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Posted in Anatomy, Genitals: A User's Guide

Rubber Band Theory…

In schools at least, some variation of this question is reasonably common – people worry either that a vagina isn’t big enough to accommodate a penis/sex toy/ tampon, or that it will become stretched out of shape by any of those things.

The vagina is a tube, about 8cm long. It isn’t quite hollow – but it can stretch a lot. To make space for a baby’s head, for example – which is much  bigger than pretty much any penis.

The vagina might change shape after childbirth (after any number of children). But the idea of it becoming ‘baggy’ is probably more of an exaggeration.

 

 

Posted in Uncategorized

About Me

Emma Chan works as a Facilitator for Sexplain UK, delivering inclusive and sex-positive sex and relationship workshops, mostly to secondary aged children, across the UK.

They qualified as a doctor (BMBS) in 2015 from the University of Nottingham, going on to begin speciality training in Obstetrics and Gynaecology in 2017. They previously studied Psychology (BSc), also gained at The University of Nottingham. They are currently working towards an MSc in Reproductive and Sexual Health Research at the London School of Hygiene and Tropical Medicine.

Emma is a member of The Candid Collective, regularly helping to run ‘Genital Making Magnets’ workshops.  She has been interviewed about topics relating to sexual health by Cosmopolitan Online, Ask Ella and even BBC Radio Devon! She has appeared as a guest speaker at UCL’s Institute of Education, on the ‘Gender, Sex and Education’ MSc module.

Emma’s pronouns are she/her or they/their. They are comfortable with the gender label ‘woman’. However, she is conscious of this having been strongly ‘externally’ imposed through a life-time of social conditioning. For example, Emma attended an all-girls secondary school in North London and still has the pink baby name band she was given at birth. If they had grown up in the fearless post-feminist, gender-stereotype-free utopia they would like to try to bring about, maybe this label would not be so appropriate…

Posted in contraception, Genitals: A User's Guide, Uncategorized

Put a Ring On (?/In) It!

Last week I was interviewed for Cosmopolitan about ‘femidoms’ or internal condoms. These are one of a handful of contraceptives that often get talked about in sex ed classes, but appear to be less commonly in use.

Another type of contraception that this can be said about is the vaginal ring.

It gets its name from it’s shape – it’s a ‘ring’ made from a soft rubber like materials, about 5 cm across. It is inserted in to the vagina by the user and once inserted sits just below the cervix.

It’s another type of hormonal contraceptive – which means it protects against pregnancy by affecting the womb, ovaries and the fertility cycle.

It contains the same hormones as the combined pill – oestrogen and progesterone. Because of this, it works in a very similar way:

  1. Stops the ovaries from releasing an egg.
  2. Helps make the lining of the womb stay thin, rather than building up (a thick womb lining is needed for a fertilised egg to implant in and grow).
  3. Helps create a thick ‘plug’ of mucus in the cervix – the entrance to the womb. This helps stop sperm from entering the womb from the vagina in the first place and coming in to contact with an egg.

Also like the combined pill, the vaginal ring is used for three weeks and then not for one week – usually with a ‘withdrawal bleed’ in this week off. The main difference is that whilst the pill is delivered to your system by swallowing a pill, the vagina ring releases these hormones in to your system slowly over time.

After the week off, a new one is inserted. This is done by the user – so no need to attend a clinic or other appointment to get it fitted by a health professional, like with other contraceptive methods such as the coil.

From speaking to friends about their personal and professional experiences it seems like the vaginal ring isn’t something that is as easy to get hold of as other forms of contraception, at least in the UK!

Pros and cons

Because it doesn’t form a barrier between the vagina and the penis, it doesn’t protect against STIs. The vaginal ring is a form of contraception (helps reduce the risk of pregnancy) but not protection (doesn’t help reduce the likelihood of passing on infections through sex).

Some people may find it difficult to use – it involves being quite comfortable with your anatomy, slightly more so than a tampon.

On the other hand – it works very well. If used correctly, the vaginal ring is more than 99% effective. For comparison, this is more effective than condoms (98% effective). It only needs removing and replacing every four weeks – unlike the pill, which you need to think about every day.

For further details see:

NHS Contraception advice 

 

Posted in Genitals: A User's Guide

Reduce and reuse…

Just a quick reminder that not all period products are disposable. We already looked at period products in some detail here.

When we talk about periods in schools, most people seem to know about tampons and sanitary pads. Menstral or ‘moon’ cups however, seem to be a little less well know about and to cause alarm. Made from a soft rubber-like material, they can be squigged a little to fit in to the vagina, where they they retain their shape and stay in place in the vagina. There it collects blood. It can be emptied, washed and reused. They can also be sterilised in between uses – the one I use recommends either boiling it or using baby bottle steriliser in between cycles.

Several companies have started making moon cups. Most are a basic ‘cup’ design but come in different sizes. oftentimes the little ‘pull’ at the bottom of the cup to help remove them is a slightly different shape too.

IMG_0747.jpeg

Washable pads are a bit more conceptually easier to get your head around! Just like disposable sanitary pads, they can be washed after each use.

Or of course, there’s… IMG_0746.jpeg

‘Freebleeding’ means not trying to stop the blood flowing in any way. For now, accounts of free bleeding seem largely restricted to those making a political statement or investigative journalists… but maybe that’s something that will change in the future!

 

 

Posted in SRE

My Clear Vision for 2020!

Here are my (blogging) new year’s resolutions…

(also fine if you want to shave it off – it’s yours!)

I look forward to spending lots of 2020 with menstral cups and 3D printed clitorises (as I did for much of 2019).

Sex is literally what you make of it. Also, for those of you living in London, UK – why not check out Sexual Health London’s online and home testing kits?!

Happy New Year and let’s go for a patriarchy smashing 2020

XOXOXOX

Posted in Genitals: A User's Guide

Just Add Water…

There are a vast array of sprays, wipes, lotions and potions to clean the vagina on sale. They are often sold under the umbrella of ‘feminine hygiene products’. But remember…

Unusual discharge (i.e. in smell, colour or consistency) can be a sign that something isn’t right. However, it is a normal function of the vagina to produce secretions…

See here for more details.

Posted in Good Question?!

What is Sex?!

Both as a Doctor and as a Sex Ed Facilitator, I get asked questions about sex a lot. Sometimes this is in spaces that are designed for that, such as a in classroom sessions. Sometimes it’s a furtive WhatsApp query from a friend or someone ‘@ing’ me. Today I’m starting a collection of some responses to some of the interesting ones.

This one ‘comes up’ in that it’s one we tend to pose to explore assumptions children and sometimes adults have…

*Heteronormativity. It happens.

Posted in Genitals: A User's Guide

Bloody Periods

Much of my primary school experience rolls in to one, but learning about periods is one of the more vivid memories I have.  All of the girls in year 6  were segregated from the boys, marched off into an assembly room and shown a video.  We were each given a bag of period products at the end.  I don’t know what the boys learnt about.   They might have been shown the same video.   They were definitely not given the goody bags, as this later became a point of contention!

2019-07-26 11.40.00

This was in the 90s, so we were limited to being told about disposable tampons and sanitary pads.  Overall, we weren’t given any guidance on why we might want to use a certain type of product over another.  We were only told how they worked in very basic terms.  Talking to other friends about managing periods, very specific individual needs and preferences need to be taken in to account.  For example, I hate using anything disposable because of the environmental impact.  I also can’t get over the similarity in principle between nappies and sanitary pads and find this really off-putting.  One of my friends however, just doesn’t feel she would every be comfortable inserting a tampon.  Another feels the same way as I do about disposable period items but can’t bring herself to wash and use a menstral cup.  Here’s a rundown of some of the things people do with their period blood.  I’ve based this information on mine and friends’ experience of using various methods and medical experience, as well as questions that come up a lot in sex ed workshops…

TAMPONS

A bundle of soft, absorbent material which is inserted in to the vagina to soak up blood.   They sometimes come with ‘applicators’ – card or plastic tubes that help to insert the tampon further in to the vagina.  There is a string that sits outside the vagina, which can be pulled to remove the tampon.  The tampon (but not the packaging or any applicator) is designed to be flushed down the toilet, like toilet paper.   They are a disposable method, so obviously have an environmental impact.   Manufacturers often suggest leaving them in for between 4-8 hours.  They come in various sizes – smaller tampons absorb less blood and so are for lighter periods, larger ones for heavier periods.   Tampons seem to be the period product that people frequently concerns about:

  1. Toxic Shock Syndrome.  This is an infection that can be caused by a foreign object left in the body for a long time, including a tampon.  It is quite rare though, especially if tampons are changed regularly.
  2. Penetration.  Many people have worries about it being painful to insert a tampon.  Tampons are typically only a couple of inches long though, which is much smaller than some of the other things that people easily fit in and out of vaginas (baby’s heads, dildos and penises for a start!).   It might take a bit of practice to do it easily, but many people find that this is something they can learn to do.  Others worry that it ‘counts’ as losing your virginity if you’ve used a tampon before you’ve had penetrative penis-in-vagina sex.  ‘Losing your virginity’ is a social construct which relates to what you find arousing so this is just not true for most people!
  3. Getting stuck.  As someone who’s been the oncall doctor for an out of hours Gynaecology service, this is something this does sometimes happen.  People do insert tampons which they later feel they can’t remove.  However, there are manoeuvres you can try that really do work… and if it doesn’t I’ve never seen a ‘stuck’ tampon that couldn’t be removed easily in a clinic setting.

MENSTRUAL CUPS

These are my personal period product of choice!  The can take some getting used to and you may well splash a small amount of blood about getting to grips with them.  But once you have you may grow to love these reusable, washable devices that sit in the vagina and collect blood.  This is then emptied in to the toilet bowl.  The cup can be washed with water in between uses and sterilised in between cycles, so is completely reusable and produces minimum waste.  Cups don’t seem to be very widespread at the moment – I found out about them from a sticker on the back of a loo door!  There are several different brands.  I use Mooncup – basically because this was the only one that was available at the Chemists when I bought mine.  I’ve been told by a friend that their sizing is not the best however.  All manufacturers make cups of different sizes, again according to how heavy a person’s period is.

SANITARY TOWELS

Pads or towels are absorbent material made in to a pad that lines your underwear.  Unlike tampons, there is usually a large plastic component, which is not possible to flush down the toilet.   Reusable pads – ones that can be washed and reused – are becoming more widely available. They can be bought or made.  Free patterns for making your own are available online, such as here from Luna Wolf.  More recently pads seem to have been extended to ‘period pants‘ – where the bit that soaks up the blood is built in to underwear and the whole thing is washed.  

FREE BLEEDING

There is of course the ‘do nothing’ option.  Some people choose to sidestep all of the above and opt for free bleeding.  This is when nothing is used to collect period blood and someone simply allows their clothing to soak it up.  This often seems to be done as a point of political protest, such as against the ‘tampon tax’.  This might partly be because free bleeding in and of itself is seen as a political act, such as when runner Kirin Gandhi free bled during the London Marathon.  There are probably many more people who unintentionally or unwillingly free bleed, due to lack of period product resources.   ‘Period poverty’ seems to be an issue worldwide, with campaigns against it evident in both developed and developing countries.

Posted in Anatomy, SRE

Lark in A Park

As well as facilitating Sex Ed workshops in schools for the last month, I’ve been involved in a few events aimed exclusively at adults.  Although the style of presentation has been different, these have all involved using an arts & crafts or D.I.Y approach.  These events reaffirmed my belief in this as a particularly good medium for exploring personal issues in a fun, engaging and accessible way.

The first was a ‘genital making’ workshop, hosted by the Candid Collective.  Adapted from an activity used to teach children about anatomy, puberty and health, this saw us showing adults how to make vulvas and penises with air drying clay to then be turned in to fridge magnets!  Held in a cosy upstairs room of a pub in South London, it had a very different feel to the classroom and was lots of fun.

The second was a talk for the antiuniversity lecture series – in which a group of us took to a local park to talk about arts and craft as a medium for discussing bodies and our own experiences of sex ed.  This culminated in making a ‘zine page about some of the issues that had been brought up.

There are a couple of future crafting themed sex and relationship events (in London) for adults that you may be interested in:

Thanks to Lisa, Leah, Adam and Bel for the images!