Written by Sam Mishra and Cleo Campbell-White, Massage Therapist, Aromatherapist, Accredited Course Tutor, Oncology Practitioner
Sam Mishra's medical background as a nurse and a midwife, combined with her own experiences of childhood disability and abuse, have resulted in a diverse and specialised service.
Having just received the Kent Women in Business Award for Women’s Champion on International Women’s Day, I spoke about how my dual medical background, combined with my own personal experiences of trauma and gynaecological issues, really helped me to become an advocate for women. I have dealt with an extensive list of issues affecting women and inequalities that unfortunately impact accessibility to treatment and even a diagnosis, including menopause being passed off as stress, endometriosis being explained as a heavy period, and a complete lack of understanding over issues such as female genital mutilation, which has become more apparent due to the increase in refugees from areas where this is culturally accepted.
Given the cultural taboos, societal expectations, and resulting lack of interest in and research into women’s health issues (because they’re often considered just part of being a woman), the vagina has been that invisible thing that we’re not meant to talk about. Let’s face it, half of the population has one; we birth our children from them, yet sex education is often basic at best, and many women don’t even realise how varied the appearance of the vulva can be or that the vagina is the internal part and the vulva is the outer.
Despite the lack of education about the different parts of our genitals, so many women still won’t even look at their vulva or masturbate because we’re taught not to be curious. It has become a dirty word, so our doctor probably knows more about our vagina than we do, and in a world where there are these medical inequalities against women, our trust in our doctor’s knowledge means that we often question whether we do actually know our bodies best. Men, on the other hand, talk about their penises regularly, which is considered socially acceptable, and it is expected that men will masturbate, look at porn, or be interested in sex. If a woman shows too much interest in sex or talks about her vagina, she is often considered a slut.
The impact of social media and celebrity culture in recent years hasn’t helped because women are bombarded with the perfect image of what they should be or what men apparently want, and sex sells, so pornography, fashion, and beauty businesses play into this. Sending naked pictures has become a common practice even in the early stages of dating, placing extra pressure on women to appear perfect.
These factors all have a knock-on effect on women’s body image as a whole and on their view of their vagina, which also affects their view of themselves as a woman. This can impact how women deal with gynaecological problems, including attendance for smear tests, because it all feels very awkward, so many women will tense up, and then it can become really uncomfortable.
This constant striving for perfection and feeling inadequate due to a lack of knowledge about what is normal has surely played a major role in the increase in cosmetic labiaplasty cases. Why can’t we explore our vaginas and look at every part of our vulva and feel confident in saying, “That looks good?”
Why do we not talk about our vaginas?
Gender inequalities when it comes to sexuality are painfully apparent, with the expectation being that men and women will talk about penises quite openly, yet any mention of a vagina just makes people cringe. Maybe the visibility of a penis makes it easier to discuss, whereas the clitoris and the vagina are hidden away and shrouded in mystery.
The reality is that female sexuality is not something that is respected in society; men can be curious and masturbate—it’s seen as a manly quality—but women are not given the same acceptance. Consequently, we have learned from an early age not to talk about or explore our vaginas. Even the word feels kind of sterile and clinical, unlike penis, which just sounds like a whole load of fun.
In Scandinavian cultures, children are taught about their genitals from an early age, and nudity is much more accepted. Consequently, there is no fear or embarrassment associated with words such as vulva and vagina, and women have a much healthier view not only of their own body image but also of their sexuality.
We have created a world where, even in times when a vagina is the focus, the word is still avoided. How offensive can a vagina be that even in advertisements for tampons, we are met with the image of a woman playfully running along a beach, full of energy, rather than the reality that a lot of us are in pain, tired, and, in some cases, actually suffering from a medical condition that is ignored almost as much as our vaginas? If we were watching an advertisement for toilet roll, we would be hearing about how soft and gentle it is on our bum, yet it is somehow inappropriate to talk about whether a tampon will be a comfortable fit in our vagina or whether it will absorb our completely natural discharge, even in those who experience flooding and clots every month.
Even medical professionals don’t always tell patients what they want to hear, describing everything in medical terminology that most people don’t understand, rather than talking about the realities of how a certain surgery or disorder will affect them. I hear this from clients so often. An example is that following a hysterectomy when the cervix has been removed, many women will have the issue after having a bath or sex, where a certain amount of liquid is going to leave the body a bit quicker.
Women like to know this so that if they’re on a date they can prepare instead of trying to waddle to the bathroom as quickly as possible with their legs clamped together, to avoid looking like they’ve wet themselves, like some kind of demented penguin trying to look seductive. Why can we not just be open with patients about the realities of their vagina, rather than maintaining a very formal, and often quite cold, demeanor?
There are many aspects of sex, yet sex education in schools focuses purely on the reproductive element and preventing pregnancy. I fully support the rights of parents to make choices for their children’s best interests, but the government has enabled them to withdraw even basic sexual education when the parents may not be willing to educate their children themselves. Both parents and schools need to accept some responsibility not only for teaching about reproduction but also about sexual morality and ethics as well as sexual pleasure, because these things will undoubtedly impact the child’s relationships, self-esteem, body image, and health as an adult.
When dealing with trauma, it is widely accepted that children will internalise negative feelings or suppress things that are considered socially unacceptable, so why should this be any different with a topic such as sexual pleasure? We educate boys about parts of the penis and how to maintain hygiene, yet we don’t do the same with girls. If we don’t educate our daughters about the parts of the vulva and vagina and their functions, how are we preparing them for acceptance in a relationship, to view themselves positively, to be sexually safe and aware, or to recognise when there may be a health issue? We teach children about the function of a vagina in terms of being the birth canal, but not about its pleasure-related functions. This also happens with breasts, which are viewed purely as sexual objects, yet they have a reproductive function that is often ignored or seen as a subject of social embarrassment. Why can we not just accept all aspects of the parts of our bodies instead of allowing societal and generational attitudes to dictate?
Whether it’s through trauma, generational or cultural attitudes and traditions, or the portrayal of the perfect woman across social media, too many women are feeling shame associated with their body, and commonly their vagina. Either they don’t meet that social perception of the perfect image, or if they dare to feel comfortable in their own skin and become sexually aware, then they are labelled as slutty. A lack of knowledge and connection with our vaginas will only exacerbate these feelings of shame and lead to sexual dysfunction. If we don’t understand our own bodies, it becomes easier to disconnect from ourselves than to express our desires, needs, and vulnerabilities to our partners.
Why is it so important for us to talk about our vagina?
Studies have shown that a high percentage of women are unable to name the seven main structures of the vulva, with a shocking 46% being able to label the three orifices and only 9% having knowledge of all seven structures. Surprisingly, the ability to identify structures other than the vagina was no better in women than in men, but the vulva is an important part of the body, involved in significant bodily functions, and has a huge capacity for pleasurable or painful sensations. Given the increased understanding we have of hormones and menstrual cycles and the more open discussions that have been happening in recent years about menopause, combined with sexual pleasure in women coming to the fore due to a vast array of sex toys, why is the correlation between women’s health issues and emotions and knowledge of our vulvas still either unrecognised or ignored?
We need to talk about our vaginas! But we’re not. Nine years ago, an artist called Jamie McCartney created “The Great Wall of Vagina" (www.thegreatwallofvulva.com) by taking casts of the vulvas of 400 women to demonstrate to people that there is no perfect vulva, as social media and celebrity culture often lead us to believe. In some circles, this was seen as controversial, but the fact is, if we don’t acknowledge or talk about how every woman’s vulva looks different, then we are feeding into that commonly perceived idea that we aren’t normal or perfect down there, and this can have a huge impact on how we experience pleasure.
There is this ridiculous belief that if we mention the dreaded V word to our children, we will somehow corrupt or sexualize them, but if we have more open conversations about the vagina, we can transform how we relate to that part of our body from an early age. In fact, if we look at many of the countries with a lower incidence of bullying and prejudice against the LGBTQ+ community and teenage pregnancies, these are often the countries that also help their young daughters grow up into empowered women through early sexual education using the correct anatomical terms. Not only can this boost adult sexual satisfaction rates by enhancing our natural ability to express our sexual desires, boundaries, and preferred touch methods, but it also empowers our daughters to communicate when something is amiss, potentially positively impacting some of the teenage pregnancies I assisted in delivering as a midwife.
The truth is, this can’t happen if we continue to attach stigma to our vaginas. We have so many names for our genitals. fanny, lady garden, chuff, burger, muff, pussy, vajajay, minge, foo foo, beaver, and nunny, like these funnier words, save our embarrassment or reduce the intimacy of the topic. Why can’t we just say “vagina”?
By making vagina a more friendly word and by becoming better acquainted with our own vaginas through self-exploration, we can reduce any fears associated with it, and this can have a knock-on effect on our emotional health, our relationships, and our acceptance of physical medical conditions.
There’s nothing like sexual intimacy to expose all of our vulnerabilities, and when only 37% of research participants could identify the clitoris, it is easy to understand why we suppress so many emotions around sexual pleasure because we can’t talk about what we aren’t aware of. This can be further exacerbated by trauma, particularly sexual, birth-related, or emotional, where sexual partners have used degrading language about the woman’s vagina and we simply disconnect from our body. This is why I run a training course on yoni massage as a means of empowering women who have been through trauma to normalise touch around the vagina and re-establish that connection with it, thus also promoting consent. (For more details, see my previous article, “Is Yoni Massage Effective in Aiding Women’s Recovery from Sexual Trauma? , January 2024.)
The topic of consent, however, isn’t only applicable to our sexual relationships but also to our medical experiences. To consent to medical treatment, we must be informed of the benefits and the risks, and we can’t do this if we don’t have the knowledge. So often, I see clients in my practice who have been suffering in silence because maybe they weren’t adequately able to explain exactly what the issue was to their doctor, or maybe they just didn’t understand the language that their doctor was using. Society has this view that gynaecological issues are simply because we are women, because we are past menopause, or because we have had children. These things do not mean that we should fall into the acceptance that dysfunction is part of being a woman.
Vagina facts we should know
Many use the term vagina when they are actually referring to the vulva, but they are two different things. The vagina is the internal canal leading up to the cervix, sitting at 130 degrees with an anteverted uterus, although up to 25% of women have a retroverted uterus, which can contribute to painful sex. This 130-degree slant can also be responsible for the slight resistance we sometimes feel with either tampon or penile insertion.
The visible structures (urethral os, labia minora and majora, clitoris, vaginal os, and the perineum) are referred to as the vulva. It’s hard to believe, but many think that women pass urine through their vagina, just as it passes through the penis in men. But no, we have three orifices: the urethra, the vagina, and the anus. There are, however, some commonalities between the clitoris and the penis, since both develop from the same erectile tissue, but the clitoris has around twice the number of nerve endings as the penis. There is no normal when it comes to vulvas, and the colour, size, and shape of the labia will vary greatly, but unfortunately, the increase in porn and, more recently, labiaplasty, often cause us to believe that we aren’t perfect. This perceived imperfection has possibly also become more apparent with porn and changes in fashion, leading to more women having Brazilian or Hollywood waxing, therefore increasing the visibility of those ‘imperfections’. Everyone has their own preferences, but pubic hair does offer a barrier, helping to prevent vaginal infection.
Just as there is a variation in the appearance of the labia, this is also the case when it comes to vaginal discharge, depending on what time of the month it is. Discharge can be transparent, white, thick, wet, or stringy, but if ever there is a fishy odour or the discharge is yellowish-green, it’s time to get a swab. Anything that upsets the vaginal pH can affect the discharge and likelihood of infection. Even the smell can differ due to personal hygiene, vaginal flora, clothing material, nutrition, etc. We now discourage the vaginal douche because it can interfere with the natural flora, thereby promoting infection. Instead, we recommend relying on the vaginal glands' self-cleaning ability to naturally cleanse us internally.
Oestrogen is responsible for our natural lubricant, but this declines with menopause, so using an additional lubricant can make sex more comfortable and reduce the chances of vaginal trauma. While we’re on the topic of sex, there is a lot to be said for the big O, as a lack of orgasms and sexual frustration in general can cause an uncomfortable heaviness in the vulva. Plus, the dopamine release and increased flow of blood during orgasm can help reduce menstrual pain. For many, sex has unfortunately become quite habitual without much variation. While the majority of women orgasm through clitoral stimulation, and let’s face it, many men and women are unaware of the six main stimulation points around the vulva and vagina, which could lead to vaginal orgasm, it is even possible to orgasm through the anus or even with breast stimulation. Lack of knowledge about these stimulation points means that while women have the potential to ejaculate, most of them don’t or think it isn’t possible. Female ejaculation is completely normal and occurs as a result of stimulating the G spot and U points simultaneously. The ejaculate, while simulating the feeling of wanting to urinate and having a clearer appearance than the usual vaginal discharge, is not urine, as some believe.
All of this is simply physiology that affects all women, so why are we so embarrassed by the thought of talking about discharge or even a bit of vaginal farting after sex? Let’s face it, men are often very proud of their farts, so why can’t we women be equally proud of a pleasantly warming queefing session?
Women's perceptions of their vaginas after trauma
There are numerous factors that can impact a woman’s view of her vagina, and even in those of us that accept that we are all different, we can still feel that we are not looking or feeling our best, and this can damage our self-confidence, our body image, and our intimate relationships.
As previously stated, every vagina is different, and the appearance, in terms of size and colour, will be determined by age and genetics. Certainly, any oestrogen deficiency from menopause can cause the vaginal canal to atrophy and the muscles to lose their elasticity, but there are other factors that can influence our own perception of our vagina.
Our upbringing and any trauma can directly impact how we view our vagina and sex. For example, if sex is portrayed as something disgusting and the subject is avoided, we can hold a lot of shame around sex and therefore, how we think about our vaginas. In Scandinavian countries, where there is a positive attitude towards nudity, as well as early sex education, people have a much more open view of sex and positive body image.
Research has shown a correlation between childhood sexual abuse and the inability to achieve orgasm, fear of intimacy, and the perception of sex as being painful. Even as an adult, sexual abuse can alter our perception, maybe through dissociation, and lead to medical issues such as vaginismus. It is easy to understand how negative attitudes towards the genitals would result from this.
However, we must stop thinking about the vagina as just a sexual organ because it is closely interlinked with brain activity, such as an increased secretion of dopamine, not only upon orgasm but also simply when thinking about being aroused. Dopamine and oxytocin, which are also secreted during orgasm, can have a positive impact on mood, creativity, and self-confidence. Different emotions can be triggered by activating different stimulation points around the vagina, and this concept forms part of the theory behind yoni massage, where the release of tension at certain points can cause a sudden release of anger, fear, sorrow, etc.
The question has been raised in some circles as to whether the capacity of the vagina to influence confidence, creativity, and motivation may play a part in abusive shaming practices, which are intended to maintain a certain level of ignorance in women about their sexual abilities. While there is a belief in some cultures that female genital mutilation is done to make a girl clean, due to the vagina and vulva being seen as "dirty," it would seem to be more about suppressing female confidence and sexuality.
In cases of sexual trauma, therefore, given what we know about the dysregulation of the nervous system and also the vagina-brain connection, it is easier to understand how rape victims can experience long-term mental health issues as well as an increased incidence of certain medical conditions, including gynaecological problems, for years afterwards.
How does our medical history impact the relationship we have with our vaginas?
Probably the most commonly recognised factor that we believe contributes to a negative perception of the appearance of our vagina is childbirth. We know that the stretching that occurs during pregnancy, particularly with large or multiple babies, is more likely to have a long-term impact on the pelvic floor, the appearance of the vulva, and the tone of the vagina. The vagina may atrophy a little after childbirth due to the drop in oestrogen, and if the woman has suffered, particularly from a 3rd degree tear or an episiotomy, this can also impact vaginal function, with pain during sex being a long-term consequence. The tone and strength of the pelvic floor will affect the occurrence and strength of orgasms.
There are many medical issues that will also contribute to how we view our vagina, including vulvodynia, dysmennorhoea, prolapse (bladder, vaginal, or rectal), vaginal fistulas, vaginismus, hypertonic pelvic floor, incontinence, endometriosis, infertility, and menopause. These conditions can affect not only our physical health but also our mental health, body image, intimate relationships, and sexual health. Plus, the inequalities that we see with women’s health issues simply add to the idea that we should simply ‘get on with it’ because it’s all part of being a woman, so many of us don’t talk about it and subconsciously internalise feelings of being inadequate or imperfect.
There have also been debates as to whether surgical treatment for some of these medical conditions is really necessary. Certainly, with endometriosis, I know only too well, from my own personal experience, from my nursing days, and now as a massage therapist with many endo clients, that surgery, while sometimes necessary, can initiate a vicious cycle of pain, surgery, and scar tissue. In this case, there should always be consideration of more natural treatment options prior to boarding the surgery train. However, with issues such as a severe prolapse, no amount of massage, pilates, etc. is going to fix the problem.
When we live in a patriarchal society where social media is constantly telling us that we need to cover up certain elements of our womanhood, for example, menstrual discharge, we are introduced to a way of thinking that can negatively impact our awareness of our own bodies and inhibit education about such issues. When we become ashamed of these issues because society deems them to be too dirty, how are we to openly discuss them with professionals when we have a problem with our vulva? This can also sometimes lead to women automatically agreeing to certain treatment plans when there may be another better option because they don’t have the education to question things or are too embarrassed to ask.
As a gynae nurse I would hear women talking about having had their bladder repaired due to a prolapse, but not understanding that it wasn’t the bladder that was the problem, but the vagina, or women not understanding the vagina-brain connection to know that their vaginismus is causing penetration issues due to some kind of fear. Hypertonic pelvic floor can also arise from issues such as incontinence, where women feel anxious about relaxing, and this may not be something that the woman consciously recognises.
Alternative treatments
As I’ve stated, surgery is sometimes the best option for certain gynaecological issues, but sometimes there are other options. If we educate ourselves with knowledge of the vagina and bring about a more open culture of discussion around this topic, then we are more able to choose the right option for us and ask the right questions from professionals so that we can make informed consent.
Two natural treatment options that can be really effective for some vaginal issues are yoni massage and vaginal rejuvenation. I’ve talked previously about yoni massage in my article listed under references, but with more open conversations, the value of this treatment could be truly appreciated, rather than it sometimes being seen as a sexual service due to a lack of understanding.
Yoni massage
A considerable percentage of women report having discomfort during a sexual encounter at some time, which can be attributed to various factors, for example, social conditioning, circumstances surrounding virginity loss, pelvic floor weakness, menopause, vaginitis, prolapse, female genital mutilation, sexual abuse, traumatic childbirth, infection, endometriosis or retroverted uterus. Whatever the reason, these issues result in muscle tension, hardening, and numbness in the vaginal muscles. The vagina can store suppressed emotions related to these issues, making it difficult for women to relate intimately to their partner and preventing them from experiencing an orgasm.
Not only do such issues create physical problems, but they also negatively impact a woman’s perception of how she looks, which, along with feelings of shame and guilt, is likely to cause her to disconnect from her genitals or her body as a whole.
Yoni massage eases numbness and stiffness caused by repressed traumatising emotions, restricted energy, and inadequate blood flow. It also heightens one's awareness of oneself and one's sexuality. As a result, the woman will develop a greater capacity for experiencing pleasure and re-establish a connection with herself and others.
By rewiring the pelvic connection with the self in a caring and consentual way, yoni massage facilitates healing and empowerment.
Vaginal tightening
Also increasingly popular is the non-surgical vaginal tightening offered by my advanced aesthetician colleague Cleo Campbell-White of iBeautify, but there are still many women who are not aware of this option, and again the embarrassment of talking about our vaginas can hold us back from discovering this very successful treatment. Cleo says.
“Have you ever heard about HIFU and its incredible positive effects on female intimate tightening? It's a topic that many shy away from discussing, similar to the symptoms of menopause that are often overlooked. But why just endure it when you can transform your life with Vaginal Tightening using HIFU (High-Intensity Focus Ultrasound)?
With the latest state-of-the-art HIFU technology, this treatment offers a range of solutions to address unwanted symptoms in a completely non-invasive manner. By targeting deep layers of the skin, HIFU stimulates new collagen production and regeneration at the source, revitalizing vaginal tissue.
During the treatment, energy is released to target the mucous membrane, fibrous, and muscle layers directly, leading to tissue contraction and increased collagen production. The benefits of HIFU include:
Increased vaginal moisture
Enhanced sensitivity during sexual activity
Boosted sex drive
Improved vaginal tightness and firmness
Reduction in stress incontinence
Firmer and tighter muscles in the treated area
Reduction or elimination of vaginal bacterial infections
Treatment of signs of aging for an overall vaginal revival
Clinically proven, safe, and effective
Cost-effective and less invasive than surgical options
No need for anaesthesia or harmful drugs
No incisions or risk of infection
No downtime, with results visible after just one treatment
Long-lasting results that can extend for two years or more”
By having more open discussions, women can open the door, to less pain, infection and incontinence, and better sexual relationships without the need for expensive and time consuming surgery. Cleo provides the utmost consideration and discretion, prioritizing your comfort and well-being, and starting with a consultation to address any questions or concerns you may have. You can find out more on the links below.
Summary
Given that our patriarchal society conceals the impact of women's vaginas on their mentality, why should we persist in suppressing ourselves? By talking openly about our vaginas, we not only reduce the pressure on women to be seen as perfect, which improves our body image and self confidence, but we are also empowering women to be more sexually aware and to experience more orgasms, leading to improved mood, motivation, creativity, and self-esteem. Plus, more orgasms mean more opportunity to release negative emotions, particularly following trauma. Improved sexual awareness and knowledge also means reducing fear, which can impact relationships and emotional and physical health, and reducing embarrassment and shame that we so commonly inherit from our upbringing or from cultural practices, which can cause long term chronic pain. It is crucial to expand our understanding of these cultural practices, particularly as refugees grappling with similar issues increasingly integrate into our communities. By reducing these negative associations, we can also empower women by promoting consent and normalising intimate touch even after trauma.
It is apparent from other cultures that by offering earlier age-appropriate sex education, our children can develop into more sexually moral adults who have higher self-esteem and better quality relationships. This earlier education has also been shown to reduce bullying, increase acceptance of LGBTQ+, and better equip pregnant teenagers to deal with childbirth.
Finally, by enabling open discussions about our vaginas and the problems that we are experiencing with them, we can improve diagnosis and accessibility to treatment for women’s health issues, have a better understanding of medical treatments and surgeries, and hopefully change inequalities in women’s health so that women don’t continue to be told ‘it’s all part of being a woman’. After all, if a man went to his doctor with a penis problem, it wouldn’t be passed off as ‘just part of being a man’. Women are also more likely to feel less embarrassed about accessing natural therapies as they will feel more empowered to talk openly about the problem.
Cleo Campbell-White
Email: info@iBeautify.co.uk
Text/WhatsApp 07713248885
Sam Mishra, Massage Therapist, Aromatherapist, Accredited Course Tutor, Oncology Practitioner
Sam Mishra (The Medical Massage Lady), is a multi-award winning massage therapist, aromatherapist, accredited course tutor, oncology practitioner, trauma practitioner and breathwork facilitator. Her medical background as a nurse and a midwife, combined with her own experiences of childhood disability and abuse, have resulted in a diverse and specialised service. She is motivated by the adversity she has faced, using it as a driving force in her charity work and in offering the vulnerable a means of support. Her aim is to educate about medical conditions using easily understood language, to avoid inappropriate treatments being carried out and for health promotion purposes in the general public.
