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i'm mom and doctor jones a board
certified ob gyn amont four today we're
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[Music]
sexism does have a role in most of those
things and i definitely agree this is
still very much a problem when i was
pregnant with my last baby i was
actually told by a male physician
colleague who was an obstetrician that
he only took two weeks of leave when he
had his prostate removed so he didn't
understand why i wanted to take eight or
ten weeks after birthing an actual human
i asked him if he stayed up at night
breastfeeding his prostate making sure
it was okay checking on it to make sure
it hadn't stopped breathing and he said
no so i went ahead and took my maternity
leave i do want to talk about the birth
control for men thing this is actually a
little more complex than it is often
made out to be it's often presented as
they do a study and the men in the study
are like oh i have a headache my back
hurts this makes me feel bad so they
pull it and they stop it and they don't
release it to the market however it's
not quite that simple when the fda is
deciding if they can approve a
medication they're looking at risks of
being off the medication and risks of
being on the medication there is some
room to say that we need to change this
process in regards to what we're
discussing right now but the way it's
currently done is that if you are
looking at birth control for people who
can become pregnant the risk of not
being on it
is pregnancy and all the risks that come
along with that so when they're looking
at male birth control you're looking at
the risk that this person being off
birth control can get someone pregnant
and of course that's the goal is them to
not be able to do that but the actual
risk to the person taking the medication
is
minimal if they're not taking it so the
weighing of side effects is different
because the outcome of being on or off
the medication is different so i hope
that makes sense i still think it's
wildly bizarre and not the correct way
to look at this particular topic but
this one is not just all the men were so
poorly accommodating to the side effects
it is a little bit deeper than that
what was that
what
was that yeah i don't know
i mean i'd
like to know i mean really could be
anything i mean it feels like we just
started i don't know you might have
you're gonna make me go check aren't you
yeah that is the most accurate
representation of a conversation that i
think every person who has periods has
ever had with their body hi how are you
doing have any questions no okay good
okay lay back let's measure your belly
oh perfect measure measuring just on
time let's get that heartbeat
baby me okay good she's perfect all
right have any questions again no okay
yes so we'll see you on your next
appointment bye
that's a really accurate representation
of anybody going to a prenatal
appointment who was lucky enough to have
a very straightforward and uncomplicated
pregnancy i often feel bad at the end of
that conversation because i'm not sure
what else to do when you're healthy and
you don't have any concerns or
complaints
a lot of times the visits can be that
easy it's just how it happens
hello i'm going to need everyone to go
to the ob gyn immediately and i don't
like to give advice but i'll give it um
because you don't know what's going on
up there i stopped in on the way to work
two days ago
because i woke up and my boyfriend's dog
fluff who he thinks the sweetheart was
licking me in an inappropriate place so
now my biggest enemy is name fluff and
we don't make eye contact and it's hard
to be mad at a dog but people think
you're mean
anyway i stopped in the the clinic about
two days ago on the way to work and they
say we don't do walk-ins and i go i'll
walk right in because we have a
situation
and i just think i have an affection
probably so
also i'm in there doctors putting her
gloves on she goes up there and she
something's in here and i go i don't
really care for the small talk unless
you found a baby in there what's going
on
she pulls out a soggy piece of paper i
go did you lose a tool up there she goes
i don't none of my tools are paper so
then it's actually a note she starts
reading i go pass it here
um and
i can barely read the writing because
it's been up there for about 43 years um
my age
and uh it is from my birth mom
it goes
from your birth mom i didn't want to
give you up but i didn't have the funds
for twins i kept your sister
we're gonna need you to come to texas we
miss you
luckily i have miles so i fly to texas
and she only said her name was mary so
it took a long time to find her lots of
mary's i met one enemy one close friend
i end up finding her house
she's passed
she passed away
but she left gold for me in the backyard
there's another note on the doorknob so
i'm digging for gold in the backyard her
neighbor comes out shotgun he goes get
out of this yard our friend died i go
this my mom let me get the [ __ ] note
that i found my ob gyn found it i
promise um and i showed him and
the point is just go to the doctor
because you could have an std
you could be pregnant or you could have
a note from a loved one
that was the longest obviously very true
story that i have ever listened to on
tick tock and honestly the only notes
that i've ever found in there have been
people looking to talk to you about your
car's extended warranty and i just
usually throw those away so you're
welcome you know whenever my desire to
the patriarchy into the ground
gets a little defeated i always remind
myself that the placebo pill in singular
phase women's birth control is not
medically necessary that it was put
there to appease the catholic church
because they deemed it unnatural for
women not to have periods
even though it's been medically proven
that for this type of birth control it's
more healthy for women to stay on a
plateaued regimen i didn't know that
that was the reason at the time that it
was probably decided we didn't know
whether it was safe to take pills
continuously or not but it is accurate
that you don't have to take the placebo
pills you can skip them and just keep
going straight into new pack and not
have bleeding every month the downside
to this is at some point you probably
will have breakthrough bleeding or
irregular bleeding and i tell my
patients to go by the rule of threes if
you've had three days of bothersome
bleeding look back on your calendar make
sure it has been at least three weeks
with no missed pills no placebo pills a
normal hormonal pill every single day
and if it has then take a three-day
break to have a period and restart your
pills that's the way i have my patients
manage break their bleeding on
continuous pills obviously there's a
whole bunch of ways that people do this
i don't know that i would say it's
better to be on continuous pills i think
it's better for some people some people
like to have a period every month it's
just they're normal and they want to do
that and some people don't i prefer
continuous pills i take birth control
pills and i like to take them
continuously some people have too much
breakthrough bleeding it drives them
nuts it's very individual i don't think
it's healthier or unhealthier to be on
pills continuously or not continuously
her story about how they got put there
is interesting can't confirm or deny
whether that is true but it is true that
it is medically safe for most people to
take birth control pills continuously if
they prefer them when doing a vaginal
exam why should you be careful sitting
in a rolly chair like this an awkward
young med student prepares his speculum
and leans forward to insert it into the
middle-aged patient when all the sudden
the rolly chair flies out from behind
him and he goes basically face-first
into her vajayjay no
comment with what you would say in this
situation and follow for more i really
hope that is not a true story and if it
is i am so sorry to whatever patient
experience that and also to whatever
attending was standing there watching it
happen med students surely you can use a
rolly chair better than that this is a
horrifying story and i hope it's not
real
it's finally time ashley started her
first period well we kind of have a
problem do you not see that
i i can't freely bleed
she hasn't found out about you has she
no
she just knows that there's one uterus
not two
that means she doesn't know about her
friend kidney up there either i am so
tired of filtering the salt
and the coke out of this little girl's
body she needs to stop drinking like
there's two of us there's only one
i don't know what to do with this period
blood
it's just sitting here
we could always give her severe cramps
and then maybe her mom will take her to
the doctor
no genius
she's a toxic mother her mom's not gonna
listen to her you're just gonna make her
suffer we have to do something
i mean i can't just sit here drenched in
my own blood
maybe kidney could do something
like what try to kill this girl put her
into kidney failure where she belongs
with all this coca-cola drinking you
think they're gonna look at her uterus
for that no
i know what to do
what are you doing
i'm just gonna dilate till it comes out
so i'll pass it like a baby
[Music]
ashley i'm so sorry
it's not working what is going on down
there
um i don't know but she just took three
ibuprofens kidney you better have
something in plan
i hate my life that's it i've had four
months of this pain we are telling her
mom
good luck
i have dilated a full 10 centimeters
and that blood is still
there i think this ibuprofen is killing
me guys i have good news her mom is
taking her to the doctor
thank god
you're talking i'm halfway shriveled now
that's cool
all right y'all here's the plan ashley
finally figured out about her two
uteruses and her one kidney she's gonna
get a part removed out of her uterus to
remove that blockage that's holding that
blood in causing hers to dilate
she's what i didn't know tic tocs could
be that long but what this is describing
is the process of someone finding out
that they have a condition called
uterine didelphus or duplicated uterus
now what they're discussing here is
basically in embryology when you are
growing from a tiny tiny little zygote
an embryo and forming all of your organs
you have two sides of the development of
the uterus that come together they grow
together and they eventually dissolve to
become one if any point in that process
goes wrong you can end up with two
completely separate uteri and two
different cervixes even sometimes two
different vaginas or you can end up with
like a partial septum a bicornuate
uterus an arcuate or heart-shaped uterus
all manner of different
levels of it failing to completely
combine the reason the kidneys come into
play here is because embryologically the
kidneys and the uterus develop at the
same time so when this process of coming
together and forming one goes awry it
often goes awry in the same way in the
kidneys so you can either have a
malformed kidney because the kidneys
grow like up into two and you can have
like a horseshoe kidney that's just one
in the middle of your abdomen or you can
have just one kidney on one side or you
can have totally normal kidneys and
still have a uterine didelphis when you
have a period
sometimes it doesn't matter sometimes
people start having periods they have
two uteruses and it goes fine a lot of
times the question here is do you have
periods at different times no hormones
manage when you have your menstrual
cycle and so you're bleeding at the same
time so you may not even know if you
have two and they're both working
normally the person may not know it
becomes problematic when one of the
uteruses doesn't develop quite right and
it may not have an exit so it grows the
endometrial tissue and it grows the
uterine muscle so it is responsive to
the hormones that make it have cycles
but the blood has nowhere to go so what
happens is over the first few times that
this person has a cycle the blood is
kind of collecting in there and that's
something called a hematometria it's
just getting bigger and bigger and
causing that uterine horn on whichever
side it's on to dilate and that's really
really painful if you first start having
periods and you're having severe pain or
if someone is around the age that they
should be having periods they're not
having periods but they're having severe
pain that comes once a month this is a
sign that we should do an abdominal
ultrasound and look at the uterus to see
if we can figure out what's going on
after that they need an mri and they
need to have the kidneys evaluated as
well interestingly
hearing also develops around a similar
time so i typically recommend that
people have a hearing test if they've
never had one most people by the time
they get to me have already had a
hearing test and they can hear fine but
you do want to examine the ears as well
ears kidney and uterus develop around
the same time in embryologic development
oh no i hope i don't fall
[Music]
copper iuds can fall out just like any
other iud and i always tell people to
learn how to feel their string so that
they can make sure the iud is still in
place she actually has a follow-up video
to this which i will go ahead and watch
now because i think it's going to be a
really common question i keep getting
this comment asking if it hurt
no
um it literally just fell out i wouldn't
have even noticed it if i didn't hear it
hit the ground below me and i did not
feel a thing likely what had happened is
it had come out at another point there
was no blood involved there and usually
if it has just come from uterus through
cervix and out you're going to have some
blood with it that being said these can
fall out without people knowing and
that's why it's important to be able to
feel your strength usually what i tell
people is you're probably going to
notice if it falls out but i have seen
people who didn't know so if something
changes in your periods if you have a
mirena iud or something and you're not
having cycles and then suddenly you get
your cycles back or if you were having a
sudden really heavy cycle and lots of
bleeding and clots and it might have
come out and you didn't know and it was
lost in a clot or if you know you just
notice anything is different just come
in and let us check it doesn't happen
often expulsion of an iud especially if
you've had it more than 6 to 12 months
is really really unusual but you still
need to be cognizant of if anything is
changing if there's any differences in
your periods or your body or your
symptoms or if you can't feel your
strings using a finger around the cervix
[Music]
no we can't i can't
that's disgusting
you can do a handstand with a diva cup
in and that definitely won't happen and
usually they won't leak either they
create suction around the cervix so
they're very good for people who are
athletic doing handstands moving around
that was disgusting all right y'all
that's it for today i hope that you
learned something i hope you got a laugh
join us next time when we go through
some of the worst gynecology advice that
i've recently found on tick tock if
you're new here and you'd like to
subscribe hit that subscribe button turn
on notifications so you never miss an
upload and i will see you next monday
[Music]