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Get the inside track on those down-below issues that we’re often too shy to talk about
hen it comes to discussing the foods we’re eating to keep us healthy, which exercise regimes we’re following to help us get fit, and what lotions we’re using to nourish our skin, it’s no holds barred. But talking about our lady parts? Hello, awkward silence. Well, it’s high time ‘down there’ moved up your health to-do list. So hear this: after all, it’s not every day your vagina speaks to you!
This is one exam you shouldn’t miss; in fact, it could save your life. ‘A smear test takes minutes, yet can offer protection against developing cervical cancer,’ says Rebecca Shoosmith, head of support services at Jo’s Cervical Cancer Trust.
Which is why I’m extremely concerned about the results of a survey by the Trust: it found that 3.7 million UK women eligible for cervical screening (aka a smear test) hadn’t attended in the past five years. Plus, the number of older women being tested is at a 17-year low – yet the 50-64 age group is more likely to be diagnosed with advanced-stage cervical cancer.
‘If you have concerns, tell your doctor or nurse,’ urges Rebecca. ‘Yes, smear tests can be daunting, but they shouldn’t be painful. If you experience discomfort, tell the person carrying out the test. Speculums [which are inserted into the vagina as part of the exam] come in different sizes, so asking for a smaller one may help, too.’ Plus, even though the nurse will cover you with a paper sheet, wearing a dress or skirt can make you feel more at ease, as you won’t need to remove them. For more, go to jostrust.org.uk.
Another tip? Check out the Boots HPV Vaccination Service* (boots.com/hpv), which is available in 68 stores. The vaccination helps protect against cervical, vaginal and vulval cancer, as well as genital warts.
I might not be able to write a note to leave in your knickers, but I’ll talk to you in other ways that are, well, pretty obvious – such as spotting or bleeding between periods. This can be a common side effect of hormone-based contraception, but may also be caused by stress, injury, dryness or benign polyps in the womb or cervix. It could also be a symptom of a sexually transmitted infection (STI), or even cervical or womb cancer.
Keep an eye on my discharge, too: a sudden change could indicate an infection. Look out for differences in colour and consistency, an unusually large amount, or a bad odour, as well as itching or soreness around my entrance, or pain in your stomach or pelvis, or when peeing. The moral of this story is: if in doubt, give your pharmacist or GP a shout. OK?
Guessed thrush? Wrong! It’s bacterial vaginosis (or BV), which is associated with an imbalance in my pH and bacteria levels. Around one in three women will get it, but about half have no symptoms (sorry). For the other 50%, I may show my distress with a discharge that’s thin or grey (and heaviest after a period or sex) and an unpleasant ‘fishy’ odour, which may be more noticeable following intercourse. It’s not sexually transmitted, but you’re more likely to develop BV if you’re sexually active. If untreated, the condition may mean a higher risk of pelvic inflammatory disease (which can cause an ectopic pregnancy or infertility), STIs and urinary tract infections. In pregnancy, it could lead to miscarriage, premature birth or pre-eclampsia.
So how can you lower your risk? ‘It’s important not to disrupt the pH or bacteria of your vagina,’ says Boots pharmacist Angela Chalmers. ‘So avoid douching, excessive washing, using medicated or scented products and vaginal deodorants. It’s best not to wash underwear in strong detergent, either. Hormonal changes during your cycle, IUDs, smoking, semen in the vagina and genes could also play a part.’ How can you treat it? ‘If you’re worried, go to the GP for a swab,’ adds Angela. ‘If it’s positive, treatment is simple: you’ll be prescribed oral antibiotics or a vaginal gel.’
A recent survey by Vagisil found a third of women over 25 have suffered intimate dryness. And with 84% saying it had a negative impact on their sex lives, it’s time to help me to help you. Yes, the most common reason for dryness is the menopause (blame the drop in oestrogen – and thanks to perimenopause, it can start fluctuating years before the big M). But in pre-menopausal women, causes can include childbirth, breastfeeding, taking antidepressants, cancer treatment and oral or injected contraceptives.
No need to nix nooky, though: there are many ways to help. ‘Don’t suffer in silence,’ advises Dr Vanessa Mackay, spokesperson for the Royal College of Obstetricians and Gynaecologists. ‘If you’re pre-menopausal, occasionally needing additional lubrication doesn’t mean anything is wrong. Your GP may be able to prescribe creams or gels to help. Or try an over-the-counter vaginal moisturiser or artificial lubricant, and apply it liberally over the vulval area. For a more natural feel, there are hydrating gels that coat the vaginal wall and release moisture over time, so you can feel comfortable and ready whenever the moment is right.’ Stick to water-based products, as anything oil- or petroleum-based may damage condoms or cause irritation.
And the menopause? ‘Again, see your GP if you’re having troublesome symptoms,’ says Dr Mackay. ‘Hormone replacement therapy (HRT) may be a possibility and can help relieve symptoms, including vaginal dryness. There are also non-hormonal therapies, including moisturisers and vaginal lubricants in the form of creams, gels and pessaries – the choice is yours.’
I get called many things: foof, flower, lady bits, front bottom, tuppence, undercarriage (and they’re some of the more flattering ones), yet many of you feel uncomfortable using my real name. Frankly, I’m hurt. And sadly, your shame extends to how I look and function – a survey conducted by gynaecological cancer charity The Eve Appeal found that around half of you can’t even identify my bits correctly (vulva, anyone?). If you don’t know what’s what, how can you spot signs of cancer?
As for my aesthetics, unless you’re in extreme discomfort, there’s no need to change a thing. Need reassurance? ‘Some women come to see me because they don’t like the look of their vagina, or because their labia cause discomfort,’ says Dr Mackay. ‘But the labia minora (the inner folds of the vulva) are there for a reason. They contain numerous glands, designed to secrete mucus to protect from dryness and irritation. Labia come in all shapes and sizes, and it’s normal for one to be bigger than the other.’
What about the rise in women asking about labiaplasty? ‘In 20 years of working in gynaecology, I’ve rarely seen a need for surgery,’ adds Dr Mackay. ‘I think part of the issue is that we don’t talk about our vaginas, and because of this we’re often unsure what’s “normal”. I tell my patients that I see about 30 vaginas a day, and hopefully this reassures them that I know when there’s nothing wrong.’ See – no need to be embarrassed about me!
The kit for happy lady-bits
Can't see your GP for weeks? Canestest Self-Test For Vaginal Infections, £9.99/999 points (1 swab), can assist in working out whether you have thrush or BV.Add
If you're suffering from recurring BV, Balance Activ BV Pessaries, £10.99/1,099 points (7-pack), can help relieve discomfort.Add
Vagisil Prohydrate Internal Hydrating Gel, £12/1,200 points (6x5g), contains moisturisers, including hyaluronic acid, to help relieve dryness, either pre- or post-menopause.Add
Got that itchy, thrush-like feeling? Multi-Gyn Floraplus, £13.49/1,349 points (5x5ml tubes), treats and helps prevent recurring symptoms.Add
If you've no time for a shower after the gym, try pH-balanced, soap-free Boots Feminine Wipes Boots Exclusive, £2.35/235 points (20-pack).Add
*Subject to pharmacist and stock availability; charges and eligibility criteria apply.
Words Danielle Hine Illustration Louisa Edge