Searching for medical advice on the internet

can be confusing and just lead to lots of anxiety.

So, I'm here to answer,

some of the more complex medical questions

that you may have.

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I am Dr. Candace Fraser and I'm a board certified OBGYN.

Why is it so hard to get pain relief in advance

to getting an IUD

and why do some doctors tell you that it will not hurt?

I don't know why people say it does not hurt.

I usually tell my patients that from my experience,

about 50% of my patients at the end of getting an IUD,

they say, Oh, it wasn't as bad as I thought.

25% were like, Kind of what I thought.

And 25% was like, Oh my gosh,

what did you just do to me that was the worst thing ever.

What I usually say is that

it's a pretty quick procedure getting an IUD inserted.

For most people it's gonna be a couple minutes

and there's gonna be moments where there's intense cramps

and surges that can feel painful.

We have done some studies about pain management

for IUD insertion

and it's kind of inconsistent,

about what is the best pain management to administer,

before you get an IUD.

Most people would agree that taking

an anti-inflammatory medication prior

to get your IUD 30 minutes to an hour,

will help somewhat with during,

but also definitely with any cramping afterwards.

Some people will recommend topical or local medications,

so medications that you can just apply with a spray

or a gel or a cream on the cervix

or also their medications that we can,

local anesthesia we can inject into the cervix.

As far as like a local injection,

a lot of times it's decided that

we'll just do the IUD insertion,

versus having the pain of the injections

and then the IUD insertion,

'cause it may not completely take away the pain.

Why don't we just put people asleep?

Because there are a risk to anesthesia

and so to undergo general anesthesia,

it'll take you longer to fall asleep and wake up

than to get the IUD inserted

and there are a lot more risk for anesthesia

than for a two minute procedure.

However, sometimes patients

who are already undergoing a procedure,

may opt to get an IUD inserted,

while they're already under anesthesia

and there are some cases where it may be necessary

to undergo general anesthesia,

but for most patients, I promise you,

most people do pretty well with an IUD insertion.

I always recommend eat before you go in.

Don't go in hungry, don't go in dehydrated,

take some anti-inflammatory medication like ibuprofen,

before you go in and you'll likely be fine.

For those times when it's the worst thing ever

and you feel like we're like really attacking you,

just be open to letting us know if you need to take a break

or if you are like you're out,

you're tapping out, this is not for you.

That's okay for you to want to discontinue procedure

if it's not feeling right for you.

But the summary is that we don't have consistent data,

about what is the best thing to do to prevent

or reduce the pain during an IUD insertion.

So, it should be a discussion with your doctor

to decide what's best.

If you feel like it will be helpful

to have something to help your anxiety during the procedure.

Many doctors will be willing to prescribe you

a short acting medication

to help reduce your anxiety before your procedure.

So, feel free to have that discussion with your doctor.

What can I do to make it easier to have an orgasm on SSRIs?

This can be a complex question.

So SSRIs, which are medications that are commonly used

for anxiety and depression, PMDD

and many other things has been associated

with decreased sex drive

and also may impact a person's ability to have an orgasm.

There are some conflicting data about whether or not

this is directly related to the SSRIs

and some people may believe that it may be also due to

the underlying condition, which is depression,

which can also affect someone's sex drive

and their ability to have orgasms.

It will be important to assess whether or not

the SSRI is working,

how well it's working to manage your depression,

and also how severely are your orgasms affected?

Is it that you're not having an orgasm at all?

Is it just less?

Is it just more difficult?

And so sometimes doctors may recommend reducing the dose

of the SSRI and seeing if that is helpful.

Sometimes you can add medications to the SSRI

that may reduce its impact on sexual function

and sometimes it may be necessary

to completely change the medication.

I also kind of have a discussion with my patients,

because sometimes we tend to think that sex drive should be,

should look a certain way.

But if you're someone that you're not really bought

and you're like, I feel better with this SSRI,

I'm cool,

my relationship I'm cool, I'm okay.

It doesn't necessarily mean that that's a problem.

If it's not a problem for you, it's not a problem for me.

We have to weigh the actual impact of things in our life,

but it's important to discuss it with your doctor

and figure out what the best thing to do.

I'm someone who has lost my libido or sex drive,

what can I do to get it back?

So, what can cause a decreased sex drive?

There's a few things.

It can sometimes be related to medications

that we're taking.

Sometimes it's related to the relationship

or how we feel in a relationship, what's happening.

That can also definitely affect our sex drive as well.

Sometimes other medical conditions

can affect your sex drive.

Sometimes being a new mom,

having a baby at home and just adjusting to new life

can also affect your sex drive.

So, I think you just moved, you're starting a new job,

you were ill.

Someone else in your family was ill.

These are all big life events and stressors

that it makes sense that your body is going to prioritize,

some other essential functions

or what it deems to be other essential functions

and may not kind of focus on the sex drive part of it.

So, that's acceptable.

I want you to be able to lean into that

and be aware of what's going on

and then think about how can I reduce the stress

that I'm undergoing right now?

If you have a new baby,

that baby needs to be kept alive and fed

and it's not really concerned about what's going on

with you and your sex drive.

So, you may be consumed with that for many weeks

and even many months.

And that's okay.

I think in those situations

it's important to have a discussion with your partner,

prioritize other things,

just being closed, touch, massages,

other things that may help nurture the relationship

while you go through this stressful period in life.

I think sometimes if we can identify medications,

they may need to be changed or altered.

If there are medical problems,

those things can be worked on as well

to determine why someone has a decreased sex drive.

Don't play on prioritizing your partner

and your relationship and sometimes we're in a relationship

and we haven't like had a date night

for like five years.

Sometimes you have to focus on the relationship

and do things to kind of spice things up.

And those things can definitely be helpful in women.

There's also good medical data

that shows reading erotica novels

can be helpful in increasing sex drive.

There are some medications that are available

for treating low sex drive.

So, if we cannot think of any other reason,

there's no medical conditions, there's no medicine,

life is pretty good,

but your libido kind of took a dive.

We can discuss if a medication may be helpful.

There are also sex therapists that you can go to

that can help you with more of the lifestyle things

and the relationship things and identifying those things

that will help you get your libido back.

But as always, start with your doctor.

Have an honest, open discussion.

How will I know when I'm emotionally ready

to try again after a miscarriage?

So after a miscarriage, there are a lot of things

that are happening in your body

and also mentally and emotionally.

It is a very tough time.

We have to grieve when things like that happen

and we all process it in different ways.

I think getting support from family and friends

and maybe even a medical provider with counseling,

things like that, it's gonna be very helpful.

Most people that have a miscarriage,

go on to have a successful pregnancy later in life.

Pretty soon after you've had a normal period,

you can definitely try again.

Also, you want to discuss with your doctor,

depending on the type of miscarriage you had,

say molar pregnancies, ectopics.

If you were treated with medication

that your Dr. May recommend waiting a few months.

I think when you are able to kind of accept whatever happens

with your next pregnancy,

knowing that miscarriages are pretty common.

So, some people do have more than one,

being able to be present for another pregnancy.

Be healthy, do everything that you need to do

to support another pregnancy.

I think when you are at that place

then that might be a sign.

And also when you feel like you have the support

to help you through with whatever happens next

and you're able to manage your stress

and you're able to cope.

I don't think that there's a time that's too soon

or there's a time that's too long,

because I think if you had a miscarriage,

it may be that you carry that throughout your life.

So, there's never gonna be a point where you're like,

Oh, when I forget about it, then I'm ready.

I think, when you feel like you're able to move forward

and be present for your next pregnancy,

that's probably a good indication.

I hope you enjoyed this video.

I just wanna remind you that everyone is different.

Everyone's body is different,

so always consult with a medical profession

when looking for advice that's relevant to you.

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