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Sue's Blog

My latest blog on Kegels or Pelvic Floor Exercises generated many conversations in our professional Facebook pages – some agreeing with what I said and others definitely having an alternate view. But debate and discussion is always productive and all the comments have been respectful so I thought I would write a second and then a third blog looking at other elements of the programmes that are using the concept of ‘No Kegels’.

This blog will give an overview of the evidence around vaginal steaming, discuss the value of an internal examination and introduce a case situation where I would like readers to reflect on the way you direct a treatment plan for an individual patient when there are complexities that might cloud the data entered into a patient screening sheet intake form.

The point of this is not to denegrate or abolish women’s entitlement to seeking as many options for treating their pelvic health issues as they would like. It is just to point out the evidence supporting or not supporting some of these newer treatment options available when googling.

In my first blog I spoke about Influencers and Social Media (aka SoMe). I am the first person to acknowledge the value and importance of SoMe and use it all the time. In fact my Bio that I give to organisers of conferences where I am asked to speak says:

“Sue is a passionate advocate for pelvic health issues and speaks at physiotherapy, nursing and medical conferences and does many lectures to the general public. Sue writes a blog (over 350 to date) on Pelvic Floor Dysfunction for the public and health professionals, and she has discovered the power of social media such as Twitter, Instagram and Facebook to freely disseminate information around pelvic health.

My daughter is in Public Relations and she started my SoMe journey back in 2011 when she got me onto Twitter and she must have been so sorry she did because for the first few months I had to constantly ring her and say: Darling I’ve forgotten what to do again!? But it didn’t take me very long to get the hang of it and see the power of it. Suddenly telling the world about the value of pelvic health physiotherapy one patient at a time seemed a thing of the past when this amazing tool could spread the word with the flick of a button ‘send’ or ‘post’ .

Actually all my kids have been instrumental in speading my SoMe wings. If you read my very first blog you’ll realise that it started because my son had to do a blog as one of his first Uni tasks when commencing his Architecture studies. Recently he received the news that he has passed his Registration exams and he can now call himself a Registered Architect – an incredible committment and achievement – congrats Michael!

That little conversation with him as he answered my question What does a blog entail?  has now lead to over 360 blogs over 11 years. The other day a patient said thanks for my blog on faecal incontinence – that little trick you put in about getting clean after finishing a bowel motion has made the world of difference. Imagine that! Mike starting me on my blog writing journey has helped that lady eleven years later. My other daughter has also been instrumental in my SoMe journey over the years – introducing me to the power of telling stories through images and videos on Instagram.

SoMe allows women to connect with their Tribe. If you look on Facebook and search whatever your medical calamity is – there almost certainly will be a Facebook Group about it and what that means is you connect with people (not just women) suffering the same issues. This ensures that there is sharing of information but also potentially sharing of mis-information. So if we as Health Professionals are using the medium to dispel myths and educate the masses – we better be sure it is based on evidence not just someone’s personal biases, personal experiences or money-making endeavours.

I am very open to any evidence-based articles to the contrary of what I am discussing below. Please include the references in the comments of this blog so I can update the content with the evidence.

Lets start with vaginal steaming. 

While Gwyneth Paltrow is cited as starting this trend in her GOOP newsletter – this is what is mentioned in many articles about Gwyneth and vaginal steaming: “You sit on what is essentially a mini-throne, and a combination of infrared and mugwort steam cleanses your uterus, et al. It is an energetic release – not just a steam douche – that balances female hormone levels.” – when I went searching on her website about vaginal steaming, I couldn’t find any reference to it. Maybe there have been some ‘incidents’ (see article below on second degree burns for woman with prolapse – ouch!) and the content has been removed from GOOP?  Vaginal steaming is a practise that has actually been around for centuries. It seems to relate to the theory that women are dirty in their vagina and need cleansing, which is not an uncommon theme through the ages with respect to women.

 

Some screenshots of googling Vaginal Steaming – it’s a little off-putting to say the least. 

When you do a Pub Med search on vaginal steaming the first two articles are not too enticing. Second degree burn sustained after vaginal steaming’  Magali R Case Reports Journel Obstets Gynaecol Canada 2019 Jun;41(6):838-839. doi: 10.1016/j.jogc.2018.07.013. Epub 2018 Oct 23. and ‘Basically it’s sorcery for your vagina: unpacking Western representations of vaginal steaming’ Vandenburg T and Braun V Culture, Health and Sex 2017 Apr;19(4):470-485. doi: 10.1080/13691058.2016.1237674. Epub 2016 Oct 10.

This last abstract was interesting in that it discusses the concept behind vaginal steaming of cleansing which perpetuates the myth that women need to be constantly improving themselves.

“We analysed a selection of online accounts of vaginal steaming to determine the sociocultural assumptions and logics within such discourse, including ideas about women, women’s bodies and women’s engagement with such ‘modificatory’ practices…….. Within an overarching theme of ‘the self-improving woman’ we identified four themes: (1) the naturally deteriorating, dirty female body; (2) contemporary life as harmful; (3) physical optimisation and the enhancement of health; and (4) vaginal steaming for life optimisation. Online accounts of vaginal steaming appear both to fit within historico-contemporary constructions of women’s bodies as deficient and disgusting, and contemporary neoliberal and healthist discourse around the constantly improving subject.

I feel as health professionals we need to inform women accurately about the self-cleaning nature of the vagina and the lack of evidence about the need to artificially clean it.

The first article points to the inherent danger involved with vaginal steaming. Apart from the risk of burns, if a woman is post-menopausal her tissues may also be lacking oestrogen and be thinner and more fragile – so exposing them to steaming practise is risky and there appears to be no evidence to support any claim that it cures pelvic health conditions such as prolapse and urinary incontinence. I am happy to be corrected with any evidence-based articles.

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