Do you know your urethra from your clitoris? And could you locate them on a diagram? Half of Britons could not identify the urethra, while 37% mislabel the clitoris – regardless of gender, according to a survey of patients in hospital waiting rooms. Meanwhile, only 46% correctly identified that women have three “holes” at the bottom.
Dina El-Hamamsy, a senior registrar of obstetrics and gynecology, now at Addenbrookes Hospital in Cambridge, and her colleagues, led the investigation, fearing that many of their patients were bewildered by the nature of their medical problems.
“A lot of women don’t understand the difference between urinary incontinence and prolapse. In addition, when they file complaints, there is a lot of confusion about what their condition was and how it should be treated, ”El-Hamamsy said.
The team distributed anonymous questionnaires to 171 women and 20 men attending general outpatient or urogynecology clinics at a Manchester University Hospital. They were asked how many holes the women had at the bottom (in their private parts) and to name them. Less than half identified the correct number.
Co-author Fiona Reid, consultant urogynecologist at St Mary’s Hospital in Manchester, said: “We see women who don’t understand that there is the urethra, vagina and anus. They seem to think that the urethra and the vagina are the same thing.
Participants were also given a diagram of the area and were asked to label as many structures as possible, using their own words.
Of those who attempted labeling – and almost half left this section blank – only 9% correctly labeled all seven structures. Most people correctly identified the vagina and anus, while only 49% labeled the labia and 18% correctly identified the perineum – the area between the vagina and the anus. There was also confusion between the clitoris and the urethra.
Women were more likely to label the vagina and anus correctly than men, but there was no difference for other structures. White ethnicity and higher education levels were also associated with better anatomical knowledge. The study has been published in the International Urogynecology Journal.
“It’s horrible that people know so little about the vulva and female anatomy,” said Lynn Enright, author of Vagina: A Re-education. “It’s not that surprising. I think we’re much more familiar with the diagrams depicting the female reproductive system – the uterus, fallopian tubes, and ovaries – than with images of properly labeled external genitalia.
The team also assessed people’s contrasting knowledge of general and female-specific medical conditions. While most people understood what stroke and diabetes were, 53% understood what pelvic organ prolapse was, while only 23% knew what fibroids were – even though both conditions affect a third of women at some point in their lives. A prolapse occurs when one or more organs in the pelvis slip out of their usual position and swell in the vagina. Fibroids are non-cancerous growths that grow in or around the uterus and can cause a heavy, painful period and general discomfort.
Enright said: “I think we need a lot more health education for women from an early age. In schools we need to talk about issues related to female genital anatomy and people need to know about their health. They need to know the importance of pelvic floor exercises and things like that, because if not, the first time they hear about it is probably when they are pregnant with their first child, and at this time- there, they have a lot more things in mind. “
The study also raises questions about women’s ability to consent to medical procedures. Stephanie Shoop-Worrall, an epidemiologist at the University of Manchester, who was also involved in the research, said: “If a doctor is going to examine you or suggest any kind of treatment plan, you need to fully understand what is going to happen. , as well as the risks and benefits, to be able to give permission. If people come for their hospital appointment and don’t understand the basic anatomy, or what’s wrong with them, how can they properly consent to treatment? “
Enright said: “You must be asking yourself: what are the long term implications of people being so ignorant of their own bodies? What does this mean for people’s sex lives? What about the conversations they have with their GP when they encounter a problem? We know that too often pain is just accepted as a normal part of being a girl or a woman or having a period – it’s worth thinking about how not having the words. to describe the pain or where the pain occurs could affect this.