Did you know that this week is Cervical Screening Awareness Week (CSAW) 2017 between 12-18 June?
Regular cervical screening offers the best protection against developing cervical cancer, which is a largely preventable disease.
Evidence shows routine screening prevents up to 75% of cervical cancers and saves 5,000 lives a year in the UK, yet one in four women don’t take up their screening invitation. Please don’t be that one in four and book a smear with your GP today!
So this week, with our lady parts at the forefront of our minds, I thought it would be a good idea to I’ve ask gynaecologist Dr.Anita Mitra to answer some questions on what’s going on down there!
“I’m an NHS doctor in the (very long) process of completing specialist training in Obstetrics and Gynaecology.
I actually started off doing a BSc in Medical Biochemistry which is where I developed an interest in medical research, and I also wrote my dissertation on the anticancer mechanisms of turmeric…waaaaaay before Pret a Manger ever thought of selling a turmeric latte! I continued working in the same research group during the first few years of medical school and then went on to do research in the field of kidney transplantation and had big ideas of being a kidney transplant surgeon. During the last few months of medical school I saw the light and realised that a career in Obstetrics & Gynaecology was for me, and whilst there have been many bumps and detours along the road, I’ve not looked back.
I recently took 3 years out of clinical training to do a PhD about the mechanisms of cervical cancer development. During my time on the wards, in clinics and theatres, I realised I had a bit of a knack of making people feel at ease to ask questions and have conversations that the usually find embarrassing. It was this, coupled with my aforementioned love for research and the lack of reliable and relatable information on women’s health available online that prompted me to start my blog called ‘The Gynae Geek’.”
Biggest myth when it comes to women’s sexual health that you want to bust?
“HPV aka Human Papillomavirus: it isn’t the shameful, dirty sexually transmitted disease that everyone makes it out to be. It the virus that causes abnormal smears and ultimately cervical cancer in a very small number of women. But it’s actually a surprisingly common virus, and by the age of 50 years, 90-100% of women will have had an infection, but most won’t even know it because they cleared naturally. Sex is what gets the virus to the cervix, but it’s actually all around us in the environment and on our skin. So as much as I love the programme ‘Girls’, I need to correct Hannah…when she famously referenced HPV and stated ‘all adventurous women do’, what she actually meant was ‘all women do’. I recently wrote a blog post on this for anyone who wants to learn a bit more which you can find here.“
The gut microbiome is one of the biggest areas of research at the moment and we know that it is linked to a number of conditions from irritable bowel syndrome to obesity, and even our mental health.
What do we know about our vaginal microbiome?
“I spent a lot of time during my PhD researching the vaginal microbiome, and this is also something I recently blogged about. Firstly it’s completely normal and healthy to have bacteria living in your vagina. The healthy vaginal microbiome contains a lot of lovely Lactobacillus bacteria, which are really clever when it comes to keeping us healthy. They work really hard to stop the growth of ‘unhealthy’ bacteria that can cause smelly, irritating discharge, and also increase the risk of getting sexually transmitted infections, HIV, pregnancy-related complications (such as miscarriage and early labour) and cervical cancer. But also what’s super interesting is that some women survive very well without really any Lactobacillus, so we still have a long way to go to understand the intricacies of how the vaginal microbiome interacts with the workings of each individual body.”
Should we be taking a probiotic for our vaginal microbiome?
“For the moment the answer is ‘not right now’ for the majority of women.
There are some ‘women’s health’ probiotics out there, but there’s not really a huge amount of evidence to suggest they’re really the right type of probiotic for women who don’t have any symptoms. The best thing I advise currently is to make sure you have a healthy diet that contains lots of good pre- and probiotic foods. Studies suggest that the gut microbiome influences the composition of the vaginal microbiome, so all the foods that promote gut health should promote vaginal health.
There are a small group of women who could benefit from taking a probiotic. They are people with recurrent bacterial vaginosis, or recurrent urinary tract infections, and although their use in these conditions is not currently recommended by the NHS, there is a lot of evidence to suggest it could be helpful and they certainly don’t do any harm. That said, it’s definitely worth doing a quick dietary shape-up before shelling out for any probiotics.”
Is there a such thing as a “normal” vagina? what would be an abnormal sign or red flag which we should look out for?
“I get asked ALL the time ‘does my vagina look normal?’, which I totally don’t mind, as I would rather people ask rather than worry about it. But I always respond with ‘there’s no such thing as normal’.
Just like humans, vaginas come in all shapes and sizes. And what people are actually asking me is whether their vulva (the bit you can actually see), rather than their vagina, looks normal. Your labia usually do poke out a bit and are not meant to be symmetrical, and you do not need to have them cut off to ‘look normal’ regardless of how women are portrayed in the pornography world. Labiaplasty is the name for the surgery which involves trimming the labia, which can be a cosmetic procedure, but in my opinion should only be performed in women with really physical problems where the labia rub during physical activity and become inflamed and very sore.
Other vagina related red flags are mainly related to vaginal discharge. You should go and see your GP if you have a discharge which is: blood-stained, itchy/irritating, bad smelling or associated with pain.”
What should, or shouldn’t, we be doing in order to have a healthy vagina?
“As well as having a healthy diet, here are my top tips
1. No smoking – believe it or not, nicotine and other harmful compounds found in cigarettes can be detected in the vaginal secretions of smokers. It kills off the healthy Lactobacillus putting us at risk of the complications I mentioned earlier.
2. Don’t douche – your vagina is very self-sufficient. It knows how to clean itself, so just leave it well alone.
3. Get a sexual health check – it’s not a shameful thing to do, it’s the responsible thing to do.
4. Get your smear when you get your invite – it’s every 3 years from age 25, it takes about 3 minutes and it’s the number one thing you can do to protect yourself from cervical cancer”
Finally, what are you most excited about in the world of gynaecological medicine?
“Getting women to talk about it! And men! We all started life in a womb, and the majority of us came into the world through a vagina, so I’m not sure why it’s such an awkward topic to talk about. Many gynaecological problems go undiagnosed for a long time because women are embarrassed to talk about it. If we can make people feel more comfortable to talk about women’s health and not treat it as a dirty secret, we will be able to improve health outcomes and prevent unnecessary suffering in silence.”