The Gynae Geek: Your no-nonsense guide to ‘down there’ healthcare. Dr Mitra Anita

option with my next chance at a training job. So to cut a very long story short, I decided that I would still try and move to London and pursue my love of research for a year. To make this happen, my plan was to email every single professor of Obstetrics & Gynaecology in London and beg them for a research job. And it worked! I got a prestigious position at Imperial College, London, where I started doing a Ph.D. – the most incredible, but challenging thing I’ve ever done. And during that time, I managed to bag myself one of those sought-after training jobs.

      As much as I thrive on the thrill of operating and the honour of being able to help women bring their babies into the world, the thing I love most about my job is the chance to sit down with them to answer their questions about gynaecological health and calm their anxieties. Many concerns often stem from lack of knowledge and understanding of what is ‘normal’ – because very few women feel it is safe to talk about a topic shrouded in taboos and shame. While there is so much general health information available online, there is relatively little engaging and reliable material about female health. There are also lots of unqualified people selling their opinions as medical fact. I began to see the conversation opening up on social media, but when I looked closer it filled me with horror. Film stars talking about vaginal steaming, beauty bloggers talking about vaginal facials, wellness coaches telling women they had successfully ‘detoxed their body’ because their vegan diet had stopped their periods, as well as other unqualified people pushing products that women simply don’t need. But where were all the doctors?

      Women drink in this information, unable to decide for themselves whether it is actually credible or evidence-based, distracted by the huge numbers of followers these ‘experts’ have and the glossy façade of the online world.

      I saw the need for a sensible voice in this unregulated chaos, so I started an online blog and Instagram account called ‘Gynae Geek’. The positive response was overwhelming. I began to receive huge numbers of comments and messages from women desperate to know more, and I get a particular thrill from seeing them tagging their friends in my posts for them to read.

      I realise that I am in a privileged position, with over fifteen years of scientific and clinical training that have given me the ability to seek out information and decide whether it is credible or not. This is one of the reasons that I back up most posts with references to scientific studies – to prove to my followers that what I’m providing them with is reliable information and not just my opinion. It is also why I use the word ‘geek’: I want women to realise that knowledge is sexy, knowledge is power and that they should never be afraid to ask: ‘Why?’ and ‘How?’

       So, what is this book about?

      This is not your average healthcare book. While it’s full of medical and scientific facts, it’s also a collection of tales from the thousands of patients I’ve treated, who inspired many of the topics in the book. It is a back-to-basics guide to gynaecological health, covering what’s normal and what’s not. It’s sensible, no-nonsense and, most of all, evidence-based. Some parts might make you blush, others make you laugh and some might even make you exclaim, ‘Oh my gosh, that’s me!’ But it’s not intended for self-diagnosis, nor as an alternative to visiting a doctor in real life. Rather, it is designed to help you to decide whether or not you need to go and talk to a healthcare professional about something that’s bothering you.

      I also hope this book will be a conversation starter for women of all ages – because we need to break the taboo around talking about what’s going on down there. The reluctance to do so often delays women in seeking the help they need, which can result in unnecessary suffering and poor health outcomes. I want women to see that there is no question that cannot be asked, no symptom that should be ignored and, most importantly, no need to suffer if they are in need of help.

      As well as covering anatomy and the mechanics, sexual health and fertility, I’ve also included a section on lifestyle and women’s wellbeing, which form one of my favourite subjects. A lot of women do not realise there is a link between gynaecological health and how we eat, sleep, move and generally live our lives. There are a surprising number of simple things that can be done on a daily basis to help you and your health today and for the future.

      Each chapter includes a section headed ‘Things you’ve always wanted to know, but were too afraid to ask’ – a collection of questions I’m most frequently asked in relation to the particular topic in hand. The chapters then conclude with a short summary – ‘The Gynae Geek’s knowledge bombs’ – which comprises the essentials that everyone should take away from the chapter.

      * * *

      I set out to write a book that would be engaging and entertaining at times (the opposite of most of the health information that is out there at the moment). And while there are areas where I’ve shared my opinion, as a scientist and a doctor I have been insistent that the information provided is evidence-based and that’s why you’ll see so many references everywhere.

      The structure and content have been led by questions my patients, friends and social-media followers have asked me. You may decide to skip over certain sections because they don’t apply to you at the moment. But they may do in the future. Or they may apply to your friend/sister/colleague right now – and I would be honoured if you would share this book with other women who you think would benefit. But also share it with the men in your lives. Because women’s health shouldn’t be a mystery to them either. The health of the nation depends on the health of its women and, therefore, it’s something that everyone should be aware of.

      My ultimate goal with this book is to ensure that every woman has access to the information she needs to understand how her body works, to empower her to seek help and thus ensure that no one suffers in silence.

      Now go forth, learn, enjoy and don’t ever forget that it’s cool to be a geek!

      Since we’re just getting to know one another, I want to share a fact about myself: I’m quite good at charades. Why is that? Because most people seem to use hand gestures, rather than actual words when it comes to their vagina/undercarriage/‘down there’/lady garden/private parts – whatever you want to call it. The fact is, most women I encounter don’t know the proper names for their genitalia. And some wince when I say the word V.A.G.I.N.A. But I want to shout it from the rooftops. It’s not a dirty word! And I think this difficulty with using the right language is one of the major reasons why people feel embarrassed to go and see a doctor when they’re concerned something is not right: because they don’t even know what to call the area in question. That’s why this section provides you with an informal anatomy lesson, with a few interesting anecdotes along the way. So don’t be shy, it’s time to learn the essentials.

CHAPTER 1

       External female genital anatomy

       Doctor, while you’re down there, can you just tell me if my vagina looks normal?

      This is one of the questions I am most frequently asked by my patients, but it is also one of the most inaccurately phrased. What women actually mean is: ‘Does my vulva look normal?’

      Many people don’t know the difference between the vulva and vagina, and I think this is a major reason why women so often feel embarrassed to go and see a doctor when they’re concerned that something is not right: because they don’t even know what to call the area they are worried about. What’s more, women’s perceptions of a ‘normal vulva’ are usually inaccurately shaped by the pornography industry, and as someone who looks at vulvas (and vaginas) for a living, I feel appropriately qualified to suggest that this area is becoming a target for body dysmorphia.

      It’s very common for women to feel embarrassed or ashamed