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The Proof with Simon Hill
Women’s health misinformation | Dr Jen Gunter, OB, GYN
Jul 17, 2023
01:48:17
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Quick takeaways
- The birth control pill works by suppressing the LH surge to prevent ovulation and does not have a permanent impact on fertility.
- Antifungal medication is the most effective treatment for yeast infections, and home remedies should be avoided without proper medical diagnosis.
- Vaginal microbiome testing is not recommended due to lack of understanding and is costly without offering actionable information.
- Hormonal contraceptives, such as birth control pills and implants, primarily contain progestin and are safe and effective options for contraception.
Deep dives
Birth Control Pills and Menstruation
The birth control pill works by suppressing the LH surge, which prevents ovulation. It also affects cervical mucus and makes it inhospitable to sperm. The pill does not completely halt egg production, but rather keeps the eggs from maturing and being released. Taking the pill continuously without a break can be an option, as there is no medical need for a withdrawal bleed. There is no permanent impact on fertility when stopping the pill.
Yeast Infections and Misinformation
Yeast infections are caused by an overgrowth of normally present yeast in the vagina. Symptoms may include itching, burning, and pain during intercourse. The most effective treatment is antifungal medication, either topical or oral. Home remedies like garlic and boric acid are not supported by scientific evidence. It is important to differentiate between vaginal and vulvar symptoms and seek medical diagnosis for proper treatment.
Vaginal Microbiome Testing
Vaginal microbiome testing is not recommended due to a lack of understanding about its interpretation and clinical significance. Microbiome composition can vary widely among individuals, making it difficult to determine what is considered a 'normal' microbiome. The testing can be costly and offers little actionable information. Some companies may sell the data collected, further raising privacy concerns.
Oral Contraception and Common Misconceptions
Oral contraceptives work by suppressing the LH surge, thus preventing ovulation. They also affect cervical mucus and make it less favorable for sperm survival. Oral contraception is safe and does not permanently impact fertility. Women should consult with healthcare providers to determine the best course of action for their contraceptive needs.
Understanding Hormonal Contraceptives and Their Effects
Hormonal contraceptives, such as birth control pills and contraceptive implants, work by suppressing the LH surge and primarily contain progestin rather than estrogen. While estrogen-containing pills may have some advantages in terms of efficacy and cycle control, newer progestins have shown comparable efficacy rates. The EdoNo gestural implant, which only contains progestin, is highly reliable and preferred by many women. Intrauterine devices (IUDs) have different mechanisms of action, with copper IUDs being toxic to sperm and progestin IUDs affecting cervical mucus. Both types of IUDs have proven to be safe and effective, with potential side effects such as irregular bleeding, heavier periods, or acne.
Managing Symptoms During the Perimenopausal Phase
During the menopause transition, women may experience erratic ovulation, which can lead to symptoms such as irregular periods, worsening premenstrual mood dysphoria, and hot flashes. Menopausal hormone therapy, including estrogen-containing pills or hormonal IUDs, can provide relief for these symptoms. For women in their 40s who haven't done blood tests recently, testing hormone levels is unnecessary for diagnosing the menopause transition. Symptoms are the primary focus, and blood work is only needed to screen for other conditions or check general health parameters.
Understanding Hormone Testing and the Misconceptions of Estrogen Dominance
Hormone testing, such as the so-called DUTCH test, is often used to prescribe specialized hormone combinations based on individual profiles. However, hormone testing is clinically meaningless for menopause transition and menopause diagnoses. Hormone levels fluctuate, and treatment is based on symptom management, not replacing specific hormone levels. The concept of estrogen dominance is considered a myth and lacks scientific backing. It is important to distinguish between symptoms due to hormone imbalances and those caused by other factors, such as lifestyle or relationship issues.
The Importance of Considering Multiple Factors in Menopausal Treatment
Menopausal hormone therapy can provide relief for certain symptoms like hot flashes, night sweats, and mild depression. It is crucial to approach treatment holistically and consider various factors impacting a woman's well-being, such as division of labor in the household, emotional labor, and self-care practices. Hormones alone cannot address underlying issues caused by inequality, and using menopause as an excuse for poor behavior is not valid. Open communication, understanding, and support from partners are essential in navigating the menopause transition effectively.
Episode #270. If you’ve ever been confused by the sea of women’s health misinformation, you’re not alone. Join me as I sit down with Dr Jen Gunter, internationally celebrated OB/GYN and New York Times bestselling author, to dispel disinformation with evidence.
We address everything from yeast infections to birth control, compounded hormones, and menopausal hormone therapy. This isn’t just a health masterclass, but also a critical conversation about the misinformation and disinformation that is pervasive in women's health discussions: essential listening for anyone who cares about promoting an equitable health landscape.
Specifically, we discuss:
- Intro (00:00)
- Dr. Jen Gunter on Gynecology (2:56)
- Misinformation vs disinformation (8:11)
- Western medicine and the truth about supplements (15:16)
- Tips for discerning online information (20:43)
- Yeast infection and how to really treat it (29:42)
- Can diet treat yeast infection? (38:04)
- Is a vaginal microbiome test necessary? (44:52)
- Understanding menstruation and contraception (47:47)
- Challenges for women in their mid-30s after birth control (54:00)
- Menopause, hormone testing, and symptom assessment (1:01:42)
- The grandmother hypothesis (1:07:13)
- Hormone therapy (1:10:32)
- Bioidentical hormones vs. what's recommended (1:18:02)
- Alternative treatments for hot flashes (1:26:52)
- What men need to know and how they can help (1:32:42)
- Outro (1:39:38)
Connect with Dr Jen Gunter on Instagram, Twitter, and TikTok. For more comprehensive information, you can read Dr Gunter’s two books, The Vagina Bible and The Menopause Manifesto. Head to her blog, https://vajenda.substack.com/, for frequent newsletters and articles.
Optimise your health with InsideTracker’s biomarker analysis. Get exclusive access to InsideTracker’s new ApoB test, and a significant discount at insidetracker.com/simon.
Looking for more episodes centred around women’s health? Listen to past episodes on this topic here.
Enjoy, friends.
Simon
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Simon Hill, MSc, BSc (Hons)
Creator of theproof.com and host of The Proof with Simon Hill
Author of The Proof is in the Plants
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