00:00:08
Speaker 1: You're listening to a Mamma Mia podcast. Hello and welcome to Well, the podcast for your health and body explain. I'm Dr. Ginny Mansberg. I am a GP and I am really into women's health.
00:00:27
Speaker 2: And I'm Kath Mahoney and I'm also into women's health. Right, Ginny, what are we discussing today? The pill needs some PR, love. the surprise impact of pollution on your joints, and in asking for a friend, your anonymous awkward health questions, we are talking about intense sweet cravings and orgasm pain. Ooh, what a combo.
00:00:49
Speaker 1: But first, it's time for What the Health? Your quick dose of women's health headlines.
00:00:56
Speaker 2: What the hell? Oh, what the hell? I don't understand. What the hell? What have you got for us, Dr.
00:01:01
Speaker 3: Ginny?
00:01:01
Speaker 1: Okay, Kath, have you succumbed to the need to buy an LED mask for your face yet?
00:01:07
Speaker 2: I'm not even joking. It was on my list of things to ask you about.
00:01:10
Speaker 3: Okay.
00:01:10
Speaker 2: Because I've been perusing them on the interweb.
00:01:13
Speaker 1: Yes, and once you get targeted by one, they're all going to come at you.
00:01:15
Speaker 2: Yeah, they're just popping up, all those red faces.
00:01:17
Speaker 1: So I was fascinated to read in the paper, because they claim to make wrinkles disappear and make you look like a teenager, right? There has been an LED mask ad that has just been banned in the UK.
00:01:31
Speaker 2: Oh, okay.
00:01:32
Speaker 1: And the reason was that the ad said that this LED mask was clinically proven to reduce wrinkles in four weeks and the Advertising Standards Authority in the UK called it out as complete BS. So you want to know why?
00:01:47
Speaker 2: Yes, please.
00:01:48
Speaker 1: So they relied on what they called a clinical trial, which involved 28 people, but there was no what they call placebo group.
00:01:55
Speaker 2: So nobody to.
00:01:56
Speaker 1: Compare the people who'd had the LED mask with.
00:01:58
Speaker 2: And they hadn't.
00:01:59
Speaker 3: Yeah. Yeah.
00:02:00
Speaker 1: And the testers were not just using the mask. They were using like an exfoliating serum and something that they called like a hydrogel. And that is despite the fact that on the instructions, it says use it on a clean, dry face. The people in the study were using this combination of the exfoliator and the hydrogel before they put the mask on.
00:02:19
Speaker 2: That's a bit cheeky. It is a bit cheeky.
00:02:21
Speaker 1: And I mean, it got me thinking about this market, the LED at home market. Do you know that it is projected to grow to $ 1. 2 billion by 2032. Like everyone is buying one. And yet we don't really have any evidence from at-home devices. There is definitely for the ones that you get in clinic. We definitely have good evidence for that. Yeah, I mean, we just don't know with the ones that are done at home. And I think partly the irony is that the people who are going to run the trials are other companies who make them. So I already apply a 90% discount to any kind of funded trial, but we just don't know whether they work or whether they're a complete waste of time and money. So I'm glad you didn't buy one. No.
00:03:03
Speaker 2: Are there any upsides to actually having one of these LED masks?
00:03:07
Speaker 1: I think when I look on social media, there are people who use them and feel very calmed by them. They're quite warming. And I think sometimes it might be a nice ritual at the end.
00:03:17
Speaker 2: Of your day.
00:03:18
Speaker 1: So if you enjoy that, that's great, but I wouldn't be spending thousands on it.
00:03:24
Speaker 2: Oh, okay, Ginny, my turn. Have you heard about this? IV drips are having a real moment and are surging in popularity in Australia's wellness space.
00:03:33
Speaker 1: Yeah, I've actually read that overall bookings are up 20% year on year this year. I don't know how they quite get that data. But anyway, this was actually brought to my attention by a The president of the AMA, she didn't call me personally. I just read.
00:03:47
Speaker 2: Something that she'd written. We don't need to say that. I don't have her on speed dial. She literally reached out.
00:03:50
Speaker 1: But she actually did say that people who are going in and getting an IV are just wasting their money and they might as well have a glass of water. The only thing is like if you actually can't absorb any nutrients. So just for example, I've seen some pregnant women who can't keep anything down. They're just going to need to get their fluids IV. Some people also, like if they've had a really bad tummy upset, it can make you feel better quicker. Because you don't want to be sculling litres of water when you've had an upset tummy. I kind of completely get that. And some people, they can't absorb things out of their stomach. They might have a really serious, serious gut issue. For everyone else, I think at best it's a waste of money and time.
00:04:29
Speaker 2: I've done it twice.
00:04:31
Speaker 1: I knew you had.
00:04:32
Speaker 2: Okay, tell me about it.
00:04:33
Speaker 1: And why did you do it?
00:04:34
Speaker 2: Oh, the first time they came to the house and it was like a hangover cure kind of thing. I kind of get that. That I did with a girlfriend, you know. Did it make you feel better? Well, is it a placebo thing? I don't know. And then another time when I was really, really depleted, probably before I got my HRT, I went and had like a bit of a concoction then. And again, you don't know if it makes any difference or if, you know, the lady you just mentioned was right and I should have had a glass of water.
00:05:00
Speaker 1: Yeah, it's so hard to know because I think a lot of us are a bit dehydrated. Don't forget, women need 2.1 litres of fluid a day on top of your food unless you're sweating and doing a lot of exercise, in which case you need more. And I think a lot of women that I see are dehydrated. They're too busy to drink unless you carry around a Cath's doll.
00:05:18
Speaker 2: Like I do. There she is.
00:05:21
Speaker 1: How much is in that?
00:05:22
Speaker 2: Two litres?
00:05:23
Speaker 1: Dolls?
00:05:23
Speaker 2: Look, I'm already... I've already done a litre today.
00:05:26
Speaker 1: And it's a resistance workout as well, carrying that around with you. I think unless you're like Kath and permanently has basically your entire day's worth of fluid in a water bottle, it is hard to actually keep up with your fluids. And so if you are dehydrated, you will definitely feel better having intravenous fluids. But for much less money and for much less needle, like if you're needle phobic, this is definitely not for you, you can actually have a glass of water and you'll probably feel really, really good. Note to self, drink water because I don't drink enough for sure.
00:05:56
Speaker 2: Are there any downsides of the IV world?
00:05:58
Speaker 1: Well, with anything, if they get the needle into the wrong spot, you can get a massive bruise like on your arm. It can be really quite uncomfortable. If they pull the needle out and you don't put enough pressure on, you can have a huge like bleed out of your arm. Like it's, there's always an introduction of.
00:06:13
Speaker 2: You do have to do waivers. Yeah. When you do it.
00:06:16
Speaker 1: You can get an infection if they don't have a really good antiseptic technique. So there are always risks with that sort of thing. Why would you have a needle when you can have something with a glass of water? Like it just makes no sense.
00:06:27
Speaker 2: What else have you got for us, Dr. Julie?
00:06:29
Speaker 1: Kath, I assume you are not currently taking a prenatal vitamin.
00:06:33
Speaker 2: No, it's probably the only thing I'm not taking. It's been a while.
00:06:37
Speaker 1: How old's Lewis now?
00:06:38
Speaker 2: 17 and a half. I took one thing, I think, back in the day.
00:06:42
Speaker 1: Right. Well, it does seem that there are a lot of companies that are selling effectively like a prenatal vitamin stack where they're basically throwing everything in but the kitchen sink. Australian health guidelines specifically emphasize essential core supplements that pregnant women need to take. And that is folic acid, which we know can help prevent something called neural tube defects, things like spina bifida. Iodine, which is really good for thyroid and therefore brain development. Folic acid and iodine are routinely recommended around pregnancy, while other supplements, you might need them like iron as an ass needs basis based on blood tests, because iron deficiency in pregnancy is... It's been linked to a whole lot of poor outcomes around delivery. They can depend on like your own circumstances. So probably go chat about that with your GP or even your pharmacist or your midwife or any other healthcare professional. But social media seems to be pushing like literally everything else, things like omega-3, creatine, collagen, high-dose multivitamins. And experts are starting to really call it out now going, listen, it's not just waste of money. There are potential risks in this sort of thing. And they really drew attention to vitamin B6, which has been all over the media because it turns out that you can overdose on vitamin B6. We never knew this before because vitamin B6 or all B vitamins are what we call water soluble. We always just thought they gave you expensive where you weed out the excess. But it turns out that excessive vitamin B6 does build up and can cause nerve damage, some of which is actually permanent. So I actually think you probably don't want to be skipping out on your prenatal vitamins. They're really, really important. But don't let anybody upsell you a whole vitamin stack saying that all these additional things are critical.
00:08:37
Speaker 2: Okay. So for anyone who is pregnant or is trying to get pregnant, hit us with those again.
00:08:41
Speaker 1: It's the folic acid, the iodine and the iron as an acinides basis. And if you're in any doubt, chat to your pharmacist or chat to your GP about it.
00:08:53
Speaker 2: Up next, it's time for Are You Well? And we need to talk about the contraceptive pill and something called the nocebo effect.
00:09:06
Speaker 1: How are you?
00:09:07
Speaker 2: Well, how are you feeling?
00:09:08
Speaker 1: Are you well? Are you well? All right, it is time for Are You Well? Where we discuss the most important things you need to know that are happening in women's health right now.
00:09:19
Speaker 2: Kath? Yes. What have we got?
00:09:21
Speaker 1: We've got the nocebo effect. Have you even heard of it?
00:09:24
Speaker 2: No, but I love it already. What's a nocebo?
00:09:27
Speaker 1: Look, it's basically where you ascribe negative things that happen to you to a medication, in particular when it probably wasn't the medication.
00:09:36
Speaker 2: Oh, I don't like the sound of it then.
00:09:38
Speaker 1: No, no. You want to marinate in your negative feelings about medication.
00:09:42
Speaker 3: No.
00:09:43
Speaker 1: Well, okay, in my surgery, the pill is totally on the nose. I feel like every woman is trying to get off the pill, believes the pill is dangerous, believes the pill is causing all sorts of negative symptoms. And I do think that the pill has got a bit of bad PR happening at the moment, particularly on social media. But there was this interesting study that came out of the University of Sheffield, and it actually found that the pill is a lot getting the nocebo effect. So a lot of women are experiencing really negative effects that they are saying are due to the pill where there's no evidence that it's happening from the pill. And I'm like, Really?
00:10:21
Speaker 2: Does that sound right?
00:10:22
Speaker 1: Yeah, I don't know. Basically, this was a study of 275 women who were aged between 18 and 45 who'd taken the pill in the last 18 months. 97% reported at least one side effect. That number does seem a bit high.
00:10:36
Speaker 2: Yeah.
00:10:37
Speaker 1: What they found was the more anxious you were, about taking the pill, worried that it was going to cause you side effects, the more likely you were to get the side effects, which does kind of suggest that there's a bit of anticipation or what you maybe have read online or heard your favorite influencer talking about makes you believe that the stomachache that you get, the headache that you get, the feelings of sadness that you get.
00:10:59
Speaker 2: The weight gain, the whatever else. Yeah, whatever is all because of the pill.
00:11:03
Speaker 1: Having said all of which, studies like this really freak me out a bit because I don't think it's true that that there is no woman who gets side effects from the pill. There definitely are women. There are women who tell me I went psycho on the pill and I totally believe them. It's just it happens to too many people for me to completely dismiss it out of hand. And I don't know how to get that balance right between validating women's concerns, which we do want to do. It's really important because this is how we make medical discoveries. We're in the field when we're using stuff. We listen to people and we actually go, actually, that's a real thing. And actually not having so few people take the pill that it's now no longer an option for women. Because we've got to remember the pill freed up a generation of women from having pregnancies they didn't want to have. It's really useful in some forms of PMS, in some types of endometriosis, in some types of polycystic ovarian syndrome, acne it can be really good for. We don't want to throw out the baby with the bathwater. And I don't know, what's your advice? You've been in PR. How do we get the PR message right for the pill?
00:12:06
Speaker 2: I think you need to speak to people who have a great sort of experience with it. I mean, I had a decent experience with it many, many years ago. Yeah. Has it changed much since when I would have taken it?
00:12:16
Speaker 1: We've got newer pills now that are maybe more specialized. We've got some progesterone only pills that are more for people with endometriosis. We do have some differences now, but not much. It's still mostly estrogen and progesterone.
00:12:30
Speaker 3: Yeah. Yeah.
00:12:31
Speaker 1: I think we've got to remember that the pill has been a game changer for women. And so rather than just listening to the TikTokers, write down all your concerns, but then maybe take them to somebody like your GP and get your questions answered so you can make a more informed decision about what you do with your body.
00:12:50
Speaker 2: Up next, RUL. We need to talk about air pollution and how it's making rheumatoid arthritis worse.
00:13:03
Speaker 1: Okay, Kath, I don't know if you've heard about this, but for people with rheumatoid arthritis, bad air days, so bad pollution days, are actually flaring their joints up.
00:13:14
Speaker 2: Wow. Okay, just so I'm clear, take me through what rheumatoid arthritis is.
00:13:20
Speaker 1: So it's not that what we used to call wear and tear arthritis, but the kind of more common form of arthritis, osteoarthritis. It's actually an autoimmune disease where your body accidentally thinks that the lining of your joints are the enemy of and start attacking them, causing inflammation can be really hard. And it's a real midlife women's thing. Like it tends to start around your 40s and 50s. I've been really fascinated by rheumatoid arthritis for a while because it's definitely more common than it used to be. And it's now impacting 2% of people in Australia, but way more women than men, like most autoimmune things. So this new study out of Korea that found that on the days where air pollution is at its highest, and that's measurable, that people with rheumatoid arthritis get major flares in their joint pain, just made me think, is this part of the overall story that's causing more rheumatoid arthritis? And what do we do about that? Because if you live in the city, because you have to for work or whatever, what are you going to do about these pollution days, which are really bad?
00:14:20
Speaker 2: I mean, my only touchpoint with rheumatoid arthritis is my dad has it. And he finds when he comes to Australia, it really, it can kind of settle in the summer. So the heat certainly helps him.
00:14:31
Speaker 1: Yeah.
00:14:32
Speaker 2: Is that a factor?
00:14:33
Speaker 3: Yeah.
00:14:33
Speaker 1: So that definitely can be a factor. Stress can make it worse. smoking makes it much worse. So it's far more likely to happen in smokers. So we've really got to stop smoking.
00:14:43
Speaker 3: Okay.
00:14:44
Speaker 1: But it is, it does run in families. So the fact that your dad has it, Kath, I would have a very low threshold for if you did get joint pains, particularly when it happens, like you get a sore hand and then the other hand identical pain, like a week later, it, you know, it'll flare in one knee, then it'll go the other knee the week later. That makes me think, oh, are we dealing with a rheumatoid kind of thing here? And the reason why we need to diagnose it is, number one, the treatments are completely different from osteoarthritis. Number two, the biggest cause of death in people with rheumatoid arthritis is heart disease.
00:15:15
Speaker 2: Okay.
00:15:15
Speaker 1: So we've got to be really aggressive in treating cholesterol, blood pressure, things like that. So we need to be diagnosing it. But meanwhile, this is one for our governments. What are we going to do about this pollution situation? Because we don't want this... If we continue to double every 30 years, like we're going to have a lot of people with this condition... And that's going to be a huge issue for women and men around the world and here in Australia. So I think the pollution thing is really important.
00:15:39
Speaker 2: When it comes to symptoms, if we've got listeners thinking, ah, maybe it's rheumatoid arthritis that I have, like how does it present to start off? So there'll be a whole.
00:15:48
Speaker 1: Lot of symptoms like tiredness, just feeling vaguely unwell. And then there's the joint pains that are more than just a bit of a, oh, it's actually really quite disabling. It's quite difficult to use your hands when you're in a rheumatoid arthritis flare. And it's what we call symmetrical. So it doesn't just happen in one hand. If it comes up in one hand, it'll come up in the other within weeks. If you have any doubt, particularly if it's in your family or you have another autoimmune disease, say you've got a Hashimoto's, thyroiditis, something like that, or your celiac, go to your GP because you'll need blood tests to actually diagnose it.
00:16:22
Speaker 2: Up next, asking for a friend. Your awkward health questions answered by Dr. Ginny that we all know aren't actually about your friend, but we pretend they are anyway. My favorite bit. I'm just asking for a friend. So my friends, they want to know. It's not for me.
00:16:41
Speaker 1: Hashtag just asking for a friend.
00:16:44
Speaker 2: Okay, it's time for my favorite, asking for a friend. Our first question comes from Liz.
00:16:51
Speaker 3: Okay, I'm 42 and lately around 10 p.m. every night, I get hit with this intense, almost aggressive craving for something sweet. And if I don't eat sugar right then, I start feeling shaky, anxious, and hot. Is my body actually experiencing low blood sugar right before bed, or is this just a bad habit wrapped up in perimenopausal cortisol spikes?
00:17:12
Speaker 1: It's hard to know, Liz. I think it is likely to be part of perimenopause, definitely. When I do hear this, the fact that you do feel shaky and sweaty, it does sound like a low blood sugar thing. And the fact that it responds well to sugar, of makes that a little bit more likely, but we've got to work out why that's happening just before bed. And I would want to have a look at what you've been eating during the day, what's been going on for you, because that's not common, what's going on for you. So what I think you should do is definitely book in to see your GP. If you can be stuffed, you could be monitoring your blood sugar levels when it's happening. So you can actually buy glucose test strips at any pharmacy and Or there are those new Fandangle ones. You can actually put them on your arm and there's an app to monitor your blood sugar. It can make you a bit OCD if you are a bit prone to that. Another app, not for me.
00:18:06
Speaker 2: Yeah, definitely not for you.
00:18:07
Speaker 1: But I think for some people it's quite interesting to see how your blood sugar does spike after different meals versus other meals. I did it for a while. I found it really, really interesting. And also the impact of exercise on how it just reduces blood sugar spikes during the day. Oh, really? It's really interesting. But you could actually document that and then take that to your doctor or just go to the doctor altogether just in case it's not to do with your blood sugar.
00:18:30
Speaker 3: Okay.
00:18:30
Speaker 1: But if you are having blood sugar dips, we do need to know why as well. So I think just going to your GP to get this sorted out. I'm not hearing anything that is making me freak out and making me think go tomorrow, but I do think you should get it checked out.
00:18:43
Speaker 2: I've got another dilemma for you, Ginny. This question comes from Anonymous. I'll read it out. Hi, Ginny and Kath. I have a slightly awkward one. I'm 32 and recently after having an orgasm, I get these really sharp period-like cramps in my lower belly that last for about 15 minutes. Sex itself isn't painful, just the aftermath. Is my uterus just throwing a temper tantrum or is this a red flag for something like endometriosis or cysts?
00:19:10
Speaker 1: Yeah, hard to know. So I think if it's just happening every now and then, it doesn't worry me too much. But if it's happening consistently, it does make me wonder if there's something else going on. So what we know with an orgasm is your uterus starts contracting. It's really interesting.
00:19:25
Speaker 2: Well, I'm here for this.
00:19:26
Speaker 3: Yes.
00:19:26
Speaker 1: So not during sex, but during the orgasm. I'm trying to work out how that's going to help you conceive a baby, which is your entire biological function as far as Mother Nature is concerned. But yes, you do have those cramps. So it does make me think that the uterus cramping is probably what's causing it. So there could be a bit of endometriosis, but it's going to pull on the ovaries. So there could be an ovarian cyst. You could have something called pelvic inflammatory disease, which is like a chronic infection. inside the uterus that can be caused by a whole lot of things, sexually transmitted infections. So I think what I would do is if it is not just a one-off, if it's happening consistently, I would go and check in with your GP. They might want to do an ultrasound just to have a look. They'll probably want to do an examination. Sometimes we actually push on your cervix. Here's me doing the two-fingered little action there to show how I would I'd push with my left hand down on your uterus and push with my right hand. It's going to be quite deep and quite uncomfortable. But if your cervix hurts when I'm kind of tilting it, then that kind of makes things like pelvic inflammatory disease or endometriosis more likely. And then we'll go and confirm that with an ultrasound. And maybe we do a wee test. Maybe we do a swab. I think you need to get checked. Well, that is all for us this week. Follow the show and the next episode is going to be waiting for you in your feed as soon as it drops. And if you want more from us between episodes, you'll find us on socials.
00:20:53
Speaker 2: And if you want to hear your asking for a friend question, send us an email or a voice note to well at mamamia.com.au and Dr Ginny will get to the bottom of it. Please remember information discussed in this podcast is for education purposes only and and is not intended to provide professional medical advice. Please seek your own medical advice specific to your circumstances from your healthcare professional. See you next time. Stay well. Mamma Mia acknowledges the traditional owners of land and waters that this podcast is recorded on, the Gadigal people of the Eora Nation. We pay our respects to elders past and present.
Speaker 1: You're listening to a Mamma Mia podcast. Hello and welcome to Well, the podcast for your health and body explain. I'm Dr. Ginny Mansberg. I am a GP and I am really into women's health.
00:00:27
Speaker 2: And I'm Kath Mahoney and I'm also into women's health. Right, Ginny, what are we discussing today? The pill needs some PR, love. the surprise impact of pollution on your joints, and in asking for a friend, your anonymous awkward health questions, we are talking about intense sweet cravings and orgasm pain. Ooh, what a combo.
00:00:49
Speaker 1: But first, it's time for What the Health? Your quick dose of women's health headlines.
00:00:56
Speaker 2: What the hell? Oh, what the hell? I don't understand. What the hell? What have you got for us, Dr.
00:01:01
Speaker 3: Ginny?
00:01:01
Speaker 1: Okay, Kath, have you succumbed to the need to buy an LED mask for your face yet?
00:01:07
Speaker 2: I'm not even joking. It was on my list of things to ask you about.
00:01:10
Speaker 3: Okay.
00:01:10
Speaker 2: Because I've been perusing them on the interweb.
00:01:13
Speaker 1: Yes, and once you get targeted by one, they're all going to come at you.
00:01:15
Speaker 2: Yeah, they're just popping up, all those red faces.
00:01:17
Speaker 1: So I was fascinated to read in the paper, because they claim to make wrinkles disappear and make you look like a teenager, right? There has been an LED mask ad that has just been banned in the UK.
00:01:31
Speaker 2: Oh, okay.
00:01:32
Speaker 1: And the reason was that the ad said that this LED mask was clinically proven to reduce wrinkles in four weeks and the Advertising Standards Authority in the UK called it out as complete BS. So you want to know why?
00:01:47
Speaker 2: Yes, please.
00:01:48
Speaker 1: So they relied on what they called a clinical trial, which involved 28 people, but there was no what they call placebo group.
00:01:55
Speaker 2: So nobody to.
00:01:56
Speaker 1: Compare the people who'd had the LED mask with.
00:01:58
Speaker 2: And they hadn't.
00:01:59
Speaker 3: Yeah. Yeah.
00:02:00
Speaker 1: And the testers were not just using the mask. They were using like an exfoliating serum and something that they called like a hydrogel. And that is despite the fact that on the instructions, it says use it on a clean, dry face. The people in the study were using this combination of the exfoliator and the hydrogel before they put the mask on.
00:02:19
Speaker 2: That's a bit cheeky. It is a bit cheeky.
00:02:21
Speaker 1: And I mean, it got me thinking about this market, the LED at home market. Do you know that it is projected to grow to $ 1. 2 billion by 2032. Like everyone is buying one. And yet we don't really have any evidence from at-home devices. There is definitely for the ones that you get in clinic. We definitely have good evidence for that. Yeah, I mean, we just don't know with the ones that are done at home. And I think partly the irony is that the people who are going to run the trials are other companies who make them. So I already apply a 90% discount to any kind of funded trial, but we just don't know whether they work or whether they're a complete waste of time and money. So I'm glad you didn't buy one. No.
00:03:03
Speaker 2: Are there any upsides to actually having one of these LED masks?
00:03:07
Speaker 1: I think when I look on social media, there are people who use them and feel very calmed by them. They're quite warming. And I think sometimes it might be a nice ritual at the end.
00:03:17
Speaker 2: Of your day.
00:03:18
Speaker 1: So if you enjoy that, that's great, but I wouldn't be spending thousands on it.
00:03:24
Speaker 2: Oh, okay, Ginny, my turn. Have you heard about this? IV drips are having a real moment and are surging in popularity in Australia's wellness space.
00:03:33
Speaker 1: Yeah, I've actually read that overall bookings are up 20% year on year this year. I don't know how they quite get that data. But anyway, this was actually brought to my attention by a The president of the AMA, she didn't call me personally. I just read.
00:03:47
Speaker 2: Something that she'd written. We don't need to say that. I don't have her on speed dial. She literally reached out.
00:03:50
Speaker 1: But she actually did say that people who are going in and getting an IV are just wasting their money and they might as well have a glass of water. The only thing is like if you actually can't absorb any nutrients. So just for example, I've seen some pregnant women who can't keep anything down. They're just going to need to get their fluids IV. Some people also, like if they've had a really bad tummy upset, it can make you feel better quicker. Because you don't want to be sculling litres of water when you've had an upset tummy. I kind of completely get that. And some people, they can't absorb things out of their stomach. They might have a really serious, serious gut issue. For everyone else, I think at best it's a waste of money and time.
00:04:29
Speaker 2: I've done it twice.
00:04:31
Speaker 1: I knew you had.
00:04:32
Speaker 2: Okay, tell me about it.
00:04:33
Speaker 1: And why did you do it?
00:04:34
Speaker 2: Oh, the first time they came to the house and it was like a hangover cure kind of thing. I kind of get that. That I did with a girlfriend, you know. Did it make you feel better? Well, is it a placebo thing? I don't know. And then another time when I was really, really depleted, probably before I got my HRT, I went and had like a bit of a concoction then. And again, you don't know if it makes any difference or if, you know, the lady you just mentioned was right and I should have had a glass of water.
00:05:00
Speaker 1: Yeah, it's so hard to know because I think a lot of us are a bit dehydrated. Don't forget, women need 2.1 litres of fluid a day on top of your food unless you're sweating and doing a lot of exercise, in which case you need more. And I think a lot of women that I see are dehydrated. They're too busy to drink unless you carry around a Cath's doll.
00:05:18
Speaker 2: Like I do. There she is.
00:05:21
Speaker 1: How much is in that?
00:05:22
Speaker 2: Two litres?
00:05:23
Speaker 1: Dolls?
00:05:23
Speaker 2: Look, I'm already... I've already done a litre today.
00:05:26
Speaker 1: And it's a resistance workout as well, carrying that around with you. I think unless you're like Kath and permanently has basically your entire day's worth of fluid in a water bottle, it is hard to actually keep up with your fluids. And so if you are dehydrated, you will definitely feel better having intravenous fluids. But for much less money and for much less needle, like if you're needle phobic, this is definitely not for you, you can actually have a glass of water and you'll probably feel really, really good. Note to self, drink water because I don't drink enough for sure.
00:05:56
Speaker 2: Are there any downsides of the IV world?
00:05:58
Speaker 1: Well, with anything, if they get the needle into the wrong spot, you can get a massive bruise like on your arm. It can be really quite uncomfortable. If they pull the needle out and you don't put enough pressure on, you can have a huge like bleed out of your arm. Like it's, there's always an introduction of.
00:06:13
Speaker 2: You do have to do waivers. Yeah. When you do it.
00:06:16
Speaker 1: You can get an infection if they don't have a really good antiseptic technique. So there are always risks with that sort of thing. Why would you have a needle when you can have something with a glass of water? Like it just makes no sense.
00:06:27
Speaker 2: What else have you got for us, Dr. Julie?
00:06:29
Speaker 1: Kath, I assume you are not currently taking a prenatal vitamin.
00:06:33
Speaker 2: No, it's probably the only thing I'm not taking. It's been a while.
00:06:37
Speaker 1: How old's Lewis now?
00:06:38
Speaker 2: 17 and a half. I took one thing, I think, back in the day.
00:06:42
Speaker 1: Right. Well, it does seem that there are a lot of companies that are selling effectively like a prenatal vitamin stack where they're basically throwing everything in but the kitchen sink. Australian health guidelines specifically emphasize essential core supplements that pregnant women need to take. And that is folic acid, which we know can help prevent something called neural tube defects, things like spina bifida. Iodine, which is really good for thyroid and therefore brain development. Folic acid and iodine are routinely recommended around pregnancy, while other supplements, you might need them like iron as an ass needs basis based on blood tests, because iron deficiency in pregnancy is... It's been linked to a whole lot of poor outcomes around delivery. They can depend on like your own circumstances. So probably go chat about that with your GP or even your pharmacist or your midwife or any other healthcare professional. But social media seems to be pushing like literally everything else, things like omega-3, creatine, collagen, high-dose multivitamins. And experts are starting to really call it out now going, listen, it's not just waste of money. There are potential risks in this sort of thing. And they really drew attention to vitamin B6, which has been all over the media because it turns out that you can overdose on vitamin B6. We never knew this before because vitamin B6 or all B vitamins are what we call water soluble. We always just thought they gave you expensive where you weed out the excess. But it turns out that excessive vitamin B6 does build up and can cause nerve damage, some of which is actually permanent. So I actually think you probably don't want to be skipping out on your prenatal vitamins. They're really, really important. But don't let anybody upsell you a whole vitamin stack saying that all these additional things are critical.
00:08:37
Speaker 2: Okay. So for anyone who is pregnant or is trying to get pregnant, hit us with those again.
00:08:41
Speaker 1: It's the folic acid, the iodine and the iron as an acinides basis. And if you're in any doubt, chat to your pharmacist or chat to your GP about it.
00:08:53
Speaker 2: Up next, it's time for Are You Well? And we need to talk about the contraceptive pill and something called the nocebo effect.
00:09:06
Speaker 1: How are you?
00:09:07
Speaker 2: Well, how are you feeling?
00:09:08
Speaker 1: Are you well? Are you well? All right, it is time for Are You Well? Where we discuss the most important things you need to know that are happening in women's health right now.
00:09:19
Speaker 2: Kath? Yes. What have we got?
00:09:21
Speaker 1: We've got the nocebo effect. Have you even heard of it?
00:09:24
Speaker 2: No, but I love it already. What's a nocebo?
00:09:27
Speaker 1: Look, it's basically where you ascribe negative things that happen to you to a medication, in particular when it probably wasn't the medication.
00:09:36
Speaker 2: Oh, I don't like the sound of it then.
00:09:38
Speaker 1: No, no. You want to marinate in your negative feelings about medication.
00:09:42
Speaker 3: No.
00:09:43
Speaker 1: Well, okay, in my surgery, the pill is totally on the nose. I feel like every woman is trying to get off the pill, believes the pill is dangerous, believes the pill is causing all sorts of negative symptoms. And I do think that the pill has got a bit of bad PR happening at the moment, particularly on social media. But there was this interesting study that came out of the University of Sheffield, and it actually found that the pill is a lot getting the nocebo effect. So a lot of women are experiencing really negative effects that they are saying are due to the pill where there's no evidence that it's happening from the pill. And I'm like, Really?
00:10:21
Speaker 2: Does that sound right?
00:10:22
Speaker 1: Yeah, I don't know. Basically, this was a study of 275 women who were aged between 18 and 45 who'd taken the pill in the last 18 months. 97% reported at least one side effect. That number does seem a bit high.
00:10:36
Speaker 2: Yeah.
00:10:37
Speaker 1: What they found was the more anxious you were, about taking the pill, worried that it was going to cause you side effects, the more likely you were to get the side effects, which does kind of suggest that there's a bit of anticipation or what you maybe have read online or heard your favorite influencer talking about makes you believe that the stomachache that you get, the headache that you get, the feelings of sadness that you get.
00:10:59
Speaker 2: The weight gain, the whatever else. Yeah, whatever is all because of the pill.
00:11:03
Speaker 1: Having said all of which, studies like this really freak me out a bit because I don't think it's true that that there is no woman who gets side effects from the pill. There definitely are women. There are women who tell me I went psycho on the pill and I totally believe them. It's just it happens to too many people for me to completely dismiss it out of hand. And I don't know how to get that balance right between validating women's concerns, which we do want to do. It's really important because this is how we make medical discoveries. We're in the field when we're using stuff. We listen to people and we actually go, actually, that's a real thing. And actually not having so few people take the pill that it's now no longer an option for women. Because we've got to remember the pill freed up a generation of women from having pregnancies they didn't want to have. It's really useful in some forms of PMS, in some types of endometriosis, in some types of polycystic ovarian syndrome, acne it can be really good for. We don't want to throw out the baby with the bathwater. And I don't know, what's your advice? You've been in PR. How do we get the PR message right for the pill?
00:12:06
Speaker 2: I think you need to speak to people who have a great sort of experience with it. I mean, I had a decent experience with it many, many years ago. Yeah. Has it changed much since when I would have taken it?
00:12:16
Speaker 1: We've got newer pills now that are maybe more specialized. We've got some progesterone only pills that are more for people with endometriosis. We do have some differences now, but not much. It's still mostly estrogen and progesterone.
00:12:30
Speaker 3: Yeah. Yeah.
00:12:31
Speaker 1: I think we've got to remember that the pill has been a game changer for women. And so rather than just listening to the TikTokers, write down all your concerns, but then maybe take them to somebody like your GP and get your questions answered so you can make a more informed decision about what you do with your body.
00:12:50
Speaker 2: Up next, RUL. We need to talk about air pollution and how it's making rheumatoid arthritis worse.
00:13:03
Speaker 1: Okay, Kath, I don't know if you've heard about this, but for people with rheumatoid arthritis, bad air days, so bad pollution days, are actually flaring their joints up.
00:13:14
Speaker 2: Wow. Okay, just so I'm clear, take me through what rheumatoid arthritis is.
00:13:20
Speaker 1: So it's not that what we used to call wear and tear arthritis, but the kind of more common form of arthritis, osteoarthritis. It's actually an autoimmune disease where your body accidentally thinks that the lining of your joints are the enemy of and start attacking them, causing inflammation can be really hard. And it's a real midlife women's thing. Like it tends to start around your 40s and 50s. I've been really fascinated by rheumatoid arthritis for a while because it's definitely more common than it used to be. And it's now impacting 2% of people in Australia, but way more women than men, like most autoimmune things. So this new study out of Korea that found that on the days where air pollution is at its highest, and that's measurable, that people with rheumatoid arthritis get major flares in their joint pain, just made me think, is this part of the overall story that's causing more rheumatoid arthritis? And what do we do about that? Because if you live in the city, because you have to for work or whatever, what are you going to do about these pollution days, which are really bad?
00:14:20
Speaker 2: I mean, my only touchpoint with rheumatoid arthritis is my dad has it. And he finds when he comes to Australia, it really, it can kind of settle in the summer. So the heat certainly helps him.
00:14:31
Speaker 1: Yeah.
00:14:32
Speaker 2: Is that a factor?
00:14:33
Speaker 3: Yeah.
00:14:33
Speaker 1: So that definitely can be a factor. Stress can make it worse. smoking makes it much worse. So it's far more likely to happen in smokers. So we've really got to stop smoking.
00:14:43
Speaker 3: Okay.
00:14:44
Speaker 1: But it is, it does run in families. So the fact that your dad has it, Kath, I would have a very low threshold for if you did get joint pains, particularly when it happens, like you get a sore hand and then the other hand identical pain, like a week later, it, you know, it'll flare in one knee, then it'll go the other knee the week later. That makes me think, oh, are we dealing with a rheumatoid kind of thing here? And the reason why we need to diagnose it is, number one, the treatments are completely different from osteoarthritis. Number two, the biggest cause of death in people with rheumatoid arthritis is heart disease.
00:15:15
Speaker 2: Okay.
00:15:15
Speaker 1: So we've got to be really aggressive in treating cholesterol, blood pressure, things like that. So we need to be diagnosing it. But meanwhile, this is one for our governments. What are we going to do about this pollution situation? Because we don't want this... If we continue to double every 30 years, like we're going to have a lot of people with this condition... And that's going to be a huge issue for women and men around the world and here in Australia. So I think the pollution thing is really important.
00:15:39
Speaker 2: When it comes to symptoms, if we've got listeners thinking, ah, maybe it's rheumatoid arthritis that I have, like how does it present to start off? So there'll be a whole.
00:15:48
Speaker 1: Lot of symptoms like tiredness, just feeling vaguely unwell. And then there's the joint pains that are more than just a bit of a, oh, it's actually really quite disabling. It's quite difficult to use your hands when you're in a rheumatoid arthritis flare. And it's what we call symmetrical. So it doesn't just happen in one hand. If it comes up in one hand, it'll come up in the other within weeks. If you have any doubt, particularly if it's in your family or you have another autoimmune disease, say you've got a Hashimoto's, thyroiditis, something like that, or your celiac, go to your GP because you'll need blood tests to actually diagnose it.
00:16:22
Speaker 2: Up next, asking for a friend. Your awkward health questions answered by Dr. Ginny that we all know aren't actually about your friend, but we pretend they are anyway. My favorite bit. I'm just asking for a friend. So my friends, they want to know. It's not for me.
00:16:41
Speaker 1: Hashtag just asking for a friend.
00:16:44
Speaker 2: Okay, it's time for my favorite, asking for a friend. Our first question comes from Liz.
00:16:51
Speaker 3: Okay, I'm 42 and lately around 10 p.m. every night, I get hit with this intense, almost aggressive craving for something sweet. And if I don't eat sugar right then, I start feeling shaky, anxious, and hot. Is my body actually experiencing low blood sugar right before bed, or is this just a bad habit wrapped up in perimenopausal cortisol spikes?
00:17:12
Speaker 1: It's hard to know, Liz. I think it is likely to be part of perimenopause, definitely. When I do hear this, the fact that you do feel shaky and sweaty, it does sound like a low blood sugar thing. And the fact that it responds well to sugar, of makes that a little bit more likely, but we've got to work out why that's happening just before bed. And I would want to have a look at what you've been eating during the day, what's been going on for you, because that's not common, what's going on for you. So what I think you should do is definitely book in to see your GP. If you can be stuffed, you could be monitoring your blood sugar levels when it's happening. So you can actually buy glucose test strips at any pharmacy and Or there are those new Fandangle ones. You can actually put them on your arm and there's an app to monitor your blood sugar. It can make you a bit OCD if you are a bit prone to that. Another app, not for me.
00:18:06
Speaker 2: Yeah, definitely not for you.
00:18:07
Speaker 1: But I think for some people it's quite interesting to see how your blood sugar does spike after different meals versus other meals. I did it for a while. I found it really, really interesting. And also the impact of exercise on how it just reduces blood sugar spikes during the day. Oh, really? It's really interesting. But you could actually document that and then take that to your doctor or just go to the doctor altogether just in case it's not to do with your blood sugar.
00:18:30
Speaker 3: Okay.
00:18:30
Speaker 1: But if you are having blood sugar dips, we do need to know why as well. So I think just going to your GP to get this sorted out. I'm not hearing anything that is making me freak out and making me think go tomorrow, but I do think you should get it checked out.
00:18:43
Speaker 2: I've got another dilemma for you, Ginny. This question comes from Anonymous. I'll read it out. Hi, Ginny and Kath. I have a slightly awkward one. I'm 32 and recently after having an orgasm, I get these really sharp period-like cramps in my lower belly that last for about 15 minutes. Sex itself isn't painful, just the aftermath. Is my uterus just throwing a temper tantrum or is this a red flag for something like endometriosis or cysts?
00:19:10
Speaker 1: Yeah, hard to know. So I think if it's just happening every now and then, it doesn't worry me too much. But if it's happening consistently, it does make me wonder if there's something else going on. So what we know with an orgasm is your uterus starts contracting. It's really interesting.
00:19:25
Speaker 2: Well, I'm here for this.
00:19:26
Speaker 3: Yes.
00:19:26
Speaker 1: So not during sex, but during the orgasm. I'm trying to work out how that's going to help you conceive a baby, which is your entire biological function as far as Mother Nature is concerned. But yes, you do have those cramps. So it does make me think that the uterus cramping is probably what's causing it. So there could be a bit of endometriosis, but it's going to pull on the ovaries. So there could be an ovarian cyst. You could have something called pelvic inflammatory disease, which is like a chronic infection. inside the uterus that can be caused by a whole lot of things, sexually transmitted infections. So I think what I would do is if it is not just a one-off, if it's happening consistently, I would go and check in with your GP. They might want to do an ultrasound just to have a look. They'll probably want to do an examination. Sometimes we actually push on your cervix. Here's me doing the two-fingered little action there to show how I would I'd push with my left hand down on your uterus and push with my right hand. It's going to be quite deep and quite uncomfortable. But if your cervix hurts when I'm kind of tilting it, then that kind of makes things like pelvic inflammatory disease or endometriosis more likely. And then we'll go and confirm that with an ultrasound. And maybe we do a wee test. Maybe we do a swab. I think you need to get checked. Well, that is all for us this week. Follow the show and the next episode is going to be waiting for you in your feed as soon as it drops. And if you want more from us between episodes, you'll find us on socials.
00:20:53
Speaker 2: And if you want to hear your asking for a friend question, send us an email or a voice note to well at mamamia.com.au and Dr Ginny will get to the bottom of it. Please remember information discussed in this podcast is for education purposes only and and is not intended to provide professional medical advice. Please seek your own medical advice specific to your circumstances from your healthcare professional. See you next time. Stay well. Mamma Mia acknowledges the traditional owners of land and waters that this podcast is recorded on, the Gadigal people of the Eora Nation. We pay our respects to elders past and present.
