Whether you're looking to start birth control or get your libido back, finding the right answers online to your women’s health questions is not always easy. Today, OB-GYN Candice Fraser, MD joins SELF to provide constructive and informative answers to frequently asked women’s health questions.
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00:00Searching for medical advice on the internet can be confusing and just lead to lots of anxiety,
00:06so I'm here to answer some of the more complex medical questions that you may have.
00:16I'm Dr. Candice Fraser and I'm a board-certified OBGYN.
00:21Why is it so hard to get pain relief in advance to getting an IUD and why do some doctors tell
00:27you that it will not hurt? I don't know why people say it does not hurt. I usually tell
00:32my patients that from my experience about 50% of my patients at the end of getting an IUD they say
00:38oh it wasn't as bad as I thought. 25% were like kind of what I thought and 25% was like oh my
00:44gosh what did you just do to me that was the worst thing ever. What I usually say is that it's a
00:50pretty quick procedure getting an IUD inserted. For most people it's going to be a couple minutes
00:56and there's going to be moments where there's intense cramps and surges that can feel painful.
01:02We have done some studies about pain management for IUD insertion and it's kind of inconsistent
01:09about what is the best pain management to administer you know before you get an IUD.
01:14Most people would agree that taking an anti-inflammatory medication prior to get your
01:20IUD 30 minutes to an hour will help somewhat with during but also definitely with any cramping
01:26afterwards. Some people will recommend topical or local medications so medications that you can just
01:33apply with a spray or a gel or cream on the cervix or also there are medications that we can local
01:39anesthesia we can inject into the cervix. As far as like a local injection a lot of times it's
01:45decided that you know we'll just do the IUD insertion versus having the pain of the injections
01:50and then the IUD insertion because it may not completely take away the pain. Why don't we just
01:55put people to sleep? Because there are risks to anesthesia and so to undergo general anesthesia
02:02will take you longer to fall asleep and wake up than to get the IUD inserted and there are a lot
02:07more risks for anesthesia than for a two-minute procedure. However sometimes patients who are
02:12already undergoing a procedure may opt to get an IUD inserted while they're already under anesthesia
02:18and there are some cases where it may be necessary to undergo general anesthesia. But for most
02:25patients I promise you most people do pretty well with an IUD insertion. I always recommend
02:30eat before you go in, don't go in hungry, don't go in you know dehydrated, take some anti-inflammatory
02:38medication like ibuprofen before you go in and you'll likely be fine. For those times when it's
02:45the worst thing ever and you feel like we're like really you know attacking you just be open to
02:51letting us know if you need to take a break or if you are like you're out you're tapping out this is
02:56not for you that's okay for you to want to discontinue a procedure if it's not you know
03:01feeling right for you. But the summary is that we don't have consistent data about what is the best
03:08thing to do to prevent or reduce the pain during an IUD insertion so it should be a discussion
03:13with your doctor to decide what's best. If you feel like it will be helpful to have something
03:19to help your anxiety during the procedure many doctors will be willing to prescribe you a short
03:26acting medication to help reduce your anxiety before your procedure. So feel free to have that
03:32discussion with your doctor. What can I do to make it easier to have an orgasm on SSRIs? This
03:39can be a complex question so SSRIs which are medications that are commonly used for anxiety
03:46and depression PMDD and many other things has been associated with decreased sex drive and also may
03:54impact a person's ability to have an orgasm. There are some conflicting data about whether or not
04:01this is directly related to the SSRIs as some people may believe that it may be also due to
04:07the underlying condition which is depression which can also affect someone's sex drive and
04:12their ability to have orgasms. It will be important to assess whether or not the SSRI is working, how
04:18well it's working to manage your depression and also how severely are your orgasms affected. Is it
04:24that you're not having an orgasm at all? Is it just less? Is it just more difficult? And so sometimes
04:30doctors may recommend reducing the dose of the SSRI and seeing if that is helpful. Sometimes you
04:37can add medications to the SSRI that may reduce its impact on sexual function and sometimes it
04:43may be necessary to completely change the medication. I also kind of have a discussion
04:49with my patients because sometimes we tend to think that sex drive should be should look a
04:53certain way but if you're someone that you're not really bothered and you're like I feel better with
04:58this SSRI, I'm cool, my relationship, I'm cool, I'm okay. It doesn't necessarily mean that that's
05:05a problem. If it's not a problem for you, it's not a problem for me. We have to weigh the actual
05:10impact of things in our life but it's important to discuss it with your doctor and figure out
05:14what the best thing to do. I'm someone who has lost my libido or sex drive. What can I do to get it
05:20back? So what can cause a decreased sex drive? There's a few things. It can sometimes be related
05:27to medications that we're taking. Sometimes it's related to the relationship or you know how we
05:33feel in a relationship, what's happening that can also definitely affect our sex drive as well.
05:40Sometimes other medical conditions can affect your sex drive. Sometimes being a new mom, having a baby
05:46at home and just adjusting to new life can also affect your sex drive. So I think you just moved,
05:54you're starting a new job, you were ill, someone else in your family was ill. These are all big
06:00life events and stressors that it makes sense that your body is going to prioritize some other
06:06essential functions or what it deems to be other essential functions and may not kind of focus on
06:13the sex drive part of it. So that's acceptable. I want you to be able to lean into that and be
06:19aware of what's going on and then think about how can I reduce the stress that I'm undergoing
06:24right now. If you have a new baby, that baby needs to be kept alive and fed and it's not really
06:31concerned about what's going on with you and your sex drive. So you may be consumed with that for
06:37you know many weeks and even many months and that's okay. I think in those situations it's
06:43important to have a discussion with your partner. Prioritize other things you know just being close,
06:49touch, massages, other things that may you know help nurture the relationship while you go through
06:55this stressful period in life. I think sometimes if we can identify medications they may need to
07:02be changed, altered. If there are medical problems those things can be worked on as well to determine
07:09why someone has a decreased sex drive. Don't play on you know prioritizing your partner and your
07:16relationship and you know sometimes we're in a relationship and we haven't like had a date night
07:22you know for like you know five years. Sometimes you have to focus on the relationship and do things
07:27to kind of you know spice things up and those things can definitely be helpful in women. There's
07:33also good medical data that shows reading erotica novels can be helpful in increasing sex drive.
07:40There are some medications that are available for treating low sex drive so if we cannot think of
07:47any other reason, there's no medical conditions, there's no medicine, life is pretty good but your
07:54libido kind of took a dive, we can discuss if a medication may be helpful. There are also sex
08:00therapists that you can go to that can help you with more of the lifestyle things and the
08:05relationship things and identifying those things that will help you get your libido back but as
08:12always start with your doctor, have an honest open discussion. How will I know when I'm emotionally
08:18ready to try again after a miscarriage? So after a miscarriage there are a lot of things that are
08:24happening in your body and also mentally and emotionally. It is a very tough time, we have to
08:31grieve when things like that happen and we all process it in different ways. I think getting
08:36support from family and friends and maybe even a medical provider you know with counseling things
08:43like that is going to be very helpful. Most people that have a miscarriage go on to have a successful
08:50pregnancy later in life. Pretty soon after you've had a normal period you can definitely try again.
08:57Also you want to discuss with your doctor you know depending on the type of miscarriage you had,
09:02sigmolar pregnancies, ectopics, if you were treated with medication that your doctor may recommend
09:07waiting a few months. I think when you are able to kind of accept whatever happens with your next
09:15pregnancy, knowing that miscarriages are pretty common, so some people do have you know more than
09:22one, being able to be present for another pregnancy, be healthy, do everything that you need to do to
09:29support another pregnancy. I think you know when you're at that place then you know that might be
09:35a sign and also when you feel like you have the support you know to help you through you know
09:40whatever happens next and you're able to manage your stress and you're able to cope. I don't think
09:44that there's a time that's too soon or there's a time that's too long because I think if you had a
09:51miscarriage it may be that you carry that throughout your life so there's never going to be a
09:56point where you're like oh when I forget about it then I'm ready. I think you know when you feel
10:01like you're able to move forward and be present for your next pregnancy that's probably a good
10:06indication. I hope you enjoyed this video. I just want to remind you that everyone is different,
10:12everyone's body is different, so always consult with a medical profession
10:16when looking for advice that's relevant to you.