Dr Anita Mitra - The Gynae Geek: Your no-nonsense guide to down there healthcare

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It is such an honour to write something for the whole world to see. But I couldnt have done it without the support of some incredible human beings who deserve huge thanks.

To Dr Rupy Aujla, my brother from another mother, for being the one who forced me to put myself out there to talk about something I believe the world needs to know.

To Dr Laura Thomas, for taking a chance on The Gynae Geek and inviting me on her podcast to discuss vaginas before that was a cool thing to do.

To Dr Hazel Wallace and Alice Liveing, who both gave me a massive leg-up by collaborating with me on their social-media channels and giving me valuable advice about how to survive in the online world.

To Carly Cook, for her sass and support throughout the book-writing process and for hydrating me with many a mint tea. To the wonderful HarperCollins team Carolyn Thorne, who saw the potential in my idea, George Atsiaris, Josie Turner and Julie McBrayne, who brought the campaign to life thank you all!

To Adam Willis, my strength coach, but most of all my friend, for always being a voice of reason.

To my best friend, Achini Wanasinghe, and my mum, who listen to my moaning on a daily basis and support me no matter what. And all my other friends who have put up with being ignored for the time that Ive spent writing the book.

To both of my parents for giving me the education that enabled me to be in the position to write this book.

To all the patients and my social-media followers who shared their stories and asked the questions that inspired it.

And finally, to Menelaos Tzafetas, aka Mr Gynae Geek, for being the one, in so many ways.

Ive snatched every spare moment over the last few months to sit down and write. Ive written in the back of the car, on the London Underground and on planes, in conference halls and on the beach, in London and Dubrovnik, in the middle of the night in the labour ward on-call room and from my bed when Ive been unable to get up due to a tough shift at work the day before.

You may ask why I put myself through all that. And the answer is that I saw a desperate need for women to get basic information about female health. Ive seen women who were unsure about whether their symptoms were normal; women too embarrassed to go and speak to their doctors about their female health; women who did not know what to call their bits; women who broke down in front of me because Dr Google had diagnosed them with all sorts of dreadful diseases (that they absolutely didnt have); women who were being misled by unqualified folk on social media; and I saw the damage that women were doing to their gynaecological health through their hectic lifestyles.

As a final refresher from these pages, here are sixteen key things that every woman needs to know:

• Your vulva is on the outside and your vagina is on the inside.
• Your labia are supposed to be visible from the outside and are normally uneven in shape and size. Dont let anyone tell you they need to be trimmed to neaten them up and make them symmetrical.
• The average menstrual cycle lasts twenty-eight days, although anything from twenty-one to thirty-five days is considered normal. Day 1 is the first day of your period.
• Polycystic ovarian syndrome (PCOS) is a common cause of irregular periods. It doesnt have to be a life sentence and there are a lot of lifestyle changes that can be implemented for a potentially profound effect on your symptoms.
• There are many reasons for heavy and painful periods that are very treatable, so its not something that you have to put up with. Cancer is the thing that everyone with these symptoms worries about, but its actually one of the rarest causes.
• Vaginal discharge is the reason you exist. Its there to protect you. You need to learn whats normal before you can work out whats abnormal.
• The withdrawal method is not a reliable form of contraception. Dont use it.
• Using emergency contraception does not cause an abortion, and abortions do not make you infertile.
• Sexually transmitted diseases, on the other hand, can affect your fertility. And if youve never been tested, you cant be certain that youve never had one.
• Smear testing is the best way of preventing cervical cancer. And pretty much everyone gets HPV, which is the virus that causes it, although it usually goes away fairly quickly and doesnt cause any problems. Its not a sign of promiscuity.
• You dont need any kind of fertility test before trying to get pregnant. In most cases they wont tell you anything useful and they are not that reliable.
• Egg freezing is a way of preserving your fertility until youre ready to have children, but its not 100 per cent guaranteed.
• Stress can come in many forms and can affect your menstrual cycle because Mother Nature never intended for a stressed-out woman to get pregnant in case she is unable to protect her child.
• You are what you eat. Food choices can have a massive impact on female health.
• When it comes to exercise you can have too much of a good thing. And if overexercising stops your periods, it can have a negative impact on your health for the future, and could increase your risk of thin bones in older age.
• Sleep is the most underrated medicine.

If any of the information in this book has worried you, or you think you may have a problem that requires further attention, I hope that you will feel empowered, and maybe less embarrassed or anxious to go and speak to your doctor.

Please value your body. Remember, its the only one youve got, so you need to look after it. No one wants to think about getting old, but its inevitable, so we all need to implement a healthy lifestyle today as an investment for the future.

Doctor, while youre down there, can you just tell me if my vagina looks normal?

This is one of the questions I am most frequently asked by my patients, but it is also one of the most inaccurately phrased. What women actually mean is: Does my vulva look normal?

Many people dont know the difference between the vulva and vagina, and I think this is a major reason why women so often feel embarrassed to go and see a doctor when theyre concerned that something is not right: because they dont even know what to call the area they are worried about. Whats more, womens perceptions of a normal vulva are usually inaccurately shaped by the pornography industry, and as someone who looks at vulvas (and vaginas) for a living, I feel appropriately qualified to suggest that this area is becoming a target for body dysmorphia.