Lots of women feel uncomfortable discussing gynaecological problems such as sexually transmitted diseases, periods and atypical changes (e.g. in discharge, smell etc.) which could be related to more serious problems such as cancers. But why is this the case?
‘Saying vagina won’t kill you, but avoiding saying it could.’
Firstly, social stigma around talking about gynaecological issues is prominent in today’s society, with studies finding 65% of women feel uncomfortable even using the word ‘vagina’.
This causes women to avoid or be embarrassed to seek help for gynaecological issues; if you don’t even feel comfortable saying the word vagina, how can you expect to explain your problems to a complete stranger! A developmental theory on why women may be embarrassed to say vagina leads right back to childhood. Pretty much every woman I know has a different ‘pet’ name for their vagina they were taught to use when they were a child. Examples include; nunny, fairy, flower, bits, foo foo, front bottom…the list goes on. This causes a habit of referring to the vagina as these euphemisms and using the word ‘vagina’ becomes stark, shocking and embarrassing purely because we aren’t used to hearing it!
An even bigger issue is a lot of women don’t actually know what the vagina is (the internal passage) and often mistake it for the vulva (the outside parts). Research from a gynaecological cancer charity called the Eve Appeal found only 44% of women were able to identify the vagina, and only 60% the vulva!
This poses a massive problem as if women do actually make it to their healthcare professional to discuss a concern, they may be describing their symptoms wrong. The #knowyourbody campaign by the Eve Appeal aims to educate women on the anatomy of their genitalia and reduce the stigma around saying the words vagina and vulva.
What are they and why are they important?
Attitudes are ways we think and feel about something (saying you like reading the Lowdown’s blog posts is an attitude!).
These are important as they influence behaviour. For example, if you have a negative attitude towards talking about gynaecological issues with friends or medical professionals, you’re less likely to actually do this when your experiencing problems. This causes a wealth of issues as women who feel uncomfortable discussing gynaecological health problems are at risk of ‘putting off’ going to a professional. This can exacerbate the issue as it is left untreated which can potentially be life threatening. This issue is highlighted by a survey done by Jo’s Cervical Cancer Trust which found 1 in 4 women don’t attend cervical screening, more commonly known as a smear test, due to embarrassment.
Considering smear tests prevent 75% of cervical cancers, this is a huge worry.
We asked you over on our Instagram, how many of you feel comfortable speaking about female health problems to a healthcare professional. Interestingly, out of 473 people, the majority (62%) of people said they were comfortable speaking to a professional. This is great and hopefully represents a change in attitudes from previous research! Although, the results may be biased due to sampling method…if you follow us (a page posting about women’s health), you’re probably more likely to feel comfortable speaking about it to others!
However, it’s not just attitudes which influence healthcare seeking behaviour, our unconscious biases also play a role and you wouldn’t even notice…
For my final year project at university I conducted a research study investigating the effect of implicit bias on gynaecological healthcare seeking. Firstly, implicit bias is separate to your explicit attitudes. For example, if you say ‘I like reading the Lowdown blog’ that would be an explicit attitude. Whereas, an implicit bias is unconscious, somewhat automatic, kind of like a reflex…but you don’t know it’s happening. Implicit bias has been shown to influence behaviour in many ways and can even override your explicit attitude. A lot of research has found people have a negative implicit bias towards stigmatized or oppressed groups in society such as overweight people and the BAME community. For example, research finds people will explicitly say they have no preference between races, when actually their implicit bias says otherwise and this can influence how we interact with different people without even realising.
As the word vagina has a longstanding social stigma attached to it, much like the groups who experience negative implicit bias against them, I decided to test the theory that women would hold a negative implicit bias to gynaecological words such as vagina and vulva. The results of my study showed over 60% of women did have an implicit bias even though the majority of women reported positive explicit attitudes. Moreover, when this was analysed against healthcare seeking behaviour, it had a significant effect (although small) on whether someone would visit a professional if they had a female health issue.
Hopefully, in the future, more research can be done on this topic and public health interventions aiming to increase healthcare seeking can take into account the unconscious biases women may hold too!
The effect of the internet
In the age of the internet, almost anything can be found online and it seems young women are turning to Google for their gynecological health problems, in place of medical professionals. A study ran by Ovarian Cancer Action found 57% of young women (aged 18-24) would do a Google search of their vagina-related problems compared to only 17% who would actually make a GP appointment.
Googling symptoms is particularly an issue as the information online is not always correct or useful. One study evaluated the accuracy and quality of 750 webpages giving information on fibroids (growths which develop on the womb). Out of all these pages, only 12 were classed as accurate and none of the sites were both accurate and of high quality.
This is very worrying as switching a qualified medical professional for the internet can lead to misinformation and potentially harmful outcomes. Moreover, using the internet to try to diagnose symptoms can actually cause confusion and a state of anxiety which has even become a condition called ‘cyberchondria’.
However, it’s not all doom and gloom as social stigma and attitudes are flexible and subject to change! As mentioned before, charities such as the Eve Appeal “know your body” campaign aim to normalise talking about gynaecological health and improve women’s knowledge of their body so they can feel comfortable talking to healthcare professionals about any issues.