The After Hours Clinic

The After Hours Clinic Date: March 27, 2023 Episode 8: ‘Irregular Periods: Could It Be PCOS?' In this episode of the After Hours Clinic, Natasha makes us feel more comfortable discussing polycystic ovarian syndrome (PCOS) and how multifactorial the disease is. What are the symptoms of PCOS and do genetics play a role? We discuss how the diagnosis is made, lifestyle changes that can help alleviate symptoms, medical management and MORE! BULLET POINTS OF KEY TOPICS & CHAPTER MARKERS 'Infertility Myths' https://www.nm.org/healthbeat/healthy-tips/6-myths-about-fertility ● Topic #1 - What is PCOS and who does it affect? [3:47] We first start off by discussing PCOS and the diagnostic criteria. Who does it affect and what are the possible environmental and genetic factors that play a role? References: https://www.ncbi.nlm.nih.gov/books/NBK459251/ ● Topic #2 - What are the symptoms of PCOS and how do we diagnose it? [8:33] We discuss chronic anovulation, hyperandrogenism, and polycystic ovaries. As well as other comorbidities associated with PCOS. References: https://www.ncbi.nlm.nih.gov/books/NBK459251/ ADHD article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8841975/#:~:text=Women%20with%20PCOS%20are%20known,some%20risk%20factors%20of%20ADHD. ● Topic #3 - How do we treat PCOS? [15:43] Are there any lifestyle modifications that I can make to help reduce symptoms? How do I manage my acne and excess hair growth? What advances have been made in PCOS management? What challenges do patients and health providers face? References: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6489978/ https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-022-01734-w EPISODE LINKS AND CONTACT INFORMATION ● Website: www.theafterhoursclinic.com ● Shareable episode links Spotify: https://open.spotify.com/show/34WhuBgPo3izBD7khy7wck Amazon Music: https://music.amazon.ca/podcasts/b78ac455-483d-4614-82bc-3eb812beb8e4/episodes/fc35b751-8d6c-4550-8cc1-5e63deb10f68/the-after-hours-clinic-about-the-podcast  Apple Podcasts: https://podcasts.apple.com/us/podcast/the-after-hours-clinic/id1665783498  Google Podcasts: https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5saWJzeW4uY29tLzQ0OTUyOS9yc3M ● Email address: theafterhoursclinicpodcast@gmail.com

The After Hours Clinic Date: March 13, 2023 Episode 7: ‘Period Pain: Could It Be Endometriosis?' In this episode of the After Hours Clinic, Natasha makes us feel more comfortable discussing endometriosis and how it is underdiagnosed and undertreated. What are the symptoms of endometriosis and are we aware of any causes? We discuss how the diagnosis is made, lifestyle changes that can help alleviate symptoms, medical management and MORE! BULLET POINTS OF KEY TOPICS & CHAPTER MARKERS 'Period poops' - https://cdhf.ca/en/period-poop-101/#:~:text=Why%20Do%20I%20Poop%20More,and%20potentially%20diarrhea%20(1). ● Topic #1 - What is endometriosis? [6:45] We first start off by discussing endometriosis. What is it exactly and what are the symptoms? References: https://www.cbsnews.com/news/bindi-irwin-endometriosis-surgery/ https://www.who.int/news-room/fact-sheets/detail/endometriosis ● Topic #2 - What are the causes of endometriosis? [13:10] We discuss retrograde menstruation, cellular metaplasia, and more. Is there a way to prevent endometriosis and how can I rule out if I have endometriosis? References: https://www.nichd.nih.gov/health/topics/endometriosis# ● Topic #3 - How do we diagnose and treat endometriosis? [17:40] What diagnostic methods are used to diagnose this disease? Are there any lifestyle modifications that I can make to help reduce symptoms? Is there a curative medical treatment? References:  htthttps://www.frontiersin.org/articles/10.3389/fgwh.2022.902371/full https://www.ncbi.nlm.nih.gov/books/NBK567777/ Reference for CBC article: https://www.cbc.ca/news/canada/nova-scotia/endo-care-maritimes-1.6771709 Current research in Canada: https://yonglab.med.ubc.ca/current-research/clinical/ EPISODE LINKS AND CONTACT INFORMATION ● Website: www.theafterhoursclinic.com ● Shareable episode links Spotify: https://open.spotify.com/show/34WhuBgPo3izBD7khy7wck Amazon Music: https://music.amazon.ca/podcasts/b78ac455-483d-4614-82bc-3eb812beb8e4/episodes/fc35b751-8d6c-4550-8cc1-5e63deb10f68/the-after-hours-clinic-about-the-podcast  Apple Podcasts: https://podcasts.apple.com/us/podcast/the-after-hours-clinic/id1665783498  Google Podcasts: https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5saWJzeW4uY29tLzQ0OTUyOS9yc3M ● Email address: theafterhoursclinicpodcast@gmail.com

The After Hours Clinic Date: March 6, 2023 Episode 6: ‘Let's Talk. Period.' In this episode of the After Hours Clinic, Natasha makes us feel more comfortable discussing menstruation and the menstrual cycle. What are normal symptoms of our period and why does our period even happen? We discuss normal cycle length, how to track our period, the phases of the menstrual cycle, PMDD and MORE! BULLET POINTS OF KEY TOPICS & CHAPTER MARKERS Proctalgia fugax - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3602260/ ● Topic #1 - What is menstruation? [4:57] We first start off by discussing menstruation. What is menstruation and why does it happen each month? References: https://my.clevelandclinic.org/health/articles/10132-menstrual-cycle ● Topic #2 - What is the menstrual cycle and the phases? [8:15] What are the phases of the menstrual cycle? How do we track our period during this time? What is a regular length of a cycle? References: https://www.womenshealth.gov/menstrual-cycle/your-menstrual-cycle ● Topic #3 - What are the symptoms of menstruation? How do I know if my symptoms are normal? [13:03] Why do we experience cramping during our periods? There are other symptoms some women may experience more than others. What is considered an irregular period and how will I know? References: https://www.mountsinai.org/health-library/report/menstrual-disorders#:~:text=Dysmenorrhea%20refers%20to%20painful%20cramps,during%20a%20normal%2Dlength%20period. ● Topic #4 - What is PMDD? [22:47] PMDD is premenstrual dysphoric disorder. It is a more severe form of PMS (premenstrual syndrome). We discuss the symptoms, possible triggers, and how to treat it. Reference: https://www.hopkinsmedicine.org/health/conditions-and-diseases/premenstrual-dysphoric-disorder-pmdd EPISODE LINKS AND CONTACT INFORMATION ● Website: www.theafterhoursclinic.com ● Shareable episode links Spotify: https://open.spotify.com/show/34WhuBgPo3izBD7khy7wck Amazon Music: https://music.amazon.ca/podcasts/b78ac455-483d-4614-82bc-3eb812beb8e4/episodes/fc35b751-8d6c-4550-8cc1-5e63deb10f68/the-after-hours-clinic-about-the-podcast  Apple Podcasts: https://podcasts.apple.com/us/podcast/the-after-hours-clinic/id1665783498  Google Podcasts: https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5saWJzeW4uY29tLzQ0OTUyOS9yc3M ● Email address: theafterhoursclinicpodcast@gmail.com

The After Hours Clinic Date: February 27, 2023 Episode 5: ‘How to Stay Healthy During Menopause' In this episode of the After Hours Clinic, Natasha makes us feel more comfortable discussing perimenopause and menopausal symptoms. Hot flashes are not the only symptom of menopause and there are so many ways to combat this! We discuss sex after menopause, healthy lifestyle changes we can make as we age and MUCH MORE! BULLET POINTS OF KEY TOPICS & CHAPTER MARKERS ● Topic #1 - What is menopause and what are the symptoms? [4:07] We first start off by discussing perimenopause and menopause. Symptoms of menopause can vary from person to person. Our cardiovascular and bone health are also affected by menopause...why? References: https://www.nia.nih.gov/health/what-menopause ● Topic #2 - What are the treatment options? [10:22] How do we treat hot flashes, bladder issues, problems with sleep, and vaginal health? What are ways that sex changes after menopause and how we can improve intimacy? References: https://www.health.harvard.edu/womens-health/nonhormonal-treatments-for-menopause https://www.nia.nih.gov/health/infographics/staying-healthy-during-and-after-menopause https://www.hopkinsmedicine.org/health/conditions-and-diseases/staying-healthy-after-menopause ● Topic #3 - What is hormonal therapy? [16:20] We talk about the role estrogen and progesterone play in women's bodies and how hormonal therapy helps treat the symptoms of menopause. References: https://jamanetwork.com/journals/jama/fullarticle/2791692 https://my.clevelandclinic.org/health/treatments/15245-hormone-therapy-for-menopause-symptoms Testerone treatment research: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7098532/#:~:text=Numerous%20studies%20have%20shown%20that,among%20women%20during%20their%20menopause. Menopause strategies: https://www.liebertpub.com/doi/full/10.1089/jwh.2020.8586 EPISODE LINKS AND CONTACT INFORMATION ● Website: www.theafterhoursclinic.com ● Shareable episode links Spotify: https://open.spotify.com/show/34WhuBgPo3izBD7khy7wck Amazon Music: https://music.amazon.ca/podcasts/b78ac455-483d-4614-82bc-3eb812beb8e4/episodes/fc35b751-8d6c-4550-8cc1-5e63deb10f68/the-after-hours-clinic-about-the-podcast  Apple Podcasts: https://podcasts.apple.com/us/podcast/the-after-hours-clinic/id1665783498  Google Podcasts: https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5saWJzeW4uY29tLzQ0OTUyOS9yc3M ● Email address: theafterhoursclinicpodcast@gmail.com

The After Hours Clinic Date: February 20, 2023 Episode 4: ‘Contraception Doesn't Only Mean Condoms' In this episode of the After Hours Clinic, Natasha makes us feel more comfortable discussing contraception and birth control. Barrier methods are not the only form of contraception! We discuss the female condom, hormonal implants, IUDs, the pill, surgical procedures and the infamous morning after pill. I also share my own birth control journey and MUCH more! BULLET POINTS OF KEY TOPICS & CHAPTER MARKERS ● Introduction - Spontaneous Sex Study  References: https://www.tandfonline.com/doi/abs/10.1080/00224499.2022.2163611?journalCode=hjsr20 ● Topic #1 - Barrier Methods [4:35] We first start off by discussing male/female condoms, diaphragms, cervical cap, vaginal sponges and more. How effective are these methods and do they protect from sexually transmitted infections (STIs)? References: https://prevention.ucsf.edu/research-project/barrier-methods ● Topic #2 - Hormonal devices and contraception [11:53] Are there more hormonal birth control methods other than the pill? What is IUD insertion really like and what side effects do they have?  References: Clinica Trial for IUD insertion https://whttps://clinicaltrials.gov/ct2/show/NCT03868137 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6915345/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108408/ ● Topic #3 - Tubal ligation and vasectomy [26:40] In this section, we briefly cover 'sterilization' procedures including tubal ligation, salpingectomy and vastectomy. References: https://www.ncbi.nlm.nih.gov/books/NBK470377/ https://med.virginia.edu/urology/for-patients-and-visitors/mens-health/vasectomy-how-it-works/ ● Topic #4 - Emergency contraception [28:47] A quick overview on emergency contraception. How long after sexual intercourse can I use the morning after pill? Is the pill the only option for emergency birth control? References: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4216625/ EPISODE LINKS AND CONTACT INFORMATION ● Website: www.theafterhoursclinic.com ● Shareable episode links Spotify: https://open.spotify.com/show/34WhuBgPo3izBD7khy7wck Amazon Music: https://music.amazon.ca/podcasts/b78ac455-483d-4614-82bc-3eb812beb8e4/episodes/fc35b751-8d6c-4550-8cc1-5e63deb10f68/the-after-hours-clinic-about-the-podcast  Apple Podcasts: https://podcasts.apple.com/us/podcast/the-after-hours-clinic/id1665783498  Google Podcasts: https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5saWJzeW4uY29tLzQ0OTUyOS9yc3M ● Email address: theafterhoursclinicpodcast@gmail.com

The After Hours Clinic Date: February 13, 2023 Episode 3: ‘Taboos in Men's Sexual Health' In this episode of the After Hours Clinic, Natasha makes us feel more comfortable discussing men's sexual health. Away with the taboos about erectile dysfunction, premature ejaculation and low libido! We discuss the causes behind these concerns, anatomy & physiology of male genitalia, treatment and MORE! BULLET POINTS OF KEY TOPICS & CHAPTER MARKERS ● Topic #1 - Erectile Dysfunction [3:47] We first start off by discussing erectile dysfunction, the physiology of an erection, the psychological consequences, Peyronie's disease and possible treatments. References: https://www.ncbi.nlm.nih.gov/books/NBK562253/ https://wchh.onlinelibrary.wiley.com/doi/full/10.1002/tre.827 ● Topic #2 - Premature ejaculation [15:00] What is premature ejaculation? Who does it affect? What are the causes and how can we treat this? We also discuss how ejaculation works and the anatomy involved. References:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7851481/#:~:text=Several%20studies%20have%20shown%20that,influence%20the%20diagnosis%20of%20PE https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6915345/ ● Topic #3 - Low Libido [19:45] In this section, we cover low libido and the causes specifically for men. How does this impact relationships, partners, and your own mental wellbeing? References: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8498958/#:~:text=Known%20causes%20of%20decreased%20libido,decreased%20libido%20is%20psychosomatic%20stress. https://urology.ucsf.edu/patient-care/adult-non-cancer/male-sexual-and-reproductive-health/decreased-libido ● Topic #4 - Sexually Transmitted Infections in Men [25:02] A quick overview on the symptoms of STIs in men, how they present and when to seek medical treatment! We will discuss this topic further in another upcoming episode on safe sex. References: https://www.urologyhealth.org/urology-a-z/s/sexually-transmitted-infections EPISODE LINKS AND CONTACT INFORMATION ● Website: www.theafterhoursclinic.com ● Shareable episode links Spotify: https://open.spotify.com/show/34WhuBgPo3izBD7khy7wck Amazon Music: https://music.amazon.ca/podcasts/b78ac455-483d-4614-82bc-3eb812beb8e4/episodes/fc35b751-8d6c-4550-8cc1-5e63deb10f68/the-after-hours-clinic-about-the-podcast  Apple Podcasts: https://podcasts.apple.com/us/podcast/the-after-hours-clinic/id1665783498  Google Podcasts: https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5saWJzeW4uY29tLzQ0OTUyOS9yc3M ● Email address: theafterhoursclinicpodcast@gmail.com

The After Hours Clinic Date: February 6, 2023 Episode 2: ‘Transitioning 101’ In this episode of the After Hours Clinic, Natasha makes us feel more comfortable discussing transitioning. We take a look at transgender history, gender dysphoria, the difference between sexual orientation and gender identity, and how to care for transgender patients! This episode is for both health care providers and patients. BULLET POINTS OF KEY TOPICS & CHAPTER MARKERS ● Topic #1 - Transgender/LGBTQIA2S+ History [4:47] We first start off by discussing transgender and LGBTQIA2S+ history in Canada, in terms of basic human rights as well as the healthcare journey for trans people. Reference: https://ftmtopsurgery.ca/blog/top-surgery/brief-history-of-transgender-rights-canada/ https://www.albertahealthservices.ca/assets/info/pf/div/if-pf-div-historical-perspective.pdf ● Topic #2 - Gender dysphoria, gender identity and sexual orientation [15:27] What is gender dysphoria? Is there a difference between gender identity and sexual orientations? We got you covered in our next section! References:https://www.frontiersin.org/articles/10.3389/fpsyg.2015.01511/full https://www.plannedparenthood.org/learn/sexual-orientation/sexual-orientation https://www.psychiatry.org/patients-families/gender-dysphoria/what-is-gender-dysphoria ● Topic #3 - Caring for Transgender patients [17:45] In this section, we cover what healthcare providers need to know when treating transgender patients and what should transgender patients know to take charge of their own health! We cover topics ranging from hormone therapy, gender affirming surgeries, preventative care and MORE! References:https://www.rainbowhealthontario.ca/TransHealthGuide/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6368014/ https://journals.sagepub.com/doi/full/10.1177/2158244020962824 https://www.ctvnews.ca/health/trans-kids-treatment-can-start-younger-new-guidelines-say-1.5947894 https://www.wpath.org/ EPISODE LINKS AND CONTACT INFORMATION ● Website: www.theafterhoursclinic.com ● Shareable episode links Spotify: https://open.spotify.com/show/34WhuBgPo3izBD7khy7wck Amazon Music: https://music.amazon.ca/podcasts/b78ac455-483d-4614-82bc-3eb812beb8e4/episodes/fc35b751-8d6c-4550-8cc1-5e63deb10f68/the-after-hours-clinic-about-the-podcast  Apple Podcasts: https://podcasts.apple.com/us/podcast/the-after-hours-clinic/id1665783498  Google Podcasts: https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5saWJzeW4uY29tLzQ0OTUyOS9yc3M ● Email address: theafterhoursclinicpodcast@gmail.com

The After Hours Clinic Date: January 30, 2023 Episode 1: ‘Is my Vagina Normal?’ In the first episode of The After Hours Clinic, physician in training Natasha Premji makes us feel more comfortable discussing the vagina. We break stigmas and stereotypes by getting down to the actual science behind anatomy, self hygiene, discharge, lumps and bumps, and MORE! BULLET POINTS OF KEY TOPICS & CHAPTER MARKERS ● Topic #1 - Anatomy [4:25] We first start off by discussing the anatomy of the vagina, well actually the vulva. Mainly focusing on the external genitalia for the episode, we go through the different parts of the vulva and their roles. We even discuss new research about the pleasure centre of the female body, the clitoris! Reference: https://www.ncbi.nlm.nih.gov/books/NBK547703/ New research: https://news.ohsu.edu/2022/10/27/pleasure-producing-human-clitoris-has-more-than-10-000-ner ve-fibers#:~:text=More%20than%2010%2C000%20nerve%20fibers%20enable%20the%20plea surable%20sensations%20created,International%20Society%20for%20Sexual%20Medicine. ● Topic #2 - Discharge and self-hygiene [11:24] Vulvas and vaginas are like self-cleaning ovens, so how do we clean them? We go over self hygiene techniques and products to avoid. What is normal vaginal discharge? This second topic takes a deeper look at normal or physiological discharge, what could cause abnormal discharge and how to recognize it. We also briefly talk about some sexually transmitted diseases. References: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2099568/ https://www.intechopen.com/chapters/56549 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7789027/ ● Topic #3 - Lumps and bumps [28:11] When should we be worried when we feel or see a new lump or bump down there? We have a brief overview of common causes of non-worrisome bumps and when things could be more serious. This third topic also leads us to discuss human papillomavirus (HPV), pap smears, and cervical cancer screening. References: https://www.sciencedirect.com/science/article/pii/S2352647521000605 https://www.statpearls.com/ArticleLibrary/viewarticle/26590 https://www.cancercareontario.ca/en/types-of-cancer/cervical/screening EPISODE LINKS AND CONTACT INFORMATION ● Website: www.theafterhoursclinic.com ● Shareable episode links Spotify: https://open.spotify.com/show/34WhuBgPo3izBD7khy7wck Amazon Music: https://music.amazon.ca/podcasts/b78ac455-483d-4614-82bc-3eb812beb8e4/episodes/fc35b751-8d6c-4550-8cc1-5e63deb10f68/the-after-hours-clinic-about-the-podcast  Apple Podcasts: https://podcasts.apple.com/us/podcast/the-after-hours-clinic/id1665783498  Google Podcasts: in process ● Email address: theafterhoursclinicpodcast@gmail.com

Welcome to the After Hours Clinic Podcast! Making uncomfortable situations more comfortable with yours truly, physician in training - Natasha Premji.