Someone who knows the importance of women truly understanding their bodies is Dr Anita Mitra, a gynaecologist and self-confessed "Gynae Geek" (as she is better known to her 45k+ Instagram followers). Her recently published book – The Gynae Geek: Your No-Nonsense Guide To 'Down There' Healthcare – is a bible for hard vagina facts and dispelling misguided, internet "wellness" theories.
Taking the reader from the basic anatomy of the vagina through their first period, sexual health, contraception, fertility and pregnancy, Dr Mitra explains in a straight-talking, friendly tone, how women should best look after their bodies. She shares her own experiences along the way, stories of her patients and her friends (one particular laugh-out-loud moment describes how a friend believed her cervix scab had fallen off "thanks to the most energetic dancing at the Pyramid Stage" at Glastonbury festival).
Here at Refinery29, we consider ourselves pretty knowledgeable when it comes to vulvas, vaginas and women's sexual and reproductive health, but even we were surprised by how much we didn’t know after reading The Gynae Geek. Read on for the five most surprising things we learned from Dr Mitra.
As Dr Mitra explains, everyone seems to have a different answer to whether or not this is advisable – some say it’s okay, some say it could be harmful. "This is because theoretically you could dislodge your coil with the... vacuum effect," Dr Mitra explains in chapter 3, the section of the book dedicated to periods. This "suction" experience, she continues, is something that she has had confirmed by a number of "SOS message[s]" from women via social media, many of which beg her to help reinsert the saved coil. "[W]hile I’m all for recycling, you can’t reuse a coil," Dr Mitra states, advising that if this happens to you, it is important to use a fresh coil in its place.
"If you do choose to use a cup with a coil," she continues, "I would advise checking the strings at the end of your period. If you feel they are lower than normal, you can feel the rod of the coil or you can’t feel any strings at all, I would use condoms until you’ve had it checked by a doctor to ensure it’s still in the right place to give you full contraceptive protection."
When you smoke, so does your vagina
"Smoking is most often associated with lung-related diseases, but nicotine and its metabolites have been found in the vaginal discharge of smokers, as well as that of women exposed to passive smoking," Dr Mitra explains. "Smoking is known to have anti-oestrogenic effects, which can cause women to go through an early menopause, have osteoporosis, as well as vaginal dryness and higher rates of bacterial vaginosis."
There is such a thing as a "retroverted uterus"
Also known as a "tipped/tilted uterus", a retroverted uterus means that "the uterus points backwards (retroverted) instead of forwards (anteverted)." Dr Mitra explains that between 20–30% of women have this and often, it is just how a woman is born and many find that it never impacts their health. "In some women, however, it may be due to conditions such as endometriosis, fibroids, or the presence of scar tissue that pulls the uterus backwards," Dr Mitra clarifies.
Though it sounds scary, Dr Mitra says a retroverted uterus – no matter its position – does not affect a woman’s chances of pregnancy because "sperm is able to swim in all directions". "As the uterus increases in size in pregnancy, it will gradually flip forward, and by twelve weeks – when most women are having their first scan – a retroverted uterus may have corrected itself, so that many women never even find out they had one."
A retroverted uterus can make smear tests a little trickier and uncomfortable as the cervix is harder to locate, but Dr Mitra promises that doctors know "plenty of tricks to make it easier and less painful".
How and when you use contraception should change when you’re on holiday
Helpfully, we also learned from The Gynae Geek that how and when we take our contraception should change as we travel. If you take the combined oral contraceptive pill (COCP) – the most commonly used contraception in the UK – and are changing time zones, Dr Mitra suggests that you "adjust the time you take it to be similar to when you are at home". For example, if you usually pop your pill at 7am when your alarm goes off at home in London, the corresponding time in a different country might not be appropriate (such as the middle of the night). If this is the case, Dr Mitra advises that it is "better to take it earlier rather than later", such as the night before.
If you’re on a long-haul flight and need to take your pill, she notes that it is important to "keep mobile, wear compression stockings and stay well hydrated on the flight to reduce the risk of blood clots."
If you take the progesterone-only pill (POP), which works to thicken the mucus produced by your cervix so it is harder for sperm to penetrate, Dr Mitra says it is important to "[b]e mindful of the three- or twelve-hour time window for taking it," something that can be tricky when contending with jet lag. "Don’t forget about the chance of getting a tummy bug if you’re going somewhere exotic," she continues. "If you’re going somewhere remote, or don’t want a 'Bridget Jones in the pharmacy'-type scene, you may want to think about taking some emergency contraception in the form of the morning-after pill."
If, like many millennial women, you use a fertility awareness app or method, Dr Mitra strongly suggests considering a different type of contraception, just "while you’re travelling and for some time after you get back until you think your cycle is back into the swing of things". This is because the "timing of ovulation may be incredibly difficult to predict when you’re working with jet lag, or even just a change of schedule".
The only contraceptive methods Dr Mitra does not consider affected by travel include the two types of coil (the Mirena coil and the copper coil), the contraceptive injection, the implant, condoms and sterilisation.
There's an STI we’ve never heard of
Thought to infect approximately 1% of under-45-year-olds in the UK, mycoplasma genitalium is an STI not commonly known or talked about. The symptoms are similar to those of many other STIs: "abnormal vaginal discharge, pain on urinating and bleeding after sex or between periods" and "it can cause long-term health complications including pelvic inflammatory disease and premature delivery if present in pregnancy". Dr Mitra tells us that the infection is "detected most effectively using a vaginal swab rather than a urine test and is treated with antibiotics". Admittedly not a cheery note to end on, but we'll bet you learned something too.
The Gynae Geek: Your No-Nonsense Guide to 'Down There' Healthcare by Dr Anita Mitra is published by Harper Thorsons, £14.99