You're listening to a Mom and mea podcast.

And one of the biggest problems I see, especially in young people, is that they think if they've got any movement at all, that's a wrinkle.

But a wrinkle is only when you see it when you're not moving.

Being able to move your forehead and frown a little bit and have some movement that's not a wrinkle, and so it's really important to educate that movement is okay.

Hello and welcome to Well Australian women.

This is your full body health check.

I'm Claire Murphy and I'm very happy to say that I inherited my mum's skin and not my dad's.

My dad looks a little bit like that rock guy from The Fantastic Four.

I think because he's worked with a lot of construction materials over.

The years, a lot of sun exposure, a.

Lot of sun exposure.

Thank you, mum, and thank you for giving me your good skincare regime.

Hello Mary, and I'm doctor Mariam.

To all the sister so lots of sunscreen and lots of moisturizes.

Is growing up you had access to their older sisters.

Yes, shorty regimes.

My skin has a lot to thank my sisters.

Well, if you haven't figured it out, today we are talking about skin, but we'll also be talking about things like anti aging, so whether that's actually a thing?

Can you reverse the hands of time?

And what the heck do you do with all of these ingredients?

I don't know if you've gone to a chemist recently and looked at the wall of things that you can potentially put it on your skin can be really overwhelming and a little bit daunting.

So we're going to try and get to the bottom of that.

The quick consult today is a question about whether you need gynecological assistance if you've never done the deed, if you've never had sex, do you need to get checked?

But next to br in bed or not to bright in bed?

That is the question.

So let's go to med school.

Welcome to med school.

So Mary, remember we talked a few weeks ago about whether we're underwear to bed or not.

Well, I had someone in the DMS ask, okay, but what about a bra?

And I have had this discussion with a few of my friends because I have a friend who wears a bra every night and she swears and declares that means her boobs will be perky forever.

I've never seen her not in a bra.

Yeah, so I can't tell whether that has actually worked for her or not.

So I mean it may or it may not.

So there's this idea of maybe it'll stop the girls from getting affected by gravity over the years.

But then there's another school of thought that think wearing a bra to a bed might actually be detrimental to your health.

Yeah.

So we'll get into that in a sec But are you a two bed bra wearer or not?

It depends on the day and the bra that I've worn.

After I've had kids, I've kind of lost the nice lacy bras.

We got a bit more utilitarian after the baby life.

Yeah.

Yeah, So if I feel like, oh god, it's been a day, you know, just like you get home and you're like, I've been restricted all day and you just take it off and it just feels like you've got that.

Do you wear an underwh I don't wear an underwire.

So all my bras are like those supported, like maternity ones.

They're just so comfortable.

How do you give those away?

After my kid was born, like five years after, I still had maternity bris in the rotation.

It's really pretty and very comfortable.

But then like if you wear them with a single, you can set or it's like quick access, like it doesn't happen to be from your kid exactly.

There you get thinking ahead.

But most nights, especially when hubby is away, I'm not wearing a bar because when he's there to get their hands up the top situation, it's like, no, it's not an invitation to play, it's just let them breathe.

Yeah.

I never have been a brighter bed girly.

Yeah.

I'm not big, but I'm not small.

Yeah, So I don't feel like it's a problem.

And the thing is for some women.

For example, I've got a friend who's got really large boobs, and she said to me, if I don't wear some kind of support to bed, they will choke me to death in much.

Like it's just like rougher out a neck.

Yeah.

And then I've got another friend who said if she goes sideways, they kind of they go to the side you're laying on and they can get kind of pinched in there.

So like there's reasons for that.

There's also people who might have piercings and things that don't want to be let free in the bed.

Like, there's many reasons why you may yes or may not want to wear one, But it turns out there is no strong scientific evidence that wearing a bra to bed has any major positive or negative impacts on you.

So obviously, as we've discussed, there are personal choices if you want to wear a bra to bed or not, that is totally fine.

The only thing I came across was that it may make you a little bit hotter at night to have that extra layer in that restriction, and that can decrease your melatonin, which we know to go a sleep.

But there's no large scale studies to actually support that either, so that is not as yet scientifically proven.

But the biggie is those myths about wearing a bra to bed at night increasing your risk of breast cancer or preventing sagging long term, None of that has any scientific research to prove at this point that that is true.

There is some suggestion wearing a bra, especially in underwire one, may impact your lymphatic drainage, but again no studies prove or disprove that that is just a theory that's been worked on at this stage.

And of course it can cause some skin irritations if there's heat and moisture building up under a bra.

But also for those of us who have boobs that aren't you know, perky high things, we know skin irritations can occur even without a brash.

That's right from the underside.

I see a lot of like contact dermatitis or have fungal infections in that area, and.

The under boob sweat can be very real.

Do you ever sniff it?

It's how how.

Do you like?

Sometimes I'm like curious, I'm like, oh, I'm sweaty.

I went to what that smells like?

Is that not a thought?

Like I'm presuming you sniff a finger after touching, because if you can get down that sniff like wow, it's.

Just like, oh I'm sweaty.

And then oh wow, that's just kind of like a sweet because of moisturizers that something.

Maybe I'm not sure, but it's a nice sweaty smell.

There you go, sweet stinky under boob sweat.

Basically, wear them, don't wear them.

It's kind of up to you and how you feel and what you're comfortable in.

Yeah, do what works for you.

Yeah yeah, But for me, when Hubby's in bed, I'm gonna wear it.

Bro don't be touching my bovies.

I need all of the things to protect me against any more babies, as she currently incubates one as we speak.

All right, it is check up time.

Next, we're talking about skin and weather.

You can actually reverse the signs of aging and can you really take back chicken neck?

It's time for the check up.

So mar in the last one hundred years or so has seen some pretty dramatic advances in technology where it comes to skincare and the products and services that we have in regards to turning back the hands of time.

Now, I do want to start this conversation though, with saying, neither you or I actually care a single bit about what you do or do not do, yep, in order to reverse the signs of aging, or all the things or none of the things exactly.

So if you are Earth Mother just allowing the elements freedom to do as they wish upon your skin, more power to you.

If you're also a queen who's had stuff done in your twenties to stop looking a day over twenty five, or you've had lots of other work done to look forty when you're seventy or eighty, like share for example, more power to you whatever you want to do and whatever makes you feel good.

The thing is, we've been taught to really harshly judge women who don't do anything and who do everything, yeah, and all of the ranges between that.

So we're going to talk about it today because it is something that we do deal with, and anti aging doesn't always necessarily mean the way you look either.

Taking care of your skin obviously is really important.

So, Marian, what do you say to someone who might speak to you about choosing, say, some of the more dramatic procedures, not using creams and serums?

Obviously?

Do you speak to people who are considering surgical intervention?

Because I understand there are some more guidelines in place now for people who are considering that, which is great.

So honestly, the leaps from serums to surgery, it's not uncommon, happens very frequent in practice.

As females, we can get frustrated.

You know, we've been using our fourteen cycle skincare regimen.

Nothing's happening.

We scroll past someone on Instagram and you're like, I want that.

Should I just do something bigger?

Instagram face was a thing for a really long time where we all essentially wanted to look like a version of the Kardashians.

I think it was like the base levels, and that required a lot of things to be done.

Exactly, and I'd say pause, not because you shouldn't do it, but because it's worth doing it the right way.

In Australia, cosmetic procedures are no longer the wild West they once were.

I'm sure you've heard a lot of things in the news about cosmetic procedures in the past, so it's good that we've got these regulations now.

So we've seen too many stories of botch jobs, unqualified providers and clinics that value speed over safety.

So the rules have changed and here's what's new.

So we have stronger guidelines in Australia and they're there to protect you.

So you need a GP referral for most surgical cosmetic procedures.

It's not gay keeping.

It's about having medical oversight and that's really important.

And does that include oversight into people who might be suffering from mental health disorders contributing to.

Yeah, exactly, because you've got people with bodies to small fear or eating disorders that are doing these procedures and just going to be worsening their condition.

Another part which is important just going on that is psychological assessments are now part of the process for certain procedures because your mental health matters as much as the result.

Right, practitioners must meet strict standards, use accredited facilities, and be transparent about risks, recovery and realistic outcomes.

And yes, marketing is now being very closely watched, so those flashy ads promising lunchtime nose jobs are undiscrutiny.

Yeah, that's the thing too.

When we're talking to you about these things, we have to be really careful in the language that we use because the TGA monitors all of the things that we talk about where it comes to specially surgical procedures and now others like anti wrinkle injection or fillers and things like that, we have to be very careful not to be seen to be promoting them.

So if it sounds like we're talking around things sometimes that might be why, because we've got to be careful about the language that we're using.

Yeah, that's exactly right.

So they're not hoops to jump through their safety nets, and in the long run, they help make sure that you're making decisions with clarity and not just impulse.

And I also wanted to talk about cosmetic tourism because that's massive.

I get a lot of patients coming in.

They do travel, and there's lots of funny things about Turkish teeth and a lot of men go.

Yeah, focus men in the plane.

Yeah sounds glamorous, like get a new face and a beach holiday while you're at it.

But here's the reality check.

Many people end up in Australian emergency rooms with complications from overseas procedures.

We're talking infections, poor healing, implant issues, scarring that needs to be corrected, often at your own expense.

So surgery recovery, let's be real, on a beach is not really realistic.

You're not going to be being cocktails by the pool while you're swollen, sore and trying not to sweat through your compression.

Yeah yeah, yeah, So just have a real think about that if you are considering.

If someone's thinking about something more dramatic like surgery, i'd encourage them to start with a great gp, especially one with an interest in maybe dermatology, cosmetic medicine or woman's health.

And again you can look that up online.

Your gps will all have bios, so you go and see what their special interests are.

They'll give you honest feedback.

They'd recommend safe for alternatives if something else exists, or refer you to a specialist if needed.

Choosing qualified practitioners really important.

If you do pursue surgery injectables, make sure they're properly credentialed, they're using license facilities, and make sure they prioritize your safety.

There's ongoing follow up and review.

It's not like you've done the surgery, see you lay and asking about that follow up care is really important.

So what happens if something goes wrong?

Who will look after you post operatively?

If the answer is vague, run that's a MYSIVE red flag.

Yeah, when you say find someone who's properly credential because there's people who say that they're cosmetic doctors, like what does that mean?

So we always recommend looking up the credentials of the person doing the procedure.

So for major surgeries in Australia, we'd always recommend going to a plastic surgeon, So a qualified plastic surgeon who's done training and is affiliated with the College of Surgery.

It's like the AFRO website.

Can you go on that, Yeah, you can check, but they should also have their credentials on their website.

Yeah, but you can also check that as well, because you know, some people do lie, which is.

Illegal, so it's good to check reviews because sometimes there might be complaints about exactors as well, so you need to make sure that's right.

And there are some doctors who don't have the plastic surgery training but fall under that cosmetic department and so they identify as cosmetic physicitions or cosmetic surgeons.

And you know, some are great, but obviously they don't have that expertise training and they're not affiliated with the college.

So I would just kind of err on the side of caution.

Talk to your GP, and it all depends on really what you're doing as well.

But for those major surgeries, we'd always encourage patients to see a plastic surgeon with appropriate qualifications.

Amazing, so do a little bit of research before you rush into anything.

So we are going to be continuing this conversation about skin and anti aging.

We are chatting to dermatologists doctor Kara McDonald next to find out what all those anti aging ingredients actually do and whether they're doing anything at all.

So Mariam I tasked doctor Kara McDonald, who is an amazing dermatologist who has also just quietly posted an incredibly confronting real recently on her socials, to give your heads up on what your neck might end up looking like if you keep following tanning trends, which are quite big on social media at the moment.

You've seen the vagina tanning trend.

I saw anal sonning and then that turned into volver sonning, Like you don't.

Do these ladies on the fills with their like legs open.

No, don't put your dinner out in the sun.

Please do not put your vulver out in the side.

There's a reason it exists where it exists.

I test her to rate, out of ten a range of very popular skin care ingredients that we commonly use in our fight against aging.

One that we hear about probably the most might just surprise you a little bit.

But I kicked off the chat asking her how much influence our mum and dad and their genes have on how our skin looks as we get older.

There is a comment that you will hear pretty regularly when it comes to looking at a woman who seems to have aged gracefully, which we obviously say tongue in cheek, because what does aging gracefully even mean?

If we look at someone who seems to have aged well, we always say, oh, she's got good genes.

How much does genetics play a part in how our skin ages look.

It's very hard to be exact and know a clear answer, but it certainly does play a role.

In general, you need all your ducks lined up to age well.

We obviously start with good genes.

We can start with genes that, for example, naturally protect us better from the sun, so we know that skin of color actually doesn't age as quickly in a sun environment like Australia as fairer skinned people.

Fair skinned people are not designed to be in the sun.

We are fair because we need to be able to get vitamin D and the nutrients from the sun from very small amounts of sun.

So when we put fair skinned people into a sunny environment, it's overwhelming for our skin, whereas darker skinned people can tolerate the sun.

So sun makes probably the biggest difference to our skin.

A genetics play a huge role in our general health and skin aging, and then all the other things we do on top of that is sort of icing on the cake, I think, but general health as well is often overlooked.

You know, sleep, stress, and nutrition.

Are the three big things, and that's obviously more environmental than genetic.

Do.

Skincare regimes anti aging regimes work the same for people who have darker skin as opposed to those who are fairer.

Yes, they do, but the needs of the skin can be quite different.

So obviously with skincare we're trying to target what each person's skin needs, not just be generic in what we do.

I always think of skin care as being much better at prevention than cure, although obviously it can correct some problems we already have.

Skin care is best in reducing or slowing down breaks on aging.

We just need to look at each person's individual skin and their skin type and skin color and work out what's best for them.

Oka.

Can I throw a bunch of the ingredients that we hear about in anti aging skin care quite regularly now, and I'd love you to rate it out of ten for me as to how effective it is in your opinion, and what is actually supposed to do.

So let's start off with the one that we hear.

Probably most often that's high uronic acid.

What does it do?

Out of ten?

How is it infighting the signs of aging?

In fighting signs of aging, it's probably a four or five out of ten.

It's a humectant, so it holds water on the skin.

It adds hydration, but it's probably a slightly overhyped ingredient because hyaluronic acid needs to be held into the skin to be effective at all, So on its own it doesn't do that much.

It's going to evaporate off.

If we include it in a lot of our other skincare products, it will actually hold that hydration into the skin so long as it is sealed in.

But on its own it doesn't do a lot, and in some people it can even be irritating, believe it or not.

Right, what about retinoids, things like vitamin A.

So the retinoid family, which includes written aude hide retinol I would give it a ten out of ten.

On the whole, it is definitely the ingredient that has the strongest evidence for reducing signs of photoaging, but most of that does come from the prescription form, but we can extrapolate that to the weaker forms which may be better tolerated for consumers, which are available over the counter.

The key to a retinol or a retinoid is to go slowly, go carefully, but go consistently.

We get more benefits with one year, two years, three years, five years with retinols or retinoids, So stick with them rather than swapping and changing and giving up every time you get irritation.

What about the family of antioxidants, things like vitamin C, vitamin E, green tea extracts, those kind of things.

Again, I would give them a pretty high rating, probably an eight out of ten, nine out of ten, even for some of them.

The problem with antioxidants is that they need to be stable, and you need to look for products that have evidence behind them.

Not all antioxidants are made equal.

The ones that work well and have good scientific data behind them work very well at reducing environmental damage to the skin by mopping up free radicals.

Because of that, they can improve the appearance of the skin and also reduce future signs of aging.

But you really need to find formulations that are scientifically proven, because just having those ingredients in your bottle does not necessarily do anything.

What about nice cinamide.

Nicinamide or this is one of our favorite ingredients.

I'd give it a nine out of ten.

Nicinamide has many proven benefits and it depends on your skin, but it can inhibit pigmentation.

It definitely helps with barrier repair, reduces inflammation, and offers some degree photo protection as well.

So the good thing about nicicinmid it's fiamin B three.

It's tolerated really by all skin types and all skin types will benefit from it a great ingredient.

What about hydroxy acids, So.

Beta hydroxy acid is salicylic acid, just to differentiate that, and it is a fat soluble acid, So that is a very effective ingredient for people who have congestion or acne prone skin because the fat soluble acid will basically track down pores, so it's actually going to find the oily part of the.

Skin, track down the poor and help unclog a poor.

So beta hydroxy acid is fabulous for congested or acne prone skin.

Alpha hydroxy acids are.

Water soluble and they will more be an exfoliating ingredient to help strip off the dead, non functioning layer on the surface of the skin, but also stimulate your own high lurronic acid, So they are again very effective.

You need to be careful not to overdo.

It because a lot of people get in trouble with causing an irritant dermatitis or inflammation by overdoing the acids, but used carefully, excellent ingredient, probably a six or seven out of ten.

What about seramides, So, seramides are a natural lipid that exists in the skin and really is instrumental critically in our skin barrier.

People who have naturally dryer skin exmaprone skin, are lacking in seramides, so seramides are very important for those people.

They can actually replenish the natural lipids in the skin to help improve our skin barrier and reduce the water loss what we call transipitent water loss from the skin.

So really they're acting like a barrier stopping the hydration coming out of the skin and stopping the irritants from the outside going into the skin.

Nine out of ten.

Next, I want to move away from more typical things and look at more procedures now, so a lot of people are now looking at laser therapy.

What exactly is laser therapy doing and is it a good option for people?

If they're dealing with, say, deep wrinkles, et cetera.

Great question, So lasers are a big topic.

What lasers are is that they are technically a single wavelength of light, and that wavelength of light will penetrate at a certain level of the skin to target a specific target in the skin.

So for example, we can have something called a vascular laser and the wavelength of light it's essentially a green light, and it's looking for a red pigment.

So that's why they're very specific.

They're going to basically leave the rest of the skin alone until they find something red, and then they're going to cook the red thing.

Okay, if you've got a pigment laser, they're more targeting brown kind of colors and they're going to leave alone a lot of the rest of the skin, so they're not going to burn or damage the rest of the skin at the right settings, they're going to look for something brown and deliver their energy into the brown pigment.

So that's why lasers are quite specifically targeting certain things in the skin, and we need to make sure that we're using the right laser for the right indication in each patient and the right skin color when you're talking about using it for wrinkles, So we're looking at more targets where we're often targeting, say water, because water is obviously throughout the skin, so we can really burn anything in the skin with a laser that's targeting water.

And then we're using these.

Lasers for a very controlled burn essentially, So I like to describe, for example, a fractional CO two laser, which is probably the one that's been in social media a lot lately and being promoted for treating wrinkles and fine lines and acne scarring.

So if you think about it, it's like, if you have the skin, you're creating millions of tiny little burn holes into that skin.

So you can burn a small, deep column of skin.

But because every little burn hole you make is only a fraction of a millimeter or a millimeter deep and thick, each one of those holes heals very quickly without.

So much risk of leaving a scar.

They are extremely effective, But there's a big butt here.

The problem with is that it's not so much the device you're using, it's the operator that's going to determine which results you get.

And the result you can get from a laser can be anything from completely underwhelming I don't even know what I did to causing severe complications because you've overcooked the skin and caused a scar or a burn.

So lasers require a lot of training, a lot of expertise, experience, nuance with different people, nuance with different skin types.

But they are great when used well by the right person in the right person.

What's the difference between getting laser therapy and using say an LED light mask?

Very different, I mean huge difference.

So one, an LED mask, which is a light emitting DIDE is usually a red or infrared light wavelength, so this is a visible light, but it's not a laser, which has only one wavelength.

So as I was saying with lasers before is that they're designed to penetrate through certain tissue to get to a target, whereas LAD mask is a kind of group of wavelengths of bright light, but it's not going to do damage.

Okay, So the problem with a laser is that it delivers enough energy that it can damage something.

That's kind of the point of it.

But if we're specific enough, we're damaging the right thing.

So if we're treating red blood vessels broken capillories, we are actually cooking those tiny little blood vessels under the skin so that they disappear, whilst not delivering too much heat around it to damage the other tissue.

With a LED light, we're actually trying to deliver energy to the skin, and it's been shown that our mitochondria in particular can use red light near infra red light as an energy source.

So if you think about LAED lights, they are delivering a kind of energy to stimulate the skin.

They stimulate our mitochondria, we hopefully produce more collagen.

We definitely know we can heal faster if we use an LED light, so they are more a stimulation versus a laser, which is technically causing damage.

Can we talk about injectibles, So there's a lot of people who now are talking about using injectibles as a preventative rather than treatment for say crows feed or forehead wrinkles or whatever.

But then there's people who say, but if you start using this stuff too young, you're actually causing an issue down the track that you maybe wouldn't have had had you not used injectibles.

How do we navigate that.

Should we be using only for treatment or should we be using as a preventative great question.

I'm going to preface this with just saying that in Australia we're limited in what we can say about injectibles by the TGA because they are a prescription only medication, But we can talk about them in an educational capacity so long as we present a balanced view.

So I'm certainly going to try and do that.

Let's look at Andrey wrinkle injections because they're the ones that most people talk about using it as a preventative mechanism.

What anti wrinkle injections do that will give us anti aging benefit is two main things.

One is that they treat dynamic wrinkles, so they are the wrinkles we see on our face from moving our muscles.

The classic one is our globella line, so our frown line between our brows.

When we frown, when we look angry, we'll.

Create a line there and it gives us a wrinkle over time in most people.

Crows feet are the other ones.

They come from more smiling or squinting, and they are literally wrinkles caused by muscle contraction.

Now, if we look at people when they're younger and they don't actually have those lines yet, if they are very strong in those muscles, or you look at their mother and they've got deep wrinkles that they haven't been able to address because they weren't treated early.

You can certainly target those strong muscles to try to weaken them or reduce them so that they never develop those deep movement lines.

That is very effective.

But if you take away all movement in some areas, those muscles can actually shrink down and down over time and actually give a slightly aged appearance.

So if you look at someone that's been having muscle relaxant injections for a long time, they sometimes have this almost shiny, thin looking skin, and that's often because they've actually lost that muscle underneath the skin.

Their skin sort of has lost its normal function, and the skin looks aged before it's time.

So I'm not against targeting strong muscles in younger people if they are looking like causing deep wrinkles, but I try to do it with a moderate dose so that it's not over frozen.

You don't want to take away all movement.

And one of the biggest problems I see, especially in young people, is that they think if they've got any movement at all, that's a wrinkle, but a wrinkle is only when you see it when you're not moving.

Being able to move your forehead and frown a little bit and have some movement that's not a wrinkle, And so it's really important to educate that movement is okay.

So it's about trying to stop them being so strong in a muscle that they're going to have a deep wrinkle they can't fix later without letting them get frozen or shiny too soon.

The other thing that anti wrangle injections do, which is often overlooked completely, is that they can treat the depressive muscles in the face.

And what I mean about that is that our brows when we frown, not only do they go in and give us a line, but they go down they give us saggy eyelids.

Our mouth.

For example, when we frown, not only does our mouth turn down we look sad, but it actually gives us jows and sagging in the jawline.

When we contract the neck, it actually pulls the whole face down and gives us sagging.

So a lot of people think that our saggy faces in our fifties and beyond all due to gravity and laxity and sun damage.

But a lot of it is just due to the strength of our facial muscles that pull down on our face the whole time.

You have a balanced approach, what you should be doing is actually weakening some of the depressor muscles that are sagging you, especially in the appropriate person who has very strong depressor muscles.

Your injector should be looking at.

Do you have strong depressor muscles?

Can we target them because they actually make us look older than our wrinkles do in later years.

What are the side effects of anti wrinkle injections that we need to be aware of the.

Thing about them is that they wear off, and so it's very unlikely to ever have any cases of permanent issue from anti wrinkle injections.

The main side effects are too much, in which case you end up with heaviness where you don't want it, so frozen forehead but heavy brows, can't lift your eyelids, and as I said before, overdoing it so you see skin changes.

But most of the side effects are reversible and temporary at least, so.

The same for fillers.

I know a lot of celebrities who are very filler obsessed to have decided that that's no longer a thing that they want to be, so they're allowing them to dissolve and float away, but are there long term implications?

So most of people get filler in their lips, and I'm just wondering, like, over time does that stretch your lip skin?

If you do want to reverse it, what is that actually doing while it's in there?

Again, there's been a lot of negative talk about fillers.

A lot of people, you know, put off fillers, blaming fillers for all sorts of things, saying.

Filler here or filler there is terrible.

They had to get it dissolved, And sadly, it's not the filler that's the problem.

That comes down to the injector.

It's the operator again.

Again, and the right amount in the right place.

With the right product will extraordinarily rarely cause your problem.

Most of the problems people are having are because many injectors have a fairly limited skill set.

Often it's cheeks and lips, and so people go and what do they get?

They get cheeks and lips, and they might look okay the first time, and then they go back for some more because they think, oh, you know, feeling a bit old again.

What do they get?

They get cheeks and lips?

And then they get cheeks and lips and it doesn't take very long before you start to look a bit odd.

And then, of course the feler can also cause problems.

The reason it causes problems is because there's too much in any one.

Place, or the wrong product or the wrong layer.

So that's when we hear about migration, we hear about swelling, we hear about puffiness, we hear about issues with overfilling, and generally it is repeated treatments in the same area causing the problem and or the wrong area treated in the first place with the wrong product.

So Mariam I did speak to doctor McDonald about navigating sunscreen because it's become quite difficult in recent times.

We're getting a lot of mixed messages about it from not actually being the correct SPF as it's telling us it is on the bottle.

There's also this idea being spread online that it's sunscreen that causes cancer, not prevents cancer, and we're going to hear about that in an upcoming episode.

We are going to focus in a little bit more on skin cancer itself.

So spoiler alert, the benefits of using sunscreen far outweighs any issues that there may be so, but we'll get into that more when we speak about.

Looking forward to that chat.

Bottom line is your genes matter, but it's really the sun doing most of the damage to your skin.

So good news is you can absolutely do something about that.

And when it comes to all these fancy treatments and procedures, remembering that it's not so much about what's being used, but who's doing it, and that's so important.

Having a skilled practitioner with the right approach will always beat the latest trendy treatment.

Don Poorley exactly right.

Okay, Quick consult time next Today it's from an anonymous contributor.

She wants to know about going to get her downstairs checked out if she's never used them for sexy time with a partner.

It's time, Marriam, let's do it.

Let's get into today's quick consult.

Welcome us in please.

The doctor will see you now.

Just through here to consort room one.

Thanks for waiting.

How can I help you?

Alrighty?

We are taking your questions to find out what general advice.

The word general is very important there.

It's not specific to you.

Go speak to your own doctor.

That our good doctor Marriam here can impart for you to take your own health care into your own control and then take it to your doctor and figure it out.

So today it is a question via our anonymous waiting room.

I'm a forty nine year old woman who has never had sex.

I wanted to, but life just never happened.

Should I be seeing a gynecologist to check on my health though my friends talk about getting PAP smeares, etc.

Or more broadly, should I see a gynecologist and if so, how often?

What can they share that's different from my GP?

Great question.

A lot of people think about it, but never really say it out loud, So let's get into it.

Just because you haven't had sex doesn't mean you should think about skipping follow up for your reproductive health.

In Australia, GPS your first port of core for women's health concerns, So think cervical screening previously known as PAP smears.

Contraception, Yes, even if you're not currently using it or having sex.

We use contraception for other purposes like heavy periods, painful periods, menopause, perimenopause chats, weird periods, pelvic pain, and all the stuff you'd be googling at midnight about your for JJ.

This could be anything from dermatitis on your volva to clitteral adhesions that we talked about a little while ago, all sorts of things.

Yeah, you know, ovarian cancer.

Like, there's a billion things happening in there that aren't related to Heaver having had sex before.

Right, that's right, And most of the time, if everything's tracking normally, you don't really need to see a gynecologists.

Often.

That said, gynecologists are experts for a reason.

They go deep, literally and fleurichably, into reproductive health.

They're the people you'd see for more complex or specific concerns like persistent pain, normal vaginal bleeding, suspected conditions like endo or fibroids, for instance, or if something just doesn't feel right down there and your GP wants an expert opinion.

There's no rule that says you see a GUANO on a set schedule.

It's more of a when needed kind of thing.

Your GP can absolutely help you figure that out and when a referral makes sense.

If you want to skip the GP and go straight to the gynecologists, you can just keep in mind you'll need a referral if you want that medicare rebate.

If you'ren't your where to start.

Here's what I'd suggest, Book a well woman, Check with a GP, ideally one who has a special interest in women's health.

Check their bio online, bring your questions.

Ask about cervical cancer screening, remembering that we still encourage you to do it even if you haven't had sex.

Oral sex also counts any concerns you've got, even if they feel small, and whether seeing a gynecologist would be useful for you.

So whether you're twenty nine, forty nine, sixty nine or anywhere in between, and whether you've had sex or not, your reproductive health matters.

So never too late to check in with your friendly GP.

Can you remember the first time you did an exam on a woman, because I imagine it would be fascinating to see how people's structures are, because not every woman looks the same, right, So can you remember what it's like looking in there and suddenly discovering all of that?

Yeah?

I do, but I've seen so many cervixes and vaginas that like it's just the.

Whole range, Like you haven't committed any of us to memory.

No, no, but it's interesting, Like I have young patients and then you've got ladies well and truly heading towards seventy and things start to look different down there.

But it's beautiful.

It's all part of the process.

No judgment.

We're not judging your cervix, I would hope not.

Thank you so much for standing in your questions, and thank you for spending some time with us and the good doctor Marriam here today.

We'll be back next week to talk more skin.

This time we're talking all the itchy and scratchy stuff, which is something I will be very invested in as a very itchy, scratchy person in general, so things like xmera and psoriasis and all that kind of business.

If you do want to chat to doctor Marriam or myself, I mean, I can't give you any kind of helpful advice, but we can chat.

You can do it in a few ways.

We have a waiting room, you can be anonymous.

You can chuck in a question.

It's like our online form.

The link to that is in our show notes.

Email us well at mamma Mia dot com dot au, or have a little chatski in the dms of Instagram.

Just so you know, this discussion is for general information only.

And is not medical advice.

Cosmetic injection procedures are prescription only and must be discussed with a qualified medical practitioner.

We don't endorse or promote any particular product or treatment.

Always seek professional medical advice before considering any procedure.

Have a top stay.

We'll catch you for your appointment next week.

Bye Bye Well is produced by me Claire Murphy and our senior producer, Sally Best, with audio production by Scott Stronik, video production by Julian Rosario, and social production by Ellie Moore.

Mamma Mia acknowledges the truetional owners of the land.

We've recorded this podcast on the Galligill people of the Urination and the Wannaroa people.

We pow our respects to their elders past and present and extend that respect to all Aboriginal and Torrestrat Island are cultures