Does naming things properly matter? I think so…especially when it comes to women’s health.

Are you talking about vaginas when you should be talking about vulvas?

The vagina is the tube on the inside, whereas the vulva is the external female genitalia, and the vestibule is at the entrance to the vagina,

so: Vulva -> Vestibule -> Vagina

thanks to the fabulous Lori Forner for allowing me to use this!

It’s World Continence Week…but I still hear ‘experts’ talking about ‘Bladder Weakness’.

There are lots of factors that can cause urinary leakage – uncoordinated, weak, tight or painful pelvic floor muscles, pelvic organ prolapse, detrusor dysfunction, constipation, neuro issues like MS or a stroke…but bladder ‘weakness’? Not so much.

Endometriosis – a disease that affects more than 10% of all the women in the world, is still mis-diagnosed (the average length of time a woman waits for an accurate diagnosis is over 7 years) and it’s STILL inaccurately described, by many of the medical community as endometrial tissue growing outside the womb.

I came across the phrase ‘bikini medicine’ a few years ago and I was reminded of it last week, when I was reading the book ‘Sex Matters: How male-centric medicine endangers women’s health and what we can do about it’ by Dr Alyson McGregor. In her book, Dr McGregor explores how ‘…despite all the scientific advances we’ve made in the past 40 years, women still experience poorer outcomes in all areas of health, and women of colour experience worse outcomes than white women.’

She elaborates further: ‘…recent research is revealing that female bodies are physiologically different from men’s, on every level – from our chromosomes to our hormones to our bodily systems and structures. Therefore, the medicine that works for men, doesn’t always work for, or even apply to, women.’

And this: ‘Sex and gender differences in medicine weren’t even being explored beyond the traditional scope of ‘women’s health’ – meaning obstetrics/gynaecology and breast health’ Hence the term ‘bikini medicine’.

Now, I’m passionate about both breast health and pelvic health  but there’s a whole person attached to those breasts and that pelvis – and we have to take her into account – what her problems are, her history and her goals. So many of my expert colleagues are busy focusing about Peri Aqueductal Grey Matter pathways in the brain’s pain processing…that they can sometimes forget they are dealing with a real life person. Don’t get me wrong – I’m not doubting motives about trying to help people or casting aspersions on people (like me) who love a deep dive into anatomy and neurophysiology and …<disappears down rabbit hole…> BUT, are we focused on what matters? And how can we empower women in their healthcare journeys?

I have some suggestions…

Firstly, teach women the proper names for their anatomy. Know the difference between a vagina, vestibule and a vulva. Listen to women when they tell you something IS wrong (even if the tests say everything is ‘normal’). Ask them how they feel, what they think is causing their issue and what their goals are. If you work in women’s health – don’t just practise ‘bikini medicine’ – understand that women’s health is more than breast and pelvic health. See the whole person.

‘The truth is, women’s health deals with exactly what the words, removed from their vernacular context imply: the overall health and wellbeing of women. It is not simply about female reproductive organs, or pregnancy, or breast health, although those are all vital components. When I talk about women’s health, I’m referring to the whole woman, body and mind, with all the complexities inherent to a physiologically female body’.

So, where can we begin? By listening and learning.

Teaching women how to do self-health checks, including learning the proper names of their own anatomies, starts here, with learning how to do a vulvar self check.

Here’s a video I did on female pelvic floor and core anatomy:

And perhaps even more importantly – recently, the Vulval Pain Society asked me to come on their webinar series and do a presentation on pelvic health at menopause – I suggested that, instead of ‘death by powerpoint’, perhaps we could open it up, and ask women what THEY wanted to know?

We got heaps of great questions – here’s Part1 of the interview.

(The Vulval Pain Society are an amazing organisation – please consider supporting their work)

As always, if you have questions…I’ll try to help find the answers – tag me on social media!

Until next time

Onwards and Upwards,