Would you know the vagina from the vulva?
The moms pubis from the perineum? Foof, fanny, fairy…There are words galore that are used to describe female genitalia but in 2019 it’s still a taboo a subject and Tough Cookies Education say it is time to change that! AS a sex and relationships educator, I spend most days talking to teens about bodies, consent, sexting, and condoms. The terminology around sex and relationships education is pretty normal to me and I share these words without even thinking about it.
And so I was surprised recently, as I began to work with teachers and educators whose role it will be to provide sex and relationships education. Finding many could not label the female genitalia confidently and most described feeling uncomfortable using the vocabulary needed to teach young people about this. And it seems this lack of understanding and embarrassment about the female body extends further than my experience too.
Research carried out by YouGov, which involved showing British adults an image of female genitalia and asking them to identify the various parts and functions also found that 45% of the women asked were unsure about the location of the vagina, many more were unable to explain where the urethra is and others failed to correctly label the labia.
Males didn’t do any better either, with 59% unable to label the vagina and unsure where the urethra or labia was.
WHY WE NEED TO TALK ABOUT THE VULVA!
A new booklet aimed at educating young people ‘So what is a vulva anyway?’ was launched in March 2018 by the Royal College of Obstetricians and Gynaecologists. Research led by the team found that many young women felt there is a lack of understanding about the vulva, they said they were not taught enough in school and were likely to find out what they wanted to know through searching online. Laura West, participation and volunteering manager at Brook, who said: “All young people deserve an education, support, and advice about anatomy, but unfortunately there is a lack of accurate and sensitive information available as part of the school curriculum and on the internet. This new booklet will help to address this need and will inform doctors, girls, young women and their families, as to what is normal and where to seek further help and support if required.”
Labiaplasty which is often referred to as a ‘designer vagina’ is a surgery that involves the lips of the vagina being shortened or reshaped. The NHS states that it should not be carried out on girls before they turn 18, but according to NHS figures, more than 200 girls under 18 had labiaplasty in 2015-16, and more than 150 of these girls were under 15.
Women’s gynaecological cancers
There are five gynaecological cancers – womb, ovarian, cervical, vaginal and vulva – but awareness levels of these cancers are very low. The statistic from The Eve Appeal state that each year in the UK, over 21,000 women are diagnosed with a form of gynaecological cancer. Their campaign #GetLippy encourages women and men, to speak up and out about the signs and symptoms of women’s cancers, and raise funds for life-saving research.
“One of the things that made me so angry is that fact that I had never heard of vulva cancer, we need to raise awareness. It is important to me that the word vulva is used, and that people are better educated about the female body, these small steps could make big changes and save lives.”
Cancer survivor, Clare Baumhauer is on a mission, she is making it her goal to get people educated about the vulva!
Clare, 46 from Kent, was diagnosed with vulva cancer and lichen sclerosus in 2016, she had been visiting the GP with symptoms for over ten years.
“We need to be taught to look at our bodies, the same as we are encouraged to check our breast. I think it is changing, and the younger generation are finding it much easier to talk about than the older generations did. Things like the ‘vajazzle’ are probably helping younger women have these taboo conversations. But there is still a long way to go, and encouraging the correct use of vocabulary is key that.
“For me though, I didn’t even know about the word vulva until I got diagnosed with vulva cancer”.
Clare explains: “When I was going to the doctor and describing my symptoms, I was using the word vagina, which I now know does not describe the whole area. It is very important to know the parts of the body to be able to describe your symptoms and help you get the correct diagnosis.”
Clare repeatedly went back to the doctors throughout her 20’s and 30’s, she said: “Eventually, I just stopped going. I was always told the same things. I saw a number of doctors, locums, nurses. The symptoms I had are similar to cystitis and thrush, such has itchiness around the vulva area, burning sensation when I went to the toilet. So, I was always given the same diagnosis.
“TV adverts for thrush treatment and vaginal itching normalised the symptoms for me. I started to believe that this maybe wasn’t an illness and was just ordinary for some women. This meant that I ignored the symptoms even more in my late 30’s”.
It wasn’t until Clare developed a painful tear in her perineum, that she decided to seek help again: “At first I told myself this was normal after having children and presumed it would heal by itself.
“I was seen by midwives and I never missed a smear appointment and so I assumed if there was anything ‘not right’ it would have been picked up on these occasions. But nothing was ever said.
“My smear test results were always clear, and I thought that the people carrying out smears would be educated to spot any symptoms, it is only now that I know they haven’t been trained which is something I am campaigning for to change now”.
Eventually, the tear, which Clare had suffered with for a few years, worsened and turned into an ulcer. “I had been to see a doctor about the tear and was told it was nothing to be concerned about. But I couldn’t stand it any longer, it was hurting to just sit. I went back to my local surgery. It was a different doctor, and this time she said it may be vulva cancer, this was the first and only time this had ever been mentioned to me. I explained I had never heard of it.”
Clare was referred to the oncologist hospital, where they carried out a biopsy, and in April 2016, she was diagnosed with grade 3 squamous cell carcinoma of the vulva (perineum). Clare said: “I had surgery, to remove a tumour, and 24 sessions of radiotherapy, a routine scan after this, showed that there was a swollen lymph node. I underwent further surgery to remove 6 lymph nodes which were also shown to be cancerous”.
Clare is campaigning to raise awareness of lichen sclerosus, she would like to see health professionals that carry out routine gynaecological procedures to be trained and for more women to be made aware.
Clare said: “Embarrassment wasn’t an issue for me, obviously it was there, many doctors were men and it was awkward and embarrassing, but it never prevented me from going for help. On many occasions, I was not even examined, they didn’t look. They always asked for symptoms and then they prescribed over the counter medicines. Vulva cancer was a cause of the untreated lichen sclerosus and for so many years I was using other over the counter remedies to treat this.
“Now is the time to bring about change. We need health professional and nurses to be trained and made aware of lichen sclerosus, my diagnosis was missed over 30 times, if this was detected earlier, I may have had treatment which was not as invasive.”
WHAT IS LICHEN SCLEROSUS
Lichen sclerosus (LS) is a chronic inflammatory skin disease. Mainly affecting the genital skin. It affects men, women, and children at any age. It is known to be a progressive condition that relapses and remits. There is no cure and there can be a small risk of genital cancer in men and women.
WHAT IS SQUAMOUS CELL CARCINOMA
Squamous cell is the most common type of vulval cancer. About 90 percent of vulva cancers diagnosed are this type. Before it develops, there might be precancerous changes in the cells of the vulva. These can be there for several years
THE EVE APPEAL #GETLIPPY
The Eve Appeal is the only UK national charity raising awareness and funding research into the five gynaecological cancers – ovarian, womb, cervical, vaginal and vulval. For more information go to www.eveappeal.org.uk
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First Written for @pressmum