Do you know vagina from your vulva? Have you ever looked at your cervix? How well do you know your breasts? What does your clitoris feel like? What’s the difference between your labia menora and majora? Do you know what day of your cycle you are on? Did you notice the last time you ovulated? How do you deal with your menstrual blood? When you look at yourself naked in a mirror do you feel pleasure or disapproval?
If you are struggling to answer some of these questions, don’t worry, you’re not alone. Apparently up 50% of women in the UK between the ages of 26 and 35 have trouble telling their vulva from their va-jay-jay.
Women of my age are supposed to be living in the post-sexual liberation, post Sex and the City, post Vagina Monologues era. We have Girls, Amy Schummer and Laci Green. Nevertheless, it seems we are having more trouble than our mothers in terms of identifying correctly our own anatomy, comfort in speaking about our bodies and seeking gynaecological care. According a recent survey conducted by the UK cancer charity the Eve Appeal: “65% of young women saying they have a problem using the words vagina or vulva, and nearly 40% of 16-25 year olds resorting to using code names such as ‘lady parts’ or ‘women’s bits’ to discuss gynaecological health (…) half of women aged 26-35 were able to label the vagina accurately. In contrast older women aged 66-75 were much better educated about their bodies, with eight in ten able to correctly label ovaries and nearly nine in ten the womb.“
So what is going on that women of my generation? We have more access to information than any previous generation yet we have little knowledge of and are highly embarrassed by our own bodies. Is it poor sex education which focuses solely on fear-mongering, pregnancy and disease prevention, not to mention abstinence? The ever greater pressure on young women to conform to a narrow ideal of beauty that stipulates blond hair, a 28 inch waist and a hairless vulva? The fact that body hatred in general is soaring among young girls and women? That labioplasty is becoming an increasingly popular elective surgery among teenagers worried their vulva is not ‘normal’? That using the correct names for female anatomy in a classroom is enough to get you fired? That in the US 80% of 10 year old girls have been on a diet? That public policing of women’s bodies and women’s beauty has become so internalised that the average woman monitors her body every thirty seconds? Is my tummy sticking out, am I slouching, can you see my double chin from this angle?
Perhaps it is all this and more? We are only begining to address the centuries of fear, suspicion, censorship and control of women’s bodies and sexuality. Religion and later science conspired to relegate women to a subordinate position in society on the biological determinants of reproduction and motherhood. They have created pathologies of women’s natural biological processes and regulated our reproductive capacity from before conception even occurs. Hysteria, a condition where the womb was said to roam about the body causing all kinds of emotional disturbances in women may seem laughable to us now. 150 years ago however, this diagnosis was regularly used to condemn women to psychiatric insitutions and forced clitoridectomies and hysterectomies.
The emergence of the Western medicine, with all its advances in treating and curing disease, has given rise to both liberty and the further regulation and medicalisation of women’s bodies. Modern methods of birth control are to be celebrated for sure but pregnancy and birth have never been more heavily medicalised. ‘Hysteria’ is no longer regarded as a medical condition, yet research is underway into possible medications and procedures for ‘correcting‘ female sexual response and low libido. Research of these ‘conditions’ should be welcomed, but maybe they have more to do with living in a culture of systemic violence against women where the concept of sexuality is very often limited to vaginal penetration by a penis. Meanwhile there is a whole pharmacuetical industry dedicated to maintaining us disconnected and ignorant of our bodies and a beauty industry that profits from our body hatred by offering us inumerable ways to ‘transform’ and ‘improve’ our physical selves.
As the Eve Appeal report highlights, the lack of knowledge and embarrassment, fear or hatred of our own bodies does not just have consequences for our self-esteem and body image, but for our health as well. According to the Eve Appeal: “it’s not just a knowledge gap between the different generations that was revealed by the survey however, as the data also showed a distinct difference in attitudes towards talking about gynaecological health issues. Whilst more than one in ten of 16-35 year olds said they found it very hard to talk to their GPs about gynaecological health concerns, and nearly a third admitted that they had avoided going to the doctors altogether with gynaecological issues due to embarrassment, these figures dramatically decrease amongst women in the older age groups.” These results are particularly worrying when it comes to preventing and treating gynaecological cancers, which have a 40% mortality rate for women.
Taking Our Health Into Our Own Hands
According to Our Bodies Ourselves (my gynecological bible): “Learning about our sexual anatomy and observing and exploring our bodies are good ways to become more comfortable with ourselves and our sexuality. There are also god ways to learn what is normal for each of us and to become aware of changes and potential problems. Understanding the way our sexual and reproductive systems work, how they interact with other body functions, and how they are influenced by our life-style, environment, and general well being can help us enhance sexual pleasure, reduce the risk of health problems, and make informed reproductive decisions.”
To get over our embarrassment in talking about our gynaecological concerns with medical practitioners, we must first become comfortable and familiar with our own bodies. Gynaecologists may be experts on women’s anatomy but nobody is more of an expert about our own bodies than ourselves. Knowledge is power, and power allows us to make choices about how we care for ourselves and not simply rely on what the Doctor tells us. What would happen if we assumed an active role in the care and treatment of our bodies?
First, we might already have an idea of what is going on with our own bodies, whether that means being confident that everything is working well, or already having an idea about what might be going wrong.
Second, we will better equipped to confront the often judgmental medical staff or the over-cautious doctor that wants to prescribe a veritable shopping list of medications. To be able to say, ‘OK I understand the diagnosis but I want to try treating this condition naturally first and if that doesn’t work I will consider other options’ with the confidence that comes from knowing that there are many alternative ways of treating the most common health issues from yeast infections to UTIs to ovarian cysts. Or, when told by a nurse or gynachologist that you look a bit ‘odd down there’ (this actually happened to me) knowing that there is no one way a vulva should look and on your last inspection everything ‘down there’ looked normal for you.
Third, we might begin detecting problems far earlier and taking early action to treat infections and illnesses. Like stopping that little tingle in your vulva before it turns into a full blown yeast infection. Or, knowing when period pain or pain at ovulation go beyond the normal threshold and going for a check up. Or, realising that a missed period is a red flag telling you you’re stressed out, you may have an underlying gynaecological issue or you may be pregnant, and taking the appropriate action for you. Or, detecting irregularities in your breasts through monthly self-checks.
Finally, we might find that we actually have far less gynecological issues to begin with because we are actively caring for ourselves and not ignoring the signals our body sends us.
Self-knowledge is about taking the step from being passive patients to active participants in our own care. Your essential tools on this journey of self discovery will be first your senses, using your eyes and hands to explore every inch of your body, how it looks and how it feels in its normal state. Using your sight and your sense of smell to become familiar with your daily discharge and your monthly flow, and to spot any changes quickly. Then you will need a mirror so you can become intimate friends with your vulva, knowing intimately every fold and freckle, every shade and hue, and, off course, your all important pleasure button, your clitoris. Finally for the truly brave: a speculum. The speculum is the ultimate tool for getting up close and personal with your vagina and cervix, which can provide you with important information from ovulation to cervical abnormalities.
For absolute beginners and for a refresher course on female anatomy the Guardian has launched a new interactive online series called ‘The Vagina Dispatches’ taking you through the ins and outs of female sexual anatomy. This all does require a bit of work, patience and setting aside time to dedicate to yourself. In a world where many forces would seek to have absolute control of all aspects of our sexual health and (non)reproductive choices, self knowledge is the first step towards bodily autonomy. It is about loving yourself and your body in all its glorious imperfection.