The Current Struggle of Gynecological Health in College

by Shaunice Ajiwe

What A Gynecologist Wants You to Know About Women’s Health

Grades, doctors’ visits, meetings, classes, forms, FAFSA, studying, groceries, working, etc. These concepts are but a fraction of the long list of responsibilities that constantly occupy the mind of a young adult during one of the most stressful times in their lives: going away for college. But for some women just starting out in college, this list does not include their gynecologic health. While college is an incredibly liberating time for new students, it is also profoundly time consuming and busy. Juggling one’s academic standing, extracurricular activities, and social life are hard enough to successfully manage, but to add vigilant watch over one’s gynecologic health can prove to be too much to handle.

Temple University Hospital

Dr. Gail Herrine, Associate Professor of Clinical Obstetrics and Reproductive Services at Temple University Hospital and General Gynecologist for over 20 years explains the roots of this common struggle.

“It’s the first time they’re on their own – and to take my GYN hat off and put my parental hat on – you know, when we raise children to go to college we infantilize them to some extent so that they can continue the rest of their education. We don’t often give them life skills about how to take care of their banking or health. We sort of protect them, we go to the doctor, give them the [family health] history and I’ll tell you that’s one thing I often talk to young adult patients about – taking control of your healthcare. It relates to a variety of things, one of which is talking to family members about what their health is so that they know what their risks are; what family members have medical problems, who has high blood pressure, diabetes, if there are any cancers.”

While lack of discussion around family health history is often an issue of misplaced responsibilities or plain unwillingness, the lack of discussion of sexual health seems to be an issue of social stigma. Herrine finds the absence of sex positive language and the air of taboo around open discussion of sexuality to be a catalyst for avoidance of gynecologic care.

“Health care issues are sometimes hushed about. They used to talk about it in Woody Allen movies and they’d say ‘cancer’ in a whisper,” she whispered behind her hand, “and when it comes to sex, it not something that’s talked about easily. We don’t have good language for it. It’s usually pretty couched in a sort of negative light, and it’s not something that you often talk to your parents about so I think particularly for gynecologic care, it’s kind of a trifecta of all of that. I think it’s because they’re newly in charge of themselves, they haven’t been given the information about good sexual health from their family members, because there’s not good language to talk about it and certainly we don’t talk about it in public. Most of the language about sex is pretty negative, dirty and quiet.”

Albeit today’s college students find it easier to discuss and seek out gynecologic care than those did decades ago, characterized by new apps like “Flo”, a period tracker, and “Nurx”, a birth control prescribing app, the growth in better language and arguably decreased stigma around open conversation on the female body. Yet the problem remains, as societal taboos fall away and new ones arise, so do certain struggles. Issues of scheduling conflict, insurance, stigma, lack of resources or visibility of such resources if available, difficulty of learning to make such decisions on your own still remain despite new technology and discussion that comes about over time. Herrine candidly acknowledges the awkwardness that surrounds seeking out your own gynecologic care for the first time.

“Most people really don’t want to have their vaginas touched.”

While Temple overtly advertises the availability of health resources during times of dire need, such as the recent severe outbreak of the flu, more regular gynecologic care is much identifiable on campus. She adds that many students may not know that they need this kind of routine medical attention, or the frequency with which they should obtain it.

But most importantly, Herrine has a list of things she urgently wants more women to know about maintaining their gynecologic health.

1. “You should be using condoms, for the first 6 months of a monogamous relationship. If you’re having sex you should be using condoms, period, end of discussion. The first time you have sex you should be using condoms. If you have the conversation about monogamy, that’s fine, but the condoms stay on for 6 months of monogamy. If you don’t have the conversation, the condoms stay on. If you don’t remain monogamous and have an open relationship, the condoms should stay on. And you can negotiate about if this is a primary relationship and you’re STD negative and you want to be non-monogamous and using or not using condoms outside of the relationship, of course that’s assuming you’re using something else for birth control and assuming you don’t want to get pregnant.”

2. “STDs happen and they can happen to you when you don’t use protection.”

3. “Birth control is available and out there. There’s lots of great birth control, especially what we call long acting reversible contraceptive (LARC). There’s lots of that available now, it’s very affective, it prevents pregnancy very well and it lasts from anywhere between 3 to 5 years and then you only have to use condoms for STD protect.”

4. “Women should know about Plan B, it is available now in this state over the counter so you do not need a prescription to receive it. So, if you have unprotected sex you can at least protect yourself from getting pregnant. Everybody should know about that. You should also get a prescription from your gynecologist, every gynecologist will give a prescription to be filled as needed.”

5. Herrine’s final piece of advice is simple but essential: “See a gynecologist at least once every year if you’re sexually active.”

#college #health