I walked into the exam room for what was listed as a “problem gynecology visit.” These appointments can be for any number of issues – missed periods, heavy periods, contraception concerns, STI testing, vaginal discharge, low libido – the list of possibilities is endless. I introduced myself to the patient and asked her, “So what brings you in to see me today?”
The patient told me that she was concerned because of a lump on her “cookie.” When I asked her specifically where, she waved her hand in front of her lower abdomen and pelvic region and said, “Right about here, in my vagina.”
I asked her questions about the “lump.” When did she notice it? Was it painful? Had it gotten worse over time? Did anything make it better or worse? Any related vaginal discharge? Any other related symptoms? Did she have any new sexual partners recently?
When I finally examined her, I asked her to point to the problem area. She pointed to a red, angry-looking rash on her groin and right labia. There was actually nothing wrong with her vagina at all; she had contact dermatitis, most likely from shaving her pubic hair.
I am an advocate for knowing your body. I support self-breast exams, tracking periods, and knowing when you last had a bowel movement. Part of this self-awareness should include knowing the proper names and at least the general location and function of the parts of your reproductive system.
As the mother of boys, I know that from a very early age, men know the difference between their scrotum and their penis. Women, on the other hand, often refer to their vaginas when they are actually talking about their vulva, or more specifically, their labia or clitoris. Many women don’t know the distinction between their cervix, uterus, and ovaries. I’m always alarmed when adult women think that urine and babies come through the same “hole.”
Maybe I’m being nitpicky, but I find this sad. Women’s bodies are quite complex, and our reproductive systems can do some pretty amazing things. We should take pride in this and not have to resort to words like “cookie” or “coochie” – especially when seeing the gynecologist.
I take the time to teach women where their cervix is during an exam, even showing it to them in a mirror if they want. I distinguish between the labia, the vagina, and the mons pubis. I encourage them to tell their daughters, sisters, and friends that there is more to our sexual organs than just the vagina. This is all part of knowing one’s body, taking pride in it, and taking care of it.
Robyn Carlisle, MSN, CNM, works as a full-scope midwife in Philadelphia.