IamA (OBGYN) AMA!

How can you live with yourself when you pull babies out of their homes for a living?

babies are only temporary squatters in that home :)

I have a question, something I always wondered about.

Why are there male gynecologists?

I am not asking to be disrespectful, my current gynecologist is male and he's awesome. But I can't shake the idea that men get into this like of work out of a desire to squeeze breasts and poke at vaginas all day, and it's a little disconcerting.

I mean...you don't have breasts or a vagina. You can't know what it's like to have a period or get a pap smear. Of course, you can care about health and the well-being of your patients and I'm sure you do. But why gynecology? Why not proctology, or podiatry, or opthamology?

Four words: the miracle of birth. I delivered my first patient when I was a medical student, and never wanted to do anything else again after that.

Would you rather fight a horse sized vagina or 100 vagina sized horses?

I'll give you credit for creativity. How about neither. I'm a lover, not a fighter.

I lost an ovary as a baby and doctors have speculated about my period until I hit puberty (it's totally regular and every month) and now the big mystery is when I'll hit menopause. I'm 24.

What do you think? :)

Most likely you will continue to have regular periods, and go into menopause at a normal age. (average is 50ish).

What are the best ways to induce labor? PS - you are my fiancé's dr. Thank you!

it really depends on the individual patient and their circumstances. Also, induction is not right for everyone, or even for most people. Let's talk about it more next time in the office.

Have you ever been physically sick from what you've seen, and/or what is the worst vagina you've ever seen? What made it so bad?

cancer of the cervix. Necrotic (rotten/dead) tissue. Get your pap smears!

Is it true that IUD's can cause a miscarriage way after it has been removed? I don't like to take hormones as birth control so i had a copper IUD for about 9 years before it was removed, never had any troubles during. But i did have 3 miscarriages before giving birth. Or is it just a coincidence ? Thanks for your time!!!!

Coincidence. And, I'm glad you did finally have a baby! I tell all my patients with recurrent pregnancy loss that most of the time, even when you have lost several, nature finds a way!

Best answer ever?

https://youtu.be/XtS2D4aS6Po?t=23

Thank you for that.

Can you explain what Pap smear results mean in practical terms? When does an abnormal result call for going straight to colposcopy rather than retesting in a few months?

Pap smears are a microscopic exam of cells from the cervix. Also, molecular DNA testing of the cells to look for presence of HPV (human papilloma virus) can be done from the fluid.

In either case, the purpose of the pap is to look for (usually) precancerous changes (dysplasia). There are guidelines for when to go straight to colposcopy vs repeating the pap. I'll post a link to them in a moment.

http://www.asccp.org/Portals/9/docs/ASCCP%20Updated%20Guidelines%20%20-%203.21.13.pdf

Is it true that after you give birth, the hospital won't let you leave until you poop?

It is not true. Sometimes it could be several days until a bowel movement occurs. We do sometimes prescribe stool softeners to make the process "smoother." :)

What's the biggest misunderstanding a patient has ever shared regarding reproductive health?

The correct location for the "gift of life."

I'm signing off for now, but will check back later for more questions, so feel free to post

Can a woman truly know when she has actually ovulated by using a basal thermometer or ovulation predictor kits? Also, do you think the Shettles method for gender selection has any merit? Thanks.

BBTs are useful in retrospect in combination with a menstrual history when trying to confirm if ovulation has occurred. They are not very helpful in terms of timing for fertility. Ovulation predictor kits, on the other hand, are fantastic and I recommend them highly.

I'm not aware of any data that supports the utility of the Shettles method for gender selection. Even using very high-tech methods such as flow cytometry and intrauterine insemination, selection rates at best might approach 85%.

How many coat hanger abortions and STIs do you see due to "abstinence only" education in Utah?

Fortunately, I've seen none. I have not looked at the data, however in my opinion, compared to the East Coast where I used to practice, the STI rate does not appear to be any different.

How was the marathon?

It was great! and cold and soggy. But great. I can almost walk without pain!

I don't have a strong family history of uterine/breast cancer - except a grandmother with breast cancer on my Dad's side. Should I still bring up BRCA testing to my doctor the next time I see him?

Generally, I encourage patients to consider BRCA testing if they have one first degree relative (mom, sister, etc) or several second degree relatives (g-mom, aunt, etc).

What are your thoughts on the increased use of birthing centers and home births with the support of nurse midwives?

For low-risk patients, it is probably fine for a lot of people. However, the transition from low risk to high risk can be instantaneous. I've seen it happen enough times that I am very happy to deliver in a hospital with a level III NICU.

As a guy, does what you see day to day, does it ever make you not want to look at a vag for personal reasons?

They haven't changed at all. Work is work, and personal life is personal life.

what, if in any way, have your views on sex stuff changed after your education and career revolving around female genitals?

They haven't changed at all. Work is work, and personal life is personal life.

Can you please tell me in great detail everything you know about the blue waffle?

In brief, it's an urban myth. http://www.urbandictionary.com/define.php?term=Blue+waffle

How is it a myth when there are pictures of it?

There are pictures of spiderman and superman as well.. I also have a picture of myself flying over NY City.. Pictures can be faked.

Agreed! If I had a nickel for every time someone asked me about something they saw on the internet...