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Beyond the stigma and shame – a spotlight on Genital Herpes

Beyond the stigma and shame – a Spotlight on Genital Herpes

How many of us would ever admit we have or have had a sexually transmitted disease?  We might discuss that we have been tested and are ‘clean’ with a new partner but we might not discuss that we have had herpes in the past, especially if we are asymptomatic.

But do you know that having herpes is lifelong?  You could have it and not know.  You may have had one infection and never have a further infection.  Herpes can remain dormant in your system until a flare takes you by surprise years later.

Herpes is caused by a virus called herpes simplex. There are 2 types – Herpes simplex 1 (HSV1) and Herpes simplex 2 (HSV2).  HSV1 is more commonly oral herpes (cold sores found around the mouth and on the face) and transmitted through oral-to-oral contact but which can also cause genital herpes.  HSV2 is a sexually transmitted infection (STI) that causes genital herpes only, passed on through vaginal, anal, and oral sex.

Many people feel they are the only one with herpes.  The more it’s not talked about then the more it becomes a stigma. But in reality, according to the World Health Organisation, an estimated 3.7 billion people under age 50 (67%) have HSV1 infection globally.  And an estimated 491 million people aged 15-49 (13%) worldwide have HSV2 infection. These figures are thought to be considerably higher as herpes is not tested for in standard STI screening unless there are sores on the genitals or anus. You can carry the herpes virus and never have symptoms so many of us could be carrying one or other of the HSV1 or HSV2 viruses and not know it.

Having herpes is not indicative that you/your partner have slept around or not used condoms. Your partner may not have lied if they tell you they tested negative for STI’s due to the lack of routine testing.   So, you can be told you are negative for STI’s and still have herpes.  Herpes can live on the skin all over the genitals and hips not just the vagina and penis so a condom can not necessarily stop you getting it.

Genital herpes is very easy to pass on from the first tingling or itching of a new outbreak (before any blisters appear) to when sores have fully healed. You may also be able to pass on the virus even if you do not have any symptoms.

That’s important to remember.  Why? Because what seems to be a common theme I hear from people who have genital herpes, are feelings of guilt, shame, and disgust at themselves for being ‘dirty’. They have often kept it secret from everyone, even their partners.  ‘Jenny’ told me how she had had herpes for almost 30 years and I had been the first person she had ever told.  She felt dirty and was concerned people would think she had been promiscuous, when in reality she got herpes from the first person she had had sex with.  She avoided sex if she had a flare, which had been a rare occurrence. But the flares were happening more as she was very stressed at the moment. And the more she stressed about the flares, the worse they were.

Symptoms of genital herpes are usually:

  • small blisters that burst to leave red, open sores around your genitals, anus, thighs, or bottom – similar to what you see as cold sores around people’s mouths,
  • tingling, burning, or itching around your genitals,
  • pain when you pee,
  • and in women, a change in your vaginal discharge.

Herpes will stay in a nearby nerve forever, causing blisters in that area only but spreading can occur:

  • from skin-to-skin contact with the infected area (including vaginal, anal, and oral sex)
  • if a cold sore touches your genitals
  • by transferring the infection on fingers to genitals (your own and your partners)
  • by sharing sex toys

Even when there are no visible sores or blisters!

 

But you cannot get it from sharing cutlery or crockery as the virus dies quickly when not on the skin.

So, remember, we may all be carrying the virus and we can reduce our chances of catching or passing herpes on by:

  • using a condom every time you have vaginal, anal, or oral sex – but bear in mind herpes can still be passed on if the condom does not cover the infected area.
  • avoiding vaginal, anal, or oral sex if you or your partner has blisters or sores, or a tingle or itch that means an outbreak is coming
  • not sharing sex toys – if you do, wash them, and put a condom on them.

It is also important to remember that it can take months or years for symptoms to appear.  And they may appear even if you have not had sex for a long time.  Again, why is that important to remember?  Well, imagine a scenario where you have been with a partner for a few years and you get a herpes outbreak for the first time? You might assume that they have cheated on you.  Or if you have not had sex for a long time, you may wonder why you are having symptoms now.   You or your partner may have had the dormant virus in your system from an earlier infection for years and just not known.

Triggers can include:

  • Illness
  • Stress
  • During the menstrual cycle
  • ultraviolet light – for example, from sunbathing or sunbeds
  • friction in your genital area – for example, from sex (lubricants may help) or tight clothing
  • smoking
  • drinking alcohol
  • a weakened immune system – for example, from having chemotherapy for cancer

It is possible to get pregnant with herpes.  Rarely will it hurt the baby (provided there are no active sores at the time of vaginal delivery).

Treatment of Genital Herpes:

  • keep the area clean using plain or salt water to prevent blisters becoming infected
  • apply an ice pack wrapped in a flannel to soothe pain
  • apply a barrier cream or painkilling cream (such as 5% lidocaine) to reduce pain when you pee
  • wash your hands before and after applying cream or jelly
  • pee while pouring water over your genitals to ease the pain
  • Antiviral medicine may help shorten an outbreak by 1 or 2 days if you start taking it as soon as symptoms appear. But outbreaks usually settle by themselves, so you may not need treatment. Recurrent outbreaks are usually milder than the first episode of genital herpes. Over time, outbreaks tend to happen less often and be less severe.
  • I support many women who have herpes breakouts with homeopathy. Both for their feelings of guilt and shame at having caught herpes and as flares often happen when they are very stressed and run down. By addressing the root cause of their stress, we can alleviate their symptoms and possibly stop the flares reoccurring.

So, let’s start having open conversations about herpes and stop feeling like you are the only one with a dirty secret that you have to be ashamed about.  You are really not alone and it is treatable.

Becca is a homeopath and reflexologist specialist in gynaecological health available at www.healing-space.co.uk

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Not ‘just a heavy period’ – a Spotlight on the Emotional Impact of Miscarriage

In recognition of Pregnancy and Baby Loss Awareness week (October 9th-15th 2021), I wanted to focus on the emotional difficulties women face during miscarriage.  I spoke to five women about their experience of miscarriage and the impact it had on them.

Sadly, around 1 in 4 pregnancies ends in miscarriage, and so it is likely that most women have had at least one miscarriage, and yet it is not widely talked about.  Sarah said she had never discussed her miscarriage that happened 20 years ago with anyone before me.  It was a huge shock and she felt it was almost a taboo to discuss.   Possibly she said due to feelings of shame and failure.  Chris said she felt ashamed because her body had let her down and not done what it should have done. She felt disbelief and guilty that she had done something to cause it. The shame she felt was on a par with the shame she felt after being sexually assaulted.  It took years before she could talk about it.

Yet, surely, if we don’t talk about miscarriages; what really happens in a miscarriage; women will continue to feel shocked, ashamed, and guilty.  People will continue to behave like we haven’t had one as they are uncomfortable or say insensitive things so our feelings aren’t validated.  I think that needs to change.

Miscarriage is when a baby (or foetus or embryo) dies in the uterus during pregnancy. I will use ‘baby’ throughout, as I feel it is important to recognise that to many women, no matter when the loss occurred, this is a baby that have often already planned a future with and may love.  For those who prefer not to think that they have miscarried a baby, I apologise. In the UK, the legal definition of miscarriage applies to pregnancies up to 23 weeks and 6 days. Most miscarriages happen during the first 13 weeks of pregnancy. A late miscarriage (when the baby dies between 14 and 24 weeks) is much more unusual. A late miscarriage is not the same as a silent or missed miscarriage, where the baby died before 14 weeks, but the miscarriage does not occur until later in the pregnancy (although these can also occur in the second trimester).

Whenever a miscarriage happens the emotional impact can be devastating. There is no right or wrong way to feel afterwards; it depends on your circumstances, your miscarriage and what the pregnancy meant to you.  For some people, hearing the loss of their baby later in their pregnancy called a miscarriage can make them even more distressed; especially as miscarriages cannot be registered as a death. In the UK, any loss from 24 weeks is classed as a stillbirth and a baby born alive, even for a few minutes before 24 weeks is considered a neonatal death. By law, stillbirths and neonatal deaths must be registered as a death and be buried or cremated. There is no law concerning miscarriages. After a late miscarriage most hospitals offer a simple funeral, with burial or cremation. Some hospitals do this for all babies, however early the miscarriage. A chaplain came to see Ann and told her what could happen concerning her missed miscarriage at 12 weeks. There could be a blessing and cremation with other babies, or she could take the baby home.  The Miscarriage Association and SANDS both provide certificates you can ask the hospital to sign if they don’t provide their own that notes your baby’s name and the date of miscarriage.

It seems that women are unprepared for what miscarriage can physically be like and this impacts on them emotionally.  Some people assume a miscarriage (especially an early one) will be like a heavy period.  The gritty reality is that you can experience contractions, a huge amount of bleeding, breastmilk (in miscarriages after 14 weeks) and hormonal imbalances for some months afterwards. In her mind, Sarah knew she wasn’t pregnant but her body still felt it.  Jane said the same and that this was one of the hardest aspects for her to deal with. It took a while for both of them to get their bodies and heads aligned due to the pregnancy hormones still being present. Some women experience flashbacks and are triggered by their subsequent periods. Others choose not to look at their baby (whenever the miscarriage happens) or regret not looking. The trauma of miscarriage can increase your sadness and fear at the time and for a long time afterwards. Maggie told me looking back it was like a horror movie, slightly eased by her subsequent pregnancy.

The Miscarriage Association says, ‘miscarriage is a different kind of loss. It’s not like grieving for someone you knew. Instead, you might mourn the loss of your baby’s future and your own future as that baby’s parent. This can be hard for others to understand and relate to’.

Chris said that for her, from the moment she suspected she was pregnant, she felt a mother to that baby; even though it was a surprise pregnancy for her.  If family and friends do know, they don’t know what to say and will often say inappropriate or shocking things; or even ignore discussing the miscarriage entirely. Chris told me that you don’t tell anyone that you are pregnant in case it goes wrong but when it does its exactly that time that you need support.  Chris’s mother asked why she was so upset when the pregnancy wasn’t planned, and when another family member had their baby shortly after, Chris had to put on a brave face whilst being torn up inside. No one acknowledged her miscarriage and or how hard it must have been for her.

However, Sarah didn’t want to see anyone or have their sympathy.  Jane felt no one understood.  She said her miscarriage felt sacred and private; precious in a funny way and she didn’t want to share it with anyone who didn’t understand the emotional impact it had on her.  People said ‘you’ll have another baby’ – but she said; ‘I didn’t want another one, I wanted that one’. Jane was surprised at how emotional and down she felt for a few months afterwards. She said her heart was broken.  Other people said to her ‘oh that’s a shame, I just sailed through my pregnancy’.  This added to her worry that she had done something to cause the miscarriage and her feeling that her body had let her down. Jane had suffered a missed miscarriage where her baby died at around 8 weeks but she did not know until she started bleeding at 17 weeks.

It can be a comfort if you have a child or children already. But it doesn’t always make this loss easier to deal with. A frequent comment made is ’at least you have a child already’.  Maggie and Ann were shocked that their second pregnancies ended in miscarriage. Both Sarah and Maggie said that as they had young children they just had to get on with life.  Jane said it was important to her that she was pregnant again by her due date.

Subsequent pregnancies can cause anxiety and distress too. Ann was anxious all the way through hers, with nightmares that she didn’t have a baby.  Jane said her miscarriage took the shine off her next pregnancy even past 12 weeks as she didn’t know if she could get past that stage again. It must be unbelievably difficult for those who go on to suffer further miscarriages or cannot conceive again.

It should be assumed that the insensitive comments people make are not malicious, said more from a place of not knowing what to say, possibly not understanding what a miscarriage entails and trying to make things better by saying something…anything. But they are not helpful for the grieving woman nor does it help her process and recover from her experience.

Medical staff often use very clinical language and terminology and the treatment of women can add to their distress.  Chris’s friend was told the baby she had delivered at 23 weeks was ‘clinical waste’ when she wanted to see her baby (it is usually possible to see the baby if you so wish).

When Ann’s 12-week scan didn’t look right and there was no heartbeat, she was given the option of waiting to miscarriage naturally (which could take up to a month to occur) or to have a D&E (Dilation and Extraction).  She opted for the latter, but as it was not classed as an emergency, she had a ‘really difficult weekend’ knowing her baby had died. The D&E was carried out in the maternity unit with Ann having to sit in the waiting room with pregnant women.  Ann was unaware that this type of miscarriage could happen and it was a complete shock. The male consultant she saw told her to calm down as she was crying.

Chris’s scan was also done in a maternity unit where she had to sit with pregnant women knowing after a weekend of bleeding that she had probably lost her baby.  Sarah was very shocked when she started to bleed when she was 11 weeks into her second pregnancy.  With this one she felt different; no nausea this time.  She said she just knew. She phoned the doctor and they told her they didn’t need to check her and to crack on with it.  Sarah was left feeling that their attitude was ‘well that’s just what happens’.   She was told that it was ‘early days as it was only 11 weeks.  That dismissed her feelings, implying that the emotions she felt were not valid.

Chris’s miscarriage was the most recent of all those I spoke to.  And still she was unaware of what a miscarriage would involve and no one told her what to expect.  The intense contractions surprised her – not as severe as labour but worse than a period. Chris had PTSD after her first labour and had amazing support.  But that was in complete contrast to the support she had with her miscarriage and she was very depressed for a long time afterwards.

Maggie was followed every time she went to the toilet so that, as the nurse put it, they could catch ‘the products of pregnancy’.  An experience she understandably found humiliating.  She went on to have a D&C (Dilation and Curettage) the next morning, booked for her without an explanation of what that involved.  She didn’t know she was going to be internally scanned until a nurse approached with a large probe.  She felt like she was just being processed.

What has struck me from talking to women (and reading accounts online) is that it appears that miscarriage care has not really changed over the last 30 years. I’m sure that there are compassionate staff working in obstetrics.  But it is obvious that being in the dark about what a miscarriage might entail, using terminology that does not do justice to what is happening to women, them having to sit in waiting rooms with pregnant women or your late miscarriage being delivered on a labour ward where you can hear babies crying is going to add to women’s distress.  Perhaps more understanding and humility from everyone involved in supporting a miscarrying women could alleviate some of this anguish.

If you know someone has had a miscarriage, it is important to listen to their experience. Acknowledging the loss of plans they made for the future and understanding the physical process they have gone through can help validate their feelings. And understand that there is no set time to grieve. Jane told me that 30 years later she remembers what would have been her due date and it still makes her feel very sad although she has mixed emotions as she would not have had her subsequent child.

Thank you to everyone who shared their experience with me.

If you have been affected by this article Baby Loss Support can be found no matter when your miscarriage was.

Aching Arms – offer support to recently and longer ago bereaved parents after a loss during pregnancy, birth, or infancy. Call or text07464508994 or emailsupport@achingarms.co.uk

Alternatives Listening Rooms – Dundee-based charity supporting parents who have a lost a baby at any stage of pregnancy or at birth with counselling and support that is free and confidential.
Support can be face to face, telephone online or webchat.

Phoneline: 01382 221112 (24 hour answering service)
Textline: 07599 955231 (Text now to make an appointment)

ARC: Antenatal Results and Choices – specialised bereavement support around termination of pregnancy after a prenatal diagnosis. Contact Number: 07875480076 Email: info@arc-uk.org

Children of Jannah– supporting bereaved parents who experience baby loss, holding at their core the Muslim belief that all children who die enter Heaven (called Jannah in Arabic).

https://www.childrenofjannah.com/contact

Cradle – supporting anyone that has experienced baby loss, run by a dedicated team of volunteer ambassadors, of which all have experienced early pregnancy loss.

Zoom support available via email: cradle@earlypregnancyloss.co.uk

Daisy’s Dream – professional support service which responds to the needs of children and their families affected by life threatening illness or bereavement. Available in Berkshire, the surrounding areas, and East Cheshire. Please note: the service is primarily focused on the children in a family, they are sadly unable to support parents unless there are already older children in the family.

Phone: 0118 934 2604

The Ectopic Pregnancy Trust – The Ectopic Pregnancy Trust supports women and their families through the devastating ordeal of ectopic pregnancy loss.

Information and support via call-back helpline and email.

Helpline: 020 7733 2653
Email: 
ept@ectopic.org.uk

First Light – professional counselling support for bereaved parents and families in Ireland

Contact Number: 1850 391 391
Email: info@firstlight.ie

Held In Our Hearts – providing virtual baby loss counselling and also befriending and regular support groups online for bereavement support, dads’ support, twin and multiple loss support, antenatal results and choices support, grandparents’ support, pregnancy support and parenting after loss.

Email: info@heldinourhearts.org.uk

The Lily Mae Foundation – is a UK registered charity providing much needed support to parents and families who have lost a baby to stillbirth, neonatal death, miscarriage, or medical termination.

Email: info@lilymaefoundation.org

Lullaby Trust – support for bereaved families who have lost a child through SIDS.

Bereavement Support: 0808 802 6868
Email: support@lullabytrust.org.uk

Information Line: 0808 802 6869
Email: info@lullabytrust.org.uk

The Miscarriage Association – support and information for anyone affected by miscarriage, ectopic pregnancy or molar pregnancy with helpline, live chat, email service and online support available.

Helpline: 01924 200799 (Mon-Fri, 9am-4pm)
Email: 
info@miscarriageassociation.org.uk

MISS (Aberdeen) – Supporting anyone impacted by miscarriage. Open to any region & currently providing online support packages, as well as continuing their phone service.

Helpline: 07808 638428
Email: info@miscarriageinfosuppservice.co.uk

Muma Nurture – supports fertility, pregnancy and related loss through counselling, holistic therapies, and support groups.

Contact Number: 07460775495

Email: contact@mumanurture.org.

Petals – the baby loss counselling charity, offering free specialist counselling to women and partners who suffer psychological distress from trauma and grief related to pregnancy or baby loss.

Helpline: 0300 688 0068
Email: counselling@petalscharity.org

Sands – stillbirth and neonatal death charity. Up-to-date information and support available for bereaved parents, families, and healthcare professionals.

Helpline: 0207 436 5881
Email: helpline@sands.org.uk

Simpson’s Memory Box Appeal (SiMBA) – memory boxes and baby loss support for bereaved parents and professionals.

Support Groups via Zoom: https://www.simbacharity.org.uk/support/support-groups/

Teddy’s Wish – support for bereaved parents and families through care packages and fully funded counselling.

TimeNorfolk – the pregnancy loss charity, offering free specialist support to women and partners. Covering all pregnancy related issues.
Phone: 01603 927487
Email:
 info@timenorfolk.org.uk

Together for Short Lives – support for bereaved families and professionals working to support children.

Tommy’s – health information for parents-to-be, and funding for research into the causes of pregnancy loss.

Email: midwife@tommys.org

Twins Trust – the Twins Trust Bereavement Support Group (BSG) exists to support all parents and carers of multiples who have experienced loss whether it was during pregnancy, at birth or at any point afterwards. Email: Bereavementsupport@twinstrust.org

 Marking your loss

The Miscarriage Association suggests ways in which you can mark your loss whether you have a funeral for your baby or not.

  • It may be important to you to name your baby. If you do not know whether your baby was a boy or a girl, you could choose a name that could be given to either.
  • Some parents gather mementos in an album or a special box: for example, a scan photo, a hospital bracelet, letters, or cards, and maybe toy or clothes that they had ready for their baby. Some hospitals offer to make hand or footprints of babies miscarried late in pregnancy and may put them in a special memorial card.
  • Other parents mark their loss in other ways, perhaps planting a bush or tree, donating to charity, or creating something else in their baby’s memory.
  • Your hospital may have a book of remembrance where you can enter your baby’s name and the date of your miscarriage. Some hospitals hold regular remembrance services for babies who died during pregnancy or around birth.

Article first written for This is Me!, Well Woman Network Magazine.

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When itching is not ‘just’ thrush – a spotlight on Lichen Sclerosus

First published for This is Me! Wellwoman Network Magazine – available at: https://issuu.com/theforwardthinkingtherapist/docs/final_issue_august_september_2021

Whilst thrush is often the first thing women with an itchy vulva will think of, there are many other causes of vulva itching including menopausal symptoms, irritation due to medication, latex, perfumes and washing powders and threadworms.  Sex, periods, exercise, heat/moisture and friction can also be triggers for itching. If itching is also accompanied by vaginal discharge, then this can indicate an infection such as bacterial vaginosis, trichomoniasis and of course thrush.

One other often under and misdiagnosed cause of itching is a skin issue called Lichen sclerosus (LS).

LS can affect people of all ages (earliest recorded is 18 months) although more commonly pre-pubescent girls and menopausal women and has a slight (3-5%) risk of turning cancerous.  Childhood LS often resolves with puberty although it can continue into adulthood.

Therefore, it’s worth being aware of what your vulva looks like even if you don’t have symptoms (like regular breast self-exams) and any changes that might occur as LS can have a significant impact on people’s lives.

LS is typified by white patches on the skin anywhere on the body but most often on the vulva, penis and anus.  The main symptom is intense itching, especially at night which affects sleep. Alternatively, burning, sore and inflamed vulva or penis may be the main symptom instead of itching.

Skin becomes thin and raw, tearing easily during sex or a bowel movement, or often for no reason.  Over time, skin affected by LS can thicken, become scarred and atrophy (shrink and tighten). There can be ‘architectural changes’ where the labia fuses or even in some cases disappears. The entrances to the urethra and vagina can become tighter and the clitoral hood can fuse.  These changes can cause pain and problems peeing, pooing, having sex and orgasming. In severe cases, surgery may be required to widen or uncover your vagina opening and clitoris.

The emotional impact of LS is rarely discussed.  An LS diagnosis can be devastating.  Constant itching is distressing and embarrassing.  Changes that can occur to a women’s vulva can impact on feeling feminine as well as relationships, let alone the pain of simple things like sitting and walking. Anxiety that the LS will become malignant can be overwhelming.

Diagnosis is usually based on appearance.  But if there is a doubt (as LS can present like other skin conditions such as Lichen planus), then a biopsy will be taken.

Helen* told me that she was unable to wear jeans as they were too uncomfortable and she rarely had sex because it was so painful and led to tearing over the whole vulva.  Her husband was very understanding but it had impacted on her relationship.

Sarah* said her LS had progressed to such an extent that her inner labia had fused to her outer labia and her clitoral hood had also fused which was very painful and made orgasm difficult and sex impossible.  Itching was very distressing and keeping her awake. .

The cause of LS is unknown. However, about 1 in 3 people have another autoimmune disease such as thyroid disease, vitiligo, or pernicious anaemia. Many women have told me that stress aggravates their LS symptoms and they have often had significant emotional trauma in the years preceding their symptoms starting.

There is thought to be an inherited risk (12%) but symptoms are often not discussed with family so the true extent may be more. Some studies show a link to Lyme disease. Trauma can also increase the risk of LS which starts in surgical wounds and following radiotherapy and sunburn. LS can be triggered by pregnancy or more commonly after childbirth trauma such as at the site of an episiotomy or tearing.

My own LS started 14 years ago after I had a fast vaginal birth with a 9lb 4 oz baby. My ‘what I thought was thrush’, itching became insane and my thyroid levels were unstable (I already had Hashimotos and Crohnes Disease).  I have since realised my thyroid levels being out of range will cause a flare up.

Conventional treatment for LS is a high dose prescription steroid cream to reduce inflammation applied regularly for three months. After the first three months, it may only be necessary to use the ointment or cream once or twice every week to keep symptoms away.

However, some people are reluctant to use steroid cream in such a delicate area or find the steroid creams aggravates.  There are other things that help them reduce symptoms (either alongside or instead of steroid cream) including:

  • Avoiding certain foods – Gluten, dairy, sugar, soya and high oxylate foods are common irritants for LS sufferers.
  • Considering what goes on your skin and what you wash your clothes with. Avoid synthetic fragrances and ingredients as these can increase the itch and burn of LS. Petroleum based products can be especially aggravating to some people. Wash with emollient soap substitutes or natural products.
  • Moisturise daily and find a soothing cream/ointment – Most of us put moisturiser on our face and bodies but how many moisturise their vulva? As we get older our skin becomes less elastic and supple. Commonly used creams that people find soothing include; Luca’s Papaw Ointment, Emuaid, Calendula Oil, Perrins Naturals, CBD Oil, Coconut Oil (always apply after a shower as it can be drying), and V Magic. It can be trial and error to find what works for you personally.
  • Toilet paper can be irritating – try an unbleached brand or clean yourself with water instead.
  • Use lubricants if sex is uncomfortable.
  • Wear cotton/silk underwear and loose clothing.
  • Homeopathic remedies – homeopathy addresses symptoms on a physical, emotional and mental perspective and is individualised to each person.
  • Soaking in a Borax solution is controversial but many women in support groups report it helps stop and reverse fusing.

If you are itchy do not assume you have thrush and self-treat it.  Talk to your doctor. And return to your doctor if symptoms do not resolve with treatment.  Despite LS not being contagious or caused by not washing enough, Helen* had first been told that her itching and burning was due to poor hygiene, which resulted in her being too embarrassed to seek further treatment for another 10 years – by which point her vulva had started to fuse.

Vulval exams should be part of your monthly self-care so you know your own ‘normal’ (as there is no normal vulva!) or what changes might be happening. Persistent pain and/or a lump or ulcer that doesn’t go away should ALWAYS be discussed with your doctor.  And don’t forget as LS can affect children, that any itching they have needs checking out.

Further Support is available at:

Association for Lichen Sclerosus – https://www.lichensclerosus.org/

Sharing is Caring – Lichen Sclerosus et al – www.facebook.com/groups/1329440753906331

Lichen Sclerosus -sclerosis- UK Support Group For Women – https://www.facebook.com/groups/221930761513570

Lichen Sclerosus UK Natural Support Group – https://www.facebook.com/groups/128295724617899

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Vulval-Vaginal Atrophy

Needles in My Vagina – a spotlight on Vulvo-Vaginal Atrophy (VVA)

Published first in the Well Woman Networks This is Me! magazine at: https://issuu.com/theforwardthinkingtherapist/docs/final_issue_august_september_2021

Do you ever feel like your vagina is pressing into your vulva? Or that you have shooting pains in your bits like knitting needles?  Is it uncomfortable to walk at times?  You are not alone!

Itching, burning and sore vulvas, vaginal dryness, painful sex, feeling like you have thrush or a urine infection can all be signs that you have vulvo-vaginal atrophy (VVA).

VVA is widely reported to affect 70% of menopausal women but as only around 7% get treatment, that figure could actually be far higher.

Lisa told me she had no idea what was happening to her when her symptoms first started a few months ago at 49. She thought she was suffering a prolapse or scarily worse. None of her friends she spoke to knew either. Catherine said the pain was so intense at times it was as if knitting needles were being poked into her vagina.  At its worse, Jacqui could not sit down or walk, the pain was so excruciating.  All these women were subsequently diagnosed with VVA but not without a fight to get their symptoms taking seriously.

VVA doesn’t just affect women of a certain age. Freya first noticed symptoms 8 weeks after having her baby.  Within a week she had become more aware of pain in her vagina and inner labia (the lips of the vulva) while walking, and progressively symptoms became even more painful with a feeling that the vagina was putting pressure on the vulva.

After birthing a 9lb baby 6 months earlier, my GP told me that the discomfort I was having was due to having been stitched too tight (yikes) and a new diagnosis of lichen sclerosis so I was referred to a gynaecologist. By the time I got to see the gynaecologist several months later, I’d stop breastfeeding and my tightness had resolved.  At no point was I told by my GP that my reduced oestrogen enabling me to breastfeed was causing my vagina to be tight.

My article in July on the wonders of our cervical fluid (LINK) touched on how oestrogen can affect how much cervical fluid we might have.  Oestrogen levels can drop at any time, but typically happens during breastfeeding and perimenopause as well as after menopause.

Menopause (when a woman has not had a period for over 12 months) is usually preceded by some years where periods are irregular – the ‘perimenopause’ (unless menopause is medically or surgically induced) and includes the hot flushes we all know about, as well as joint and muscular pain, mood changes, brain fog, a lower sexual desire and urogenital problems. Every woman is different.

This is all caused by a decrease in oestrogen which affects every tissue in our body including those in our bladders and vaginas. With less oestrogen, our vaginas shorten and narrow and the lining becomes thinner and less elastic. Cervical fluid is reduced and vaginal PH changes. All symptoms of VVA, part of ‘genitourinary syndrome’ (GSM).

Whilst it is a natural part of the ageing process, treatments are available which can really help symptoms.

In the UK on the NHS, options include:

  •  Oral or topical systemic hormone replacement therapy (HRT) as a patch or gel usually a combination of oestrogen and progesterone and occasionally testosterone given as a gel. This is not always a necessary start to treating VVA.
  • Vaginal low dose oestrogen given as a cream, pessary, tablet or ring, that can be used alongside HRT or as a stand-alone even if HRT is contra-indicated. Dosages and frequency of application can be adjusted so do discuss this with your doctor if you are not finding relief. The amount of oestrogen released into the blood stream is very low and symptoms may come back if treatment is stopped. Hormone therapy can be lifelong if required. In other countries, compounded creams are available that are tailored to your needs.
  • Ospemifene taken orally is suitable for women who have had breast cancer treatment or who don’t want to use anything vaginally or hormonal.

Other things you can try to help VVA include:

  • Vaginal Moisturisers and Lubricants – whilst they do not address the underlying cause of VVA, moisturisers can offer temporary relief from symptoms if used regularly and lubricants can help with vaginal dryness and pain during sex.
  • Vaginal DHEA – studies have shown topical DHEA (which converts to oestrogen and testosterone in cells) can significantly improve symptoms. Julva contains natural DHEA and was developed by an American OBY-GYN.
  • Hyaluronic acid – in studies it has been found to work as well as vaginal oestrogen for temporary relief.
  • Exercise – not being overweight may improve symptoms.
  • Diet – Nutritionist and homeopath Silvia Giunta suggests eating plant oestrogens such as legumes, nuts seeds and fermented soya such as tempeh and miso to boost oestrogen levels. Fermented foods such as kimchi, sauerkraut, kombucha and kefir as well as avoiding sugar encourages a healthy vaginal microbiome. Avoid caffeine and alcohol.
  • Homeopathy – can be used on its own or alongside other treatments and individualised to your own unique symptoms on a physical and mental basis.
  • For breastfeeding mums, symptoms usually ease after weaning, but some women can be affected until they stop completely. It is possible for new mums to be prescribed oestrogen cream but it’s a fine balance to not affect milk production.
  • Use natural products – Avoid having a bath as this can affect vaginal PH. And avoid shower products that are highly scented or contain artificial chemicals as they can irritate.
  • Dilators – again contentious in their helpfulness. Dilators and lubricants do not address what is wrong with the cells – the lack of oestrogen giving them elasticity. However, other women told me that gentle stretching before intercourse was helpful.
  • Pelvic floor muscle training improved some VVA symptoms in women using topical oestrogen.
  • Vitamin D and Vitamin E suppositories – studies have found they improved VVA and vaginal PH.
  • Sea buckthorn oil as a supplement can positively affect vaginal health and elasticity.

There are some suggestions that increasing blood flow to the vagina with regular sexual activity may help. However, all the women I spoke to said that even a finger was too big when their VVA was at its worst – due to pain and tightness.  This suggestion apportions blame to a woman who may already be feeling frustrated with their bodies and guilty. Which is not warranted and unjust.

I’m sure this won’t be my only exploration of this issue.  I’d love to hear your own experience and what has worked or not worked for you.  Thank you to the women who spoke to me candidly about their symptoms.

Becca x

Becca is a homeopath and reflexologist specialist in gynaecological health available at www.healing-space.co.uk and www.formulahealth.co.uk

Menopause Did you Know? 

  • The average age of menopause is 51 although 1 in 100 women experience menopause before they are 40.
  • According to the UKs’ NHS NICE guidelines x:
    • women over 45 should be diagnosed as being in perimenopause and menopause based on symptoms alone – you do not need blood tests.
    • Reviews of treatment from your GP should be carried out after 3 months to assess efficacy and tolerability and then annually unless side effects develop.
    • there is no clear evidence for the use of anti-depressants to ease low mood in menopausal women who have not been diagnosed with depression. It is not all in your head and you are not going mad!
    • Referral to a menopause expert should take place if treatment does not improve symptoms or you develop side effects.
  • There is a real lack of menopause specialist centres in many parts of the UK.
  • VA can cause itching. Regular monthly examinations of your vulva (like breast examinations) are crucial to ensure you know what your own body looks and feels like and to be aware of any changes.  White patches as well as itching can be a sign of lichen sclerosus.
  • There are 5 types of gynaecological cancers that can affect women – cervical, womb, ovarian, vaginal and vulval. So any unusual lumps and bumps, bleeding, discharge or concerning changes should always be checked out with your GP.

References:

  1. 2016 Apr;19(2):151-61. doi: 10.3109/13697137.2015.1124259. Epub 2015 Dec 26.Treating vulvovaginal atrophy/genitourinary syndrome of menopause: how important is vaginal lubricant and moisturizer composition? D EdwardsN Panay
  2. The British Menopause Society https://www.youtube.com/watch?v=ZVRMLmR_cnU&t=3s
  3. J Sex Med. 2021 Jan;18(1):156-166. doi: 10.1016/j.jsxm.2020.10.016. Epub 2020 Dec 5. Hyaluronic Acid in Postmenopause Vaginal Atrophy: A Systematic Review, Carlos Campagnaro M Dos SantosMaria Laura R Uggioni Tamy Colonetti Laura Colonetti Antonio José Grande Maria Inês Da Rosa 
  4. Menopause. 2016 Jul;23(7):816-20.doi: 10.1097/GME.0000000000000620. Pelvic floor muscles training to reduce symptoms and signs of vulvovaginal atrophy: a case study Joanie MercierMélanie MorinMarie-Claude LemieuxBarbara ReichetzerSamir KhaliféChantale Dumoulin
  5. Support Care Cancer. 2019 Apr;27(4):1325-1334.doi: 10.1007/s00520-019-04684-6. Epub 2019 Feb 7. The effect of vitamin D and E vaginal suppositories on tamoxifen-induced vaginal atrophy in women with breast cancer. Zahra Keshavarzi Roksana Janghorban Shohreh Alipour Sedigheh Tahmasebi Azam Jokar 
  6. Larmo, P. S., Yang, B., Hyssala, J., Kallio, H. P., & Erkkola, R. (2014, November). Effects of sea buckthorn oil intake on vaginal atrophy in postmenopausal women: A randomized, double-blind, placebo-controlled study. Maturitas, 79(3), 316-321 

Resources and Women raising awareness of Menopause and VA

Menopause NICE Guidelines: https://www.nice.org.uk/guidance/ng23/resources/menopause-diagnosis-and-management-pdf-1837330217413

The British Menopause Society

Vaginal Atrophy Self Help Facebook Group

Davinia McCall and her Documentary – Sex, Myths and the Menopause available on All4

Meg Matthews and her new book – ‘The New Hot, taking on the menopause with attitude and style (2020), Vermilion, UK.

Turning Back the Clock on Your Vagina – Lauren Streicher, (2021), USA

Me and My Menopausal Vagina: Living with Vaginal Atrophy – Jane Lewis, (2018), PALS, UK

Naomi Potter and Lisa Snowden on Instagram

Davinia Taylor on Instagram

Menopause and Employment Law – https://henpicked.net/category/menopause-hub/menopause-and-work/

 

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The White Stuff – Our Amazing Cervical Fluid

Credit Shutterstock

I have been surprised in the past at just how many women I work with who think they have thrush every month (without discussing it with their GP) or who are disgusted with their normal vaginal secretions.

Cervical mucous or fluid, discharge, our juiciness – whatever you want to call the white stuff you see in your pants is a crucial part of being a girl/woman. And is pretty amazing when you look into it. It keeps the vagina clean and moist and protects the uterus from infections.

Cervical fluid is produced by cells in the glands of the cervix (the passageway between your vagina and upper reproductive tract). It is produced because of stimulation by the hormone oestrogen and is a good sign of how healthy and fertile we are.  It is made up of approximately 90-98% water (so being well hydrated may help fertility and menopausal vaginal dryness) and gets its consistency from stringy molecules called mucins. These mucins entangle to build a network. Hormonal fluctuations change the ratio of mucins to water, thus altering the consistency of the cervical fluid.

A normal cervical fluid will vary in consistency and amount throughout your menstrual cycle and may be white, gloopy, creamy, or clear.  It is usually odourless or has a light musky smell that is unique to you.  Amounts will also increase when we are aroused and will fluctuate at other times of our lives such as during puberty, during and after pregnancy and during menopause when there may be very little. Cervical fluid can be seen on our underwear, where it will have dried slightly causing some alteration in its characteristics. It is not unusual for it to fade the colour of dark underwear.

In a woman who is having periods, there will be clear changes in the consistency of cervical fluid depending on where in the cycle she is.  Just after a period (at the beginning of the cycle), cervical fluid will be dry and sticky.

Around day 9/10 in a normal menstrual cycle, cervical fluid will gradually become more wet, creamy and white/yellowish (especially on your underwear) and increase in volume. As oestrogen peaks 1-2 days before ovulation (day 14 in a normal 28 day cycle), cervical fluid often resembles raw egg white that you can stretch for inches between your thumb and finger. The amount of cervical fluid is unique for everyone but it can be up to 10–20 times more than at any other point in the cycle.

Post ovulation, cervical fluid will become more dry and sticky again, or be absent.  Obviously if you have unprotected sex then the presence of semen will change how cervical fluid presents.  If you are on hormonal birth control then this will stop these patterns of cervical fluid and you are likely to be drier. Medications such as antihistamines can reduce the amount of cervical fluid you produce whereas decongestants can increase the amount of cervical fluid.

Amazingly, depending on where you are in your cycle, the changes that occur in your cervical fluid will make it difficult or easy for sperm to swim past your cervix and into your uterus.  Cervical fluid protects sperm from the acidic environment of your vagina and acts like a sperm filter, stopping any sperm that can’t swim properly or that have irregular shapes getting to the egg.

Sperm can start to swim through cervical fluid from about day 9 of a 28 day cycle.  It will then stay suspended in cervical fluid allowing it to survive there ready for an egg to be released, thereby extending our fertile window by up to 6 days longer. So, if you are trying to conceive you should be aiming to have intercourse every other day in the week up to when you think you ovulate so that good sperm is in situ and you do not miss the 12-24 hour window when an egg can be fertilised.

After ovulation, cervical fluid becomes a barrier to sperm reaching the upper reproductive tract.

All of this permeability is due to changes in the amount of mucin and water that the cervical fluid contains.  When you are fertile, the cervical fluid has more mucin that form channels allowing sperm through.  Under a microscope, fertile phase cervical fluid shows the strand-like mucins as branches and fern leaf-like structures hence the name a ‘fern test’. The results of the fern test help doctors to confirm ovulation and reveal beautiful patterns as these pictures show.

It is possible for women to be taught to keep track of their cervical fluid (as well as basal temperature) to determine when they are most fertile and time intercourse accordingly. However, it is still possible to have fertile looking cervical fluid yet not ovulate, as your body has prepared itself for ovulation that then did not take place.  This is most often the case when your menstrual cycles are irregular.

Knowing what is normal for you, both in terms of smell and texture throughout your cycle is a good way to keep an eye on whether you and your vagina are healthy. Significant or sudden changes in the smell, colour or consistency of your cervical fluid might mean something else is going on, like an infection that needs treatment.

A doctor should be consulted if the cervical fluid becomes consistently thicker, cottage cheese-like or textured. Or, if it becomes grey, green, yellow or brown and/or has a fishy or foul smell and/or causes itching and burning. It could be a sign of Thrush, Bacterial Vaginosis or other infections. Not all vulval itching is a sign of thrush and could be something like lichen sclerosus so do get any itching diagnosed if it persists. It is worth noting that during pregnancy, Thrush can be common but so is an increase in the amount of cervical fluid which forms a barrier between the foetus and the outside world.  So a change at this time should be discussed with your doctor to rule out an issue.

Our vaginas are like a unique ecosystem that can be affected by scented products, sexual activity, hormonal birth control or IUD’s, antibiotics, steroids, prolonged bleeding or spotting, smoking, diet and uncontrolled diabetes.

It is not necessary to douche or use any products in your vagina or on your vulva to clean away your cervical fluid or mask your smell.  Doing so may change the delicate pH balance of your vagina. Instead think of the beauty of Cervical Fluid under a microscope and just how essential it is for reproduction and keeping us healthy. I think it’s pretty amazing!

I would love to hear your thoughts and experiences regarding cervical fluid, or any issues you might have had such as vaginal dryness, Bacterial Vaginosis or Thrush.

I have been surprised in the past at just how many women I work with who think they have thrush every month (without discussing it with their GP) or who are disgusted with their normal vaginal secretions.

Cervical mucous or fluid, discharge, our juiciness – whatever you want to call the white stuff you see in your pants is a crucial part of being a girl/woman. And is pretty amazing when you look into it. It keeps the vagina clean and moist and protects the uterus from infections.

Cervical fluid is produced by cells in the glands of the cervix (the passageway between your vagina and upper reproductive tract). It is produced because of stimulation by the hormone oestrogen and is a good sign of how healthy and fertile we are.  It is made up of approximately 90-98% water (so being well hydrated may help fertility and menopausal vaginal dryness) and gets its consistency from stringy molecules called mucins. These mucins entangle to build a network. Hormonal fluctuations change the ratio of mucins to water, thus altering the consistency of the cervical fluid.

A normal cervical fluid will vary in consistency and amount throughout your menstrual cycle and may be white, gloopy, creamy, or clear.  It is usually odourless or has a light musky smell that is unique to you.  Amounts will also increase when we are aroused and will fluctuate at other times of our lives such as during puberty, during and after pregnancy and during menopause when there may be very little. Cervical fluid can be seen on our underwear, where it will have dried slightly causing some alteration in its characteristics. It is not unusual for it to fade the colour of dark underwear.

In a woman who is having periods, there will be clear changes in the consistency of cervical fluid depending on where in the cycle she is.  Just after a period (at the beginning of the cycle), cervical fluid will be dry and sticky.

Around day 9/10 in a normal menstrual cycle, cervical fluid will gradually become more wet, creamy and white/yellowish (especially on your underwear) and increase in volume. As oestrogen peaks 1-2 days before ovulation (day 14 in a normal 28 day cycle), cervical fluid often resembles raw egg white that you can stretch for inches between your thumb and finger. The amount of cervical fluid is unique for everyone but it can be up to 10–20 times more than at any other point in the cycle.

Post ovulation, cervical fluid will become more dry and sticky again, or be absent.  Obviously if you have unprotected sex then the presence of semen will change how cervical fluid presents.  If you are on hormonal birth control then this will stop these patterns of cervical fluid and you are likely to be drier. Medications such as antihistamines can reduce the amount of cervical fluid you produce whereas decongestants can increase the amount of cervical fluid.

Amazingly, depending on where you are in your cycle, the changes that occur in your cervical fluid will make it difficult or easy for sperm to swim past your cervix and into your uterus.  Cervical fluid protects sperm from the acidic environment of your vagina and acts like a sperm filter, stopping any sperm that can’t swim properly or that have irregular shapes getting to the egg.

Sperm can start to swim through cervical fluid from about day 9 of a 28 day cycle.  It will then stay suspended in cervical fluid allowing it to survive there ready for an egg to be released, thereby extending our fertile window by up to 6 days longer. So, if you are trying to conceive you should be aiming to have intercourse every other day in the week up to when you think you ovulate so that good sperm is in situ and you do not miss the 12-24 hour window when an egg can be fertilised.

After ovulation, cervical fluid becomes a barrier to sperm reaching the upper reproductive tract.

All of this permeability is due to changes in the amount of mucin and water that the cervical fluid contains.  When you are fertile, the cervical fluid has more mucin that form channels allowing sperm through.  Under a microscope, fertile phase cervical fluid shows the strand-like mucins as branches and fern leaf-like structures hence the name a ‘fern test’. The results of the fern test help doctors to confirm ovulation and reveal beautiful patterns as these pictures show.

It is possible for women to be taught to keep track of their cervical fluid (as well as basal temperature) to determine when they are most fertile and time intercourse accordingly. However, it is still possible to have fertile looking cervical fluid yet not ovulate, as your body has prepared itself for ovulation that then did not take place.  This is most often the case when your menstrual cycles are irregular.

Knowing what is normal for you, both in terms of smell and texture throughout your cycle is a good way to keep an eye on whether you and your vagina are healthy. Significant or sudden changes in the smell, colour or consistency of your cervical fluid might mean something else is going on, like an infection that needs treatment.

A doctor should be consulted if the cervical fluid becomes consistently thicker, cottage cheese-like or textured. Or, if it becomes grey, green, yellow or brown and/or has a fishy or foul smell and/or causes itching and burning. It could be a sign of Thrush, Bacterial Vaginosis or other infections. Not all vulval itching is a sign of thrush and could be something like lichen sclerosus so do get any itching diagnosed if it persists. It is worth noting that during pregnancy, Thrush can be common but so is an increase in the amount of cervical fluid which forms a barrier between the foetus and the outside world.  So a change at this time should be discussed with your doctor to rule out an issue.

Our vaginas are like a unique ecosystem that can be affected by scented products, sexual activity, hormonal birth control or IUD’s, antibiotics, steroids, prolonged bleeding or spotting, smoking, diet and uncontrolled diabetes.

It is not necessary to douche or use any products in your vagina or on your vulva to clean away your cervical fluid or mask your smell.  Doing so may change the delicate pH balance of your vagina. Instead think of the beauty of Cervical Fluid under a microscope and just how essential it is for reproduction and keeping us healthy. I think it’s pretty amazing!

I would love to hear your thoughts and experiences regarding cervical fluid, or any issues you might have had such as vaginal dryness, Bacterial Vaginosis or Thrush.

Becca is a homeopath and reflexologist specialist in gynaecological health available at www.healing-space.co.uk and www.formulahealth.co.uk

This article first appeared in This is Me! Wellwoman Network Online Magazine, July 2021

 

 

 

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Tip of an Iceberg – Taboos, Myths and History of Our Amazing Clitoris

 

Credit: Marie Docher

Ignorance and shame have plagued the clitoris for all of history. Human biology lessons at school focused on reproduction and periods.  I don’t recall ever being taught about the clitoris or certainly no emphasis was placed on it.  It is situated just above the urethra and vaginal opening and part of the vulva – the name encompassing the whole of the external genitals. ‘Vagina’ is a Latin word meaning ‘sword holder’ and medically only describes the opening.

From the Greek ‘Kleitoris’ meaning ‘Little Hill’, over the centuries the clitoris has also been known as ‘Little Bell’, ‘Electric Bell’ and ‘The Devils Teat’, as in the 1500’s the Catholic Inquisitor ascertained that Lucifer himself suckled from it.

The anatomy professor Matteo Realdo Colombo described the clitoris as the ‘seat of pleasure of a woman’ and said it was similar to the penis and should be called ‘the sweetness of Venus’.

Another leading anatomist at the time dismissed the clitoris as an organ, saying he had never ‘once seen in any woman a penis… or even the rudiments of a tiny phallus’.

This latter thought was grounded in the theory that the Greeks and Romans had, that viewed the male body as the perfect human model, and so the vagina was the opposite to the penis. So, as the male body had no equivalent to the clitoris, it was dismissed.

It was not until 1671 when a midwife Jane Sharp published a manual where she described how the clitoris stretches ‘when the spirits come into it’…and ‘makes women lustful and take delight in copulation.. (without which) ‘they would have no desire’.  At that time there was a commonly held view again rooted in Greek theory, that a male and female orgasm was essential for conception. Sharp agreed but said that penetration alone was not enough to bring about a woman’s orgasm and the clitoris was key.

Even this week in one of my Facebook groups someone posted that they ‘can only have orgasm with clitoral stimulation’ as if this is a lesser orgasm.  Sigmund Freud perpetuated this myth in the 1900’s saying that only girls played with their clitorises whereas mature women had vaginal orgasms.  And horrifyingly he also said that women were mentally ill and needed treatment if they could not achieve vaginal orgasms. Princess Marie Bonaparte, Napoleon’s Great Grand Niece, did research and concluded that only women whose clitoris was 2.5 cm from the vagina could reach orgasm from penetration and decided to have it surgically moved.  Unsurprisingly, the surgery (which she had done twice – ouch!!) did not work.

At the time, there was no understanding on just how deep the clitoris reached into the pelvis. So Princess Bonaparte, believing Freud’s theory, concluded that it was all in her head.   When her family fled to Eqypt after the German invasion of France she continued interviewing women who had undergone what we now know as female genital mutilation.  FGM (also known as circumcision or cutting) is thought to have its roots predating Islam and was designed to suppress sexual drive in women, making them clean and pure for their husbands.

Even now some statistics suggest that 140 million women have had their clitoris cut off. It is usually carried out on girls up to the age of 15.   It is important to stress that FGM shouldn’t be compared to male circumcision.  Sexual pleasure is inhibited with FGM, but not in male circumcision. FGM can lead to severe bleeding, pain, complete loss of sensitivity, complications during childbirth, infertility, severe pain during sex, recurring infections and urine retention. And in some cases it is lethal. FGM became illegal in the UK in 1985 and is classed as child abuse.  Religious leaders now stress that nowhere in religious texts does it say that FGM should be performed.  FGM is a sensitive issue, and its discussion is discouraged in some parts of society.  But young people should be made aware of the physical and mental health implications of FGM, and be given support to report any suspicion of it being carried out.  Links to support are available at the end of this article.

The idea of suppressing female sexual desire was not limited to African and Arabic countries.  John Harvey Kellogg (of breakfast cereal fame) recommended smearing the clitoris with acid to permanently prevent women from becoming over-excited. And the doctor Isaac Baker Brown claimed in 1858 that female masturbation caused hysteria, epilepsy and insanity, and he performed clitoridectomy’s without consent.

Dr Charles Mayo Goss even removed the clitoris from the 25th Edition of Grays Anatomy in 1947. And Art has traditionally ignored the clitoris.

Until recently the clitoris was only thought to consist of the ‘glans clitoris’– the visible part covered by the clitoral hood. It wasn’t until 1998 when urologist Helen O’Connell did MRI scans on aroused women for the full extent of the clitoris to become clear. The visible clitoris is the tip of the iceberg as O’Connell discovered a large structure hidden beneath the surface.  Characterized by spongy erect tissue like the penis, there are ‘arms’ that come down from the clitoral head and run for approximately 10cm either side of the vagina. And there are another 2 wings that flare out into the pelvis from the clitoral hood.

Having looked at pictures of the whole clitoris, I can see the similarity with the male penis and testicles. It’s not that surprising since all foetuses have the same erectile tissue until around 10 weeks, at which point sex is determines and either a penis and testicles, or clitoris and vagina, is formed.

The clitoris has been found to have 8,000 nerve endings – more than twice what the penis has and most are located in the glans.  Recent studies suggest that vaginal orgasm through what has been called G spot stimulation is actually due to clitoral stimulation.

Contemporary female artists are beginning to embrace the clitoris.  Sociologist Odile Fillod created a 3-D life size model of the clitoris that anyone can download and reproduce on a 3-D printer. Whilst Sophia Wallace created a large gilded climbable model of the clitoris in 2012 and promotes ‘Cliteracy’ reframing our focus away from the penis and vagina and onto the clitoris.

It is normal for girls to be taught that sex hurts, that sex is about vaginal intercourse and that if you cannot orgasm from vaginal penetration then you are lacking something.  We need to change these misconceptions.

In recent years moves have been made to revise textbooks to show the full wonderous structure of the clitoris.  And websites such as OMGYes are creating a better understanding of the clitoris and female orgasm.  In the birth work area there are also discussions about female orgasm during labour for pain relief and even the concept that birth can be orgasmic.

There is still a way to go. A 2017 study found that only 65% of heterosexual women usually or always have sexual encounters that result in orgasm, while for lesbians this figure is 86%.  So that’s 35% of heterosexual women who have sexual encounters usually without orgasm.  Let’s take a moment to let that sink in.

Regular orgasms strengthen the immune system, are good for the heart and sleep, help you look younger and of course reduce stress.

There are of course many reasons why women have difficulty orgasming. Some are physical, like the fusing of lichen sclerosus. Low libido can also be caused by hormone issues and what’s going on in our heads.  The women having regular orgasms reported that this was due to more oral sex, more clitoral stimulation, longer lasting sex, new positions and their last encounter including deep kissing, as well as asking for what they wanted.

The clitoris is phenomenal. So let’s stop chasing vaginal orgasms, ensure we are respected and communicate with our partners about our needs and put the clitoris on centre stage of our bedrooms. After being shamed, denied, ignored, scorned and cut off let’s celebrate our clits. They really do deserve it.

I would love to hear from you about your thoughts on the clitoris, orgasms and what makes sex great.

Becca is a homeopath and reflexologist specialist in gynaecological health available at www.healing-space.co.uk and www.formulahealth.co.uk

 

Installation view of Άδάμας (Unconquerable), 2013, by Sophia Wallace

Female Genital Mutilation:

  • If someone is in immediate danger, contact the police immediately by dialling 999.
  • If you’re concerned that someone may be at risk, contact the NSPCC helpline on 0800 028 3550 or fgmhelp@nspcc.org.uk.
  • If you’re under pressure to have FGM performed on your daughter, ask a GP, your health visitor or another healthcare professional for help, or contact the NSPCC helpline.
  • If you have had FGM, you can get help from a specialist NHS gynaecologist or FGM service – ask a GP, your midwife or any other healthcare professional about services in your area.

This article was first published June 1st 2021 in the This is Me, Well Woman Magazine online available at: https://issuu.com/theforwardthinkingtherapist/docs/june_2021_launch_issue

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Why I became a Therapist

My first experience of reflexology was in a job where I was working as a product development technologist for M&S in London.  It involved a lot of travel and long hours which I found pretty stressful. The occupational therapy department offered reflexology and I thought it was wonderful.

I had reflexology regularly and noticed the effect it had on me; helping me manage my stress and reducing the pain I had with the symptoms of my Crohnes disease.  Whilst at M&S I went through several restructures and each time I needed to re-apply for my job.

At the same time, my friend Clare was diagnosed with breast cancer at 26. I would sit in sales meetings where everyone was distraught about the lack of sales of winter coats in 30° weather in July and it all felt a bit superficial when someone close to me was going through such a devastating diagnosis and treatment. M&S was meant to be my dream job but it just wasn’t fulfilling anymore.

So, I did a years reflexology practitioner training at the Philip Salmon School of Reflexology in London qualifying in 2001.  I went part time at M&S whilst working in a clinic in Northwest London.

Devastatingly, Clare’s breast cancer spread. We were living together, both working in retail and not particularly happy in our jobs.  Clare motivated me to do something else and not stay in a job I wasn’t happy with. I took the plunge and resigned from M&S to become a full- time reflexologist in 2003.  The same day I found out I was pregnant.

Clare died when my son was 9 weeks old. It was devastating and it’s not a surprise that I developed post-natal depression.

One day I saw an advert in a local parenting magazine by a homeopath. The ad asked if I was struggling; if I was stressed and anxious; and I realised that I was.  I saw the homeopath and felt better but it wasn’t until I took my 8 month old son for his eczema and it resolved quickly did I properly fall in love with homeopathy.

 

I had known nothing about homeopathy except I remember being fascinated when I was a child in Culpepper’s in Bath by the little phials of white tablets.  I did a four year degree in Homeopathy at Purton House, then part of Thames Valley University graduating in 2009 with a 2:1. I had a second son during my degree and used homeopathy for all my families ailments.

I really do believe that it is my life purpose to be a Homeopath and Reflexologist. I love my job and I love that I can help people.  I have particularly enjoyed working with women with fertility issues and then during their subsequent pregnancies.  And it’s far more fulfilling than men’s underwear (my first department at M&S!)

In 2020, the pandemic and lockdown meant I needed to move my business online.  An amazing chance opportunity with a Homeopath working in the niche of lichen sclerosus came about.  I have lichen sclerosus myself so I understand how irritating, painful and life limiting it can be, so I jumped at the chance to specialise in this area.  I have personal experience of managing my symptoms with homeopathy, but its fantastic to see how homeopathy can make dramatic changes to someone else’s life.

When women (and men and children) are diagnosed with lichen sclerosus, their only option in the medical world is steroid cream, which is known to thin the skin and yet is used on a condition that itself can thin the skin in an intimate area. It doesn’t make sense to me. Homeopathy offers options to manage the symptoms and in my experience personally and professionally to put people in remission.

Reflexology and Homeopathy are truly wonderful and I feel very grateful that I was able to train to be a practitioner.

I offer free 15 mins discovery call where you can find out how I can support you with Homeopathy and Reflexology in Women’s Health particularly gynaecological issues, those affecting fertility and pregnancy.

I have also trained in Aromareflexology (a tailor made to your needs blend of essential oils is used during reflexology), Maternity Reflexology and Reproflexology (fertility reflexology for natural conception and alongside Assisted Conception) and Facial Reflexology incorporating Zone Face Lift.

I help you feel and look amazing!

Book your free discovery call now at https://healingspace.setmore.com/

I did visit some amazing places whilst at M&S – including the Middle and Far East.

 

 

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Why everyone should try reflexology, how stress can affect the body and how reflexology can help…

Reflexology is a complementary therapy and much more than a massage! Reflexologists believe that particular areas of the feet, hands, face and ears are related to certain organs in the body and working on these specific areas with pressure may bring the body into balance. It is also deeply relaxing and many people I see who start the session saying ‘they’re not stressed’ actually realise just how much tension they were holding in their body.  They leave the session deeply relaxed and floating out of the room!

The foot has nearly 15,000 nerves, making them especially sensitive to being touched.

By stimulating reflex points, that reflexologists believe correspond to other areas of the body, we are sending a signal to those inner organs and glands. We are not clear how this might work but one hypothesis is that the peripheral nervous system sends signals between our head, hands and feet and brain. I have seen the reduction of symptoms in people suffering peripheral neuropathy after regular reflexology sessions which would concur with this view. Reflexology is also thought to improve the blood and energy circulation, gives a sense of relaxation, and maintain the homoeostasis.

A map is used that sets out reflex points and their corresponding organs and glands in the body. Pressure point massage similar to reflexology has been used historically in China, by the Ancient Egyptians, Native American Indians and Aboriginals.

 

Benefits of reflexology:

  • The treatment is free from any drugs and chemical, and it is a wide option for many health problems.1
  • Its ability to reduce pain.
  • It helps body to maintain the dexterity and locomotion ability.8
  • It promotes general sense of relaxation especially overused or tired hands, feet, and the whole body parts.2
  • It stimulates the release of body’s pain-relieving chemicals.1
  • As a prevention from any illness.2
  • It promotes recovery process from any injury particularly at any region at hands and feet.1

 

I offer virtual facial reflexology sessions where I guide you through a relaxing self-administered session to reduce your stress.

 

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Cyclical Creativity Podcast on Lichen Sclerosus Awareness

I did my first (very nerve wracking!) Podcast with Tessa Sanderson of Cyclical Wisdom. Whilst its not my best work as I’m so jittery, I think the message is too important not to share. I have a diagnosis of lichen sclerosus, a vulval skin condition.

I was diagnosed after insane itching that wasn’t going with thrush treatment. I thought I had thrush for years but I think I had LS and the hormonal changes of having my son tipped me over the edge. It’s meant to be rare but I have specialised working with women with it and I’m not convinced it is. I believe it’s under and mis-diagnosed. It can affect men and children too – my youngest client was diagnosed at 4.

LS is typified by burning, itching, tearing, white patches, some have swelling and it can lead to fusing of the labia, vagina and anus. Although not all those symptoms have to be there for LS. If you have persistent symptoms please do check it out with your GP, and get a second opinion if your symptoms aren’t resolving. Diagnosis can be done with a biopsy but this can cause issues too due to the trauma.

#lichensclerosus

#lichensclerosusawareness

#healinglichensclerosus