Barely a week goes by without another weird and wacky wellness trend hitting the internet – from Kardashian-approved vampire facials to colonics, to an ever-increasing list of things doctors have warned us not to put in our vaginas. But beyond Instagram, what exactly is driving women to try these kinds of alternatives?
Since October, I've been running Hysterical Women, a feminist blog exploring women's experiences of feeling dismissed and let down by their doctors, and I've increasingly found myself wondering just how much this disillusionment is driving the $4.2 trillion global wellness industry.
There's no denying there's a serious gender health gap. A 2003 study, "The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain" concluded that "women are more likely to be less well treated than men for their painful symptoms" and "biases have led health-care providers to discount women's self reports of pain."
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As for medical knowledge, we're also lacking. "Only 2.48% of publicly funded research goes towards women's reproductive health, and fewer women than men participate in clinical research," explains Janet Lindsay, CEO of charity Wellbeing of Women, which funds research into women's health.
"There is a clear gender bias when it comes to medical research. In 2016, for example, there were five times more studies on erectile dysfunction (ED) than premenstrual syndrome (PMS) – yet PMS affects 90% of women compared to only around 19% of men suffering from ED," she adds.
"Women's health is still too often overlooked and underfunded. Women are often told their symptoms are 'just women's problems', and this results in some women feeling that they can't seek specialist help for fear of being dismissed."
It is factors like this that are causing some women to look elsewhere. Thirty-eight-year-old artist Kia Cannons has suffered from chronic pain for seven years, since she was pregnant, and says: "I had a really bad experience with my GP. Their attitude was basically 'Why are you bothering us?' They refused to give me any tests, and my GP said, 'You just have to accept this is your life now'."
Understandably, she wasn't prepared to do that. "I was in so much pain I couldn't walk; someone else was having to take my kids to and from school while I had to lie flat in bed all day," Cannons says. "I couldn't just accept it."
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If you're pregnant, vaginal steaming can induce miscarriage. It can be problematic if you've got fibroids, and in certain women it can cause bacterial or fungal infections. Burns are also a huge issue, because it's very delicate tissue that can be really easily damaged.
Sarah Greenidge
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Cannons' first port of call was a private physiotherapist specialising in treating pelvic pain, who also introduced her to meditation and neuroplasticity, a pain management technique based on our brain and nervous system's ability to adapt. Two years on, she now sees a private functional doctor – an alternative medicine practitioner who focuses on treating the root cause of disease – and, with her guidance, has made radical changes to her diet, cutting out all grains, all dairy, sugar and alcohol, to reduce the chronic pain and inflammation.
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"I did a lot of research about natural options. My GP doesn't like the fact I'm being treated privately, but they also will not treat me, so you've got to fend for yourself basically," Cannons says. "I must have spent about £10,000 in the last couple of years – it's been an enormous investment, but I didn't want to just buy into fads so I was willing to pay more to ensure I was getting the best treatment."
And she's not the only one. When 25-year-old Shanay Smith was diagnosed with polycystic ovary syndrome (PCOS), her GP prescribed the contraceptive pill, which is commonly used to manage PCOS symptoms by suppressing the hormones that cause them, but Smith was wary of this option. "I went away and looked at research explaining the pill doesn't actually cure PCOS, it just masks the symptoms," she says. "I just thought no, let me find a natural solution rather than pumping myself full of synthetic hormones."
In her search, Smith came across herbal remedies including yoni (vaginal) detox pearls and steaming – treatments made famous, and controversial, by Gwyneth Paltrow's Goop – and ultimately founded her own business, Empress Body. For her, she says, this was less about buying into a Hollywood trend and more about getting back to ancient techniques used by her ancestors. "I come from a Caribbean background, and started looking into the traditional herbal remedies used by cultures around the world," she explains.
Crucially though, she adds: "We're very clear that it's important to check with your physician before using these products – particularly for pregnant women or breastfeeding mothers – and be aware of the ingredients in any products you're using. It's not about completely rejecting doctors' advice, and just because something is natural you could still have a bad reaction to it."
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But are all these alternative solutions safe? On vaginal steaming in particular, I spoke to Sarah Greenidge, founder of WellSpoken, an independent authority set up to promote high standards across the wellness industry. "Last year Goop got fined because of the gynaecological advice they were giving around yoni eggs and vaginal steaming. It was communicated as something very good for your body, but no risks were mentioned," she explains.
"Actually, if you're pregnant, vaginal steaming can induce miscarriage. It can be problematic if you've got fibroids, and in certain women it can cause bacterial or fungal infections. Burns are also a huge issue, because it's very delicate tissue that can be really easily damaged," Greenidge adds.
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There's no guarantee that random people on Instagram are giving good advice, and they aren't governed by anybody – unlike doctors.
Sarah Greenidge
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"Currently we only have anecdotal evidence of its benefits, and some research which found no gynaecological benefits, but we do know that science moves. Maybe in 10 years' time there might be research showing it works – but we have to communicate responsibly so women aren't put in danger."
As Greenidge points out, consumers are increasingly aware that scientific knowledge is neither static nor infallible. Once dismissed as hippy pursuits, Western medical research has now caught on to the benefits of a number of ancient Eastern practices, including yoga, acupuncture and mindfulness.
"Part of the shift in how we communicate about health is that, on the one hand, you have an over-cautious approach when you go to your GP, that is very by the book and slow to move forwards. On the other, you have this privatised sector of wellness, who are making ALL of the claims, offering ALL of the solutions – some of which is really amazing, tangible, easy to understand lifestyle advice, but there's also some absolute trash," Greenidge explains.
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"This boom of wellness information makes it look like doctors aren't keeping up, but not all information is created equal. There's no guarantee that random people on Instagram are giving good advice, and they aren't governed by anybody – unlike doctors," she adds.
A desire to combine the best of both worlds led to consultant oncologist Dr Elizabeth Thompson founding the National Centre for Integrative Medicine (NCIM), where qualified doctors offer a holistic doctor service.
"The beauty of this model is that it's not either or – it's conventional medicine AND a holistic, lifestyle approach. That would be the medicine of the future, where I'm concerned," she explains. "If we can do things in a more gentle way, with fewer side effects, and trigger the body's own healing responses, to me that makes total sense."
Conversations about side effects have played an important role in many women's disillusionment with mainstream medicine. Thirty-nine-year-old Kate Orson experienced agonisingly painful sex following the LLETZ procedure, which burns off abnormal cells picked up by cervical screening.
After her pain was dismissed by doctors, Orson turned to Facebook support groups for advice, and has used tantric vaginal self-massage, as well as yoga and meditation, to treat her symptoms. "I've always believed in natural healing, but I know a lot of women trying alternatives simply because there isn't really anything a doctor can do for their symptoms," she says.
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I do think part of what's driving the wellness industry is women who are sick and have not been taken seriously by mainstream medicine, and have conditions that haven't been well researched.
Maya Dusenbery
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This is something US-based author Maya Dusenbery found while researching her book Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick. "For women with chronic pain conditions like fibromyalgia, where conventional medicine isn't even offering a treatment approach, 'alternative' solutions are not alternatives! For something like vulvodynia (chronic pain of the vulva), the conventional medications are just as experimental and off-label as the alternative approaches," she explains.
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"I do think part of what's driving the wellness industry – which is separate from the aspirational, lifestyle component – is women who are sick and have not been taken seriously by mainstream medicine, and have conditions that haven't been well researched," Dusenbery adds.
She believes the internet has not only provided access to a wealth of information but also given women the validation and support they weren't getting from their doctors. "I think women have always been more likely than men to use alternative health approaches, but the internet makes it much easier to find other patients sharing knowledge about these alternatives. That sense of community makes women feel validated, whereas previously it was easy to believe you were the only one," she says.
"There's certainly a danger that people will exploit patients' desperation and willingness to try anything, so you need a certain degree of health literacy and critical thinking skills to wade through all the information online," she adds. "But the way we talk about this needs to place the blame on mainstream medicine for leaving so many patients in that position, rather than dismissing women as irrational for turning to wellness trends."