Dr Karl Podcast

00:00 This is a Triple J podcast. 00:02 When Dr. Carl is away, the girls will play. And that is exactly what happened. Carl was off this week, but we were joined by Dr. Naomi Kabelik and Dr. Teresa Larkin, friends of the show. They've both been on the hookup before as well. And we got into all your questions about the human body, biology, reproductive systems, and so much more. There were some really great questions that came through, which you'll hear through this episode. I'm Lucy Smith. Let's get into it. 00:29 Joining us on this week's episode, Dr. Naomi Kabelik, the bimbo biologist, and Dr. Teresa Larkin. Hey, welcome. 00:36 The girls. The girls are on. I love it. 00:39 Thank you so much for being here, covering for Dr. Carl and getting into the human body, all things biology this week. Dr. Naomi, we'll start with you. What have you been up to? Because, you know, you're someone who is a friend of the show and you're someone that we see online doing really great explainers in a very accessible way about biology. That's so sweet. Of course. So what have you been working on? What have you been up to? 00:59 This year I launched Bimbo Biology. It's a little Instagram TikTok health series. It's very cutie, very sparkly, very delightful, very me. And I'm currently ABC's inaugural science journalism fellow. Amazing. I'm very excited. I'm working on a YouTube series. It'll be coming out on ABC science later this year. Okay. 01:15 all health all body all biology well I was gonna ask can you give us maybe a little bit of a tidbit of what you're working on or what you've been looking at as someone who does work in this field and is kind of looking at ways that you can communicate this research and information what's something that's kind of struck you recently what's something that you've learned oh I mean I am so deep on research for this series so I'm currently like 01:36 drowning in endometriosis and trying to figure out all the different pieces to help empower people. I'm reading about birth control and like the very, very dark history of birth control in this country. So I've just been swimming in research, which is honestly my favorite thing to do. I'm giving myself away. I'm such a nerd. 01:56 But a few different areas there that we can tap into for questions on 0439757555. Dr. Theresa Larkin, what's been happening in your world? 02:04 Oh, well, I just finished a project where I was collecting data on hearts. 02:09 Yes, that's right. 02:09 Yeah, because I remember the last time I was here I spoke about that. 02:12 Yeah, were you doing maybe a survey or you were talking to people about it? 02:15 This one with the hearts, we were actually measuring the arteries and the veins and looking at differences between people using hearts from people who've donated their bodies to science. That's right, yes. So I finished up with 146. 02:27 Wow. Across seven different unis in Australia, one in New Zealand. So looking at that, I'm also looking at some research that a student has done on testosterone in depression. Interesting. And I'm doing a collaborative piece with some Aboriginal colleagues on the importance of the sun. And so combining Indigenous knowledges and ways of thinking, especially observation and reflection... in science and in the way we approach things, in our knowledges and in how we really think about science and apply it. Wow. So yeah, and that's relevant at the moment when we don't have as much sun in winter. 02:59 Of course, yeah. Thinking about the balance and all the good things that the sun does for us, but how we need to balance that when it's 03:05 high-risk uv oh my god so many different avenues we can go down already oh four three nine seven five seven triple five if you have a question for teresa larkin or naomi kabelik now is the time to send it in and we're going to kick it off with lisa in coffs harbour dr lisa what do you want to know yeah g'day doctors um i want to know what biologically is happening when we're having a hot flush and why are they so random or are they random like are we doing something that you know causes them 03:35 So they're random in the sense that your body's hormones are changing. So especially over that period of perimenopause and leading into menopause. And that is where, you know, some of those symptoms are so hard for people to deal with because they're not predictable. So, yeah, you're having these changes in estrogen and progesterone. It's basically because as the number of eggs is declining in the ovaries, you have a reduction in the hormones. And so they're feeding back to the brain. to try and get the brain to stimulate more eggs, to sort of see, can we get one last cycle out? 04:10 So the body's working really hard. The ovaries are working hard. The brain's working hard, especially the hypothalamus. And that's where our heat sensors are as well. So with those changing levels, especially when we have dips in estrogen and progesterone, the hypothalamus kind of resets itself almost like when we have a fever, because that's what happens when we have a fever is that the hypothalamus resets its level. So I don't know, Lucy, if that's what you've been experiencing in terms of feeling that way. And then what happens obviously is that the body says, oh my gosh, now we're too hot and we need to increase sweating. 04:44 We need to increase blood flow. And that's when people might feel a bit nauseous because they've got these physical effects happening. 04:51 Wow. And the sweats from hot flush are no joke. Up to 75% of people who have menopause experience those hot flushes and it's really excessive periods of sweat. The amount of sweat you get from just two to three minutes of hot flush is actually comparable to what you make while doing heavy exercise. Really? 05:09 It do be so much on your body. Wow. Oh my gosh. Losing calories at the same time. Love it. 05:16 Lisa, does that help or feel validating for what you're going through? 05:19 No, it really does. Yeah, because I was just like, it did feel like a fever, like every pore is on fire. And I was like, is it compared to a fever or is it something completely different? And so does it eventually just stop when your body says, look, there's no more eggs. Stop, guys. Stop trying to bite and make these eggs. 05:35 Yeah, that's right. So if you looked at this as a graph, like if we had a graph of time going across the bottom and the amount of hormones on the y-axis through menopause, it's going up, down, up, down, up, down, which can actually also happen during puberty, which is why people have those crazy mood swings in puberty as well when the brain's trying to readjust to these changes. So, yeah, you kind of go through this period where you've had the approximately 28-day cycle of, you know, having your periods during your menstrual years and then it starts to just become a bit erratic but all the time it's erratic, it's going down and down and down but down and up, down a bit more, up and down, down a bit more, up and down, down a bit more until it goes down to not much hormone and then that's when generally the hot flushes should subside. 06:21 Right. Okay. Lisa, thank you so much for your question. 06:26 Thank you so much, doctors. We've got Maddie in Sydney here. Dr. Maddie, you've got a question about twins. 06:33 Hey, doctors. I do. So I have two beautiful MCDA twins at home. Well, one set of twins, obviously, I hope. And I'm wondering... You're like, where are the others? I don't know. Oh, God. Not even. Not even. So many people joke about it. I'm not okay with it. 06:49 I'm wondering if there's something that actually causes that psychote to split. And then as sort of a leg off of this question... 06:57 if one of the twins was to become or to already be neurodivergent, would the other twin also be neurodivergent? Seeing as it's, yeah, I don't know. 07:07 They're obviously identical, but I don't know how that works. So Maddie, oh, well, Teresa, what does MCDA stand for? 07:13 Yeah, that stands for monochorionic diamniotic. So the chorion and the amnion are essentially the sacs that the that the baby is growing in the zygote and then the embryo so yeah nice that yeah onto onto those um like you can call it straight off with having these twins and so what happens is with whether someone whether twins have two amniotic caps or cavities or they share their placenta or they have their own placenta all of those things depends on at what day the zygote split so So if we have a zygote splitting early within the first four days approximately, then the placenta and the amniotic sac, they haven't started to develop yet. 07:55 So that means as those ball of cells basically split in half and we have two developing embryos, then they each start developing their own placenta and their own amniotic sac. So someone that is diamniotic means they've already developed their own amniotic sac, but then the chorionic sac, so the larger one develops around them together. So they've split a little bit later, so around days 8 to 12. 08:25 And then do you know about the neurodivergence potentially between twins, how that could potentially play out? 08:32 Yeah. So it's interesting that you asked specifically about that because that is one of the traits that has the highest concordance between identical twins. Really? So there are certain things with identical twins. Some... cancers and autoimmune diseases are not highly likely. If one has it, it's really not necessarily likely that the other one will get it because there's more of an influence of the environment. Certain cancers like breast cancer, for example, but neurodivergence and personality traits, even things like agreeableness or irritability, but neurodivergence and autism specifically, like in that sort of category, they have a high concordance rate. 09:12 So yes, it is likely. And same with even sexual preferences traits. So they also are highly likely to be the same. Wow, really? 09:22 You know, I feel like people have spoken about that with twins, how sometimes they can both be gay, you know? Very interesting. 09:30 I've heard a lot but I didn't realise that there was actually like a research base to show that that was so likely. 09:37 And we've learnt so much about different diseases and the impact of genetics versus environment from looking at identical twins. Yeah. 09:45 Maddie, thanks so much for your question. 09:48 No worries. Thanks for answering it, guys. 09:49 We've got Andrew in Wollongong here. Dr. Andrew, you've got a question about sleep. 09:55 Sure do. Good morning, Doc. My question is in regards to is it possible to have too much sleep in one night? There are examples. If I go to bed early, I get a good nine to ten hours sleep. The next day I feel terrible at work. I'm feeling down and a bit drained. Sometimes we're generally almost six to seven. 10:15 And I'm probably a lot better. Can you have too much sleep? 10:19 I love this question. 10:20 I have a lot of friends asking me about sleep maxing too, where they're trying to optimize how much they sleep. And I think the biggest thing to understand about sleep is the best indicator for whether or not you're getting enough sleep is actually how you feel. So if you're saying here that you're feeling not as well rested, not as alert, not as happy maybe... then choosing whatever makes you feel better is actually truly our best indicator of sleep. We actually find lots of people are wearing these trackable devices to help them determine whether or not they're having quality sleep. 10:53 And those devices often tell them that they're not having quality sleep. even though they feel like they are and we're seeing this new range of sleep disorders coming about where because even though they're sleeping well and their body is getting the rest it needs because they're being told they're not sleeping well they start to feel that they are in fact not sleeping well and then probably start stressing which is then impacting the sleep correct so the best way to determine it and honestly the simple sometimes it sounds so simple that it can't be right but if you're waking up feeling well rested then that's what your body needs 11:23 Andrew, does that help maybe the six-hour vibe, Teresa? 11:27 Yeah, I was just going to say the thing that's all super interesting, Naomi and True, and the thing that makes people feel the tiredest even after they've had sleep is having too much time in that initial light sleep. Yeah. So you know how we have the sleep cycles? We've got that non-REM sleep and then we've got the REM sleep. So the non-REM sleep is when the heart rate goes down, the breathing goes down, the brain waves slow, our body temperature drops. It's really restorative and good for our immune system. But that very first bit that we can all identify with is that really... 12:00 light sleep where we're not quite sleeping yet we're not super awake and if you're finding it hard to get through that part to the deeper part of sleep then that's when actually your body hasn't had enough restorative time and that's when even if you've been in bed for nine hours and you've been sleeping but not fully sleeping yeah that's when you can feel the tiredness the next day thank you doctors 12:24 We are in the midst of the Science Hour. Dr. Naomi Kabelik and Dr. Teresa Larkin join us talking all things biology and the human body. Now, if we're getting into the body, Lockie in Blacktown, what's your question? 12:38 Hi, doctors. I want to talk about corn. So... Not to get too blue on your Thursday morning. It's all medical. 12:48 Anytime I'm eating corn, I feel like I'm chewing it pretty thoroughly. But no matter what, it's coming out the other end in like one piece. And I want to know what's up with that. 13:00 I can answer that one, but I actually am a chronic under-chewer, so I feel even more personally attacked and I can hard relate to this. 13:09 Seeing corn in your poo is not something to freak out about. It is totally normal. It's the outside of the corn, that beautiful yellow glossy bit. It's just full of cellulose. It's a type of fiber and it just goes straight in and straight out, my friend. And that's why you get to see those beautiful little golden bits of corn in your toilet bowl. 13:28 So is it a membrane, would you say, the skin of the corn? Yeah, the outside. 13:32 I mean, dietary fibre is good for us. It's an important thing for us to eat, nothing to be worried about. Our body just doesn't know how to digest cellulose, so it just goes all the way through. 13:41 All the way through. And that's good for us. Yeah, like Naomi says, we need dietary fibre to bulk up the stools, get it moving, prevent constipation. But I feel like something Dr Karl would say is like, you can do an experiment on this, you can see. Absolutely. 13:55 You can then see how long the transit time is from your mouth to anus basically. So that can be anywhere from 12 to 72 hours. But yeah, you can start to take note. When did I eat that corn and when did I see it come out the other end? 14:09 And Lucky, remember, you've got to document it. You've got to take photos, all the rest. Please don't send those to the text line though. I don't want to see them. Lucky, thank you for your question. 14:17 Thank you so much. 14:20 Sarah in Toowoomba, what's been going on with you this year? 14:25 Um, I've been, Hey doctors, how are you all? And I'm a massive, massive fan of the show. So, and massive fan of you, Lucy, like I love you. And you just fill my ears with like good music and the rest of it. My question is about the common cold, um, or whatever. So I eat healthy. I eat like fruit veggies all the time. I eat salad sandwiches. I have my chicken soup. And I'm getting the common cold, whatever, three or four times already this year. And that's from December. And normally like, normally every year I'm pretty good. 14:56 Like I'll have it like maybe once or twice and it's gone. But for this year, I don't know what the heck I'm doing wrong. I don't know if it's something to do with my body or where I'm living or whatever, but yeah, it's, It's getting ridiculous and I'm trying everything I'm having, like, you know, multivitamins and all the rest of it and I'm just not winning. 15:15 Sarah, I feel that frustration. 15:17 Yeah, I know. Dr. Naomi, what do you reckon? I mean, I can hard relate. I've also had the cold a bunch of times this year and I am also a Lucy fangirl. 15:28 Hey, something we all have in common. 15:30 The thing to understand about the cold is that it is really common. If you're experiencing something that feels very different to what you normally experience, it's always worthwhile going and chatting to your doctor. But there are some things that can increase getting the cold. For me, it's how often I see my friends' wonderfully gorgeous little infectious children, especially the ones who are... who are at daycare, who are just making me sick every single time I see them. And also how much sleep you're getting and how stressed you are. The best thing we can do to prevent things like cold and flu spreading is the flu jab. 16:02 The optimal time to get it in Australia is actually April to May, but you can still get it outside of that window. But me, myself, I am a forgetful girlie. I actually put passive aggressive calendar reminders in every single year when it gets to April or May. And it's like, get your jab, get your jab. 16:17 And it freaks me out whenever I see it, but it's helpful. So do you think... you know, what Sarah's going through. Is that a new infection each time, do you think? Or is it maybe just the same one, underlying one? Dr. Theresa, what do you reckon? 16:29 Look, there's hundreds of viruses that cause the common cold. So that's what's hard, you know, like there's so many viruses and it's changing all the time. And it's different to the flu. So the flu shot won't prevent you getting colds because they're caused by viruses. 16:43 But one of the questions... Yeah, and I'm not a big fan of, like, the jab either, like, and that's what I'm trying to say with, like, the healthy fruit and veggies. And I was thinking, like, if that was going to help, so... 16:53 I guess one question is, what are the symptoms that you normally get with it? 16:59 Like, the blocked nose, runny nose, really, horror coughs, the sneezes, that kind of stuff. I know I did have the flu... Um, about two weeks ago where I literally couldn't move out of my bed and I ended up throwing up and I know I knew that that then was the flu. Um, but I stayed at home that entire week and I just called my boss and I said, look, I'm not coming in. I'm not great or whatever. Um, Where I work, it spreads, unfortunately, I think pretty quickly, whatever. Like a lot of people at work have it, but I can't not go to work, if that makes sense. 17:31 And I guess one of the hard things is that the more that you have coughs and congestion in your nose and all that, you can have some irritation in the lining. So maybe sort of seeing if you can do things to really make sure you stay hydrated. If there's anything, obviously, see a doctor that you can do to kind of almost repair or help with a barrier on the inside of your nasal cavity and down the throat. 17:53 I am, yeah, I had a bout of time off because I had sinusitis and I've kind of been on a nasal spray regimen. Yeah, that's right. Things like that. And it has helped. 18:02 That can help. Yeah. And even just the nasal spray when you've come home from work, it can clear out. Yes. If there's a salt water rinse, it can clear out if any viruses have just gotten into the... into your nose and mouth and washing your hands. 18:15 But of course, be careful of decongestants because if you use them long term, they can exacerbate it. Yes, that's right. No, not yet. This is my area of expertise. Sarah, thanks for your question. 18:24 Awesome. Thank you so much, guys. And hopefully I'll get better soon. I know. 18:29 Yeah, I was going to say, hopefully you feel better soon and it's not going to continue into the year. Josh in Glenory. Josh, we were just talking about corn making its way to the anus. What's your question? 18:41 Hi, doctors. My question was just, sorry, a bit nervous. 18:51 Why, why, why I can tolerate my own farts, but I can't, I run from other people, like I move away from other people's farts. 19:03 Josh, you might be nervous, but it is a great question. Thank you so much. Dr. Naomi, Josh, loving the smell of his own farts, can relate. 19:11 thank you for calling in with a question about farts and poop these are my happy place i love talking about normal bodily functions yeah josh we see you um so what's happening that we have to understand is your gut microbiome first of all so there's little bacteria all throughout your gut and they are chowing down on everything you chow down on um in turn as they break down that food they're making gas The bulk of it actually isn't stinky, but we obviously know some of it is. And that very classic like rotten egg smells from sulfur. So if you're feeling that really stinky farts, maybe your bacteria is just having a really yummy meal. 19:47 The other thing to be aware of is that we humans have an incredibly well-developed sense of smell. I know we don't often think of that because like, you know, other animals communicate really well with smell, but we do too. So that's probably why you can, you know, when someone near you has farted. Yeah, yeah. And I don't know specifically why you're okay with your own, but I'm the same and I'm going to guess it's just familiarity. You know what I mean? Those are my gut microbes. They're my friends. They're making the smells I know and love. Maybe not love, but I tolerate. 20:18 You've got a little pride for them. 20:20 Dr. Theresa, what do you reckon? That is so interesting. I haven't thought about it from the sense of your own nose and smell because our receptors in our nose that detect smell they can adapt really quickly, which we all understand. You know, we can walk into a room and something stinks, but then we'll get used to that smell. And then the next person walks in and they're like, how are you sitting in here in that stench? And you've sort of phased it out. You know, you've blocked it out. Maybe it's that, like you say, Naomi, it's the familiarity. If we're smelling our own farts regularly enough, we kind of, our noses turn down a little bit to that. 20:52 They turn off the receptors and then when there's a new smell, we're like, whoo. I also wonder if that's why I like that like after grog bog feels so offensive because it doesn't smell like it's my own. 21:01 Like I've changed something and I was like, whose is that? 21:03 Not me. I don't know who that is. They're not my little bacteria friends. I don't know who she is. Josh and Glenory, thanks so much for your question. 21:10 Thank you so much, guys. I just thank you for taking my... Scrap it. 21:17 Thank you. Thanks, Josh. If you've got a question, 0439757555. And a lot of responses coming through as well. Someone saying, I'm in the same boat as Sarah. I've gotten sick in many ways in the past year, way more often than I usually do. Always done everything to help my immune system. So frustrating. It's interesting. I was chatting to a friend recently and, you know, I just had sinusitis. She just had some sort of, you know, we call it the germ. And she said, I swear it's getting worse every year. And I feel like that every year is kind of a reference to, you know, post COVID and post lockdown. 21:50 Is that, is it getting worse every year, Dr. Teresa? Like, I'm not sure that it is, or if we're just aware of it, but whether it is because, you know, there was legitimate research to show that people's immune systems weren't as exposed during those years with the lockdowns and It is important for us to be exposed to different people, different viruses and all of that. So unless it is still just taking a little bit of time or people are more aware of it or it's, you know, different with age, yeah, not sure with that one. 22:20 We are in the midst of the Science Hour. We are getting so many questions in on 0439757555 for Dr. Naomi Kabalik and Dr. Teresa Larkin, who are standing in for Dr. Carl, talking all things the human body and biology. Damo in Victoria. Damo, what's your question? 22:39 Morning, doctors. My question comes from my wife. She's always said that having sex cures a headache. Just wondering if this is true or if it's placebo, just for her. 22:50 Is it? Yeah. I mean, either way. Is it a problem? Dr Naomi, what do you reckon? 22:56 Oh, look, I've heard about this a lot from many of my friends as well. And I can think of some scientific reasons why it might make sense. If you do reach an orgasm, it could be that endorphins are actually being released and that could be helping with the headache or maybe even migraine. But also it could just be like a distraction from the pain as well. 23:17 Yeah, that's right. And sex is a positive stress response. So we always hear about all of those bad stresses, but sex is an example of a good stress. And so when we have this increase in blood pressure, increase in cortisol, that can actually cause headaches for some people. So that can exacerbate some people's headaches or migraine pain. But because then we have that increase in the cortisol, in the heart rate, in the blood pressure, in the physical activity... and then it drops down and we have the oxytocin being released at the same time the post sort of activity you know as we have everything coming down then that's actually quite healthy and the body goes into quite of a relaxed state it's kind of a unique situation sex because we've got this high sympathetic drive which is sort of that fight or flight at the same time that we've got the parasympathetic, which is the rest, digest. 24:07 We've got oxytocin, which is the connection. So yeah, and absolutely like Naomi said, the destruction and the orgasm and the endorphins. For some people, absolutely. It could help their headaches, but not everybody. Some people, it could make it worse. 24:20 Okay. 24:20 Dammit, does that help? 24:22 It does. Thank you very much. 24:23 Pass it on to your wife. She can listen anytime on the Triple J podcast. Jade in Orange. Now, Jade, we kind of touched on this a little bit earlier, but tell us about the difference between you and your teenage son that you're noticing. 24:37 Hi, doctors. 24:39 I'm wondering why, as a perimenopausal woman, that... which is when I'm aware that my hormones are depleting in my body, why does my body odor smell so much worse than my teenage son's when you'd expect him to be stinkier? 24:54 What do we reckon? I do think of teens as stinky, but there's actually a bunch of research on it. So we have different types of sweat glands. I should preface that sweating is totally natural, normal and healthy. Yes. And so is your sweat being stinky. So most of your body is covered in your ecrine sweat glands. They're kind of found everywhere and they release water that is stink-free. But in your pits and bits, you have your apocrine sweat glands. 25:20 And these bad boys are the ones that are responsible for that classic bio smell. And it's because the sweat you release there isn't just salt and water, it also contains oil. And the bacteria, it's always bacteria again, they're just chowing down, they're having a little meal and they're producing that smell. The reason why teenage boys, or really all teenagers, I know I was a stinky gal myself, get particularly stinky around puberty is because of those hormonal changes. Beforehand, your apocrine sweat glands aren't doing much. And I would imagine it's the same thing we're seeing here during menopause, that there's just a change in hormones that are impacting your apocrine sweat glands and how much they're functioning. 25:55 Interesting. Hey, Jade, you also had another question, which... 25:59 I thought was a good one. 26:00 I don't usually allow a double bill, but Jade, for you, I will, you had a question about hysterectomies. 26:05 Yeah, thank you. I've always wondered if you have had a hysterectomy, are your ovaries then just floating around if they don't have, you know, the attachment to the uterus anymore? What's happening inside there with your ovaries? 26:17 Yeah, it's a good question. So when there's a uterus in the body as well, so the ovaries are attached to the uterus by the uterine tubes, which were previously called the fallopian tubes, but the uterine tubes is a better name. But they are still attached to the side of the pelvic wall. So the lining of the abdomen that goes all around the outside, and then over all of the organs so it's basically just like it's attached to the wall of our pelvis so right down you know if you feel where your pubic bone is at the front of your pelvis it's it's very low your ovaries are very low they're down there so yeah absolutely if someone's had a hysterectomy and their uterus removed then the vagina will continue to the cervix and that will be closed off the uterus won't be there but the ovaries will still be in the pelvis just attached to the left and right wall Wow. 27:04 And that's great because then they can still do their job. So they can still then secrete the hormones that are needed and that goes into the bloodstream. So yeah, it's positive to even when someone's had their uterus removed, if they can, they will always leave the ovaries. 27:17 Right. Dr Naomi? I love hearing you say uterine tubes. I have so much rage about so many of my reproductive organs being named after dead old white dudes. 100. 100%. 27:27 Can you talk about that? So you said there was a change from fallopian tube to uterine tube? 27:33 It hasn't been an official change. 27:34 Change in my heart. 27:35 Oh, okay. Tell us more. So actually I'm going to a conference in Melbourne. I'm on the organising committee next week. It's the International Federation of the Associations of Anatomists. 27:46 Say that three times more. 27:48 And that's all anatomy associations around the world. And they have a language committee and there's definitely talk. So their recommendation is that we should not use, they're called eponyms, which are names of a person's name. Because even just in the female reproductive system, as you say, Naomi, there's things called Bartholin's glands, you know, Skeen's glands, the pouch of Douglas, all these names. Who is he? Exactly. They don't tell you. The Skeen's glands are the para- urethral glands which means next to the urethra that makes so much more sense so that we know where they are yeah descriptive yeah uterine tubes because they attach the uterus to the ovaries oh my gosh it seems so simple doesn't it jade thanks so much for your questions yes thank you yeah we got bianca in eora sydney bianca you've got a question about the iud 28:40 Correct. Hey, doctors. I was wondering if having a copper IUD could make me more susceptible to getting an STI. 28:48 Oh, I love this question. 28:50 So I should clarify what IUDs and STIs are. So IUDs are your intrauterine devices. So there's different types. They can be copper or they can be hormonal. We tend to call that one the marina is the one that's available here. And STIs are your sexually transmitted infections. 29:07 And for some reason, my brain is also thinking about UTIs at the same time. I don't know why, my brain's floating everywhere, but I know there's definitely no proof that IUDs can raise UTIs and they also shouldn't be increasing your likelihood of getting an STI either. 29:21 The only thing that – and I did have a quick look with this – if the IUD can change the pH, which is the acidity or how acidic or basic the vagina is, then that can have an effect on susceptibility to infection and that can be STIs as well as UTIs. So, yeah, it's an interesting – I don't know of any studies that have looked at that. I don't know any stats. Right. If there was an effect, then I imagine that that's one possible way. And the thing is, you know, people are so variable. Someone might be really sensitive to having something that just slightly changes their pH enough to mean that they're a little bit more susceptible. 29:58 We're back to bacteria. Yeah. 30:00 A little bit more susceptible for bacteria to grow, et cetera. Wow. I'll add that's why it's really important that like when you're washing your nethers, that you're not using soap because you can really disrupt your pH there as well. And once you make your wonderful complex microbiome upset, oh, it's not going to be a good time. You'll know about it. 30:19 Yeah, you'll know about it. Bianca, thanks for your question. 30:22 Thanks, guys. 30:26 Ahmed in Parramatta, what's your question? 30:29 Hey doctors, hope all is great. So we hear a lot about the 28 day female cycle, but what's the deal when it comes to the guys 24 hours testosterone cycle? Does it actually peak and crash throughout the day? Does it affect our energy and mood? Is the irritable male syndrome a real thing? So I hope we can get an answer there. 30:49 Oh, are you happy that we make that a new thing, the IMS? 30:53 So, yeah, absolutely. This is true that we have so many changes in all of our hormones across the day. I love it. It's super interesting. And like with cortisol peaking in the morning, our sex hormones do peak in the morning. So testosterone secretion is generally highest between 7 and 9 a.m., And I suppose it makes sense in that it is a building protein. You know, it's there for energy, like cortisol and other things are, but it's a building protein, I suppose, we can think of. And then it does drop off in the afternoon, but alongside other hormones. 31:24 You know, that's when our cortisol is the lowest. It's also when we have the highest body temperature. You know, we do have a genuine mid-afternoon slump. So whether, you know, that can be blamed for a general IMS or not is probably the question can be out there. But, yeah, absolutely there is a 24-hour cycle. And I think also just to know that there's also a change across the lifespan. So from around 40, 50 testosterone declines in a similar way to estrogen and progesterone declining in women. 31:55 It's just we don't talk about that change as often. Yeah. 31:58 okay all right yeah thank you ahmed thank you for bringing that into the fold the ims the iterable male syndrome uh we've got megan in brisbane dr megan we just had a question about copper ieds what's your question um hey doctors um if you're on hormonal contraception do you still release an egg each month 32:20 And if not, does that mean your eggs last longer and you can actually have more eggs at an older age? 32:29 Yeah, so this is an interesting question. So we're born with all our eggs as a female and millions of them and then they gradually drop off over time. So even at the beginning of puberty, we've got around 125,000 or something like that. And so over time, so over what that approximately 40 years or so of menstruating, We go from hundreds of thousands to zero anyway. So we actually have eggs that are dying off every month whether they are or aren't ovulated. In terms of the contraception, so the combined oral contraceptive pill it acts to stop ovulation. 33:07 But other things like the mini pill, the IUD, the copper, they actually still allow you to ovulate. They work as a contraceptive by changing the environment of the uterus to prevent either sperm getting in or to prevent implantation, you know, to set up an environment that's not conducive to fertilization and implantation while still allowing you to ovulate because some people like to still keep their natural cycle. 33:34 What I find really crazy is like the breadth of hormonal birth control that we actually have. Like here in Australia, we have 30 different types of the pill that you were just talking about. And why are they all named after Bratz dolls? It's like Yasmin, Estelle. It's whack. But the difference between them is that they tend to use different types of estrogen or progesterone and that they're in a range of doses. But to be honest, the estrogen is pretty consistent. It's the progesterone that really changes from different types of Bratz doll pills. Yeah. 34:02 but i i also didn't realize i was meant to take it at the same time each day i did when i was taking it i'd just be popping them like candy whenever i remember and that affects the efficacy doesn't it it does a bit yeah you are you are meant to try and take at the same time each day i found um the longer lasting things like uh the one the hormonal wonderful little friend implanon i shoved into my arm um that was really handy because i didn't have to remember to take anything 34:27 Hey, Megan, thanks for your question. Yeah, no worries. Thank you. Dr. Naomi, you were chatting earlier about some of the work that you're doing for endometriosis research. Can you give anyone who's just joined us a bit of a refresher on what you've been up to? 34:40 It's pretty bleak, hey? I feel like there are things that are looking better and there is more research coming up and there's more investment into... facilities and research here in Australia so things are getting better but it's it's been a pretty awful journey for a lot of people and I find that going through and reading about endometriosis um it's very it's very taxing on people it's very exhausting you have to self-advocate um and something that I find particularly tricky around things like diagnostics is that endometriosis frequently co-occurs with something called adenomyosis and they have a lot of similarities so um They are both estrogen-dependent gynecological disorders and they also function quite similarly. 35:21 And while they do look different under a microscope, it can make it really hard to work out what you have or if you even have both at the same time. 35:29 So they look similar? 35:31 They look different once you get under a microscope, but there are a lot of steps before you even get to get that sample because, you know, they're inside of us. Yeah, yeah. 35:39 Dr. Teresa, anything to add there? This was actually a question that came through from Emma. Literally, what is the difference between endomosis and endometriosis? Yeah. 35:50 So I guess we can even use the words and break them down to help people understand. So osis at the end just means a condition. So endometriosis means it's in condition of the endometrium, which is the innermost lining of the uterus. That's the lining. It's very thin. That's the lining that changes during the cycle. It gets thicker and then that bleeds with periods. Adeno refers to glands essentially. So this is a condition of glands and the myo is muscle. So in endometriosis, that's where we have... 36:22 inflammation, proliferation, excessive endometrial tissue. And so women often then have or people with that often have painful periods because there's too much of it can cause inflammation. It's usually associated with heavy bleeding. Adenomyosis is also really painful because the lining, that lining actually grows into the deeper muscular wall. And so you can have extra, like the glands get bigger and on an ultrasound, the uterus often looks bulky because it's the thicker muscle layer that becomes kind of infiltrated. 36:55 And then absolutely, as Naomi said, under a microscope, very different because you're looking at what's going on in those layers. Lots of pain with both though. 37:02 Well, that's it. That's what Emma wanted to know. What does it mean to have both? 37:05 I mean, it can vary. Even just endometriosis individually, we often think about it as pain, but it's more than just pain. A lot of people don't experience pain when they have endometriosis. There are two main things we're looking at, pain and infertility. And just having more pain doesn't necessarily correlate with having more infertility. It's much more complex than that. And that's what makes it so hard because maybe if you aren't experiencing the pain, you aren't going and presenting to a doctor. Mm-hmm. And even if you do present to a doctor, you're probably getting gas lit anyway. It's a lot of self-advocating. 37:36 It's improved a lot, but that process is very taxing. We can make symptoms-based diagnosis based on what you're experiencing, but then there are further steps. Maybe it's imaging like we were just talking about, but different types of endometriosis, like the very deep kind, that's really hard to pick up on imaging. Yeah. So then you end up needing something like a surgery, like a laparoscopy and it's all of these different stages. What I found really shocking when I first started looking into endometriosis is that it does impact people of all genders. We find cisgender men who have endometriosis and also unlike most diseases where I think over time the disease must get worse, that isn't always the case with endometriosis. 38:14 It can actually vary. So for some people it gets worse, for some people it regresses and gets better and for some people it actually stays the same. So it is really complicated. It's a lot to tackle. 38:23 If people want to keep up to date with your research when it drops or as you start releasing it, what should we follow? What should we do? 38:29 It'll be on ABC Sciences YouTube and I'll also be screaming about it from my own personal stuff, which is at Naomi Cobelli. 38:36 Amazing. Dr. Teresa Larkin, if we want to follow what you've been up to, where should we go? 38:40 Yeah, Dr. Teresa Larkin on Instagram. 38:42 Fabulous. You too. Thank you so much for stepping in. So many great questions covering for Dr. Carl this week. We really appreciate it. Thank you so much for hopping on. Thank you. Thank you. Yay! 38:52 And that's it. Thank you so much for listening to this week's episode of Science with Dr. Carl. A big thank you again to Dr. Naomi Kabelik and Dr. Teresa Larkin for coming through. You can check out both of their info. We'll chuck their Instagrams for you in the show notes of this episode. And Dr. Carl, we'll be back with you next week. If you are missing him this week, that's all good. You can go through the podcast feed, tap back into any episode you like, no matter where you're listening from. I'm Lucy Smith. This episode was produced by Ella Carter and Byron Smith, and we'll catch you next week. 39:23 Bye. 39:24 Dave Marchese here from the Triple J Hack team. Hey, if you love Dr. Carl's podcast like I do, you might enjoy the Hack podcast as well. Each day we bring you the news that matters to you, from the latest science on climate change to what's happening in politics and news around the world. The Hack podcast. It's your daily fix of the news you need to know. 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