Female Sexual Health

Part 1: Being Aware of Reproductive Cancers 

Discussion about female sexual health is often supressed and discouraged, as it is viewed as a taboo. As a result, many women grow up uneducated about sexual and reproductive health, and unaware about ways they can keep themselves healthy in that respect. This piece will be the first of a series of articles, where we will be discussing some important issues relating to women’s sexual and reproductive health, how to seek medical advice, and who to contact.

One of the most important things to do, that doctors encourage, is to familiarise yourself with your body. This is vital, as it allows you to detect any changes that are out of the norm for you (since everybody is different). Unfortunately, a history of suppression of female sexuality (which still takes place in many cultures) has made it extremely difficult for women to be open to having these conversations, and as a result, issues regarding sexual health are often neglected and ignored. This piece will be the first in a series, where we will discuss issues related to female sexual health. In this piece, we will be going over two very important topics: cancers of the female reproductive system, and breast self-examinations.

 

Cancer Screenings

In the UK, women are invited by the NHS for a pap smear (also commonly referred to as a smear test) from the age of 25 years old. The test is often avoided by women, mostly out of nervousness as it involves a screening of the vagina. However, the test itself is very quick (taking around 45 seconds to swab the cervix) and is performed by very experienced nurses. The sample of cells collected is then sent off to a lab to check for cervical cancer cells, pre-cancer, and human papillomavirus (HPV), which is the virus associated with causing most cervical cancers. Women aged 25 to 49 are invited to a screening every 3 years, whereas women aged 50 to 64 are invited every 5 years. It is extremely important to attend these screenings; while tests come back negative the majority of the time, they are important to detect any changes in cells, which in many cases present no symptoms and can only be detected via pap smear. Cervical cancer has no symptoms in its early stages, but can make you have abnormal bleeding, bleeding between periods, after sex, or after menopause. Abnormal bleeding does not mean you have cervical cancer, but it is important to see a GP if you are experiencing this.

The NHS does not offer regular screenings for other female reproductive cancers, such as ovarian, uterine, vaginal, and vulvar, so it is important you are familiar with your body in order to be able to detect any changes, so they do not go unnoticed. Changes in your menstrual cycle, discharge, and even appearance of your vulva should be discussed with your GP. We will list the symptoms for these cancers below:

Diagram of Gynecologic Cancers.
Diagram of Gynecologic Cancers.
  • Ovarian Cancer:

This is the cancer of the ovaries, which are the two organs that make female hormones and produce eggs. Ovarian cancer symptoms often present themselves in the form of abnormal bleeding, pressure or pain in the pelvic area, pressure or pain in the abdomen and back, bloating, feeling full quickly while eating, and changes in bathroom habits (constipation, blood in urine or stool). The risk of ovarian cancer is higher in those over 40, those with a family history of ovarian, breast, or colon cancer, and never giving birth.

  • Uterine Cancer:

This is the cancer of the uterus (womb), which is the organ in which the baby grows when a woman is pregnant. Again, symptoms of uterine cancer include abnormal discharge or bleeding, pressure or pain in the pelvic area, and bleeding after menopause. Those at a higher risk are women 50 years old or older, women who are overweight, and having a family history of cancers of the uterus, ovaries, or colon.

  • Vaginal Cancer:

This is the cancer of the vagina, which is the hollow channel that leads from the uterus and cervix to the outside of the body. Vaginal cancer symptoms include abnormal discharge or bleeding. Women who smoke, who have HPV, cervical cancer or pre-cancer, have HIV or a weakened immune system are at a higher risk.

  • Vulvar Cancer:

This is the cancer of the vulva, which is the area surrounding the opening of the vagina. The symptoms of this include itching, bleeding, or burning of the vulva, or a rash or sores around the opening of the vagina that do not go away. Or, changes in the colour of the skin around the opening of the vagina. These symptoms are common in many other diseases and infections, including STDs and yeast infections, which are fairly common and treated with over-the-counter medication. If symptoms persist, please see your GP. Again, those at risk of vulvar cancer are women who smoke, who have HPV, cervical cancer or pre-cancer, have HIV or a weakened immune system.

Breast Examinations

Breast cancers are often grouped with female sexual cancers, however, since its symptoms are not present in the vaginal area, we have decided to discuss it separately. Breast self-examinations are highly encouraged by the NHS, and again, allow you to detect any changes to your breast tissue that needs to be addressed by a doctor. Often, we are told to feel for any lumps or bumps in your breast, however, the texture of breast tissue is naturally very lumpy and bumpy, so women examining their breasts for the first time may panic, or not know what they are searching for.

Self-examination of the breasts is easy and quick to do and involves checking for any changes in the breasts. We recommend following the following steps to thoroughly check for any changes:

Step 1 of the Breast Self-Exam (Source: breastcancer.org)
Step 1 of the Breast Self-Exam (Source: breastcancer.org)

Step 1:

Check breasts in the mirror. Look for any discolouration, visible bumps, changes in size, bulging, puckering, or dimpling of the skin, redness, soreness, a rash, or any other visible changes or pain in the breasts.

Steps 2 and 3 of the Breast Self-Exam (Source: breastcancer.org)
Steps 2 and 3 of the Breast Self-Exam (Source: breastcancer.org)

Step 2:

After checking in the mirror, raise your arms up and look for the same changes. Often, lumps and bumps may appear in, or near your armpits as the lymph nodes in that area are sometimes the first to be affected.

Step 3:

Check your nipples. Are there any changes? Any watery or milky discharge? Any yellow fluid or blood? Any puckering or retraction of the nipple? Any bump under or around the nipple?

Step 4 of the Breast Self-Exam (Source: breastcancer.org)
Step 4 of the Breast Self-Exam (Source: breastcancer.org)

Step 4:

Feel your breasts while lying down. Use your right hand to feel your left breast, and your left hand to feel your right breast. Move the pads of your fingers across your breasts while keeping a firm touch, moving your fingers in circular motions. You may feel your breasts naturally lumpy texture and panic, but the lumps you are searching for are generally hard and circular. Breastcancer.org recommend the following method:

“Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically, in rows, as if you were mowing a lawn. This up-and-down approach seems to work best for most women. Be sure to feel all the tissue from the front to the back of your breasts: for the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you've reached the deep tissue, you should be able to feel down to your ribcage.”

Ensure you are feeling not only your actual breast, but your armpits, the area up to your collarbones, and cleavage.

Step 5 of the Breast Self-Exam (Source: breastcancer.org)

Step 5:

Feel your breasts while sitting or standing, with arms up and arms down. This is easiest and most conveniently done in the shower when you are wet and slippery, so your hands can glide easily across your skin. Use the same method described in the step above, checking for any lumps, bumps, or abnormalities.

It is extremely important to be aware of cancers that can affect the female body, as they are often not discussed openly. Also, like with many other illnesses and diseases, the early symptoms are ones that can only be detected by you, so it is vital to be aware of them. Many women will notice abnormal changes to their breasts or vaginal health and will ignore it, as they feel anxious or embarrassed to speak about intimate issues with a doctor. While the majority of the time, these symptoms will most likely be nonthreatening, in some cases, they can lead to the discovery of cancer in the body and catching this as soon as possible increases the chances of a full recovery significantly. So please, if you do notice any changes, book an appointment to see your doctor as soon as possible, and do not feel scared or embarrassed as they come across cases like these every day.

Finally, it is important to erase the shame and stigma around female sexual health. Do not be afraid to speak about these issues openly and confidently, do not be afraid to enquire or ask questions. By being more open with ourselves and others, we can lead the change and empower each other.

Women in the LGBT Community

Women and the LGBT Community

While pride month is over, it is important we continue discussing LGBT issues, especially those relating to women. This is a perfect time to reflect and become educated on these issues, as the LGBT community continues to fight for inclusion, equality and visibility all year round, not just during pride month.

This year, 2019, has marked 50 years since the Stonewall riots, which was a revolutionary moment in LGBT history. The Stonewall riots served as a tipping point for the Gay Liberation Movement in the United States; it brought with it a new cultural awareness for a community which was largely ostracised and has been referenced to pin point the historical moment wherein “pride began”. In fact, women have been at the centre of the fight for LGBT equality, as Marsha P Johnson, a black trans woman, famously led the stonewall riots. And ironically, 50 years later, black transgender women remain one of the most disadvantaged members of the community, due to combined systemic prejudices stemming from misogyny, racism, and transphobia.

Marsha P. Johnson hands out flyers to students at New York University. (Photo by Diana Davies)
Marsha P. Johnson hands out flyers to students at New York University. (Photo by Diana Davies)

Women in the LGBT community who come from minority ethnic backgrounds continue to be faced with cultural and religious barriers when coming out, and often, coming out comes with life-threatening risks. Many religions and cultures are not open to the idea of homosexuality and being transgender, and instead subscribe to the traditional belief that relationships consist of a man and a woman, who each have different societal roles. Many LGBT people of minority ethnic backgrounds go through their whole lives without being able to openly live as their authentic selves, however, we are making some steps as a society to allow for the liberation of these members through healthy discussions and representation. However, we still have a long way to go to ensure the safety of these members.

6000 Black and Minority Ethnic LGBT People Enjoying the Black Pride Event in 2017. (Photo by: BBC)
6000 Black and Minority Ethnic LGBT People Enjoying the Black Pride Event in 2017. (Photo by: BBC)

Historically, women have been taught that they exist for the pleasure of men, they should upkeep their external appearance for the attention of men, they should focus on developing skills that they will use to cater to men, and so on and so forth. Centuries of this outlook has allowed these beliefs to become ingrained in the foundations of our society, and they are manifested and observed through everything; societal hierarchy, laws, interaction, entertainment, so on and so forth. Therefore, when women express that they are attracted to women, and women only, they are not taken seriously by men, who often feel entitled to them due to the patriarchal system. Lesbian women are seen as a “challenge” for men to “convert”, often using statements such as “you’ve never been with a real man”, “you haven’t met the right man” etc. This demonstrates how women are not seen as people capable of making their own decisions, but as helpless creatures that need to be guided and taught.

Furthermore, in a hyper-sexualised male dominated world, lesbian women are often subjected to increased objectification and fetishization by heterosexual males. The fetishization of lesbians is often a result of lesbian representation in society, coupled with views towards women stemming from the patriarchal system. For example, lesbian couples are frequently portrayed as overly sexual, with all romantic aspects of the relationship omitted; this indicates that this media is created for the consumption of heterosexual men, and not for the inclusion of queer and lesbian women. Not only does this lead to eroticisation, objectification, and fetishization, it also represents lesbian women in an unrealistic way, which influences people’s perceptions of them and alienates lesbian women. This narrative of lesbian women is dangerous, and can lead to violence; for example, recently, a lesbian couple were attacked on the bus on their way home by a group of men for refusing to kiss each other. The behaviour leading to the physical attack signals that the group of men felt entitled to be “entertained” by these women and did not take their sexuality or their relationship as legitimate, or worthy of respect.

Lesbian women in films are often portrayed as highly sexual, indicating the media was created by straight males, for straight males.
Lesbian women in films are often portrayed as highly sexual, indicating the media was created by straight males, for straight males.

Although we have made great strides as a society to respect LGBT people’s rights, create visibility and representation, for example, members of the LGBT community can legally marry, can join political movements and represent their community, and their history becoming a part of the school curriculum, it is important to continue the conversation and highlight issues that still exist. Many of the issues women in the LGBT community face stem from misogyny, which is a by-product of the patriarchal system. As a result, unlearning and unpacking the dynamics of the patriarchal system is key to addressing these issues. Additionally, women from minority ethnic groups face added hurdles due to racism, with black trans women being the most disadvantaged. It is important to understand these issues and allow for healthy discussion, as through this, change can happen.