A survey looking into the understanding of the public about female genital anatomy has found that less than half (46 percent) of people could identify how many "holes" women have in their private parts.
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Researchers at Addenbrookes hospital in Cambridge, England, wanted to investigate the understanding of anatomy among the public, and the understanding of pelvic organ prolapse specifically. The motivation for this was concern that patients with pelvic organ prolapse may not understand their condition because of misunderstandings about healthy anatomical structures of female genitalia. Without this knowledge, they may not be able to make informed decisions with their healthcare providers about treatments.
The research, published in the International Urogynecology Journal, distributed anonymous questionnaires to general outpatients departments (OPD) to males and females, and specialist urogynaecology (UG) clinics (for females only). As well as the patients, accompanying friends, family, and carers of those attending the appointments were also asked to fill in the questionnaire.
Participants were asked to answer two parts. In the first, they were simply asked "how many holes does a woman have in her private parts?” and what they were, and in the second they were shown a diagram with seven annotated structures (labia majora, labia minora, clitoris, urethra, vagina, perineum, anus) asked to label as many of them as they could. They were allowed to use layperson language – “peehole” and “bumhole” were seen as acceptable labels and would count as a correct answer.
Just 46 percent of participants correctly identified that women have three holes down there. The most commonly mentioned "holes" were the vagina (67 percent), followed by the anus (55 percent) and then the urethra (35 percent).
In the labeling portion of the questionnaire, only nine percent of participants were able to label all seven annotated structures correctly. The structures which most identified correctly were the vagina (71%), anus (67%) and labia (49%). The biggest confusion came between the urethra and clitoris. Of the 73 percent of people who labeled the clitoris, 63 percent labeled it correctly while 9 percent labeled it as the urethra. Of the 51 percent of people who labeled the urethra, 51 percent labeled it correctly and the other 49 percent labeled it as the clitoris.
"Different terms were used for urethra, e.g. "peehole", and anus, e.g. "bumhole" and "back passage"," the study noted. "However, "vagina" was the only term used by participants for the vagina, although with variations in spelling, e.g. ‘virgina’."
The study found not much difference between men and women in their ability to label the structures, other than women were more likely to be able to label the anus and vagina than their male counterparts. A common misconception for all was that the cervix was an external genital hole.
One of the biggest factors in the ability to label female genitalia was level of education, age, and ethnicity, with people more likely to have knowledge of the general area if they were educated to a higher level, were older, and white. The differences may reflect a particular need for better health education in particular communities, the researchers believe.
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"Efforts to improve health literacy in gynaecology may benefit from targeting younger women using accessible, culturally appropriate methods across diverse populations," the researchers concluded.
"Future research should focus on effective interventions to breakdown taboos, expand knowledge and thereby empower women to be able to participate in meaningful shared decision making with clinicians."