A women's health expert shares the information you wish your doctors would

I’ve been working in the women’s health field for 30 years and it still shocks me that only around 2% of UK public research funding, and between 1-6% in the US, goes to support a better understanding of women’s gynaecological health and childbirth. We are half of the world’s population after all.

Evidence also suggests women’s pain is taken less seriously, takes longer to diagnose and is more likely to be under-treated than pain in men.

As a journalist who struggled to get a PCOS diagnosis or information, I began researching and sharing my own findings. Since then I’ve authored books, spoken at support groups and spent 30 years advocating with PCOS charity Verity. I now focus on women’s health for national organisations and health-tech start-ups. And I’m obsessed with sharing properly useful tips. Here are a few of them…

Schedule your mammogram just after your period

Appointment reminders rarely mention how to reduce pain – despite research and feedback saying women want that help^[v]. There are things you can do.

• Book in just after your period if you can. Hormonal changes affect how swollen and sensitive your breast tissue is.
• Let your mammographer know you find it painful and ask them to compress slowly so you can say if it hurts. This kind of control helps reduce pain.
• Avoid caffeine for at least a day, if not a week before. It can create breast tenderness.

Talk about your vagina, vulva and clitoris

Forget ‘down there’, ‘bikini area’ or ‘private parts’. Using the biological names gives your doctor specific information to help them diagnose and treat you faster – because there are so many different conditions, for example…

• Vulvodynia – ongoing burning or soreness of the vulva without an obvious infection or skin condition
• Lichen sclerosus – a skin condition linked to auto-immunity
• Vaginismus – involuntary muscle tightening that makes penetration (medical exams, tampons or sex) painful
• Clitorodynia – clitoris pain, often from injury or infection
• GSM (genito-urinary syndrome of menopause) – when hormonal changes can cause vaginal dryness, tissue shrinkage and bladder issues

Bonus tip: medical influencer Dr Aziza Sesay says some women find it hard to use these words due to "taboo, stigma and embarrassment" and risk not getting the right treatment. If you need to get comfortable saying them, why not sing along to her earworm song They’re Not Bad Words?.

Ask for a small speculum – or to insert it yourself – at your PAP smear

If you find cervical screening uncomfortable or painful (like I used to), there are some key things you can do to make it easier. (Thanks, nurse Janine from 15 years ago, who transformed the experience for me with these tips.)

Ask your healthcare professional to:

• start with the small speculum – as a tall and broad woman I experienced assumptions being made about a large speculum being needed, when actually I need a small one
• let you insert the speculum yourself – your pace, your comfort levels
• tell you what’s happening at each step and count down the process so you know the end is in sight
• give you time to do some slow, deep belly breathing – it can help relax your pelvic floor muscles, which can tighten up when you’re nervous

Bonus tip: exciting news in the pipeline that a new speculum designed by women for women is in development – Lilium opens with a curved flower petals’shape for more comfort and is the first redesign of this implement in 180 years.

Ask your doctor – not TikTok – about non-hormonal contraception

Social media is full of influencers providing misinformation about hormonal birth control – including exaggerating side effects or overstating how well cycle tracking works (sticking to the exact instructions is hard, so around 24 in 100 women will get pregnant when tracking their fertility for a year).

Ask your trusted medical professional about what non-hormonal options could work best for you.

• Diaphragms and caps – more like menstrual discs or cups
• Condoms – including internal (female) condoms
• Copper IUD – needs medical professional to insert it

Prep with these phrases to help your doctor hear you

Women’s health specialist doctor and author Nighat Arif flags key phrases to advocate for yourself. They demonstrate the efforts you have made and your willingness to challenge:

• I have struggled to get appropriate care for this problem
• My problem/pain can’t be managed with pharmacy medicines
• I have gone to all reasonable lengths to self-manage this situation and I now need to escalate it
• I am looking for X, Y, Z outcome from this appointment
• Please can you make a note why you are denying me this treatment?
• Could you please send a copy of my medical records to me after we're done?

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