Participants: Allan Handysides, Stoy Proctor
Series Code: WM
Program Code: WM000349
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00:01 The following program presents principles
00:03 designed to promote good health and 00:04 is not intended to take the place of 00:06 personalized professional care. 00:08 The opinions and ideas expressed are those 00:10 of the speaker. Viewers are encouraged 00:12 to draw their own conclusions 00:14 about the information presented. 00:37 Hello, my name is Stoy Proctor, 00:40 I'm here today hosting 'Wonderfully Made.' 00:43 We have wonderful bodies. Today we're 00:45 gonna talk about a part of a woman's body 00:48 the uterus and what can go wrong sometimes 00:52 with a uterus. Uterus is a cavity that, 00:55 that sort of nurtures the fetus while it's 00:58 growing and eventually it propels the fetus, 01:01 what is known as Child birth. Today we are 01:04 very fortunate to have Dr. Allan Handysides, 01:06 And welcome Dr. Handysides, it's good 01:07 to be over here, to our program today. 01:10 Dr. Handysides is a Gynecologist and he has 01:12 been so for about 40 years, so he's had 01:16 much experience in this area. 01:19 Would you explain a little bit about the 01:21 uterus and the function of the uterus and 01:26 well, the anatomy of the uterus? 01:27 Stoy, the uterus as you have already 01:30 mentioned is that container in which a baby 01:33 grows and develops, it's a very specific 01:37 and very highly specialized organ, 01:40 it provides for the nutrition the correct 01:42 implanting of the developing fetus, 01:45 it has a lining which forms the interface 01:48 between one life and another. 01:52 In order to perhaps illustrate this for 01:54 our viewers because it sometimes is 01:56 difficult to illustrate for over viewers. 01:58 What I did was I took a papaya often 02:02 known as paw paw in certain parts of the 02:04 world and I used that, I cut it half to show 02:10 the various parts and anatomical parts of 02:14 the uterus. Of course a papaya is not a uterus. 02:18 It is a seed bearing structure so it's a 02:21 plant's uterus if you want to think of it 02:22 like that, but in terms of human it is just 02:26 an example, but I did do that and I think 02:29 our viewers can see the papaya now. 02:34 Here you see there is this papaya, 02:36 I'm touching the cervix portion which 02:38 would be the neck of the uterus, 02:42 the top part would be the fundus and I'm 02:45 going to cut it and open it up so that we 02:47 can see what the inside of the uterus might 02:52 be looking like or at least have an idea 02:55 as to the structure of what is going on 02:58 in the uterus. Now, here you see the seeds, 03:01 these would represent the baby and a 03:02 normal uterus but the red flesh would 03:05 represent the muscle and the green 03:09 portion would represent the outside, 03:12 the inner portion that I am there marking 03:14 with the knife represents what's called the 03:17 endometrium and the lower portion is the 03:20 cervix. Now I'm taking the knife and 03:22 cutting off the cervix so that you see that 03:25 portion that I have cut off would be called 03:27 the cervix and when we talk about cervical 03:31 cancer. We're talking about cancer in this 03:33 part and if we were to talk about the part 03:37 that's protruding into the vagina that's 03:39 the cervix that we can see, the upper 03:41 part is the body of the uterus and cancer 03:45 if it's going to start in the body of the 03:47 uterus would start in the endometerium 03:49 the part that I'm there touching with a 03:51 knife blade. Now, as I scrape that off 03:54 from the meaty portion of the papaya there, 03:59 but if it were the uterus, that part, 04:01 that yellowish part that we would be 04:03 cutting off would be endometerium and 04:06 the endometerium is the part where 04:09 cancer commonly begins in cancer of the 04:12 body of the uterus, and so if we talk 04:15 about endometrial cancer now I have an 04:17 idea. Sometime cancer is just in there 04:20 but it may extend into the muscle of 04:24 the uterus and that is called invasion. 04:27 If cancer is spreading into the muscle 04:30 particularly if it goes right through we 04:32 have a fairly extensive invasion of that 04:35 cancer. Obliviously we would like the cancer 04:38 not to invade all the way through but 04:40 to be restrained to the lining portion of 04:44 the uterus. So, I hope by looking at this 04:47 paw paw we'd been able to get an 04:48 understanding of what we're going to be 04:49 talking about in the rest of the program. 04:54 Now, in your illustration there you 04:57 mentioned endometrial and cervical cancer, 05:01 may be first for our viewers you would explain 05:03 a little bit about the cancer itself and 05:06 what really takes place. Cancer is an 05:10 unrestrained, uncontrolled division of cells. 05:15 The cellular mechanisms of division are 05:19 regulated through the nucleus and in many 05:22 ways cancer is a disease that starts in the 05:26 nucleus the nucleus of each cell and every 05:29 cell if our viewers would remember, has a 05:31 nucleus that contains the chromosomes, 05:34 the genetic material of that individual. 05:36 If that nucleus becomes damaged either 05:39 by infection possibly by toxin, possibly by 05:43 hormonal influence or stimulation, possibly by 05:47 degenerative processes, possibly by inherent 05:50 weakness but whatever cause that the nucleus 05:53 becomes damaged then the regulation of 05:56 cell division may go away, and so cells 05:59 begin to divide in an uncontrolled fashion 06:02 another factor in cancer that's very important 06:05 is that the stickiness or adhesiveness with 06:08 which cells stick to each together is lost in 06:11 these rapidly dividing cells, which means that 06:14 they can break off, get into the lymphatics or 06:16 into the bloodstream and spread. 06:19 So, there are two ways of spread, 06:20 either by direct extension growing into 06:24 the local tissues or cells breaking off and 06:28 being transported in either the lymphatic 06:30 which is the drainage of the liquids of the 06:33 tissue or in the bloodstream to distant 06:35 sites, where they can set up and we call 06:38 that metastatic spread, those are secondaries 06:42 that have come from the original cancer. 06:46 We have in the uterus two predominant forms, 06:48 although there are several forms of cancer, 06:51 two predominant forms one we call cervical 06:54 cancer which seems to have its own 06:56 particular predisposing factor and the other 06:59 endometrial cancer which also has its own set 07:02 of factors and as I explained with the paw 07:05 paw, these anatomical sites differ and so 07:09 does the progress and the actual 07:11 characteristics of those cancers. 07:13 Now, you mentioned preexisting conditions 07:15 are maybe causes or what are some of the 07:18 factors that, that might precipitate 07:21 endometrial or cervical cancer. Well they are 07:24 different for each of the cancers may be 07:25 we should start with one cancer and go with 07:28 that and then we could explain the other one. 07:30 Which would you like me to do first? 07:31 Endometrial, endometrial cancer alright, okay. 07:34 If we look at a group of women who had 07:36 endometrial cancer, we can actually predict 07:40 that there are certain groups who are more 07:42 prone to endometrial cancer. So, for instance 07:45 if we see a woman who is overweight we 07:47 know that she has a risk, an increased risk 07:50 in the endometrial cancer. If she is diabetic 07:53 we know she has an increased risk of 07:56 endometrial cancer, another factor that may 07:59 predispose very much has to do with the 08:02 regularity of ovulation and if a woman has 08:07 a regular menstrual cycles she is not ovulating 08:10 regularly, she is going to be more prone 08:14 to have endometrial cancer. So, when we 08:17 look at that we say well those women will 08:19 probably have fewer babies, so we see 08:21 people who don't have children. People who 08:24 are overweight, people who are diabetic, 08:28 people who have irregular or erratic ovulation 08:32 or no menses, this group of women are at 08:35 an increased risk for endometrial cancer. 08:39 Now, what can a women do something 08:41 about like say her diabetes, can she control 08:44 it, will that help any, well, what about the 08:46 regularity of her period, can she control that, 08:48 is there is any ways of, you see, 08:50 reducing this risk. We might need to ask 08:53 ourselves what could be the common pathway 08:57 in all these people that is predisposing to her 09:02 having endometrial cancer. And the 09:05 current thinking is that women who are 09:08 not ovulating regularly, women who are obese, 09:11 the fat tissue actually produces estrogenic 09:14 component, women who don't menstruate 09:17 regularly don't have progesterone, 09:18 so it looks that the effect of an unopposed 09:24 presence of estrogen, in other words, 09:26 not a cyclical estrogen, but a continuous 09:29 estrogen may be playing a factor in 09:32 developing cancer. So, what we need 09:34 to do in that situation in a younger 09:36 woman is we need to do everything possible 09:39 to reduce this single hormone stimulation 09:45 and to get them into the situation that they 09:46 have a cyclical reaction. So, a consultation with 09:50 one's doctor may be a good idea because the 09:55 doctor convince like look we can do certain 09:58 things to induce regularity, of course 10:01 losing weight maybe one of those very 10:03 important things, good control of the 10:05 diabetes maybe one of those things. 10:07 So, there are things that can be done. 10:09 What can a woman do to maybe detect the 10:13 cancer early? Endometrial cancer 10:16 usually comes later in life, and the cardinal 10:21 feature in endometrial cancer is a change 10:24 in bleeding patterns. So, a woman, 10:26 at menstrual cycle maybe, menstrual cycle, 10:28 in other words it's really not menstrual cycle 10:31 it's bleeding that may be mistaken for a 10:34 menstrual cycle, but is actually bleeding 10:38 from the cancer that is in the endomentrium. 10:41 Typically a woman who has reached post 10:44 menopausal years lets say we have a post 10:47 menopausal woman she stopped menstruating 10:51 and out of the blue there appears to be 10:54 bleeding, that is a, oh I'm getting young 10:57 again, very significant. She is not getting 11:01 young again, she has got to take that 11:03 seriously and she has to got to go for an 11:05 immediate consultation with a doctor. 11:08 A younger woman may find that she starts 11:10 to have bleeding irregularly between her 11:14 periods at a time when she wouldn't 11:16 suspect that she should be bleeding and 11:19 so should that happen that again is indicative 11:23 that she needs to go and see the doctor. 11:24 What the risk for a younger woman, 11:26 you mentioned earlier that it was the 11:27 older woman who usually got the endometrial 11:29 cancer, but and you now say that younger 11:32 women may also get it, is it rare or? 11:35 It's much less common in a younger woman, 11:39 but a younger woman who is obese, 11:41 who is diabetic, who has irregular menses 11:45 has not had children, who begins to find 11:47 abnormal bleeding, she needs to pay 11:50 particular attention to this and seek some 11:53 advise from her medical professions. 11:55 Is there any test that one can get for 11:56 endometrial symptoms or like cancers? 11:58 As with all types of cancers we do really 12:02 need to be definitive about the diagnosis. 12:07 So, yes, a history is taken and a physical 12:10 examination is taken, we might examine the 12:12 lady if she finds huge fibroids. We may know 12:16 to find out on the history that she's been 12:18 taking some hormonal preparations or some 12:21 type of alternative therapies that have a 12:25 hormonal like activity, so depending on 12:28 what she's been doing well there may be 12:29 an answer for the abnormal bleeding on 12:32 the other hand in the absence of clear cut 12:35 factors we may need to say what is going on. 12:39 The examination may not be very helpful 12:42 and in that situation sometimes an 12:45 ultrasound examination will show us the 12:48 thickness of the endometrium, that lining 12:50 that I showed you in the paw paw, 12:52 that can be thickened and enlarged and will 12:54 be shown on ultrasound to be so. 12:57 But the most definitive way would be to 13:00 actually obtain some tissue from the 13:03 endometrium and a gynecologist will possibly 13:06 even in the office do what is called an 13:08 endometrial biopsy. Now an endometrial biopsy, 13:11 you take a little cannula, a little plastic 13:13 canola its inserted, is like a tube, 13:17 a little tube okay, it's inserted into the 13:19 cavity of the uterus. So it would be put 13:22 where you saw the seeds all that there 13:23 are not seeds in usually, but we put it 13:25 through the cervix into that cavity and a 13:28 little syringe on the end and with the syringe 13:30 you can create a vacuum, a little suction 13:35 and then you manipulate that little cannula 13:39 up and down and it sucks cells into that 13:44 cannula, those cells are then placed in a 13:47 little jaw of fomblin and sent to the 13:50 pathologist, hopefully the pathologist is 13:53 gonna give us a good diagnosis. Now, in a 13:56 woman who is post menopausal she may 13:58 be bleeding because her hormones are so low, 14:01 she has a low grade infection something like 14:03 that and you do that procedure and you get 14:05 very, very few cells, the pathologist says 14:07 atrophic that means lacking of hormone, 14:10 atrophic thin endometrium, no 14:13 evidence of any malignancy. So that you 14:15 say well this is probably because we just 14:18 having a very, very low hormone or 14:20 inflammation or something like that, 14:22 but we may also find cells that are 14:25 inductive of cancerous or precancerous 14:29 change and that would be very good, 14:31 we'd like to see precancerous rather than 14:33 cancerous, because that means the 14:35 treatment that we're going to do, can be 14:37 done in such a way that we treat this 14:39 very early and the prognosis or the outcome 14:43 for somebody that has an early diagnosed 14:48 endometrial cancer is really excellent, 14:50 just very, very good. But there is really 14:53 then, are you saying that there is really no 14:54 test, there is no blood test, there is no 14:56 hormone test, the doctors can do on a 14:59 regular basis than that's what we like to 15:00 talk about, how often should a woman go 15:03 to her gynecologist. Well, a woman should 15:06 certainly go to her gynecologist if we're 15:08 talking endometrial cancer, this is not 15:10 cervical, may be I'll answer that question in 15:11 like of cervical cancer a little differently 15:14 but certainly go if she has any bleeding 15:16 after the menopause. The menopause comes, 15:19 she's gone her years, she knows she 15:20 has no further bleeding, when bleeding 15:22 comes out of the blue absolutely mandatory 15:25 that she should go and seek highly 15:28 skilled professional attention immediately, 15:31 don't delay it, don't put it off, take no 15:35 chances because you can be a hundred 15:37 percent killed, of course a regular 15:39 gynecological examination visit with 15:41 your gynecologist during reproductive years 15:44 is advised for most women because it's 15:47 much better to pick something up early 15:49 and prevention is far better than cure. 15:53 Now, suppose unfortunately the doctor 15:55 finds that there is cancerous cells there, 15:59 what happens then, do they, what about, 16:02 I understand there's something like putting 16:06 this cancer in stages of seriousness, 16:08 well of course, as staging, as with all 16:10 cancers we want to stage. You know there 16:12 are different systems of staging, one is 16:14 the tumor itself, one ought to see if there 16:17 are lymph nodes and other is metastasis, 16:19 so we sometimes call it the TMX or TNX 16:23 staging system. What really needs to be 16:26 done is to see if there is any evidence that 16:30 this cancer has spread, so the doctor will 16:32 order a series of investigations, the aim 16:36 of which is to show the extent of the cancer. 16:39 If the cancer is spread to the pelvis, 16:40 to the lymph nodes and so forth, 16:42 then to do that he may order a bone survey, 16:46 he may order MRIs, ultrasound, but MRI is 16:49 probably what he's going to want to do 16:51 to see that he may do x-rays of the kidneys 16:54 to see that the kidneys are draining well 16:56 and so forth but once he has delineated 17:00 this then there are two principle modalities. 17:03 The one for endometrial cancer would be 17:05 a hysterectomy, which would include the 17:08 tubes and the ovaries, because one would 17:10 want to get a wide scope here. If lymph 17:14 nodes are detected by extension then 17:16 further therapy would be added. 17:19 Radiation therapy is usually done in 17:22 conjunction with the surgery. So, because 17:24 the surgeon says I think we will use radiation. 17:27 Doesn't mean that he believes that you 17:30 have a particularly worse situation but we 17:32 know the results of radiation combined with 17:34 surgery give better results, some give the 17:37 radiation before, some give the radiation 17:40 afterwards. Your own practitioner, 17:42 your own specialist will tell you the 17:45 gynecological oncologist will tell you what 17:47 is the preferred method of treating your 17:50 particular cancer. Now, this is serious, 17:53 taking out your ovaries and all those sexual 17:57 aspects of a woman, should someone ever 18:01 think about getting a second opinion. 18:03 I think it's very wise to have second opinions, 18:05 second opinions are good for the physician, 18:08 second opinions are good for the patient, 18:10 you don't look back and think I wish I'd done 18:12 this, I wish I had done something else, 18:14 in a clear cut case most cases will follow 18:17 what I have said and it is serious to have 18:20 the uterus removed and the ovaries, 18:21 but unfortunately it's an older woman's 18:24 condition and by that time many woman have 18:27 ceased to need their uterus for child bearing 18:31 procedures and they are post menopausal 18:33 and so the hormone production from the 18:35 ovaries has dropped. So, usually women do 18:39 not notice it as being very serious as far as 18:43 hormonal deprivation is concerned. 18:46 Now, if they have a, if a woman has a 18:47 hysterectomy how is that gonna effect her 18:49 sexually, the way she feels, her energy 18:52 level, how does that effect, any notice, 18:56 any difference? I think some women claim 19:00 that it does make a difference and we 19:02 would be insensitive to their claims if we 19:05 said it didn't make any difference, in reality, 19:09 in large studies people who have sexual 19:12 difficulties after hysterectomy are not 19:14 very much increased over those who do not 19:17 have, sexual difficulties may come from reasons 19:20 of hormonal depletion, aging process and so 19:25 forth. We sometimes say that a woman who 19:28 has a normal sexual drive, normal sexual 19:30 activity before will continue to do so 19:34 afterwards and person who has had 19:36 problems or difficulties will continue with 19:38 problems and difficulties afterwards. 19:40 But of course there may be some consequences 19:43 of surgery that could cause for pain, 19:46 scarring and tissue damage, and a women 19:49 needs to be upraised of all of this by her 19:51 physician. Now, another type you mentioned 19:54 early was cervical cancer. What, how does 19:57 that differ from endometrial, of course the 19:59 place is different but, place is difference as 20:00 you've explained, and it's a different 20:02 cellular process. Okay, tell us about that. 20:04 With cervical cancer we're looking at a 20:06 situation, that the epidemiology of it, 20:09 that is studying the population that gets it, 20:12 they found that people who had early 20:15 sexual encounters, multiple sexual partners 20:19 and women who had been or had evidence 20:22 of having been affected with the Human 20:24 Papillomavirus. Those people have a 20:28 much greater risk of cervical cancer. 20:33 And today we believe that the bulk of 20:35 cervical cancer not all, not all and I 20:38 would not want, have used to go away with 20:40 the idea that anybody had cervical cancer 20:43 must have had a Human Papillomavirus 20:45 infection, but the bulk of them are 20:46 probably related to that. There are other 20:49 forms of cervical cancer that are not 20:53 related to human papillomavirus. It also 20:56 seems that herpetic infection, herpes 20:59 plus human papillomavirus may 21:02 increase the risk. How are these acquired? 21:05 Well these are all sexually transmitted 21:07 and acquired through sexual intercourse. 21:10 That's why multiple partners and beginning 21:13 very early seem to be factors in 21:16 predicting whether you will get a cervical 21:19 cancer. So that's one of the different 21:20 pertaining cervical cancer and endometrial 21:23 And endometrial cancer. Very big 21:24 differences. Early sexual encounters has 21:27 nothing to do with endometrial cancer. 21:29 Now another interesting feature here is 21:31 smoking. They have found that women who 21:33 smoke have an increased cervical cancer 21:36 and women who take birth control pills 21:38 seem to do, but it is thought that it may 21:41 not actually be a direct effect but just 21:44 an associated effect, because women who 21:46 start on birth control pills early may have 21:49 more sexual partners and be more sexually 21:52 active, they're not people who don't, 21:54 and smokers we know, women who 21:57 smoke also are more sexually active and 21:59 may have more sexual partners, as a 22:01 group not an individual of course. 22:03 But as a group. So, that shows through 22:06 when you start looking at the epidemiology 22:08 of cervical cancer. So, some of the things 22:10 that we can do or may be instruct our 22:13 daughters to do or not to do would be 22:16 not to smoke. First of all, not to have 22:19 early sexual partners. I think that's the 22:22 order. Not to have multiple. Which order 22:24 would you put them in. Well first of all 22:26 I think it's definitely related to the 22:28 sexual activity. Okay. See and of course 22:31 when they are rebellious or when they 22:33 are wanting to prove their womanhood 22:37 sometimes they smoke and those same 22:39 motivating factors that would lead them 22:41 to smoke. Sometimes lead them to be 22:44 experimenting with sexual activity and 22:46 to be more interested in sexual activity 22:50 then would be people who tend to take 22:53 a more measured lifestyle and be more 22:56 controlled themselves. I think we need to 22:58 teach our daughters that there are dangers 23:00 in early sexual encounters, particularly 23:04 young girls seem to be more at risk for 23:06 Human Papillomavirus infections. So it's 23:09 very, very important for us to stress that, 23:12 and this is probably related to taking 23:14 drugs or taking alcohol, and of course that 23:17 whole scene you see, yeah I saw sort of. 23:18 These pictures are all tied together so, 23:21 using alcohol, using drugs. Drugs are often 23:24 used to heighten sexual activity. 23:26 So all of these factors tied together, 23:28 so the lifestyle that we choose when we 23:31 are very young, may actually impact us 23:34 evenly. I remember seeing a 70-year old 23:37 lady, who had cervical cancer and it came 23:41 on, you know, at 72 I diagnosed it, 23:43 and when I took her story, she told me, 23:45 yes when I was young I used to be 23:47 sexually somewhat promiscuous. And so she 23:51 had carried the virus for many years. 23:53 The virus had got into the nucleus of the 23:55 cells. And over the years has caused trouble. 23:57 Now we would be remiss, if we didn't 24:00 stress the importance of the pap smear. 24:03 Oh yeah, that's why it is a test we can 24:05 do for that. We don't have that test for 24:07 endometrial, but we do for cervical. 24:09 But for, for pap smears have reduced 24:13 the numbers of deaths. I remember 24:15 sitting in a clinic in Africa. I worked with 24:18 King Edward the VIII hospital in Durban 24:20 for a year. We could walk in there, 24:23 there maybe 200 people in the out patient, 24:25 gynecological out patient coming to see us. 24:27 You could walk past and smell the two or 24:31 three women that day would be coming 24:33 in with cancer of the cervix. Of course 24:35 at that point it's too far gone, because 24:38 it's invaded the bladder, it's invaded the 24:40 rectum, maybe it's closing off the tubes 24:43 coming from the kidney, those women are 24:44 doomed. But, if it can caught early, it can 24:48 be treated so successfully so that the 24:50 pap smear has reduced the amount of 24:55 deaths from cervical cancer so dramatically. 24:58 And it's a simple test. So we recommend 25:01 for most women over 21 that they 25:05 should go. Now a virgin who has not had 25:08 any sexual activity probably doesn't need 25:11 to be having a pap smear. But a woman 25:14 who has been, even may be not, 25:16 is still a virgin, but has been sexually 25:18 experimental may acquire Human 25:21 Papillomavirus, so we do recommend that 25:24 people should be checked and they should 25:27 take a very great care to look after 25:29 themselves. Even if they have had sexual 25:32 dalliances along the way. One question, 25:35 what about personal hygiene. Daily bathing 25:38 and things like this, does this have 25:39 anything to do with it? Well you know, 25:41 one's personal hygiene is a reflection 25:43 of one's lifestyle and people who are 25:46 clean will be punctilious about their care, 25:50 but you can be as clean as you like, 25:54 the Human Papillomavirus will be transmitted 25:58 even in clean people. So you have to 26:00 be careful about your partner. 26:01 That's why it's important for partners 26:03 not to have many sexual dalliances, 26:05 because they may finally settle down 26:08 but they bring to their marriage these 26:10 viruses that can cause disease. Now you, 26:13 in the illustration of the papaya, you are, 26:15 or paw paw, you cut off the end. 26:17 That's the surgery. That would be surgery 26:19 would it not. But that was just an illustration. 26:21 I know, but what about surgery. Is that. 26:24 Well we have to quickly go through the 26:25 treatment maybe of cervical cancer, 26:27 in the very early stages we can actually 26:30 skin the surface and get rid of the cancer 26:32 that can be done with Cryo freezing therapy, 26:35 can be done with Electro therapy. 26:37 It can even sometimes just be cut off 26:39 with a Conization. But if the cancer starts 26:42 to extend then we are either going to go 26:45 to radiation and radiation therapy is very, 26:47 very useful for the cervix, because you 26:49 can put the rod containing radio active 26:52 material right into the cervix and actually 26:55 radiate. The problem with cervical cancer 26:57 is when it's diagnosed late and is already 27:00 spread to other organs, in that situation 27:03 we are going to have much more difficulty 27:05 in controlling it. Although great things 27:07 can be done and major surgeries can be 27:09 done to clear it out, but it's much better 27:12 to diagnose it early. So the take away 27:13 message that I would like to leave is 27:16 please if you're a woman take good care 27:19 of this wonderful body that has been 27:21 given you, and if you feel that there may 27:25 be a problem follow up early, don't delay. 27:29 Very good, I want to thank you Dr. Handysides 27:31 for being with us today, good to be, 27:33 enlightening us on this important topic. 27:35 And to our viewers, I want to thank you 27:37 for watching Wonderfully Made today. 27:40 We have discussed an important topic 27:43 about an important body of ours. The only 27:45 one we'll ever have. And so remember, 27:49 if you have any irregular bleeding, 27:51 go see your doctor. Go see your doctor 27:53 to get a pap smear on a regular basis. 27:57 Keep faithful to your husbands and if 28:00 you're not yet married wait until you do 28:03 get married before you have sexual activity, 28:06 because that's going to protect you from 28:07 having a very terrible disease and 28:10 remember it's curable in most cases. |
Revised 2014-12-17