Speaker 1: Wind Down with Janet Kramer and I'm Heeart Radio podcast.
Speaker 2: On today's Whine About It Thursday Therapy, we have Karen
Speaker 2: Iliber and she is a BORED certified urologist and she's
Speaker 2: got a BORED certification in female pelvic Medicine and reconstructive
Speaker 2: surgery and has over twenty years of experience taking care
Speaker 2: of women.
Speaker 1: Most intimate needs.
Speaker 2: She's also a professor of urology and I can never
Speaker 2: say that word obastrous. She knows as a woman in
Speaker 2: gynecology at Cedar Syana Medical Center, so she is full
Speaker 2: of knowledge. She also has a book out called A
Speaker 2: Woman's Guide to her Pelvic Floor. What the frick fuck
Speaker 2: is going on down there?
Speaker 1: I love it.
Speaker 2: Let's get her on. Hey girl, I'm Jana. Hi Karen,
Speaker 2: nice to, welcome to wind Down. I was just I
Speaker 2: was reading your breakdown. So I've been obviously going to
Speaker 2: the gynecologists, you know, whenever or what started?
Speaker 1: What?
Speaker 2: When do you just start? Sixteen seventeen eighteen around that time. Yeah,
Speaker 2: I still cannot say the first part of that. Ohb's oh,
Speaker 2: oh what obstetrics.
Speaker 1: Obstetrics. I'm like, why is that so hard?
Speaker 3: Obstetrics That's why everybody says obi guyin.
Speaker 1: Yeah obg y N.
Speaker 2: That's like, what is even obstrics obstetrics?
Speaker 4: So obstetrics is actually like delivering babies, and then the
Speaker 4: guy ecology Like so the obstetrics is the pregnancy and delivering,
Speaker 4: and then the guyn ecology is really just anything vagina.
Speaker 1: Okay, so you do you do that and the urology.
Speaker 3: So I do not deliver babies.
Speaker 4: I'm a urologist and I have subspecialty training in euro gynecology,
Speaker 4: so I do like all bladder and vagina surgery, so
Speaker 4: like if your bladder is falling, or if you're in continent,
Speaker 4: or we take care of a lot of female sexual dysfunction,
Speaker 4: So anything in the vaginal area that has nothing to
Speaker 4: do with babies, I will take care of.
Speaker 2: What is what female dysfunction? Things are you referring to
Speaker 2: when you say that.
Speaker 4: So some women can have pain with intercourse because they
Speaker 4: have like to their public muscles are too tight. Some
Speaker 4: people actually have nerve disorders. Unfortunately, you can have a
Speaker 4: very traumatic vaginal delivery that causes nerve damage, but also
Speaker 4: hormonal changes like a perimenopause and menopause or surgical changes,
Speaker 4: so there can be a lot of unfortunately causes the
Speaker 4: pain and then of course for women.
Speaker 2: So my mom I remember, I'll never forget it because
Speaker 2: I went to the doctors with her because she thought
Speaker 2: she was pregnant and it was when she was thirty
Speaker 2: four years old and she was actually going through menopause,
Speaker 2: so she wasn't pregnant and she was Her doctor was like, no,
Speaker 2: you're you're in menopause and she's like, I'm thirty four
Speaker 2: years old. So since that, yeah, since that moment, I'm like,
Speaker 2: oh my god, I have to have kids early because
Speaker 2: I'm going to go through menopause at the same time,
Speaker 2: because they say that it can be gene. I mean,
Speaker 2: obviously I've had kids. I'm now thirty nine, still have
Speaker 2: not well I don't know, I'll ask you that, but
Speaker 2: you know I've I've had kids. Yeah, I was like
Speaker 2: I had my I had my son at thirty five.
Speaker 2: But that always like freaked me out, and I'm like,
Speaker 2: how how did she get menopause that early? Like is
Speaker 2: that is that like is that super rare or like it?
Speaker 2: Because I've always wondered that.
Speaker 3: I mean, it's not that common.
Speaker 4: They used to use the term primary Oberian insufficiency or
Speaker 4: bear In failure. Now they like to say primary over
Speaker 4: and insufficiency, and some people can actually get it back.
Speaker 4: I mean, it could be like an illness, it could
Speaker 4: be like a lot of stress. But I have known
Speaker 4: women who have literally stopped having periods and then you know,
Speaker 4: did meditation other things fix any health. Like like let's
Speaker 4: hear a thib raiate is off. That might make your
Speaker 4: periods stop. But that happens actually in a very small
Speaker 4: small percent of women.
Speaker 1: Mm hmm. It's yeah.
Speaker 2: I because it was about it was last winner, I
Speaker 2: commpletely skipped my period, and I'm like, that has never happened.
Speaker 2: I mean, girl, I am like twenty six days like
Speaker 2: on like the mark. The only thing that's changed with
Speaker 2: my periods is after I had my second son. It's like,
Speaker 2: I'm like, is this normal? How much I bleed? Like
Speaker 2: it's it's a lot. Yeah, And I know that's like
Speaker 2: massive TMI. But for the girl's thing, the guys, maybe
Speaker 2: this is not like you're or if you want to
Speaker 2: have some knowledge, share but this one. But yeah, it
Speaker 2: was just like I remember going in going like I'm
Speaker 2: kind of scared, Like I think I'm losing too much
Speaker 2: blood and she's like, well, this is actually very common
Speaker 2: after kids and you know you're getting older, periods are
Speaker 2: changing and.
Speaker 1: I'm like, whoa.
Speaker 2: But then it was Leah. Last winter, I took a
Speaker 2: pregnancy task because I was like, I think I might
Speaker 2: be pregnant because I'm like, I missed my period.
Speaker 1: And then I wasn't. So I called my doctor.
Speaker 2: I'm like, it's been like, I mean, I'm on like
Speaker 2: day forty I still have not had my Like what
Speaker 2: is going on? And she's like, well, you probably missed.
Speaker 2: It's called like a miss period. I'm like, I've never
Speaker 2: even heard of that too. I'm like, what is like?
Speaker 2: So then we did some blood work, but they didn't
Speaker 2: really find anything. So I'm like, is that is that
Speaker 2: super common?
Speaker 3: Again?
Speaker 4: I mean, skipping a period here and there is not uncommon,
Speaker 4: especially like stress.
Speaker 3: Are you still nursing?
Speaker 1: Oh no, my kids are seven and four?
Speaker 3: Yeah, I mean it can happen, but yeah, missing a
Speaker 3: period here and there is not.
Speaker 1: Am I going through menopause?
Speaker 3: Probably not? If they checked everything.
Speaker 2: Okay, because perry is the beginning of menopause, right, Like,
Speaker 2: aren't we all in perimenopause? When we hit forty I mean,
Speaker 2: statistically speaking, yes probably, but you know, symptoms of perimenopause.
Speaker 2: But that's why it's much harder for a four year
Speaker 2: old woman to get pregnant than a thirty five year
Speaker 2: old woman, you know, because unfortunately we're like on the
Speaker 2: downhill five.
Speaker 3: But perimenopause typically.
Speaker 4: People start having symptoms like you know, difficulties, sleeping, hot flashes.
Speaker 3: But the perimenopause can go on for a long time.
Speaker 3: So by definition, menopause is when you don't have a
Speaker 3: period for twelve consecutive months. So let's say you went
Speaker 3: ten months no period, then you had a period. You're
Speaker 3: not actually metopausea yet.
Speaker 1: Hmm, okay, got it.
Speaker 2: What for the pelvic area? What is the most what's
Speaker 2: the question that women are always kind of embarrassed to
Speaker 2: say or ask about.
Speaker 3: Women are really embarrassed to ask that. I mean, like,
Speaker 3: is what I look like down there? Normal? And my
Speaker 3: normal size? Is my odor normal? You know? There is?
Speaker 3: It's these are things that we.
Speaker 4: Don't ever talk about, you know, which is why, like
Speaker 4: my colleagues and I wrote this book like a Woman's
Speaker 4: Guide to a Pelvic Floor subtitled what the F Is
Speaker 4: going on? Down there because we see a lot of
Speaker 4: very educated, smart women who just don't know, and it's
Speaker 4: because we've never told them about these things. Right, you
Speaker 4: have one health class, maybe somewhere in junior high, and
Speaker 4: you learn some very basic things than that you were
Speaker 4: on your own, figure out what your birth control options were, right?
Speaker 4: What is a normal period? What I mean, every time
Speaker 4: sex is brought up, it's negative. Either you can get pregnant, right,
Speaker 4: or you can get infection. Sex is never like, oh
Speaker 4: maybe you uhoul to do it, you know, so you
Speaker 4: can enjoy yourself type of thing, right, So I think
Speaker 4: that also, I mean, women are embarrassed to ask a
Speaker 4: lot of things, you know, just intimate questions like you know,
Speaker 4: is it normal that you know, my orgasm isn't as
Speaker 4: good as it was before I had babies, And there's.
Speaker 3: All sorts of things.
Speaker 4: So I the reason I can't only answer your question
Speaker 4: is probably the question they're the most embarrassed to ask.
Speaker 3: They're not asking sure.
Speaker 2: Yeah, I think I think the one that I always
Speaker 2: get really embarrassed sound is like if it was having
Speaker 2: weird discharge, like even just like saying that, and then yeah,
Speaker 2: it comes with it because it's like certain things, like
Speaker 2: I used to have a yeast issue, so I'm like
Speaker 2: I always get east infections, and like I didn't realize
Speaker 2: it was the soaps that I was sensitive to, the
Speaker 2: soaps that I was using that had like the fragrance
Speaker 2: in it. So I was like, all right, you know,
Speaker 2: then I looked into this, but I didn't I was
Speaker 2: embarrassed to ask it. So I was googling, like you know, odor,
Speaker 2: all these things, and then I saw this one website
Speaker 2: where it was like, you know, do boric acid and
Speaker 2: apple something and it had like an actual cleanser. So
Speaker 2: I was like, oh, thank god, okay, and so like
Speaker 2: I got that, but it was like I was even embarrassed,
Speaker 2: and like my doctor, why didn't I trust my doctor
Speaker 2: to like ask that and say that, you know.
Speaker 4: It's it's so well because because I think there's a
Speaker 4: part of every person that they fear that if they
Speaker 4: ask the question, the doctor looks at you like I've
Speaker 4: never heard of that before, right, Like you don't really
Speaker 4: want to be like a dinner party you're talking to
Speaker 4: your girlfriends, you know, yeah, you know, like when you
Speaker 4: call for you laugh and you wet your pants and
Speaker 4: you're waiting for him to go yeah, and like nobody
Speaker 4: says anything, right, you really don't want to be that girl.
Speaker 1: Right, yeah, hmm.
Speaker 2: What is something that in your you know, your studies
Speaker 2: and your years of doing what you do. Is there
Speaker 2: something that has stumped you that's go, oh wow. I
Speaker 2: don't know the answer to that.
Speaker 3: I've been doing it. I'm sure there was along the way.
Speaker 4: I've been doing this for like over twenty years, so
Speaker 4: there's not a lot of things that I haven't seen.
Speaker 4: There is always something that kind of stumps, but those
Speaker 4: are very unusual. But I think that people be surprised
Speaker 4: at how few things do stump specialists like me, because
Speaker 4: I think general urologists, general kind ofcologists, I think, for
Speaker 4: the most part, just aren't necessarily interested in this stuff
Speaker 4: that my colleagues and I do, and not because they
Speaker 4: don't like taking care of women, but you know, it's
Speaker 4: more fun to deliver babies and you know, to take
Speaker 4: care of discharge per se or also you have to
Speaker 4: have specialized training to take care of women if they
Speaker 4: have in continence. But it's so satisfying because I can't
Speaker 4: tell you, like how many times I've seen a woman
Speaker 4: who she just cries out of relief to know that
Speaker 4: she's not the only one who's experiencing these things, right.
Speaker 2: I saw something in one of the questions, but it
Speaker 2: was like, like vibrators, I mean, like, is that a
Speaker 2: cause for things that you know can be problematic for
Speaker 2: the pelvic area.
Speaker 4: They can be problematic, but they're probably more beneficial. So
Speaker 4: I actually recently had a case where it was one
Speaker 4: of the section vibrators I think was just too strong
Speaker 4: and so and you know, the clitterist has this crazy
Speaker 4: concentration of nerve endings, and I think it was so
Speaker 4: strong that like for weeks afterwards she would have symptoms.
Speaker 3: So that's pretty unusual. But for the most part, especially if.
Speaker 4: You're not sexually active with a partner on a regular basis,
Speaker 4: I think it's really good to use a vibrator. So
Speaker 4: one of our research projects that we've done has shown
Speaker 4: that regular use of a vibrator, whether a woman used
Speaker 4: it to orgasm or not, was beneficial for things like
Speaker 4: pell of the pain pain with intercourse incontinence because you're
Speaker 4: increasing blood flow to the pelvis when you're aroused. So
Speaker 4: if you're not sexually active, then it's good to use
Speaker 4: a vibrator on a regular basis.
Speaker 1: Oh see something we wouldn't know.
Speaker 3: So when your partners use your rybrary or your bedstand
Speaker 3: or your nightstand, you could just say my doctor recommended it.
Speaker 1: We love that.
Speaker 2: I mean it's like that's so sometimes like you know,
Speaker 2: the glass of wine and like it was doctor recommends it.
Speaker 1: I know, I know, you know.
Speaker 4: I think that's also when you're asking about what people
Speaker 4: are embarrassed about. We just don't really normalize sexuality specifically
Speaker 4: for women. So as a urologist, I take care of
Speaker 4: men and women, right, and we talk about viagra all
Speaker 4: the time and a rectile dysfunction. It's like it's an
Speaker 4: everyday conversation, but we don't talk about female sexualist function
Speaker 4: because you know, traditionally, if a woman enjoys sex, you
Speaker 4: must be something wrong that you must be like some
Speaker 4: kind of core or slut or something right. It's not
Speaker 4: just because it could be the equivalent of males enjoying it.
Speaker 4: And we really have not paid as much attention as
Speaker 4: we should to female sexual dysfunction. Right, So women who
Speaker 4: have had bad sexual experiences, or they have conditions like
Speaker 4: endometriosis that cause pain and they can't enjoy sex and
Speaker 4: no one has helped them with the pain. You know,
Speaker 4: it can cause a lot of stress in her life
Speaker 4: and also in her relationships.
Speaker 2: Yeah, I have a friend that has like a very
Speaker 2: like how her I don't know what it is, but
Speaker 2: it's how it's shaped. It's like she has so much
Speaker 2: pain when she has sex, so like that that caused
Speaker 2: a big issue in her marriage because she didn't want
Speaker 2: to have sex. She's like, it hurts, like I don't
Speaker 2: want to do it. And then it's like, well, obviously
Speaker 2: that the husband wants to have sex, you know, so
Speaker 2: it's like trying to you know, figure that balance out.
Speaker 2: It's like it's it's embarrassing, but it's also like there
Speaker 2: are resources to be okay, right or to get better.
Speaker 3: There are.
Speaker 4: But again back to Woldiam about who I think that
Speaker 4: most women wouldn't even know off the top of their
Speaker 4: head what doctor to call to discuss her female sexual issues.
Speaker 4: You know, that's already embarrassing as it is, and you're
Speaker 4: you know, you're really kind of being a little open
Speaker 4: because you're seeking care because it's causing stress in your
Speaker 4: relationship and sexes and everything in a relationship. But having
Speaker 4: that level of intimacy I think is necessary, you know
Speaker 4: for most couples, but it you know, you think about
Speaker 4: seeing like a sex therapist, which is more like you'd
Speaker 4: consider like a you know, a psychology or a therapist.
Speaker 4: You don't really realize that there are people who deal
Speaker 4: with the physical causes of pain with intercourse.
Speaker 3: Mmm mm hmm yeah.
Speaker 1: I Uh.
Speaker 2: I get some hate because I promoted a vibrator on
Speaker 2: my page, but I'm like, I'm all about just self love. Like, yes,
Speaker 2: I'm very happy in my relationship and we have a
Speaker 2: great sex life, but like also, you know, like it's okay.
Speaker 3: Sometimes in the mood for chocolate, sometimes they move for villa,
Speaker 3: but they're both.
Speaker 2: Eviden. It's like, I'm like, why are like women hating
Speaker 2: on me for posting about something that I'm like, I'm
Speaker 2: just trying to like give you all a great code
Speaker 2: for something.
Speaker 3: That like men never masturbate right right never ever?
Speaker 1: Nope, they are just perfect little angels.
Speaker 2: But it's like, I'm like that always baffles me that
Speaker 2: I'm like, why am I getting hate for something surprising?
Speaker 4: And why why would anybody negatively look upon anybody wanting
Speaker 4: to promote another woman for feeling good? See, That's what
Speaker 4: I'm talking about like, I don't think any man would
Speaker 4: ever discourage another man from masturbating.
Speaker 2: Right, I think the piece that like ties into that
Speaker 2: is like, you know, I talk about my faith a
Speaker 2: lot in God. I'm like, I think my God's okay
Speaker 2: with it, you know. So I'm like, it's so it's
Speaker 2: like those ones that just live by and I don't
Speaker 2: know the exact like quote or whatever, but I'm like,
Speaker 2: for me, I'm just like that's the piece of Christianity
Speaker 2: that I'm just like, you know, I think it's okay
Speaker 2: to do that. So I'm like I shouldn't be condemned
Speaker 2: one way or the other. And you know, better than
Speaker 2: I agree with you.
Speaker 4: I didn't realize it was against anyone's religious beliefs, not
Speaker 4: to mean.
Speaker 2: Yeah, I don't remember because I have like a few
Speaker 2: of the people are like, if you're a Christian, like
Speaker 2: you shouldn't do that, And I'm like, well, I'm also
Speaker 2: having sex before i'm married, so you know what i mean,
Speaker 2: Like I'm already screwed.
Speaker 3: So I'm like everything's burned out.
Speaker 2: Yeah, I'm like, I am not a born again I
Speaker 2: don't know how Like I'm sorry.
Speaker 1: It's just the one piece.
Speaker 2: I like, I can't, but did you just sit around
Speaker 2: with your girls and go, oh my gosh, we have
Speaker 2: to just write this book to just normalize what it was.
Speaker 4: It was honestly just years of hearing my patience say
Speaker 4: you know, I'm so embarrassed say this, or like I
Speaker 4: think it's so funny. I'll literally have just finished a
Speaker 4: badgeal exam. They're like, you know, I'm embarrassed to say this.
Speaker 4: I'm like, I literally just had my head like right
Speaker 4: between your legs. I'm pretty sure, like all walls are down.
Speaker 4: You can ask me anything, but you just come to
Speaker 4: realize that very basic things women were really stressing out about,
Speaker 4: Like you're just charge right, and like if you just
Speaker 4: understand some basic things, I think you can probably figure
Speaker 4: things out on your own, you probably have a lot
Speaker 4: less stress in your life. And also just the women
Speaker 4: know that whatever problem you have, there probably is a solution,
Speaker 4: even though you're embarrassed to ask about it.
Speaker 1: Right, is it?
Speaker 4: No?
Speaker 2: I think pineapples for the penis, But is there a
Speaker 2: food for the vagina that's really good?
Speaker 1: Isn't that it's like pineapple? Isn't that?
Speaker 3: Those are all like myths?
Speaker 4: You know? I mean, I think that probably the only
Speaker 4: thing you really could do potentially is if you drank
Speaker 4: lots and lots of fluid to delute things out. But
Speaker 4: there is nothing that's consistently gonna make things taste better,
Speaker 4: except for if you use like a flavored you know,
Speaker 4: lubricin or something. But I mean, realistically, like nobody really
Speaker 4: tastes good anywhere, Like even if you like suck on
Speaker 4: your arm, it doesn't taste good.
Speaker 1: No, no, no, no, no, no, no, not at all.
Speaker 2: But it's so funny though that you say that about
Speaker 2: the asking questions, because I'm like, yeah, like even the
Speaker 2: other day I was at my Gaino's and when they're
Speaker 2: like and scoot down, and I'm like, okay, Like you know.
Speaker 1: It's just like it's I don't know why.
Speaker 4: What we really should say is move down so far
Speaker 4: that you feel as embarrassed as possible and you're in
Speaker 4: the right posision.
Speaker 1: Yeah, one thousand percent.
Speaker 2: Is there something in the book where you guys, because
Speaker 2: it's you and your is it two friends.
Speaker 3: Two of my colleagues?
Speaker 1: Yeah, the two of your colleagues.
Speaker 2: Okay, I love that, And did you guys kind of
Speaker 2: have like a piece where like I'm more knowledgeable in
Speaker 2: this area or.
Speaker 1: It was just like a real group effort.
Speaker 3: I don't know if it's more.
Speaker 4: I think we're probably equally knowledgeable, but everybody definitely has
Speaker 4: their own interests. So like one of my colleagues, she
Speaker 4: does transgender surgery, so she wanted to write that chapter.
Speaker 4: And you know, I'm very interested in like female sexuals function,
Speaker 4: so I wrote that chapter.
Speaker 1: But interested in what and female.
Speaker 3: Fe male sexual function and what is that? So like just.
Speaker 4: How you're like if you have normal sexuality. So female
Speaker 4: sexual dysfunction, whether it's because as of lack of desire
Speaker 4: or inability, if you're buy to respond normally pain with intercourse.
Speaker 4: A female sexual dysfunction is defined as if it is
Speaker 4: actually causing distress.
Speaker 3: In your life.
Speaker 4: So let's say that a woman is, you know, seventy five,
Speaker 4: she's widowed, she has no desire, but she's not bothered
Speaker 4: by it.
Speaker 3: That's not a dysfunction.
Speaker 4: But let's say you're thirty five and you don't understand
Speaker 4: you've totally lost your sex drive. It is putting a
Speaker 4: lot of stress on you and your partner. That is
Speaker 4: definitely a dysfunction.
Speaker 1: Okay, got it. That's so interesting.
Speaker 4: Well, The other interesting thing is, you know, I think
Speaker 4: we attribute a lot of things to hormones that have
Speaker 4: nothing to do with it, and we don't appreciate what
Speaker 4: hormones can do, you know, half the time. So like
Speaker 4: when I'm mad at you, it's not necessarily because it's
Speaker 4: that time of the month.
Speaker 3: Maybe you're just really being a jerk.
Speaker 1: All right, maybe I'm just actually really angry you have.
Speaker 2: Having said that, though it always does usually land at
Speaker 2: the week I hear that, it drives me mad because
Speaker 2: and then I hide my period. I used to hide
Speaker 2: my period from Max husband so that he can be like, oh,
Speaker 2: that's why you.
Speaker 1: Were a raging bright You can't let her know he's
Speaker 1: right away? Not a chance.
Speaker 2: Will everyone go get a woman's Guide to her pelvic floor?
Speaker 2: What the is going on down there? Thank you so
Speaker 2: much for coming on the show.
Speaker 4: I really appreciate it, and I thank you for bringing
Speaker 4: attention to these topics that women, as you point out,
Speaker 4: are embarrassed to ask about. So, you know, I just
Speaker 4: want all women to know that there are people out
Speaker 4: there to take care of these issues.
Speaker 1: Thank you.
Speaker 2: I appreciate that. Thanks all right, Bye girl, Seeya, Bye,