#EducatingEve Part 2: Tips on talking to your mum/an older woman about her body

It’s supposed to be our parents who teach us things, not the other way around, right?

We grow up learning from the adults in our lives. Mum, dad, grandparents; it’s drilled into us from a young age that the grown-ups are the ones who know everything and will teach us what we need to know. Sex education, anatomical knowledge and basic biology are things that (hopefully) children are taught by their parents and teachers in an age appropriate way, but what happens when the child grows up and hears important health information that they want to pass on to their parent?

The majority of women diagnosed with one of the five gynaecological cancers are ‘older’, the majority being post menopausal. This makes it really important to educate women of all ages about their gynae health and help them be confident about both spotting signs and symptoms as well as talking about them to a doctor.

We’ve put together some tips on key information and how to approach these conversations with your mum, granny, aunt, friends and colleagues.

Top tips

  1. Older women have sex too! (and this can affect their gynae health)- HPV is the virus which if left untreated, is a risk factor in cervical cancer development. It’s transmitted through intimate contact and can affect people of all ages. We also know that STI’s like chlamydia can upset the vaginas pH balance, which can if left untreated, lead to more serious gynae infections such as Pelvic Inflammatory Disease.
  1. Play the ‘name the five gynae cancers’ game- Yes, there are FIVE types of gynaecological cancers and they are separate diseases with different risk factors and symptoms. Ask the women in your life if they can name them, and this will almost certainly spark a conversation about gynae anatomy because the chances are, the person you ask won’t be able to list all five. If in doubt, remember this: vulva is outside and vagina is inside. It’s got the word ‘in’ in it. VagINa! Anyone who has any or all of the gynae anatomy needs to know about the cancers that can affect them.
  1. There is no such thing as a ‘normal’ post-menopause period. Period- Once a woman has gone through the menopause, she cannot menstruate i.e. have a period. Ask Eve hear things like this ‘I am 58, went through the menopause a few years ago but had a period last month’. The average age for a woman to go through a natural menopause in the UK is 51, and someone is post-menopause once they haven’t had a period for at least twelve months. There are many benign (non-cancer) reasons why a woman may have a vaginal bleed after the menopause, but the fact is that abnormal vaginal bleeding is also a key sign of womb, cervical and vaginal cancers. If anyone you know who is post-menopausal mentions that they have been bleeding, direct them to our Ask Eve service or suggest they visit their GP to be on the safe side.
  1. Toilet talk- For some reason, we seem to be a lot better at talking bowels than gynae! This is great news when it comes to knowing about ovarian cancer. Sounds strange? Well, ovarian cancer is ‘odd one out’, its symptoms are often confused with things like IBS (irritable bowel syndrome). The most common symptoms are: persistent abdominal bloating and/or pain, a change in bowel habits and needing to wee more frequently. It’s very rare to suddenly develop IBS once your over 25-30, but ovarian cancer is most common in women over 60. If your mum/grandma/aunt/older friend complains of any of these symptoms, but investigations for stomach/bowel problems aren’t providing any answers, it’s worth suggesting that they go back to the GP and discuss a gynae pathway.
  1. A clear cervical screening test (smear) isn’t a clean bill of gynae health- Cervical screening tests stop at 64 in the UK, unless a person’s last test wasn’t clear and then further check-ups will take place. There’s often confusion over what a cervical screening test actually does. Cervical screening tests check for abnormal cervical cells, that if left untreated, could potentially develop into cervical cancer. It is not a cancer test, nor is it a test for anything to do with the womb, ovaries, vagina or vulva. If someone you know is over 65, their final cervical screening was clear, but they are experiencing some potential gynae cancer symptoms, please suggest they visit their doctor, or at least tell them that cervical screening is just that – cervical screening, not a gynae cancer test.
  1. Ask about your family (medical) history- Remember that anyone older than you in your family will know more about your family than you do. Older relatives are highly likely to be able to answer questions about diseases that run in the family, what other older relatives have died from and so on. It’s not a fun conversation by any means, but it really is important to know what medical conditions (if any) run in your family. In terms of gynae cancers, ovarian and womb have hereditary links. Around 5% of womb cancers are caused by a genetic condition called Lynch Syndrome and around 15-20% of ovarian cancers are due to the BRCA gene mutation. The chances are your grandmother won’t know about Lynch or BRCA, but she WILL know whether or not her mother had ovarian or womb cancer.
  1. If you need to check upstairs, you need to check downstairs too- Breast cancer is one of the four most common cancers, and checking our breasts for lumps is engrained into most people’s minds. But did your mum also tell you to check your vulva and vagina? Probably not, and for an endless list of reasons. Breast cancer is more common, it’s easier to talk about touching your breasts than it is your genitals and breasts are more visible than what’s between our legs, and we talk about things we can see, right? Checking your vulva for lumps, sores and skin changes is necessary. If your mum told you to check your boobs, then perhaps you can return the (perhaps slightly awkward) favour of telling her to check her vulva.
  1. Hormones aren’t just for teenagers and everyone needs to know the facts about weight and physical activity- A lot of people who are going through or have gone through the menopause will take HRT (hormonal replacement therapy) at some point. However, unopposed oestrogen, i.e. oestrogen that isn’t balanced out by progesterone, can put the person at an increased risk of womb cancer. If someone who know is taking HRT, just check with them that it isn’t just oestrogen. Being overweight is an important risk factor for some cancers, womb cancer being one. This is for a very specific reasons – body fat produces oestrogen. One in three womb cancers may be caused be caused by having a very high body weight.
  1. The generation game- You and your grandmother might both have a vagina, but you will almost certainly have been taught about it (if at all) in very different ways. Younger generations who are growing up with the internet have information at their fingertips, and are likely to be using several forms of social media which are full of shareable, accessible health information. Just because older generations haven’t grown up with a wealth of knowledge at the click of a button doesn’t mean that they shouldn’t have the same knowledge available. Take the time to share face-to-face interesting and relevant gynae messages you see on social media with someone older than you.
  1. Nobody knows everything- Nobody knows everything and we can always learn something from someone else. Whilst these tips have been about communicating gynae health information to the older women in your life, sometimes you might want to ask them for advice. Our mums, grandmothers, aunts, older friends were all our age once, and could well have had the same concern or health issue that you are going through. Try talking to them and see what happens.