Pap Smears and Period Science feat. Dr. Riddhima Shetty

[00:00:00] Did you know that if you have periods, you have periods for about 7 years collectively in your life? So, what's the point? Behethereen Because that's kind of the point. That is the point of this new podcast.

[00:00:18] We want to make you think, think about the world, think about your body and think about science. My name is Dr. Tanaya. You might know me better as Dr. Cuterus and you're listening to the Dr. Cuterus Podcast. And today we have a very special guest with us.

[00:00:35] Today we have with us Dr. Riddhima Shetty. She is better known on the internet as Friendly Neighborhood OBGYN and she is a practicing gynecologist in Mumbai.

[00:00:45] And today she's going to be talking with us all about women's health, gynecology and all the fun questions about sex that you wanted to ask a gynecologist. Hi Riddhima! Welcome to the podcast. Hi Tanaya. Thank you so much for having me. Congratulations on your podcast. Yay!

[00:01:03] Congratulations on your first podcast. Yay! Riddhima, what are you? Very deep existential question. But professionally I'm a gynec and I'm practicing in Bombay and I'm also sort of a social media content creator. A little bit. Mini. Mini-wala compared to you and many of the big wigs.

[00:01:24] But yeah I do post about women's health care on Instagram and also I'm known as Friendly Neighborhood OBGYN. Too long I know. No but that's great. Thank you for that introduction. So you mentioned you're a gynecologist. Yes. What is a gynecologist?

[00:01:40] As some of my friends call it Pussy Doctor but definitely not. My friend calls it Insano ka Swiggy. That's a good one. I'm going to use that next time because I'm like Pussy Doctor no. Pussy means vagina and uterus, ovaries, everything related to reproductive health of women,

[00:02:01] deliveries, childbirth, pregnancy but also menstruation and other gynec disorders like ovarian cysts, fibroids, infertility stuff like this. This is what gynec treats. Only women. Okay so this is a question that I get very often. When do you suggest that people should see their gynecologist for the first time?

[00:02:24] So I usually advise it though not everybody follows it. It's always better to get your pre-teens and teens to a gynec first so that before they get their periods or just when they start getting their periods so that they're able to understand a lot about why it's happening

[00:02:39] because at that age they are really confused and apart from that also there are a lot of period abnormalities in your first couple of years which if they have an idea about they won't be so scared about it.

[00:02:50] Also about how to use their menstrual products, general vaginal hygiene or valval hygiene for that matter and all of these things. I prefer if they come when they are pre-teens or teenagers but usually everybody comes in the early 20s which is still okay.

[00:03:05] So I say don't wait for something to go wrong to visit a gynec. First go to the gynec, learn what's right and you know what is your normal way of your reproductive system to function and only then you'll know what is wrong. Excellent. And say,

[00:03:20] My life is over. I'm 12 years old now. I'm a great person. I'm with Dr. Ritima. I've learnt everything. It's not going to be a problem for two years now. How often should people who are not having any issues how often should they see a gynecologist regularly?

[00:03:37] Yes, they should. So for women who once they become sexually active I recommend going to a gynec every year for a routine check to rule out any infections or anything of that sort and young girls I would say if they come once

[00:03:50] then after that once they are 18 or once they are sexually active definitely they should be going yearly is a must according to me and then that's when they'll know when they have to get their pap smears done

[00:04:00] when they can take the HPV vaccine and all of these things. Yeah, so yearly. So we already have an episode on the HPV vaccine. But what is a pap smear then? So a pap smear is like a very simply put it's like a COVID test for your

[00:04:14] you could call it a COVID test because that's how we actually do it we take a smear we take something like called a spatula like a very small one and we take a swab from your cervix

[00:04:25] which is the mouth of your uterus and those cells are collected in it which we then mount on a slide we put a medium on it and we send it to the lab so that the lab can tell us whether there are any cervical changes

[00:04:37] or any changes in the cells and the tissue of your cervix which could be precancerous. If you want me to go into detail I can tell you about the HPV virus and everything. So cervical cancer is one of the second most common cancers among women

[00:04:52] in developing countries like India and it is the only cancer where we know that it's caused by a virus the HPV virus. Now the HPV virus is spread through sexual contact most of the times and 90% of people by the time they turn 30

[00:05:09] they're going to come in contact with the virus and your own immunity will generally kill the virus but there will be a few people whose immunity does not kill the virus so they are the genetic makeup of their cervix starts to change

[00:05:23] the virus integrates with it and it will eventually cause cancer. But the thing is when it causes cancer it won't be instant, maybe 20 years later but there are precancerous changes that happen way before that and that's what we're trying to catch from a pap smear.

[00:05:39] That's why we do a pap smear every 3 years. Does it hurt? It's slightly uncomfortable because we generally put an instrument which will open your vaginal walls which is called as a speculum but it's not painful because the cells that we're taking

[00:05:54] you're not going to feel anything over there, right? It'll just be when we insert the instrument inside you may feel slightly uncomfortable but if you relax and leave it loose then leave it open and it will be okay. This is something I've heard so often in Guiney Pohli

[00:06:08] Leave it open. Leave it open. It's like every day. Leave it open. But how? I generally explain to my patients about the brush itself because the brush that makes the eyebrow is soft it's spoolie. It's exactly what it looks like so it doesn't hurt.

[00:06:25] It's a soft brush with soft bristles exactly like you said, it can be uncomfortable. So how often do you do pap smear? Every 3 years once you're sexually active or about 21 years of age you can do a pap smear. Fantastic.

[00:06:39] What else should women do to take care of their general health? Like is there any other cancer prevention screening they can do regularly? Yes, they can do self breast examination and once a year they should go to their gynaq too

[00:06:52] or their doctor generally to get a breast examination. So I recommend every woman should do a breast examination once a month, generally about 7-10 days after your period starts and do it at the same time every month so that if there are any hormonal changes

[00:07:08] then you're not going to be incorporating that into your findings and you're supposed to do it in front of your mirror and in 3 positions with your hands held up and basically too much technicality but superman, angry woman. So basically you look into the mirror

[00:07:24] and use 3 of your fingers to feel your breast and see if there are any lambs or any pain or tenderness apart from that you see if there are any changes in size any skin changes that you're feeling on your breast or your nipple

[00:07:38] also if there's any discharge or bleeding from your nipples stuff like that. So if you're doing it every month that's great otherwise once a year come to your gynaq and you can also do if you have any suspicious lumps or anything your doctor will advise you some tests

[00:07:53] like a sonography, if you're over 40 then you can do a mammogram but these are routine tests that you should be doing. So you mentioned a change in size but a lot of people have different size boobs that is normal. That is completely normal.

[00:08:10] What I mean is suddenly one breast is getting massively larger than the other and you have some associated mass or lumps with it or pain with it then it's something that needs attention. Excellent. Thank you so much for answering so many of these questions.

[00:08:24] We're going to stop for a quick break and then come back with even more interesting questions about women's bodies that sounds dirty. No it doesn't. Excellent. So we are back and now I have very interesting questions to ask you about periods. Done. Tell me. I'm all set.

[00:08:49] So periods are something that intimidate a lot of people like how to take care of yourself how to maintain hygiene and aside from people who menstruate a lot of partners also ask how can I support my partner better on their periods

[00:09:03] tell us a little bit about how to first take care of yourself on your period or how we can take care of somebody else on their period. Okay so firstly let me tell you what a period is because if there are

[00:09:13] a lot of young girls listening to this so it's basically a uterus preparing itself for a pregnancy and when that happens basically what it's doing is it's growing in a wall aligning and the ovaries are producing eggs. When the egg doesn't get

[00:09:27] fertilized it sends signals to the uterus that there is no pregnancy so all the preparation done for the pregnancy has to be expelled out and that the endometrium or the lining of the uterus that comes out along with blood is what a period is. Now generally

[00:09:43] a period can last anywhere from 2 to 7 days and a menstrual cycle is how you count from your first day of your last period to the first day of your current period. The days in between are your menstrual cycle so they can last anywhere from 21 to 35 days

[00:09:59] and that is completely normal but if you feel like your bleeding has become irregular or if there is very heavy bleeding where you are changing more than 2 pads in a couple of hours and you're feeling very weak and giddy then it's something that needs medical attention. Otherwise

[00:10:15] periods is not a disease or anything like that what I would say is continue with your daily routines if you feel like you're getting a lot of cramps please take a painkiller there's no problem at all in taking a painkiller it's not going to affect your fertility

[00:10:29] like a lot of patients ask me what I can do and it's absolutely unrelated it's an anti spasmodic which helps you relieve the uterus contractions pain basically that's what it does so take a painkiller, relax if you feel like but what I would

[00:10:45] say is continue with your daily activities exercise, stay hydrated take vitamins supplements which have been advised by your doctor do not self-medicate these are the basic things that you need to do make sure you use a menstrual product completely comfortable with it can be

[00:11:01] a pad, it can be a menstrual cup, it can be a tampon but make sure whatever you're using how to dispose it off how often you have to change it like with a pad or a tampon I would say in 8 hours you should change

[00:11:15] it and even if it's not completely soaked a lot of women don't change your pad if they have the light bleeding they'll wear it the full day and they end up getting rashes sometimes they even get a UTI or another infection from it

[00:11:29] so you have to change your pad every 8 hours your menstrual cup it needs to be emptied every 8 hours and washed between uses and always always sterilized between every period which is simply by boiling it in water so these are the basic things that you need to do

[00:11:45] now as for taking care of someone on their period for brownie points get them brownies ice cream what kind of brownies are we talking in any whatever yeah but be nice to them you get them a hot water bag maybe help them

[00:12:03] lift their bags and stuff like that but honestly women don't need it they can function perfectly well on their periods but just for that extra help yeah they wouldn't mind it so you mentioned that if you're not changing your pads at the right time if you're not changing

[00:12:19] your menstrual product at the right time it can lead to a lot of infections so what are the common kind of infections you see in the clinic and yeah tell us about some infections so most commonly I see a lot of vaginal infections like fungal

[00:12:31] infections known as candidiasis I also see some bacterial infections called bacterial vaginosis and there are two basic differences between them so let me tell you firstly vaginal discharge is normal premenstrually you might notice some excessive vaginal discharge even around your ovulation time you may notice some

[00:12:51] excessive vaginal discharge but your discharge is supposed to be clear or look like egg whites right slightly milky or clear and slightly watery but if you feel like your discharge is smelling bad or you're having a lot of itching or it's looking grey and frothy

[00:13:07] like bubbling bubbling or like curd or paneer then these are infections that you need to get checked out so fungal infections generally resemble like paneer chunks in your vagina and they smell curd-y and they cause a lot of itching and they need to be treated

[00:13:25] sometimes we also treat the partner in such conditions whereas bacterial infections they have a fishy smell or they have this greenish or yellowish or frothy discharge and they require antibiotics for it a lot of times these vaginal infections might be sexually transmitted or

[00:13:43] they might just happen because your vaginal pH is destroyed which can happen from excessive cleaning of your vaginal canal which you don't need to do you only need to clean your vagina externally I mean your vulva externally nothing needs to go inside your vaginal canal because it's self-cleaning

[00:14:01] and the moment you put a soap or even an intimate wash which is a marketing hack according to me like a marketing tactic if you use an intimate wash inside your canal you're going to disrupt your pH level which destroys your good bacteria and you're going to get

[00:14:17] bad bacteria and fungus coming in so these are the common infections that I get apart from this I also get a lot of patients with urinary tract infections and you know very funnily a lot of patients confuse UTIs and vaginal infections like when they are stating it

[00:14:31] they'll say UTI who are when it's actually just discharge and itching UTI has very specific symptoms like what you'll feel like being again and again every 5 months you'll go and you'll feel like you're getting a little droppy but that sensation is not going

[00:14:47] or after being you'll feel like there's this really pricking sort of pain that you feel after you finish avoiding urine or they'll be burning while passing urine these are the symptoms of a UTI a patient of mine described it as pissing razor blades oh my

[00:15:03] that is actually how it feels from personal experience too it's the worst feeling in the world which is why so women get again because we have a very short urethra which is about 4 cm that means that our the external world and our bladder are

[00:15:19] very close this pipe is very very small that means anything around your urethra will automatically go in so we get a lot of UTIs now there are ways to prevent it most commonly drink a lot of water I know everybody says this for everything drink a lot

[00:15:35] of water for everything basically but it is a fact drink stay hydrated and don't hold in your pee for too long so if you're travelling or you're in a public place don't think that I won't go here because I have an UTI actually is the exact opposite

[00:15:49] you'll hold in your pee for 2 hours reach home because of that you've got a UTI thank you this is such an important point to be made and so many people miss it all the time and you can go and pee in a public toilet you can sit

[00:16:01] on the toilet seat guys it's not going to cause your UTI your urethra is not even close to what touches the toilet seat it's your thighs yeah I love the fact that people think I mean unless you're sitting there and rubbing your urethra on the

[00:16:15] toilet seat which is an interesting sometimes I hate having a visual imagination but I'm imagining it right now but yeah so UTIs and vaginal infections are the most common ones but they are two separate things with separate symptoms and separate lines of management and since you've mentioned

[00:16:37] there's some good safe practices you can follow what are the top sort of annoying things you see annoying pieces of advice you see that people say that if you do this then it will be nice first of all putting soap and all they'll use intimate washes and everything

[00:16:53] some of them put coconut oil inside when they get an infection I saw this woman on twitter she had bacterial vaginosis so she put she put garlic cloves inside there over environment it was like a fish curry recipe now salt, pepper, gravy the pickle had the garlic

[00:17:27] had essentially pickled inside her so she took out the blue picture on twitter and she was like this is what happened to the garlic I put inside my vagina please help how do I fix my how do I fix my infection

[00:17:39] go to a fucking doctor that's how you fix your infection so people do all kinds of stuff means coconut oil is the least and apart from this some of them will use this I won't take a brand name but use this hair removal creams means inside the labia

[00:18:01] minor, small flap covering on that too, hair removal cream got burnt got burnt all of these things lot of crazy stuff some of them are very basic a lot of people end up using flavored condoms for penetrative sex which is one of the most common reasons

[00:18:23] for vaginal infections I have done this too I didn't want to do it when I was a child I mean I was a child but in my youth, yes everyone made mistakes but yeah guys, flavored condom is only for oral sex if you are switching from oral

[00:18:45] to penetrative sex, remove it put a new one and then go through it but don't be like I will do a little then remove it then I will put condom I just got into many positions and wanted pregnancies lot of these kinds of things so remember, specifically flavored

[00:19:05] foods are also for oral sex don't put a flavored stuff inside and then the next day via fungi infection this is going to happen so what are your top tips for having healthy sexual life okay firstly consent is very important make sure you are

[00:19:23] aware that you want to do this not be pressurized or forced or even guilt-tripped into having sex. Secondly, make sure you all are using protection always unless you're planning to have a kid then of course don't. But nahi toh any other reason goes out of the window.

[00:19:41] Always use a condom to save and save yourself from STIs. Thirdly, do a lot of foreplay so that both partners are into it. This is for men. Don't just directly get into the act. For women also, insist on foreplay. Your pleasure is equally important.

[00:19:58] Fourth, make sure you go for regular checkups. Do STI testing as well and get your regular pap smears done as well. Fifth, I think mental health wise don't associate sex with guilt or if you've had multiple

[00:20:14] partners or anything like that it's not something to be ashamed of when you go to your doctor. Make sure you share all your healthcare information. If you feel like you're being guilt-tripped for that, change your doctor.

[00:20:26] There's nothing about you that's wrong in wanting to explore yourself and that's very important because a lot of women are too scared to give their entire history to their doctor and giving your history is very important because it changes so many lines of treatment. So don't be guilty.

[00:20:43] Own your sexuality. Own your sex life. Enjoy. And change your doctor if you're being made to feel guilty but don't hide stuff. This is excellent. You're very important and this is a big slap to those people who spread bullshit on the internet. Don't take it on your own.

[00:21:03] But this has been such a fun conversation. Thank you so much. I'm hoping people have learnt a lot and I'm hoping nobody uses flavored condoms for penetration after this and get their regular pap smears. Thank you so much for coming on.

[00:21:18] Thank you so much for having me at a blast. Thank you.