Women’s privates are going public
As International Women’s Day approaches, Jennie Agg explores the rise of gynae gyms and hormone coaches – and asks if the new frontier of wellness is now found below the belt
There’s a word you should probably get used to hearing in 2019: Vagina. Because, from shelf to screen, our privates are going public.
A glut of new books such as Vagina: A Reeducation by Lynn Enright, The Gynae Geek: Your
No-nonsense Guide to ‘Down There’ Healthcare by Dr Anita Mitra (both published on Thursday) and
Period. by Emma Barnett (out later this year) turn the spotlight on our innermost workings. As has artist Laura Dodsworth, with her intimate photography project Womanhood: The Bare Reality, featured in the recent 100 Vaginas documentary on Channel 4. The female reproductive system even made a cameo at last week’s Oscars, with Period.
End Of Sentence – a film about the stigma surrounding sanitary products in India – taking home the prize for Best Documentary Short.
So what’s driving our newfound interest in this, ahem, area?
The wellness industry has played its part: when Gwyneth Paltrow revealed her vagina steaming routine in 2015, she was roundly mocked – such la-la land ministrations could never catch on here. Or so we thought. For, while sous-vide-ing your nether regions à la Gwynnie has been debunked (they don’t need steam cleaning, plus this increases the risk of thrush), a host of pampering products have made their way on to the shelves, seeking to deal with “issues” such as keto-crotch – that’s the odour apparently emitted from the area by those on a low-carb diet. Add to that vulva sheet masks, The Perfect V’s “revitalising” serum (sold in Harvey Nichols) and Optibac probiotics for women (capsules of “friendly” bacteria specifically designed to improve vaginal health), which can be picked up with your Ocado shop, and it’s clear how big a business this has become.
It does go beyond the superficial, though, says
Vagina: A Re-education author Enright, who believes “there’s an increased focus – and getting back to the basics, even in the words we use”.
This has grown out of the broader conversations we’re having around women’s bodies, she explains, such as female sexual pleasure and consent – brought to the fore by the Metoo movement – as well as the Repeal the 8th campaign to legalise abortion in Ireland. “A lot of these bigger issues begin with educating people about the basics of how their bodies work,” she says.
“We’re not always given that information at school or in the healthcare system. I was working at [women’s website] The Pool when I started writing the book and I could see that whenever we covered things like smear tests in a very frank way, or published very honest pieces on infertility, miscarriage or abortion, they always sparked a lot of discussion.
“People were desperate to talk about these things, but they were somehow still taboo.”
There’s probably quite a way to go. When asked, only a third of women could identify correctly the vulva, vagina, cervix, uterus, Fallopian tubes, and ovaries on a medical diagram, according to a 2016 survey by gynaecological cancer charity The Eve Appeal. By contrast, 70 per cent of women could correctly label key parts of the male anatomy.
French lessons
Perhaps unsurprisingly, we prudish Brits are late to the gynaecology game. In the US it’s normal for wealthier women with health insurance to see an OB/GYN (obstetrician-gynaecologist) for yearly check-ups, while French women routinely start seeing a gynaecologist in their teens.
French women are also famously much more au fait with their pelvic floors (the complex of muscles that line the base of the pelvis, which weaken naturally as we age and can be damaged during childbirth – leading to incontinence and sometimes pelvic organ prolapse).
“In France, pelvic floor rehabilitation is compulsory after each pregnancy and every woman is given a referral to a physiotherapist, usually around 10 sessions,” says James Turgis, a French physiotherapist and now director of Mummy’s Physio in London (mummysphysio.com). “It’s standard – everybody does it, and this means everything is a lot less taboo.”
It also means physiotherapy techniques, such as using internal probes to stimulate and strengthen the muscles, have evolved faster in France, he says, and women’s knowledge of how their anatomy works and how to do pelvic floor exercises is generally better.
“Women who come to me here often have very outdated ideas – for instance they’re still doing what I call the “pee-pee-stop” [trying to stop urine midflow to test the strength of the pelvic floor] but this is completely wrong. You should never do this, it’s not good for your bladder and doesn’t help your pelvic floor.”
While specialist physiotherapy is available on the NHS, women have to seek it out, usually through a GP referral (although in some parts of the country you can self-refer).
Turgis adds: “Over here, women still assume it’s normal to be a bit incontinent after having a baby, whereas in France women see it as something that can be fixed.”
Gynae gyms and tweakments
Thing are starting to change though, believes Dr Shahzadi Harper, a GP and women’s health specialist based in Harley Street (theharperclinic. com). “Women are becoming more interested in their gynaecological health,” she says. “Being in your 40s – or even your 60s – doesn’t mean what it used to mean, say, 20 years ago. Women are more
‘I work with women who want to better understand their body’s natural cycle’
active than ever, often still working, and not necessarily in just one relationship for life any more.”
This means they’re less willing to put up with problems such as incontinence after childbirth, vaginal dryness, low libido and painful sex, she says.
This perhaps explains growing interest in alternative treatments available privately such as the Emsella chair – a vibrating chair designed to externally stimulate the pelvic floor muscles so they contract 11,200 times in a 28-minute session, which has been nicknamed “the v-gym”.
Dr Victoria Manning and Dr Charlotte Woodward of River Aesthetics were early adopters in this field. Both GPS by training, they’ve been offering treatments including vaginal rejuvenation for 15 years, with clinics in Lymington in the New Forest, Sandbanks, Dorset, and Harley Street, London (at Cosmesurge, 51 Harley Street). “I’ve noticed a real shift in the last year or so, with more women asking for these kinds of treatments,” says Dr Manning, adding that the interest mostly comes from older women.
“I’d say 9 out 10 of the procedures we do are for functional rather than purely cosmetic purposes,” she says. “We do a lot of work with vaginal rejuvenation – such as fillers into the labia – for women who are perimenopausal or menopausal. We also do an internal hyularonic acid filler for the lining of the vagina, which can help if women have painful episiotomy scars from childbirth or if everything has got very dry with the menopause.
“And we can use internal radio frequency to stimulate collagen production, improving the functioning of the lining of the vagina and helping to keep it moisturised. It can mildly improve the pelvic floor as well.”
Period coaching
Then there are the women on a mission to make us less shy about “that time of the month”. “I think we’re on the brink of a period revolution,” says Nicole Jardim – aka The Period Girl – who works as a “period coach” (nicolejardim.com), offering online programmes to help women better understand their cycle.
One in four do not understand how theirs works, according to a 2017 Yougov survey. “For so long we’ve ignored our periods and medicated them away,” Jardim says. “We’ve been taught to think very negatively about them, calling it ‘the curse’. I want women to see their period as a good thing – a sign that their body is doing what it should.”
Joanna Lukens, 34, from Bedfordshire, turned to Nicole’s programme when her period didn’t return after coming off the Pill in order to try for a baby. “We were thinking about a second cycle of IVF and I was at a loss to know what else to try,” says Joanna, a former project manager and now a stay-at-home mum of one. “The programme involved lots of lifestyle changes to try to rebalance my hormones, so reducing sugar drastically, less caffeine, and also working on reducing my exposure to certain chemicals such as BPA in plastics and beauty products. My cycle didn’t come back, but my mood and energy levels did stabilise dramatically – and then the second cycle of IVF worked. My son is 14 months old now, and so I’m going to go back to Nicole to work towards getting a regular cycle back.”
Period coaches also encourage women to chart their periods – something millennials are increasingly familiar with, given the rise of “fem-tech” and periodtracking smartphone apps such as Clue and Flo, which keep detailed records of their mood, sex drive, and energy levels, when their period arrives, and how long they bleed for.
London-based Claire Baker became a period coach after coming off the Pill six years ago (thisislifeblood.com). “I started looking into how the menstrual cycle actually worked – that there are these clear hormonal fluctuations that affect our mood, motivation, energy and confidence.
“I work with women who want to better understand their body’s natural cycle, so that they can identify their own strengths and vulnerabilities throughout the month and work with them rather than against them,” she explains. “We need to use our own rhythm more. It’s normal to feel more energetic in the middle of your cycle, so that’s the best time to tackle big work tasks and make lots of social plans, whereas the days before your period might be the time to take it easy and make more time for yourself.”