The Melanie Avalon Biohacking Podcast Episode #161 - Dr. Sheryl Ross

TRANSCRIPT

Melanie Avalon: Hi, friends, welcome back to the show. I am so incredibly excited about the conversation that I'm about to have. So, a little backstory leading up to this conversation. I guess, I should start by saying, I really loved my upbringing and I'm so grateful for my parents, and my school, and honestly, the majority of what I experienced in life. But I have always thought that if I were to change one thing about my upbringing, it would have been the approach to sexual health and wellness growing up. I grew up in a very Bible Belt Christian South community. So, sex was a topic surrounded in shame and guilt, and even the concept of going to a gynecologist, I didn't. And I don't know if my friends did either, because there is this whole idea that, I guess, going to a gynecologist would, I guess, encourage kids to be having sex, I guess, was the idea there. 

Since then, where I'm at now, I'm so, so passionate about sexual health and wellness. And not just my upbringing that whole concept, I think, culturally, there's still a stigma that saturates society and ongoing, like I mentioned, like a shame surrounding the topic and I just think we need enlightenment and empowerment for women to take charge of their sexual health and wellness. And so, I've been wanting to do an episode on this. 

A mutual friend, Dr. Caroline Leaf connected me to Dr. Sheryl Ross, who is honestly the perfect person to have this conversation with. She's a legend in this world. She has two amazing books. The first one is called She-ology: The Definitive Guide to Women's Intimate Health. And then she has She-ology, The She-quel: Let’s Continue the Conversation. She's definitely a celebrity gynecologist. She has many celebrity clients, she's been all over the news, so many different platforms, and TV, and we'll put more about her bio in the show notes. I read the books and she covers so much and I have so many questions. So, Dr. Ross, thank you so much for being here.

Dr. Sherry Ross: Ah, thank you for having me. I love to discuss these topics. I'm so glad you asked me to be on your show.

Melanie Avalon: I'm really, really excited about this. And we've talked before this, we are both fellow Trojans from USC. So, that's very exciting. To start things off, your personal story, I don't know how common it is that people, like, when did you want to become a gynecologist? When did you first become interested in this whole world and this whole topic? I feel it's not that common for people to want to turn to their career. So, what was your story that led up to this?

Dr. Sherry Ross: Well, my dad was a doctor. I used to go Sunday mornings on rounds with him. And so, I was exposed to medicine from an early age. My uncle was an orthopedic surgeon and just felt like medicine in some way to give people hope, and direction, and give as a career felt really empowering to me. And wasn't because of the "jelly doughnuts in the doctors lounge," which my dad would say was the case. But I really love the idea of medicine. And I hadn't really chosen the specialty. I always thought it was pediatrics. But women's health, first of all, it was really happy based, since you were delivering babies and they really weren't too chronically sick. So, it felt like a profession that would be really rewarding in a lot of ways. And would be more on the happier side of medicine and not chronic illness. So, that's how I chose medicine and then chose OB-GYN.

Melanie Avalon: I'm actually super curious just in the trajectory of your career, speaking to what I was just talking about with the approach to female sexual health and wellness. From the beginning of when you started practicing until now, have you seen a lot of changes in knowledge and just how women, like, freedom and speaking openly about all of these issues? Because maybe I'm biased with my upbringing, but I still find that there's secrets surrounding all of this and I don't know why.

Dr. Sherry Ross: Well, I'll tell you, the answer is a yes. There's been such a change in focus and mainly interest, because I think the last couple years with Black Lives Matter and the MeToo movement, just every area of women feeling marginalized has come to light. The politics of the day. Another way that women have been thrown backwards, silenced, felt embarrassed, felt less than. And I think the sexual part of all this and the sexual awakening has come on stronger than ever as well. Women have a lot of needs to be heard, they have a lot of questions, because we have been made to feel shameful of a lot of things about ourselves, and our bodies, and whether it's been an ongoing cultural keeping us suppressed, or what the issues have been. We just have questions and we want answers. And I think there's just a huge movement for changing the narrative, changing what is been the norm. And that's really exciting to see that. Despite feelings getting pushed down. Roe v. Wade, I think is the best example of that. So, yeah, there's an interest, there's a need, there's a desire, and there's a will by women, and men too, to be good partners.

Melanie Avalon: Something you mentioned in your book that blew my mind. There was a proposed bill at one point to ban the word "vagina." Is that correct?

Dr. Sherry Ross: Yeah. It was back in 2012, they were discussing cases on the floor, the government. Well, it shouldn't surprise you, in Midwest, to say the word vagina on the floor passing a bill was a no-no. It really speaks to what's happening in our world. I think for us in today's world, and I'm of course in California, so, I feel very liberal state. But when you hear what's happening in Texas, Missouri, Ohio, Florida, it's shocking to how women are second class citizens and everything surrounding our bodies. Talking about the vagina, wow. Talking about pregnancy and women's choice, it's not okay by so many people. And to me, it's just shocking, and there's really no getting equality amongst men in positions of power is, it's so obvious more than ever that we need to fight stronger now than ever.

Melanie Avalon: I recently had Dr. Laurie Mintz, on the show and she wrote a book called Becoming Cliterate. And we had a lengthy discussion about even the word "vagina," how that's an issue, because we don't even have different terminology to describe the different, like, the setup down there. And we basically call everything the vagina. I've been super aware of that recently. I'm like, "Am I calling it the right thing?" In any case, I guess again, going back to the way I open the show, it never occurred to me to be seeing a gynecologist growing up. So, what should the appropriate timeline of seeing a gynecologist actually look like? When should kids even start seeing a gynecologist?

Dr. Sherry Ross: Well, it's a great question. A lot of it too now depends on the pediatrician, because a lot of pediatricians are doing adolescent medicine, they feel comfortable with their doctor. Some as soon as you get 12, 13, or you get a period, they're punting you over to the gynecologist. So, 13 to 15 can be an age that's recommended to see a gynecologist. Mind you, you're not going for a pelvic exam. At least, most gynecologist know, you don't really need a pelvic exam. It doesn't even have to be an exam. I like to meet that age group and just sit across my desk and have a conversation with them, so they feel comfortable. It's about establishing a relationship. That's really what it's about. And then easing into coming back and showing them how to examine their breasts, and showing them taking up the mirror, and going over their vulva, and talking about all their lady parts, and using the right terms and the name. This is all part of this vagina revolution, or vulva revolution. 

We, as healthcare providers, as mothers to daughters, as godmothers, as best BFFs to daughters of our friends and so forth. We need to start teaching the right terminology, so that this group of women, the next generations learn their what is down there and what they should know about all those areas. Seeing gynecologist at 13 to 15 can just be meeting, can be going over anatomy. And, yes, we'd get closer into periods, of course, so we talk about-- As far as sexual issues comes a little later, but you always want to be a good resource for this group of young women, because sometimes moms aren't even comfortable talking about their bodies, and what's normal, what's not. So, it's a grassroots movement truthfully, Melanie, of how to me the gynecologist is so important in the life of a newbie to the gynecologist.

Melanie Avalon: I think, especially, because I feel I was slighted and I'm like, "Oh, this is an education I should have had." And also, because you mentioned it just now, but you talk about a lot in the book. And that is that relationship that you formed with a gynecologist. It reminds me how with a therapist, maybe you don't need the therapist for any acute issue right now, but it's nice to have one in your life ongoing. And then if something does come up, now, you have that relationship there. And so, I feel like, "I need a gynecologist relationship in my life for when these things come up."

Dr. Sherry Ross: It's sometimes hard to find. Even you're searching through your health care provider book, and you want it to be a network, and you're not getting good referrals from your girlfriends. I find the Yelp reviews to be really helpful. I do. I find them to be so helpful, as far as picking one, because 50% of women never talk about their vulva or vaginal health with anyone. Not even their health care provider. We have a broken system. The average time a doctor spends with a patient is seven to 11 minutes, that's not very much time to really dive into any sensitive issues. So, it's really no wonder that 90% of women think we need better education surrounding our vulva and vagina.

Melanie Avalon: We definitely, probably should establish this. So, vulva versus vagina, what do they mean? 

Dr. Sherry Ross: Yeah. Well, it's true. The vagina used to be what we would just call anything below the belly button, and it was confusing, because it led to other issues as far as cleaning your vagina. Really everything on the outside, everything that has the lips, and the hair, and where the urine comes out, and the clitoris, and the hood, and that's the vulva. That's the external genitalia. That's vulva. And that's really where all our issues come from, whether it's itching, or dryness, or our sexual health, of course, comes from the clitoris, and the erectile tissue, and vaginal opening, and some people don't even know what hole where the urine comes out of. I love seeing this group of women, the young ones and being like, "Hey do you want to just take a mirror and look?" 90% will say yes, and they're fascinated, because it's so important to know what is going on, what's normal, because if you don't know you're normal, you won't know you're abnormal. I find it very, very important to do that exercise. The vagina is really just the area, the cavity that leads to the cervix and the uterus, and that's where the baby comes out of is the vagina. So, it's very important to know those. The separation of church and state for sure. 

The vulva is important to know. And if you haven't, if all your listeners, Melanie, haven't taken that mirror, and taken a look, and believe me, I pull it out to my 50, 60 year old women, and they've been like, "Oh, I've never looked down there." So, I don't want your listeners to be one of those women that haven't taken a look.

Melanie Avalon: Basically, when we say vagina, that's the sexual reproduction part. But everything else vulva or the external. It's interesting, my personal experience with the mirror thing, because I identify-- It's like I don't want to look and I think it's just come from my upbringing. It's a very visceral shame type feeling. So, I've been very fascinated by that and would love to resolve that.

Dr. Sherry Ross: It was so much post-traumatic stress around the vulva. This is just a source of an issue, where we're also trained to-- Think about porn and social media, and beauty. A lot of women don't like their vulva. A lot of them think something's wrong. And maybe their partners have made a comment. When I wrote the #PerfectV, which was about looking at your vulva, one of my little 17-year-old patient said, "Oh, my boyfriend told me my cooch wasn't sexy and I needed to do something about my oversized lips." And I was like, "What?" We look together with the mirror and everything was normal, because a lot of us are so influenced by what we hear, what we see, we all want Jenna Jameson vagina lips like on porn, or Stormy Daniels, or whomever. We're very much affected by what we're hearing. And, of course, it's wrong information. I always say, no two snowflakes are like. Well, that's the same with your vulva, the lips of the vagina, the inner ones and the outer ones. They're meant to be different and asymmetrical just like balls. Testicles too. Some people don't think those are so pretty. It's everything that comes in twos usually has. They're never identical. There's always some asymmetry in some way and not equal in their appearance. 

Melanie Avalon: Breast, too?

Dr. Sherry Ross: Yeah, breast, everything, everything that's in pairs, and breasts are a good example of that. We all wonder, we all have a lot of curiosities, because of cultural and religious issues that we've all been brought up by our parents who they have their own issues surrounding sexual wellness, it really gets passed on with a vengeance. I find that in 2020, the millennials and the Gen X, there's a lot more like, "Hell, no, we are not--" This is stopping. Status quo is changing and we are changing this narrative, and everyone's leaning into it. It's such a great thing. The majority, and we have this little minority that's controlling other issues like Roe v. Wade. But again, I really believe the majority here will prevail.

Melanie Avalon: Speaking to the "normal," so how intuitive is that? Because I know, for example, you talk in your book about one of the most common problems we can have down there is yeast versus bacterial infections and a lot of women think automatically, it's yeast. But we should check, because it often might be bacterial, for example. Just stuff that we can experience down there, is it intuitive? Will we know if something's off or is it possible that we have no idea? 

Dr. Sherry Ross: Well, you think you have an itch like, "Oh God, I have yeast." You either going to get MONISTAT and CVS or you're calling your doctor. And because it's an itch or scratch, it really may not even be an infection at all. Classic yeast, you're going to have itching, you're going to have a white, thick curd white discharge, and maybe some redness, but the truth is, that can be bacterial and it's a completely different treatment. In a perfect world, you have an itch and it's not because you've been bicycling or spinning intensely for the last week or have other reasons to have discomfort, maybe you've been on antibiotics, or maybe you have a new sexual partner, because that can bring on either yeast or bacterial infection. If you can, go see your doctor and get cultured, that's going to be your best. 

I am impressed with some of the over-the-counter test kits that you can buy now that can maybe detect yeast or bacterial presence. Those sometimes can be helpful in calling your doctor like, "Hey, I can't come in, because I'm working," or, "I can't get an appointment." Sometimes it's not a bad alternative. Sometimes you just don't know. You think you know but you don't always know what that itch means.

Melanie Avalon: This is just a quick rabbit hole question. Is it true that cranberry juice is good for urinary tract infections?

Dr. Sherry Ross: Yes, it can help. It can definitely help it. There are better things. Let's say you don't want to get on antibiotic. The truth is if you have a true bladder infection with the most common bacteria, E. coli growing crazy in your urine, you're going to need an antibiotic. You can drink cranberry juice, take the cranberry tablets, but it's not going to treat it. That's so important to know that. D-mannitol is a great way to prevent UTIs. I would vote for that. Before cranberry tablets you can get it over the counter now. It's fantastic. Cranberry tablets is not my go-to, but if anyone has burning with urination frequency that they have to pee and only a little comes out, they've been with the new partner or they are masturbating with something inside the vagina, all these things can disrupt the pH balance and it can push bacteria E. coli into the bladder, which is the most common bacteria. And you do need an antibiotic for that. So, that's important to be aware of.

Melanie Avalon: Well, I actually got a whole new appreciation recently. You were talking about the itch-scratch or scratch-itch cycle, because I'm very food first and holistic and as much as I can like to use "natural remedies." But I recently got-- It wasn't on my vulva, it was on my elbows. But it was some sort of rash. I realized just how important it was to have a topical steroid, because if I didn't stop that itching, it was not going-- scratching. It was quite possible that I resolved whatever sparked it, but until I stopped scratching it, it was not going to heal and I was like, "Oh, okay, this is a perfect example of the very appropriate use."

Dr. Sherry Ross: That's my itchy V right there. I think we have to realize that the balance in life is really important. I don't care what we're talking about, but balance in general. And the thing is, there's the pH balance of that area, vulva-vagina is super sensitive. We start to look at little things that what can cause dryness. You use the wrong bubble bath, or the wrong soap, or you're taking an antibiotic. That just throws off your pH balance and it can lead to irritation, infection, dryness, burning. And not even with no yeast or bacteria, just dryness. I am so all about treating our vulva with the same feminine hygiene routine as we do our face, because that area is equally as sensitive. You have to clean it, hydrate it, moisturize it with the same love and attention we give our face. 

We don't think about it that way, but I'm trying to create this movement, because if you do that, if you are hydrating your vulva, you're not going to have the dryness or irritation. Certainly, you need products that are made for that area, but itching and dryness and burning, those can come up from dry skin. That's might have been what you had, using over the counter 1% hydrocortisone is fine. It's totally fine. But how it overlaps and affects your ability to work out, how it affects your ability to want to have sex or masturbate, because of the irritation on the skin.

Melanie Avalon: And speaking to the cleaning. So, two questions. I bet you get asked this all the time, but they say the vagina is "self-cleaning." Is that a thing?

Dr. Sherry Ross: Yeah. That's totally one that I get all the time. This is part of a lot of the questions is that, if you think about the vulva-vagina like a self-cleaning oven, the oven is self-cleaning, but you still have to clean the stovetop. That is how I like to refer to it, because as to we started in the beginning of this conversation, we used to call down there, vagina. Everything was vagina. Well, vaginas are self-cleaning, like tears in your eyes. It does the discharge inside the vagina, keeps it clean. So, that's why we don't like to douche, because if you do that, that can get rid of this great community of bacteria inside the vagina itself. But the outside, ladies, the vulva, the labia menorah, the labia majora, that's the vulva and the clitoral area, the clitoral hood, where the urine comes out, the urethra opening, that needs to be cleaned. There are products that are going to be better than others. You want to use products that are vagina-vulva friendly. It's important. I'm all about using extra virgin coconut oil to hydrate and moisturize the outside of this vulvar area, lady menorah and majora where a lot of itching and irritation comes from. So, it's very important to prioritize cleaning the vulva.

Melanie Avalon: I use just completely unscented plain castile soap. Is that okay to use?

Dr. Sherry Ross: It's probably fine. Yeah, if it's unscented. I don't know, if it's drying to the skin, but there are a lot of certain gentle non-fragrance soap that you can use. Taking a bath with 20 minutes with a handful of extra virgin coconut oil is very hydrating to the skin and its antibacterial effect, too. So, non-scented soaps, Dove's a good one, as well.

Melanie Avalon: And how about coconut oil as a lubricant? I remember the first time I tried it for that and I was like, "Oh." I was like, "Why have I not been using this?"

Dr. Sherry Ross: Oh, the clouds part usually with itch. 

Melanie Avalon: I know. I was like, "What is happening? This is amazing."

Dr. Sherry Ross: Yeah. I think it's great. Actually, if I had to bring one product on a desert island, it would be extra virgin coconut oil.

Melanie Avalon: So many things you can use it for.

Dr. Sherry Ross: Oh, my gosh, it's so great. Yeah, it's a great lube. You can't use it with condoms. I think that's the only downside, because it can affect the integrity of a condom. You have to be careful with that. But if you're in a steady relationship and you just want a good lube-- Everyone loves lube. That's another sort of taboo that people think using a lube might mean to your partner, you're not getting as excited, or they're not doing their job right. But it just makes sex so much better. Lube feels so good on the vulva. It's a win-win. Guys like it, too. Guys love it.

Melanie Avalon: Does wetness correlate to level of arousal at all? Are there so many factors that are affecting wetness that you can't really make any judgment?

Dr. Sherry Ross: Yeah, that's another myth because not everyone gets as wet as others. It really doesn't. Some degree of lubrication and wetness does show that you're being stimulated emotionally and physically. Our path to getting where we need to go is very different than guys and it can take a long time. It's one of those things that it doesn't necessarily mean, because you hear how some of your girlfriends get so wet and it's like a lake down there, but not for everybody. It doesn't always equate.

Melanie Avalon: You mentioned in passing earlier, you're talking about swimming, and biking, and things like that. Something that has haunted me for a very long time. When I was young, my grandmother made a comment at one point about the dangers of biking, because of how it would affect my lady parts. I have wondered to this day. Was that cultural or is that actually an issue? And you do talk about how biking and things like that might an exercise can affect everything. So, do we need to be concerned as women with our activities, our exercise?

Dr. Sherry Ross: I've wrote a chapter called The Sporty V. Again, the vulva is very delicate and temperamental. It can be affected by everyday exercises, whether you're spinning, or cycling, or long bike rides, even horseback riding. You can have saddle injuries. Some women who bike ride a long time get numbness of the vulva, and men, too, actually. It's true that that can actually happen. But it's not going to permanently make you have problems having an orgasm and so on. I think if you're going on long bike rides or you're sitting and spinning and have discomfort, it's good to take a bath afterwards, with extra virgin coconut oil, it's good for just ventilating anyway and moisturizing because that constant pressure on the vulva can cause irritation, numbness, and cysts. It's true that at that moment, but it's not lifelong. I think your grandma might have also contributed to some of the myths that we're hearing about and learning in our later years, how it's affected us emotionally instinctually.

Melanie Avalon: I just remember she seemed very, very concerned about it. You just spoke about the constant pressure and stuff. This is a broader question that I've wondered for a long time. I'm really fascinated by the evolution of the human species and how so much of our bodies is all really about having a baby. It's about fertility and reproduction, and that's the end goal of our bodies from an evolutionary perspective. I know fertility and infertility is a very nuanced, complicated topic. Do you know if there's any relation to a woman's fertility or how late in life she can have a child or how early she enters menopause based on how much sexual activity she's been having? Does the body interpret having sex a lot is keeping that system going or is it a completely separate timeline not related to what we're doing?

Dr. Sherry Ross: Yeah, I think to sexual activity, I don't think it has a play. We talk about the number of ovulations a woman has, if they're on the pill. Does that affect fertility? The thing is, we're born with hundreds of thousands of eggs. By the time, we're really able to use them, there is a timeline. The biological clock is just true in general. I think that's more relevant than how often or frequently we're having sex.

Melanie Avalon: Okay. If a woman has amenorrhea and is not releasing eggs, does that push back timeline at all or what happens to those eggs?

Dr. Sherry Ross: Amenorrhea is where you don't get a period. You have to look at the causes of that, because there can be many. If you think about it, some women who are on the pill have amenorrhea. That's known side effect, which can be normal. Or, you can have an IUD and you cannot have a period, and that's amenorrhea. Those amenorrheas are okay. But the kind that you're talking about is, it's usually if you don't ovulate, you may not get a period and you might hear your friends like, "I haven't had a period in a year." That's really not normal. That would not be normal. I would want to separate if you're on the pill or some people who have Nexplanon, or on certain medications, or Depo-Provera, they may not get a period and that's something that we're causing as doctors. It could definitely affect your fertility. It would be a bad sign for your fertility if you had amenorrhea that's not caused by anything.

Melanie Avalon: For women on the pill who have amenorrhea from that, what is happening to those eggs? Are they just sitting there?

Dr. Sherry Ross: Well, yeah, they're sitting there. If you think about it, the pill, it's meant to make you not ovulate. That's its mechanism of action. That's how it works. If you bleed each month, that's a separate issue. But everybody on the pill by definition is not ovulating. Where that helps is for ovarian cancer, it helps if you don't ovulate on a lot. So, it's a protective thing. If you want protection against ovarian cancer, you go on the pill. It does help that as an example. But it really doesn't have a place with fertility.

Melanie Avalon: Do you know why that is with the cancer connection? 

Dr. Sherry Ross: Well, it just has to do with ovulation, the use of the ovary. How much it's working? If it's not working that much, that's a good sign.

Melanie Avalon: That's what I was wondering. 

Dr. Sherry Ross: It's a good sign for that ovarian and it's the future statistic for getting ovarian cancer.

Melanie Avalon: Well, speaking of eggs, how do you feel about egg freezing, and who should consider that, when should women consider that, is there a timeline for when it's too early, too late? I feel I should probably look into this.

Dr. Sherry Ross: I love egg freezing. I just think it's the best form of family planning that you can ever, ever have in your life. It's really taken family planning into a whole new conversation for egg freezing and we are seeing it so often now, which is great. Or, at least, women are talking about it. And I think it's so, so, so important. And it's part of birth control. It just has to be part of the conversation in your 20s, late 20s. It has to come up in the whole conversation of family planning. It's techno family planning. The best age is going to be 31 to 37, 38. But if you're talking about it in your late 20s, you're creating that roadmap. You're talking about it, you're either in a relationship, or you're working. Women are very busy now. So, thinking about having a family, it can be put on hold, which I think is really, really fantastic.

Melanie Avalon: And how long will the eggs last, technically?

Dr. Sherry Ross: The freezing of eggs has really changed a lot in the last five years. It's elevated to even a better staying power, freezing power with these eggs and defrost. Whether it's 10 to 15 years, I'm not quite sure how long, but it's somewhere in that range, maybe even longer. It just evolves. The infertility and freezing process evolves. We're seeing companies like Facebook and Apple, they're embracing and protecting woman's choice to delay motherhood by paying for egg freezing. And I'm hoping that that's going to become more of a common service that jobs offer women. I think that's just so forward thinking. 

We're freezing eggs now with really a lot of confidence. It's really conversation in late 20s, definitely early 30s and really thinking about it. I think the biggest barrier is cost, because it is about $12,000 to $15,000 to go through the entire process. 

Melanie Avalon: Is it something that is at all covered by insurance?

Dr. Sherry Ross: Well, we're not seeing it yet. It's interesting. We're seeing IVF. Some plans cover a cycle of IVF in vitro. I'm hoping we see it. Again, it's all about women and making them feel equal in the workplace. Now, women are CEOs, we have seats in the boardroom. Women have a presence. I think it's going to be related to advocacy that we have to fight for a lot of things. Having your company or your insurance policy, pay for a cycle or to have egg freezing, you would think what happened. They pay for Viagra. At some point, our needs would also be met from the insurance angle.

Melanie Avalon: Yeah. That was something a little bit mind blowing you talked about in the book was the amount of medication or studies done for things like Viagra and supporting men's sexual performance compared to women having sexual issues. It was one thing that had issues even getting passed, I think.

Dr. Sherry Ross: Yeah. There's a lot of sexual inadequacy in the bedroom when it comes to medications. The FDA has approved over 26 medications for men to the one or two that they have approved for women. This is just an ongoing problem, this unequal playing field on every level when it comes to women's health, women's medications, women's everything compared to men. And that again is this cultural change that we all have to fight against. We have to let people hear our voices. We have to get to the voting polls, so that we can support politicians that are going to put our needs at the same level of importance as they do for men.

Melanie Avalon: And also, male versus female oral birth control, because is there an oral option for men? I know, there was one in development, or I thought there was.

Dr. Sherry Ross: Yeah, there is one in development. It's not out yet. It will be so interesting.

Melanie Avalon: I feel I've heard this for years and years.

Dr. Sherry Ross: It's hard enough to get them to wear a condom. I think it's going to be another push, but they're working on it. They're definitely working on it. They've been working on it for a while. 

Melanie Avalon: Well, I will be very excited about that. So, something you mentioned earlier. Well, first of all, STIs versus STDs. Are those the same thing? Are those different?

Dr. Sherry Ross: Yeah, it's basically the same thing. I think sexually transmitted diseases was a term that it's not really a disease, it's more of an infection. I think it was interchangeable. I think the preference was sexually transmitted infection just sounded a little better and I think encompassed in better as well. And it's confusing on how often you should get tested, what safe sex is. So, I was really glad to speak to some of these things that you had asked about.

Melanie Avalon: Again, another thing that we were taught in health class. We were taught that condoms don't protect at all against STDs. I remember thinking, I was like, "So, does the sperm just magically can't get through the condom, but the disease magically does get through the condom?" It did not make sense to me, but I know that they don't 100% protect just looking back.

Dr. Sherry Ross: Yeah, it is confusing for sure. But it's such an important part of the conversation is, what is safe sex practices mean? I think that's important, because condoms, they are used to prevent STIs. But they're really not a great birth control protector, because of the high failure rate. They're somewhere preventing pregnancies around 85% because they break and that's one of the things. And as far as preventing STIs, well, yeah, they can prevent certain ones with a little more confidence, but HPV, the word virus, and herpes which can be on the testicles or the base of the penis, they can be easily transmitted that way. So, it's really important to know that. 

I might add too, condoms, we talk about safe sex, it's so important to know. Well, safe sex is really using a condom with vaginal sex, anal sex, and oral sex. I don't know anyone that is given head with a with a condom on. And women, if someone is giving you oral sex, you're really meant to use some protection. A dental dam. Not a lot of women know what that is, but it's a latex covering. There's also a company called Lorals that they have latex underwear that you can wear when someone is giving you oral sex. So, it's just important. It's helpful for preventing certain STIs.

Melanie Avalon: Yeah, this is actually something that's haunted me a little bit, because I think women-- Well, I'm not in a man's body, so I don't know the different experience of experiencing oral sex, for example or just normal sex with or without a condom. But we've been told apparently, it's much less pleasurable for them. So, I think that's something that women might struggle with wanting to provide the pleasure, but then also wanting the protection. How do you navigate that?

Dr. Sherry Ross: I've heard this before. The majority of couples do not practice safe sex, for sure. I believe couple of things. I just think it's important to make sure, if you have a partner is male, that they get the right size condom and the right kind, there's many different kinds. I think it's important. I think it's so important that women are protected against HPV. It's the most common sexually transmitted infection out there. Women, men 80% to 90% carry it. Men, very hard to detect on their penis or testicle area. Women, luckily, we get to find it on pap smears because otherwise you don't know if you carry it. But problems is this, Melanie, is that HPV is associated with cervical cancer, anal cancer and oral cancers. So, it is important. What I say to the man that says, "I don't have as great of orgasms." I'm like, "Okay, well, then we're not going to have sex because my life matters. You look like you enjoyed it. You know that ejaculation." But I don't know, I just think that there has to be a conversation around it.

Melanie Avalon: This was a helpful reframe for me, because I've really wondered this, because I still want to use condoms for everything that you discussed, but then I just feel really bad if it's not as good of an experience for them. But I was asking one of my not romantic, but one of my platonic male friend this question. This was just his opinion. But he was saying that, "Yes, it's not as pleasurable with a condom, but it's more pleasurable than just being with a woman compared to by himself." I was like, "Okay, I'll take that reframe."

Dr. Sherry Ross: That's a good one. I like that. No, listen, the conversation with a new partner about protecting each other against STI, it's so awkward and it's so uncomfortable, of course. But we all have to make it more mainstream and it shows honestly respect to really be straightforward to each other. And sometimes, you have to start it, because I think it's very forward thinking. If you have something in the past, whether it's HPV or herpes, you need to talk about it. I think you've got to talk about it before you get intimate. You can't be naked in the bed making out and then be like, "Oh, by the way, what do you got?" I think it's where maybe hopefully after a couple dates that you feel it's going in that direction and you are in a good place, and you can start talking about it. I think it's better to do it with clothes on. I think it's important. But I think once we make it more automatic and more common, it's going to be okay.

Melanie Avalon: You mentioned that with HPV for testing for men, it's not really an easy process. Can men even get tested for it and do you think there'll be an evolution in that technology?

Dr. Sherry Ross: Yeah, that's a great question. The answer is, HPV, it's such an elusive little virus, because you can't see it really. Sometimes you get little small pea size, little white, they look like little cauliflower gross outside of the genitalia. But for the most part, it's going to be living on the cervix. Sometimes, men, if they're uncircumcised, it can be in their foreskin. We use a vinegar solution called acetic acid to bring it out on the cervix. When that abnormal pap happens, we look for HPV there. But for men, it doesn't work the same way to put acetic acid on the penis. We just don't see it. And that's why men, they transmitted so easily, because it's just never found. They don't have a pap equivalent like we do. It's hard that way to find it. I don't know if in the future there will be something, a swab that can detect it down the road. We're just now talking a lot about anal pap smears, because we're seeing a decrease in cervical cancer, because the HPV vaccine has been so awesome. It prevents now 90% of HPV strains from passing along, which is so great. 90%, it's protective again. So, it's working. But with oral sex, we're seeing more throat cancers. With anal sex, we're seeing more rectal cancers. In the gay male population, they actually get screened. They have anal pap smears and that's how they're detecting it. But it just hasn't happened that way. And 40% of women are having anal sex, you would think that the gynecologist could say, "Hey, are you having anal sex regularly? Because if you do, maybe we should do an anal pap smear." That conversation is not happening either.

Melanie Avalon: Wow. Okay, a few follow up questions to that. I think I always thought that these tests were swabs, but they're visual. They're looking for things visually.

Dr. Sherry Ross: Well, no, they are mainly microscopic for sure. Pap smears, with your visual eye, you're not going to see HPV. The anal area, you're not going to see HPV. You're going to swab it first. There are HPV lesions that are little cauliflower lesions that you can see, but those aren't always the one that are going to increase your risk of cervical or anal or oral cancers.

Melanie Avalon: I want to invent an at home STI test kit that people could take at home, because like you said, it's such an awkward conversation. A lot of people just don't ever ask for it. Is it a difficult process for people to go get tested and get a clear bill or not, the actual process? Is it usually covered by insurance?

Dr. Sherry Ross: Well, here's the problem. One thing is, how often should you get STI tested? And really, you want to be tested once a year, or in between partners, or if you have any symptoms, or you've had unprotected sex. That's the times you go. Now, one of the biggest myths that I hear which has been crazy, like, "Oh, I just met this new guy. We use condoms the first few times, but then he got tested, and he was negative. So now we don't use condoms." Well, here's the rub. HPV and herpes cannot be screened for.

Melanie Avalon: In men?

Dr. Sherry Ross: Well, yeah. Certainly, in men, but even with women. But it's really more with men. Even women, if you're with a female partner and she's like, "I was STI tested," it doesn't mean that she cannot give her partner HPV or herpes. That's the problem. You can never say that, "Oh, because I've been tested now. I don't need for their any use of protection, whether it's a condom or dental dam or any type of latex protection." Female condom too is another option. I just think today's world, you just have to think that way and protect yourself. Sex is one thing, but getting an abnormal pap smear, that is a whole another thing that's causes a lot of distress.

Melanie Avalon: If 80% to 90% of people have it already, if you already have it, does it make it worse getting exposed to it again? Or, once you have it, are you--?

Dr. Sherry Ross: The problem is, there's so many, what we call, "high risk strains," hundreds. We know that there are more higher restraints, 6:11, 16:18 are a few of the more higher restraints. It's hard to know what strain you're getting. Now, when you get an abnormal pap and they're like, okay, pre-cancer cells, mild dysplasia, HPV present, they'll say, "High risk type." When they say, high risk, it's this family of the 6:11, 18:16, there's a group of high-risk types versus low risk. You can have a normal pap and you can have HPV, but it may not be of the high-risk variant, in which case, it won't take over normal cells and make them abnormal. The fact that young girls and boys 11, 12, 13 are getting the vaccine. Hopefully, this trend of lowering cancers of the cervix will continue. I think we're more concerned with cancer of the anus, and penis, and throat. We're going to start to see more of these because of people not practicing safe sex.

Melanie Avalon: One more question. Warts on the hands, is that related to the sexual version? I had those growing up. 

Dr. Sherry Ross: Are you asking for a friend? No.

Melanie Avalon: No, I'm asking for myself. I remember when I was in elementary school, I had warts in my fingers and this girl walked up to me and told me that I needed to get those removed right away, because it wasn't fair to other people, and that scarred me for life. I was like, "What?"

Dr. Sherry Ross: They can be contagious, but not of the variant.

Melanie Avalon: We were talking a little bit about the menstrual cycle and periods. Something I'm confused about is, they say now that girls get their periods earlier and earlier. But then I've heard that back in the day evolutionarily, we were having children really early. So, how has the timeline of getting one's period changed, and is it abnormal the way it is now?

Dr. Sherry Ross: That's a really interesting question. What we're seeing, the typical age for periods was 11 to 12. But the range is eight to 14. Part of what triggers the body from a hormone level to get a period, it has to do with your body weight. That's one of the triggers. If you're really thin, you may get a period closer to 14 or 15. If you're heavier, you might get it earlier, eight, or nine. What we're seeing, this is going to go back to this epidemic of obesity amongst kids and certainly, ethnic wise ethnicity, we're seeing it more in black and Hispanic cultures, where there might be a higher risk of childhood obesity and we're seeing periods coming on earlier.

Melanie Avalon: When it comes to experiencing our period, how do you feel about the different options available to women? So, pads versus tampons versus now, there's deep menstrual cups, Diva Cups. Is it really just whatever we feel like is TSS, toxic shock syndrome, a big concern?

Dr. Sherry Ross: It's always a concern. I think that the great thing is, there's so many options now for what we can use to collect blood. I think for the 11 or 12-year-old using a pad is feels about right. I'm always surprised that younger women who are using tampons. The key is the conversation. How do you prevent odors, infections, and toxic shock? You want to change your tampon or pad every 48 hours, and that a tampon should never be left in for more than eight hours, like, just some basic stuff on hygiene and changing those, whatever you're using. The cup is great, too. I have patients that love the menstrual cup. This is a favorite thing, because it's so easy to use. Well, for some. It's natural, environmentally friendly, it's certainly more cost friendly, it's healthier. You can leave it in for 12 hours. Well, tampon you can only leave in for up to eight. At nighttime, it can be super convenient. So, people do love that. You have to be very vagina friendly to use it, because some people feel like it's a [unintelligible [00:55:28] move, putting it in and taking it out.

Melanie Avalon: I haven't used one, but that's what I've heard.

Dr. Sherry Ross: And you're little more prone to yeast and bacteria infection, but a lot of people, they love it. They just think it is best thing. It's not indicated wherewith any sexual activity, but you can.

Melanie Avalon: Mm-hmm. I remember when I was using tampons, when I was really young, early on, I accidentally put in two tampons without realizing it. I didn't even realize it. And then I realized it later. I was like, "Oh, well, I hope that wasn't bad." And then more recently, one of my friends now, she's my age, but she had not used tampons before, and she just tried one, and she thought she lost one in her vagina. She actually didn't. Never come out of the applicator. But do you see that a lot with patients either losing tampons, thinking they lost tampons?

Dr. Sherry Ross: Oh, my God. Yeah, I see it all the time. All the time. We call it a "lost tampon." It happens because, well, for all those reasons, you're out to dinner with your friends, maybe you got a cocktail or two. You're like, "How did I put it in?" And then you don't see the string and then you just don't remember, and then all of a sudden, you get this brown discharge and odor that smells like you're at the edge of a fishing pier. You think you have an infection, you go to the doctor. And I find them all the time. Yes, it can lead to toxic shock. But fortunately, if you ever think you've lost one, just squat down, wash your hands, get your pointer finger and your middle finger and just feel around. You can feel if something's back there, because it's never a bad thing to really go up there and feel around, because it can be really dangerous.

Melanie Avalon: Speaking of sticking things up there, so, I think this probably goes back, again, to my upbringing. I don't know how much it was my emotional response versus my just-- Well, that's actually a first question before I ask this question. Do women have different sizes of vaginas? Is the hole smaller for some women than others substantially?

Dr. Sherry Ross: Well, I think that if you aren't having much activity and that could be with any object. It could be a vibrator, it could be a penis, it could be fingers, it can be a cucumber for all I care. It doesn't really matter. If not much is going in there, then the opening is going to be smaller. That's very, very common. I can tell when I do a pap, if someone's had two or three vaginal deliveries or if someone really hasn't had much going inside the vagina itself. My second book I wrote a chapter called The Collapsed V. Collapse vagina can relate to a virgin, someone that's never had anything. But someone that hasn't had regular intercourse at all or maybe it's been a year since they've had anything inside the vagina, and that could also be a collapsed opening, because the tissue is very elastic, it's very stretchy. So, there's a lot of truth to that. Did I answer your question? 

Melanie Avalon: Yeah. The reason I was asking was, I actually benefited from dilators, like, using those. It's something that I've talked to friends about and a lot of them didn't even know this were a thing. So, have you found those helpful for some patients?

Dr. Sherry Ross: Yeah, I'm a big fan of dilators. Just for people that don't really know, for the opening. It can be that you have infrequent partners or your partner has a really large girth, or length, or you're a virgin, or you're in perimenopause or menopause, and that opening is smaller. So, dilator really is meant you do some homework and they increase in size at the entrance, they have a gradual dilation effect, and you lay down. I don’t know if you know this, Melanie, I created dilators that you can wear. One of the downsides for dilators was you had to lay down for 20, 30 minutes twice a week or three times a week. And a patient said to me, "You know, if I have to lay down Dr. Sherry, I'm either sleeping or dead." These dilators that I really like that were medical grade silicone, and you could at least sit at the computer, you could cook dinner, you could go for a walk and wear the dilators. There's a huge need for it. A huge need. 

Melanie Avalon: I'll put a link to this in the show notes. That's amazing. Basically, it's the way it shaped. It's just more comfortable? 

Dr. Sherry Ross: Yeah, the base. I made a base and I didn't make them as long, because a lot of times, the entrance is where the discomfort is. It's ergonomically curved and it goes up in gradual sizes. I have actually up to eight sizes. One of the things we see too, the average girth is somewhere around five inches of a male. To have a partner that's large is terrible for some women. There are dilators that helped the vagina have a little more recall at the entrance.

Melanie Avalon: My mom is probably going to shudder if she listens to this episode. Yeah, that's why I was using the dilators. That's amazing. I wish I had known about your brand. What's the brand called?

Dr. Sherry Ross: She-Ology. The average girth is 4.8 centimeters.

Melanie Avalon: Okay, awesome. The dilators they go up to pass that to accommodate pass that?

Dr. Sherry Ross: Yeah, actually, 4.9 centimeters inches. I'm like, "Oh, my God, that can be 4.8 inches." But they always say bigger is better, and that's so not true. I think men .

Melanie Avalon: Yeah, I was going to ask you that. I had a conversation again with a male friend. Actually, yesterday about this topic and I was like, "Men think that women love this bigger is better." I'm like, "I have not." I'm sure some women like it. Nobody I've talked to friend wise has felt that way. 

Dr. Sherry Ross: Well, they did this study and they looked at what women liked in a penis. At the end result, it had to do not with length but with thickness that women preferred a more fuller feeling than length.

Melanie Avalon: I actually got a question about that. A listener wanted to know, if lengthwise can be too long and can that happen with a vaginal wall?

Dr. Sherry Ross: Yes, it sure can. I've had a few people have horrible lacerations in the back of the vagina with long penises. Yeah. Especially if you're in menopause or vaginal dryness, it can tear the delicate tissue of the vagina.

Melanie Avalon: Would you know, because-- [crosstalk] 

Dr. Sherry Ross: Yeah, you would know.

Melanie Avalon: Should sex be painful? Is it sometimes a little bit painful, but it's not actually an issue?

Dr. Sherry Ross: Well, that's a really good question, because sex should really never be painful when you think about it. I think it really depends on the cause. If we're talking about persistent painful or it's always painful. Women are so used to just biting down and not really complaining. There's many causes of painful intercourse. It could just be positional. Positional sex with deeper penetration from behind, let's say doggystyle, that could be more uncomfortable for women. It could be better to get to the clitoris better, but it could also cause discomfort, or you can have certain skin condition, or there's all kinds of reasons of pain. But it shouldn't be. You should not really have pain with sex.

Melanie Avalon: How do you feel about masturbation and vibrators and that whole topic? Should women be masturbating daily for health benefits?

Dr. Sherry Ross: Everyone should be masturbating for sure. It's just so important to do at an early age. You really know your roadmap. That's so important. It's very part of just general life and health, and so on. Can you ever masturbate too much? Some people do it to go to sleep, because there's so many benefits of an orgasm. It's very calming and it ends stress, anxiety, it's good for wellbeing, it helps with cramps, and people love it. I think you always have to be careful that you don't over masturbate, where you have a harder time with your partner or prevents you from going to work or school. Then that might be too much. But I think it's self-love. It's a good way of knowing your roadmap, it's important to know, so you can tell your partner what feels good and what doesn't. You can get your extra virgin coconut oil, Melanie. Use that. It's important. I think it's important to do at a young age. 

Melanie Avalon: Can every woman orgasm in theory or can some women just not orgasm?

Dr. Sherry Ross: Well, 10% to 20% of women don't orgasm. I think the struggle with women that don't orgasm, it goes back to so many things about educating, giving permission, that whole thing of upbringing, and what we can do. Maybe there's a growth in it, a conversation of education. But I think it really does go to your upbringing, and your partners, and how you feel about sex, because our ability to be sexual is so mental. It's so, so mental and it all starts with that. When you close your eyes to relax, what are you thinking about? Are you thinking about how this feels so good? Are you thinking about what your mother's going to think of you, or your grandma, or was there any abuse? It's so complicated. But it's important to figure it out sooner than later, if there is any dysfunction because a lot of women have sexual dysfunction. Low libido, it's up to 60% of women do. There's so many layers as to the why. But there are specialists out there that can help you and I think like anything, part of our wellbeing, an intimate life is very important.

Melanie Avalon: How much do you think sexual identity and gender is connected to all of that, that you just spoke about and also, how does it inform--? Going back to the very beginning of the conversation like a gynecologist visit, how much does a person's sexual identity and the sex of their partner inform what they need to be looking for in the visit and do you have thoughts about that whole relationship?

Dr. Sherry Ross: Let me make sure of your question. The sexual relationship we have with ourselves, how that affects going--? [crosstalk] 

Melanie Avalon: I guess, it's a two-part question. The first part is the comfort and the shame aspect in the education. How much do you think that informs a person's sexual identity or gender identity? That would be the first question.

Dr. Sherry Ross: I think the confirmation and reassurance that a healthcare provider can give someone that's unsure, let's say, how they judge, or shouldn't judge, or guide is really, really important. Doctor relationship is often the first where you're speaking honestly, hopefully, and you don't want to feel judgment or shame. It goes back to finding the right doctor. Finding not just anybody. You can't just pick anyone that's on your insurance list anymore. You need to find someone that has good reviews, it's going to be a good listener that is going to accept you as you are and maybe give you referrals for other people that can help you if you're questioning your gender identity, "Do I like my body?" "Do I like what I have?" There's all interface with enjoying sex and enjoying intimacy.

Melanie Avalon: One more question related to that. I've actually become really passionate. On Valentine's Day, I actually experienced sexual assault from a massage therapist. So, I become very passionate about spreading awareness about this. Is that something common at all with gynecologist visits with doctors?

Dr. Sherry Ross: Well, lots happened with the MeToo movement. A lot of doctors have really had to become accountable for inappropriate touching and activities that weren't considered appropriate. I think it's important. A couple of things. This goes into being your best healthcare advocate. You have to know what's normal, what's expected of that visit, because you don't know. And I think if you were male or female, I don't think it matters. I just think you should always have a nurse chaperone in the room, no matter what. No matter what, because why not. I think it's important. It's for your comfort. It's for your security. I think it's really, really important, because you don't know what's normal. I know you've all heard the stories of some really screwed up things happening, because people just didn't know. So, knowing what to expect. 

I've written a lot on what you should expect during OB-GYN exam, but I think it's out there on good, reliable resources, whether it's Mayo Clinic, WebMD. There are some really good sites or reputable magazines that talk about, what should you expect when you go to the gynecologist for the first time? You are in control. Believe me, you don't have to have an exam or get undressed during the first visit. In fact, you shouldn't. It can just be you're going to meet them to see if you feel comfortable. I think that's really, really important. Definitely you don't have to ever and shouldn't maybe the first few times until you build some trust with your healthcare provider.

Melanie Avalon: Well, I cannot thank you enough for what you're doing with all of this. I'll maybe let you tell the story, but you notice some of the issues with the stress. Is it the echocardiogram test? So, can you tell listeners a little bit about your--? [crosstalk] 

Dr. Sherry Ross: Yeah. One of four women die of heart disease and we are really the first doctors that identify women at risk. One of my patients, Jennifer Beals, her dad had died from stroke at 63 and I sent her at 50 to go get a stress echocardiogram. She was so excited, because she's really competitive and athletic. She told me, she went down there, she had her sports bra and all her little compression things. First, you get an ultrasound and then you get your wires hooked up, and then you get on a treadmill that's moving, and you have to get your heart rate up to 85%. It's normal baseline. 

Anyway, so, they made her take her bra off and she was appalled that she'd run on the echo stress test, she says, "My boobs are flying over the place." She's like, "I have a C cup." And she just said, "I just couldn't believe it." She called me and she's like, "We need to do something about this." She and I patented a bra that women can wear during an eco-stress test. It's not your regular bra, because of all the wires and how the regular bra would affect the tracing from the wires as you're doing this running. We're having a little bit of a hard time getting it out there through the medical space, because of insurance, and because the priority of women. You think women should be running on a braless on these tests, like, can you imagine a guy not being able to wear a jock strap? 

Melanie Avalon: Yeah. Wow. 

Dr. Sherry Ross: If any of your listeners have any connections to some of the Philips that makes the echo stress test or any very rich aunt or uncle that believes in the cause of breast health and breast disease, let me know.

Melanie Avalon: No, this is amazing. I'm going to think about this. I'm putting that out to the universe. Thank you. Thank you for doing that. Yeah, so, right now, the situation is, can people buy the bra?

Dr. Sherry Ross: They can. They can buy it from Heartlanta Bra. They can actually buy it if they're interested. Yeah, I have them here and ship them.

Melanie Avalon: Okay. Well, we will put a link to that in the show notes. I got a lot of questions from listeners about the Mona Lisa. How do you feel about that?

Dr. Sherry Ross: Mona Lisa is great. It's a dermabrasion of the inside of the vagina and the outside, like, we do our face. It's not for women really that have good estrogen stores, because you're not going to be dry. Over 40, where you lose estrogen, the vagina gets very, very dry. Very dry, because estrogen is gone and it's a great hydrator. The Mona Lisa laser is actually three treatments, six weeks apart. The cells are a lasered. And by doing so, it increases blood flow and collagen production. It helps also with some of the bladder symptoms these women get. It's a great method. It's in part of something you should be doing along with vaginal estrogen, which I'm a big, big fan of as well, for all the problems that women in perimenopause and menopause get. So, I love it. It's great. I think only downside, not covered by insurance. So, it can be costly.

Melanie Avalon: And the vaginal estrogen, and you talked about this at length in the book. So, listeners can definitely get your books to learn more. But the topical estrogen does not have the concerns that people might have about the oral. Is that correct?

Dr. Sherry Ross: Right. Zero risks of any breast cancer or ovarian cancer. Every vagina over 50 should be using vaginal estrogen, because it is the way you moisturize inside the vagina.

Melanie Avalon: Oh, okay. And with lasers, is laser hair removal okay? Is it safe? Is removing all the hair? Is there a purpose for that hair?

Dr. Sherry Ross: Well, it's really up to the person. The long story of what is pubic hair for is one of those things that we don't really know the purpose of pubic hair. Some people thought it has a cushion effect, which is nice. But we're not really sure the purpose of it. It does have little pheromones we know, it doesn't really prevent dirt or other germs from getting inside the vagina. It's a great cushion, of course, for sporting activities, like bicycling. But probably the pheromones are one of the things that there's a smell that's involved that's can be enticing or erotic to your partner. How you shave or wax, or laser, it is really a personal choice. It's a truly personal choice.

Melanie Avalon: Well, maybe a question to end on since we opened with your personal story. I'm really curious about your-- What was your experience like you were an egg donor, right, you donated? 

Dr. Sherry Ross: Yeah, I did. 

Melanie Avalon: What was that emotional experience for you and is it something you would recommend for people to do?

Dr. Sherry Ross: Wow, Melanie, that's dug that right out of my book. I was an egg donor for a patient of mine, who had trouble getting pregnant. I was never asked to be one. When I was asked and I just had had my third son. I was flattered by the thought, and I went ahead and did it, and it was a great experience. It was doing the first half of an in vitro cycle. I took some shots for 10 days. And then a couple weeks later, they took out a bunch of eggs. And then my patient use them, and had twins, and to this day, I'm very, very close with the kids. And, yeah, it was a great experience. It was very, very great experience.

Melanie Avalon: Well, thank you so much. This has been one of the most, I think, helpful, enlightening episodes to date on this show. I really cannot thank you enough for everything that you're doing. It is so, so needed, if that has not become apparent yet to listeners. So, how can listeners best follow your work, are you writing any more books, what links would you like to put out there?

Dr. Sherry Ross: Yeah, I love the conversation. I'm constantly trying to talk about issues that that we really need to talk about. I'm on Instagram, @drsherryr. Come, follow me, it'd be great. My website's drsherry.com. And you can see my sexual wellness products that I have. For women, from vibrators to dilators, anal dilators for those that like anal sex, there's just all sorts of things out there that make women's lives more enjoyable in the bedroom. I appreciate you having me on the show and I love the conversations myself.

Melanie Avalon: Well, thank you so much. And this literally is the last question I'm going to ask, and it's the question I ask at the end of every single show, and it's just because I realize more and more each day the importance of mindset. So, what is something that you're grateful for?

Dr. Sherry Ross: I'm just grateful for my family. Very grateful that I have them around me and I have this very loving family around me. It means everything I do in life, I'm inspired by them. All that good in me comes from my family. So, that's what I'm grateful for.

Melanie Avalon: Awesome. Well, thank you, again, so, so much. This has been so amazing. I am really excited for all of your future work. Hopefully, when I'm back in LA, we can maybe meet, because I would love to meet you. And this has been amazing. So, thank you.

Dr. Sherry Ross: Well, fantastic. Thanks for having me. And, women, you got to be your best healthcare advocate. So, just remember that.

Melanie Avalon: Yes. Thank you. Thanks, Dr. Ross.

Dr. Sherry Ross: Thanks for having me. 

Melanie Avalon: Bye.

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