“Without a doubt” we are still embarrassed talking about certain aspects of women’s health. So says Laura Dowling, aka Fabulous Pharmacist, and organiser of Viva la Vulva, a May 5th event in the National Concert Hall, Dublin, promising empowerment, education and laughter as a panel of experts delve into often taboo discussions around women’s health and sexuality.
For the younger generation, “it’s totally normal for them to talk about periods”, Dowling explains. “It’s been totally normalised on TikTok and stuff like that. But I have seen women come into the pharmacy over the years and they don’t want to talk about leaking, they don’t want to talk about vaginal dryness. They’re embarrassed. There’s that shame around women’s bodies.
“In the pharmacy, I saw it. They were putting up with incontinence-like leaking for years and years, too embarrassed to talk to their partner about it, or their doctor and putting up with vaginal discomfort and dryness and regular UTIs [urinary tract infections].
“Women just think they have to put up with leaking, but they don’t realise if they go and see a women’s health physio, [get] a pessary, it can really make a difference to their overall sense of wellbeing and being in control of their bodies.”
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Even though the younger generation may be better at speaking about periods, aspects can remain unspoken of among some women. “I did an online video about period pants before … and when I was talking about it, I just said out loud ‘and people are always worried if they’ve a few clots, but you just take a bit of tissue paper, lift the clot off the knickers and put it down the toilet and continue to wear the knickers. You don’t need to change your knickers.’ I got so many DMs [direct messages] going, ‘oh my goodness I can’t believe you said that online, but that was the one question I always wanted to ask, but I was afraid to ask it,” says Dowling.
“I don’t think periods, as such, is as taboo as they would have been, but certainly when women are flooding during their perimenopausal years, they don’t like to talk about it.”
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Dowling says subjects such as “regular UTIs, or unsatisfactory sex, or not having a libido, or not knowing how to spice things up in the bedroom if you’ve been with someone for 25 years and it’s all a bit boring, or if you just couldn’t be arsed having sex and you don’t know why, or if you’ve never had an orgasm, or you infrequently do”, are all things women “don’t want to say out loud”.
She believes over the years we’ve become a little bit better about talking about sex, but she says, “we’re not very good at talking about the fact that women might have low libidos because women have never really been talked about in Ireland as sexual beings”.
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She references the sort of sex education many women will have received growing up. “Sex was something that was done to you. It was for reproductive purposes. It was done to you by a man. The man orgasmed, it didn’t really matter what happened to you. For a woman to even ask for certain things to be done in bed — is that seen as a bit slutty? I think there’s still that attitude for certain generations”.
Dowling continues: “No one wants to admit that their sex life is unsatisfactory. It’s normal that you want to have a good sex life well into your later years. Sex doesn’t have to be all penetrative, penis and vagina. There’s bi-relationships, gay relationships, but then there’s also women that may have such vaginal discomfort that they can’t take penetrative sex, but that doesn’t mean oral sex can’t be done.”
Dowling says women are not typically comfortable talking about vaginal dryness, “because you do feel old. If your vagina isn’t lubricating itself for sex, so sex isn’t as enjoyable so you need to use a lube, women might be a little bit embarrassed about that. The amount of women that would have come into me in the pharmacy for vaginal oestrogen and they get their prescription and I’d say to them, ‘are you using a lube when you’re having sex’, and they’d look at me as if I’ve two heads and they hadn’t even considered that. We tell them what lubes to get because most lubes out there were made for men’s pleasure.”
Not feeling comfortable discussing difficulties having an orgasm ‘goes down to Catholic Ireland and growing up in a country where we were oppressed’
— Laura Dowling
Women often don’t know how to use vaginal oestrogen properly, Dowling says, with some not realising that vaginal oestrogen isn’t just about making sex more comfortable, it can help protect against regular urinary tract infections. Again, she explains, lack of comfort around discussing these things can prevent women from seeking the solutions they need.
One of the challenges women are facing around menopause, Dowling says, is that “menopausal care isn’t standardised. You might go to a really good doctor, you’ve a couple of symptoms, you’re 45, they put you on HRT straight away, if they think it’s necessary and then that’s it. And I have other women and they’re 48, 49 and they’re dying with symptoms and their doctor’s like, ‘you’re too young for menopause — you don’t get menopause until you’re in your 50s — I’m not giving you HRT’.”
Language matters, Dowling believes. “Little girls aren’t being taught the proper words for their vulvas — it’s usually vagina or their mary or their betsy, or whatever cutie pie term.”
We don’t mix up the names of male parts, she says. She believes this adds to embarrassment around certain discussions. “Girls aren’t taught from a young age about their reproductive health, about their vaginal health about their vulvas, so how can we expect them when they’re in their 40s, 50s and 60s to have the language then, when they never had the language when they were younger.
“When we talk about menopause, we talk about hot flashes … that’s what women were associating with it — a big, hot, hormonal mess. We’ve recently started talking about the psychological effects, the depression, the anxiety, the fatigue, the irritability. The libido usually comes way down the list, even though that’s a really significant issue, particularly for couples who want to enjoy an active sex life. It can put a massive strain on a relationship.
“And it’s not just a case if you have a low libido you can just lie there, look at the ceiling. If you don’t want to have sex you feel like your body’s being used almost, if you do it, because you don’t want to. So, women want to have their libido.”
Not feeling comfortable discussing difficulties having an orgasm “goes down to Catholic Ireland and growing up in a country where we were oppressed and sex was not considered something we should do, or it wasn’t something that was supposed to be pleasurable. It was for reproductive purposes only and if you enjoyed sex as a woman you’re a bit of a tart, or a bit of a slut.” Dowling says it’s more accepted that “a man would watch porn”. The same is true of masturbation, she says.
“I always say the five main pillars of health are checking yourself, diet, sleep, exercise and orgasms.”
Dowling references a previous talk she had given, where she was approached by a woman in her 70s who wanted to know how to help herself to have an orgasm. “I gave her the name of the Sex Siopa and told her to use a little bullet (vibrator) and she was delighted with life. We can’t assume women aren’t sexual beings because we were taught that with the Catholic Church years ago. We need to be way more open”.
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