Are vaginas troublesome for girls with body image issues?

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Waiting in line at the grocery store recently, I noticed this bold headline on a popular women's fashion magazine, “Untamed Vajay-jays: Guess what sexy style is back?” Really?  I was not aware that pubic hair was a couture hot topic. But also I was fascinated, because I've witnessed a growing obsession with vulvas and vaginas among my own patients, particularly the adolescents. 

Shaved vulvas, once only seen in adult entertainment, are commonplace among the women I see for OB/GYN care.  What is alarming is that some women continue to shave despite terrible and persistent irritation.  The reason? Pubic hair is considered by many to be unnatural and nasty.  Thanks to reality television shows like “Dr. 90210,” I have 16-year-old girls asking me if they should consider labia reconstruction.  And most recently, as I was repairing a perineal laceration post delivery, a patient described her vaginal rejuvenation surgery.  “After my last baby, the doctor made me a virgin again! My husband is so happy,” she explained. 

I have no issue with these practices, if it truly brings my patients personal satisfaction. My concern is that our genitals have become another reason for self-loathing and body image issues. Don't women have enough to worry about with bad hair days, flabby thighs, jelly bellies, skin tone, and breast size? 

What we as providers need to encourage is self-awareness. Maybe familiarity with our more intimate parts could bring self-appreciation, or at least self-acceptance. I encourage my adolescent patients to get to know their bodies, whether by performing self-breast exams or through tracking their menstrual cycles. 

Women, and especially teenagers, need to be aware that it is normal to have vaginal discharge that changes throughout the month. As long as the discharge is not itchy, burning, or malodorous, it is not cause for alarm and does not require a visit to the gynecologist.

We need to educate our patients that there are a variety of sized and shaped labia and that pubic hair is natural, not disgusting. I love to bring a mirror into the exam room and offer to let a teenage girl see her cervix during the speculum exam. And if a patient gets itchy or irritated from shaving, I suggest that maybe she should consider waxing or even going “untamed.”  It is the new sexy style after all!

If any of you have had similar experiences with your patients, I'd love to hear your take on it and how you've interacted with them. Feel free to comment below, or shoot me an email.

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