our parents were. And, you know, a lot of people are really struggling still at my age to buy their own place. Yeah. Whereas that was not an issue, you know, a couple of years, decades ago. So I think that's one of the reasons. So fertility tends to decline from about 35. You will obviously, you know, every year that you age, you know, your fertility is technically declining because you're losing eggs.

But it's really from 35 that we say that that's when... But once you've had... Isn't it, say you'd already had a child. Yes. Then it's easier to have another one, isn't it? Was that not a thing? Not necessarily, no. It's just, no, there's no superpowers from a baby, unfortunately, when it comes to fertility.

But, well, I guess it kind of is a way of confirming that you don't have any problems. Oh, I see. But I think also there's a lot of companies out there that are offering people fertility tests. tests and I really it really upsets me because I don't think that people should be um you know have this idea that they need to have a test for their fertility because I get lots of patients who are like I think I want to start having um you know start trying to get pregnant so what do I need to do and I'm like well you need to have sex yeah and they're like oh yeah but do I not need like a blood test or a scan and I'm like no just go and have sex so when it comes to infertility or subfertility so problems with getting pregnant 30 are female factors 30 are male factors and the rest are unknown and probably 50 50 male and female so

it's not like a one woman show yeah this is the problem it's always everything to do with i mean it's the great thing and the difficult thing about being a woman is that so much of it is like you're the one that carries the child you're the one that's expected to like lose fertility i think this is just so much pressure put on women's bodies more than any guy ever realizes and you like are born with this just pressure yeah and you just it's like it's just always there and you're never really and then i thought i was talking to my friend about it we were like actually a guy will never understand how much weight it carries to for instance have like unprotected unprotected sex or something like that they just will never understand how scary that could feel and it comes it's the same with fertility for some reason you're right I think

everyone always assumes it's the woman yeah totally because I mean I do I'm not a fertility expert but we do fertility clinics in my department. And, you know, we're just doing kind of like the initial assessment and doing further investigations. But the men get really shocked when I turn to them. So I like talk to the woman, go through her history and get all the information I need. And then I'm like, so let's talk about you then. And they're like, oh, my gosh, which is really interesting because yeah it's it's a two-way street it takes two um but you know male male fertility is actually declining there's been

some um studies that have shown that because of various lifestyle factors sperm counts are going down so men do need to make sure that they are equally as healthy as women so that's why there's no reason to do any kind of tests to start with because you know you could have a blood test to look at your ovarian reserve for example that doesn't really help you you could have a scan to look at your ovaries again that information doesn't necessarily help you because that's not the only thing that's going to get you pregnant. But the thing is as well that if you're doing those kind of tests, is that going to change your management?

So something we always get taught in medical school is if you do a test, is the information that you get from it going to change your management? So if you were, say, 25 years old, you haven't met anybody yet, you've got no intention of having a child, what's the point in checking your fertility because is it going to make you frantic and start looking for a man or you know what what relevance does it have to you at that point so we really just recommend that people just start trying to get pregnant um and then if after a year of having regular sex you're not getting

pregnant then you would need further investigations and in terms of just like what you because you wrote a post on international women's day and you said that one of your colleagues i think said to you you're not going to try and kind of have a baby and this pressure on women it's kind of like the expectation that if you're i want to do another episode on this as well but I think when you're growing up you you have this belief that at some point you know you're going to be a mom and you're going to do this whereas the guys you could quite happily be single like into your mid-40s and no one's going to be that worried there's not that same pressure whereas as a woman everyone's like when are you having babies then and I think it starts at like your late 20s 30s like everyone starts there's a lot of um there's a lot of pressure on that and a lot of my friends um who um are married they were all like literally like a week

after the wedding everyone's like so when are you having a baby and i think that we have to be a bit careful about this um and you know i i've had a lot of people coming up to me and talking to me um at work who saw that instagram post um and they were like oh but you know she doesn't know you might actually be like struggling yeah fertility problems so true you know maybe like the man of your dreams just broke up with you well actually the man of my dreams actually just proposed to me at the weekend but i've literally been staring at your ring oh no i did know that it's unreal by the way i literally I just can't stop looking at it well thank you he did well but you know people just make these flippant comments and they don't know

what might actually be going on inside and you know I have friends who one of my really close friends actually had a lot of miscarriages before she conceived um her first child and she said to me that what the worst one of the worst things about it was just people constantly watching her for pregnancy behavior so like was she drinking was she like eating like salami and all that kind of thing and I think we have to be really careful because you don't know what's going on with somebody and it can be really traumatic if you are having problems with fertility or, you know, problems with miscarriages. But also we shouldn't just assume

that that's what everybody wants to do. And I've had a lot of people saying things like, you know, Anita, you're not that young anymore. You need to start thinking about this. But it's like, well, I have thought about it. I don't need to be lectured about it. Yeah, I'm sure you've thought about it. I also don't need to wear my, you know,

my fertility intentions on my chest so it's something that I think we need to be more sensitive about it should be okay to talk about problems with fertility but we shouldn't just assume I think there's a bit of shame around it

I think there's such a stigma I think that you feel like if people think that if you can't conceive it's like a shame and you're not worthy it's a really archaic idea feel like, if people think that if you can't conceive, it's like a shame, and like you're not worthy, and you're not, it's a really archaic idea, that like this, the woman, if it is the one,

can't produce a baby, like, as if it's like we're in royal family, or something, and it's like years ago, and you've got to produce like the prince. Exactly. It's just a really weird idea,

and also saying, my sister's like 30 and 28, she's going to come in if I put that wrong, so I think it's 29, yeah, the other one's 30, but I remember when I was younger, thinking that was odd, they're so young, they're basically, I'm 24 but they feel the same age as me, like

I just don't think 30 is old anymore and the fact that that's meant to be an age, like I don't think I'll be ready to have kids when I'm 30 still, I just don't understand where this, I know that it's a number but it's just that really weird thing where we've just gone 30, oh. Yeah, I don't think you feel, I don't think you ever feel ready I mean I don't know but that's what all my friends tell me and I think as well like when I turned 30 I was kind of like oh am I meant to feel something yeah or is something meant to like switch and I don't know I mean for me like I went to university for eight years and I felt about 22 or 23 for the whole time the whole time and then even afterwards as well i still felt

very young um and also because a lot of my friends at that point had got married and were starting to have children i was just kind of like the young one i agree this is so funny so i i did a gap year and then i changed my course and i was at uni longer but literally when you're at uni it's like a time capsule yeah definitely like you just don't because you're not in the real world you're like in between being like into your work and stuff and just there's no age just does not mean anything because you can be in a different and i've got friends who like already have a baby who already really serious relationships and then i've got other friends who like i've gone bachelor at home and at uni and we're all the same age but we're all at such different points in our life and i think that's one of the really difficult things actually about when when you like get to the stage in life because no one're all the same age but we're all at such different points in our life and I think

that's one of the really difficult things actually about when when you like get to the stage enough because no one's doing the same thing yeah I think that's one of the things I found hardest actually because I was like gosh I still feel like really young and um I don't know if immature is the right word but I didn't really feel my age and I remember um when I remember being about like 28 or 29 and thinking like gosh when I was 18 I thought that like a 28 year old was like really really like a proper adult and totally had their shit together and just thinking like god I don't feel any of that no um so yeah it's quite an interesting one isn't it but I think that yeah for women it's much harder because there is that fertility expectation I agree I think the funny thing is as well is I used to think the same,

but then I do look back at my 18-year-old self and I'm like, God, you were so stupid. Yeah. And so naive. I think that's normal. So I think you do get more mature, but it's just every time you're in that age, you just don't feel like, I think we put so much pressure on ourselves,

you never feel like you're fully doing it properly. Yeah. Which probably are so much more mature. I don't know, I completely get what you mean. It's pretty funny. At every age, I think you never quite feel like you're fully doing it properly which probably are so much more mature I don't know I completely get what you mean it's pretty funny at every age I think you never quite feel like you're yeah hitting the quota that you're supposed to I still don't really feel like an adult but I guess I am now yeah I know but there's not really like a sudden switch it's just kind of I think it just gradually um happens but I don't know I mean I don't think it matters as long as you're enjoying

life it doesn't matter how old you are or how old you feel no I completely agree okay so Anita I've absolutely loved talking to you we have discussed literally the ins and outs mainly the ins everything in between which has been amazing so just to round off the podcast I want to ask you obviously a very successful woman you're doing amazing things and I want to ask you what your one piece of advice you give to anyone who's out there in their 20s 30s whatever age are and they're maybe struggling a bit to get to grips with adulting what would be your takeaway piece of advice yeah I mean I think that that's very kind of you that you think I'm very successful but I mean I really don't think I've got anywhere close to what I want to achieve at the moment. But you know, as someone who didn't get into medical school, I didn't get onto the OBS and gynae clinical training program the first time I tried.

But I'm kind of, you know, I'm doing it now, obviously, and I'm doing what I want to do. I just think my biggest piece of advice is just if you believe that it's something that you want to do, you can do it. You just have to keep pushing. And I think a lot of people say like, oh, you're so lucky this happened to you. And I'm like, no, I'm not lucky. I put myself out there and I went and asked for opportunities. I begged people to give me opportunities and let me do things. And I mean, I obviously got turned down for things. And, you know, people were like, yeah, you're not really going to be able to do that are you but I just I believed in it I wanted to do it so

if you have the belief you'll find a way I think that's such good advice and thank you so much coming on I've absolutely loved it thank you and I'm sure you guys will all have loved it as well if you want to follow Anita on Instagram it is you do you say gynege or gyny geek? Gyny geek. So G-Y-N-A-E-G-E-E-K Okay and then I'll put that in the notes as well. And she does some really fun stuff. And if you have any questions please feel free to leave a review or you can email me

enquiries at thetinytank.co.uk or I've just remembered we've got our own Twitter now it's adulting underscore pod so that's at adulting underscore pod if you want to ask any questions thank you so much for listening and i will see you next week bye bye the podcast you just heard was recorded with anchor if you want to make your own download the android or ios app completely free from anchor.fm podcast that's anchor.fm podcast fanduel casinos exclusive live dealer studio has your chance at the number one feeling, winning.

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