Dr. Jen Gunter got Twitter famous a few years back by calling out Gwyneth Paltrow on jade vagina eggs. Since then, the Winnipeg-born OB-GYN has become the internet’s go-to medical fact checker, specializing in celebrity wellness gurus. Her 2019 bestseller The Vagina Bible was a no-nonsense guide to women's reproductive health. With her new book The Menopause Manifesto, Gunter wants to change the way we talk about “the change,” which means reclaiming the conversation from the patriarchy — and also from a certain blonde nemesis.
Here, she talks to Refinery29 Canada about why you don’t need smoothies to balance your hormones, how COVID has created a thriving new category of celebrity-endorsed snake oil and why there is no such thing as a “summer vagina.” (It’s your vulva, FFS — and it’s a year-round accessory.)
Summer is upon us. Which means it’s the season for women’s media to tell us how to get our vaginas “summer ready.” Any hot tips?
Ha. No. This is one of those things that you see every summer and it’s really problematic. It’s promoting the idea of what I call vaginal mayhem — making women feel badly about their parts and the insinuation that they have to do something to prep their vaginas for men or to meet a male ideal. What’s really scary is that you see this kind of message being targeted at younger and younger demographics. I spoke out about this topic a couple of years ago after I saw a “summer vagina” piece in Teen Vogue and then a few months ago there was a line of teen products from Vagisil. I guess if the goal is starting young people on a life of genital shame, you’ve got to get them in early. Give your vagina a “glow up”! What does that even mean?
Just so we’re clear — is there anything useful or remotely scientific around seasonal vagina care?
No! I mean, I guess maybe there are people who are going to care for their pubic hair differently at different times of the year, which is totally fine, but that’s really just a personal aesthetic choice, and it’s not about science or medical care. The other thing that drives me crazy is that they talk about vaginas, when what they actually mean is vulva. Your vulva is everything on the outside. Your vagina is the canal between the uterus and the vulva.
You explained all of this in The Vagina Bible, but it’s one of those things a lot of us still get wrong.
I just think that when we’re talking about women’s health, accuracy and using the correct terms is important. And empowering. One of my goals was to create a safe space for having open and honest conversations about our vaginas and vulvas and I think I was able to achieve that. That’s how the new book came along. I was doing press for The Vagina Bible and every time during audience questions there would be a bunch of women asking about menopause: “When does it start? What to expect in the transition?” I guess it wasn’t surprising that there was this knowledge vacuum, given how little dialogue there is about female reproductive health in general, but it wasn’t something I was totally aware of before.
Maybe we could start by dispelling the notion that menopause is something that happens to old people.
I think if we look at reproductive health care overall — starting with puberty to adulthood to pregnancy to menopause — it’s fair to say that women don’t have a great understanding of how stuff works. And we should. If you know how your body is supposed to function, so that when you’re having symptoms or problems, you’re in a far better position to say, “hey, some isn’t quite right here.” I think with menopause there is an even greater tendency to bury our heads in the sand. An analogy I always give is, “do you think an eight-year-old should be informed about menstruation so that they don’t wake up one morning covered in blood and terrified?” Of course! We don’t start teaching kids about getting their period the day before it happens, we want people to know about pregnancy before they get pregnant.
But with menopause we’d rather just pretend it isn’t a thing?
Right. And that’s because our society assigns worth to women based on ovarian function. Puberty is a reason to celebrate because — yay! — you’re fertile. And then when you go through menopause and lose that fertility the reverse is true. Like, okay, time to go off into a corner and maybe do some crafting and only come out every now and then to bake cookies. Not that there is anything wrong with crafting. And not that I love being more sore at 54 than I was at 24. Aging comes to us all, but I refuse to feel negatively about it or to carry that extra burden that we don’t put on men.
Is there one particular menopause misconception that you would most like to clear up?
Only one? I guess I would want women in their 30s and 40s to understand that symptoms start long before menopause. Technically speaking, menopause is the final menstrual period, but you can have symptoms years before, which is what’s called pre- or perimenopause. It’s totally common, but it can be scary if you are in your mid-40s experiencing brain fog and nobody has told you that this is totally normal, and not a permanent condition. Often what happens is that women go to the doctor and they’re told, “oh, you’re not menopausal yet, so there’s nothing you can do.” Or they get sold on blood tests that are totally useless and just a way to make money.
It feels like more people are talking about perimenopause over the last few years. Is that a positive thing?
It definitely is. In the past there has been a lot of stigma, so if more women are having these conversations, that’s great. The flip side though is that with every new level of dialogue there is a new level of weaponization and monetization.
And of course your old pal Gwyneth Paltrow is on a quest to make menopause cool. Does it surprise you that she has entered this particular space?
Not at all. The thing with Goop is that if there is a void, she will enter it. And we know that menopause is an area where mainstream healthcare really isn’t servicing women the way it could or should be. We can blame the celebrities, but we also need to look at the system.
Paltrow has said that menopause is in need of re-branding, which seems like something you might actually agree on.
I guess that’s true, but I think our definitions of rebranding are very different. I want to change the way we talk about menopause because the current version has been branded by the patriarchy, so that women feel a sense of shame and irrelevance. When Paltrow talks about rebranding she means selling useless products to an untapped market.
Goop has been pushing pseudoscience for almost a decade now. Are there any scammy celebrity up-and-comers who we should be aware of?
I’m not sure about celebrities, but one of the things that has been big over the last few years is influencers — some of them are doctors or dietitians who are achieving a sort of celebrity status on social media and hawking all sorts of totally unscientific products: smoothies to balance your hormones, or to cure your adrenal pain.
It’s all the code words and phrases. They can customize and solve everything from adult acne to infertility. We’re seeing an explosion of these hormone group programs geared towards women in late 20s early 30s. I want women to know that anyone selling you a hormone program is selling you a scam.
Did your experience in medical myth-busting help prepare you for the misinformation tsunami that is COVID-19?
I think it definitely did, although of course it is always amazing the things that catch on. The thing about vaccine shedding and how that can affect another woman’s ability to get pregnant. That’s absolute witchcraft, but I guess it’s in keeping with this whole move towards mysticism and trusting your body, which is something you hear a lot from anti-vaxxers.
What I find the most interesting is the way that these extreme and totally unscientific positions exist on both extremes, the left and the right. Here you have these two groups who would think they have nothing in common. But when you look at the nasty comments I get whenever I post anything about vaccination, they are coming from @jesusmama4ever and @naturemama4ever and they are pretty much the exact same. Mostly white women, typically blonde. They love their babies and their bodies, and one is a born-again Christian and the other is probably an atheist.
Is there anything scientifically legitimate around vaccination and reproductive health care?
One thing that has come up quite a bit is the idea that some women are experiencing abnormal menstruation after the vaccine. At this point, we don’t have the evidence to say that there is or is not a correlation, but it does seem possible. The lining of your uterus is part of your immune system, so it’s possible that some kind of change in your period could be part of an overall vaccine reaction, and it’s nothing to worry about.
Assuming that the end of COVID is near, it seems like a bunch of new post-pandemic wellness remedies are likely to hit the market.
I wouldn’t be surprised. The whole idea of “new life," “new spring,” how to prepare your body for the next pandemic. Definitely this whole immune-boosting myth is already become popular.
I feel like a broken record here, but you’re saying there is no way to improve your immune system?
No. It’s totally ridiculous, but it sounds sort of like science and that’s how they get you. When you’re not bound by ethics or facts it’s amazing how much shit you can make up.
This interview has been edited for length and clarity.