Doctor Nina Dølvik Brochmann, M.D. (30) and medical student Ellen Støkken Dahl (26) are spreading medical expertise and enthusiasm for sexual health as teachers for teenagers, sex workers, and refugees.
Together, they have also built up one of Norway’s most popular health blogs, Underlivet. Frustrated by the amount of medical misconceptions and shame that surround the female body, Brochmann and Dahl wrote the popular science book, The Wonder Down Under: The Insider's Guide to the Anatomy, Biology, and Reality of the Vagina.
We had the chance to chat with Nina and Ellen about their new book, why women’s health is still stigmatized, and some dope period hacks that we are definitely gonna put to good use.
Who is The Wonder Down Under: The Insider's Guide to the Anatomy, Biology, and Reality of the Vagina for and why did you write it?
Nina Dølvik Brochmann: Our book is mainly written for people with vulvas and vaginas, but people without vaginas are encouraged to read it as well! We get asked all the time, especially in the US, if the book is appropriate for teenagers and we say yes. I mean, kids watch porn from a very young age today on their smartphones, so how on Earth could a medical book on anatomy, physiology, and gynecology hurt them?
Our oldest readers are a group of women in their 80s who discussed it in their book club. They sent us a wonderful email with the title: “70 years too late!” We loved that. Our male readers use the book to better understand the women in their lives. If you know more about the everyday bodily struggles of your partner or daughter, you may become a more empathic partner or father.
Ellen Støkken Dahl: Women kept asking: “Am I normal?” And they don't have good sources to turn to when they are looking for answers. We want to give women the information they need to make informed choices regarding their sexual health. We believe knowledge is the way to empowerment.
On the cover of your book you ask, "Why are our vaginas such a mystery?" Well, why are they??
Nina: The most obvious reason is that medicine has been a man's world for far too long. I mean, a couple of hundred years ago they drew the vagina as an inverse penis! As late as 2005 did researcher Helen O'Connell publish an academic article on the inner anatomy of the clitoris, based on imaging studies. Women's bodies have been a medical curiosity and most of the research about us have been oriented towards our function as potential mothers, not as sexual beings.
Ellen: Also, women's sexuality is still taboo – have you ever thought about how few words there are for female masturbation? No wonder young women find it shameful when we don't even have a nice word for it. The fact that women masturbate so little helps explain why we have an orgasm gap, and why women have a harder time attaining orgasms. Women are just not acquainted with their bodies and sexuality like men.
Nina: It's the same with the word vagina – people don't even know the correct word for their genitalia. Why do we call our genitalia the vagina when that leaves out our main sexual organ, the clitoris? The vagina is just the tube leading up to the uterus. I would definitely prefer the word vulva, which encompasses the whole outer genitalia and the clitoris, but I guess few people know what it means. In Norwegian we call it “Underlivet” – a poetic version of the word genitals since it also means “the life down under.”
There are a lot of wild period myths out there, some more harmful than others. What are some of the craziest myths you've heard about periods, and how do you help people get past these taboos?
We don't know if these are so wild really, but at least they're common!
You shouldn't do headstands or back bends when you have your period. Wrong. You can do absolutely anything you want when you have your period, including going to your favorite yoga class. The reason for this claim is that people think the blood will go the wrong way, into your abdomen. In a way, they are partly right because tiny amounts of blood may seep through the Fallopian tubes, but this is not dangerous at all.
Periods are healthy/cleansing/necessary. Not really. Unless you're trying to get pregnant, a period is just a loss of blood and energy. Remember that historically, before we had effective contraception, women were basically pregnant or breastfeeding most of their fertile lives, and therefore, not bleeding. Skipping your periods with hormonal contraceptives is actually more like "nature's way" than having you bleeding monthly. The fact that people think periods are important and healthy keeps a lot of women with severe pains or anemia from heavy bleeding or endometriosis from getting treatment with hormonal contraceptives.
It’s important to note though, that this only applies to skipping your periods with the help of hormones. Losing your period or having highly irregular periods when not intentionally caused by hormonal contraceptives, should always make you see your doctor as it could be a sign of underlying disease.
Using tampons involves a high risk for Toxic Shock Syndrome. A lot of women are scared of tampons because of this dangerous disease, but it is actually extremely rare if you use clean, modern sanitary products. Just remember to wash your hands properly and not leave a tampon in longer than it says on the box (normally between 3-9 hours).
A fun myth: If you ask a crowd to mention one animal who has periods, they always say dogs. But this is also wrong. Dogs bleed from their vagina when they are fertile, when they are actually ovulating. We human bleed when it's too late. In reality, few mammals have periods. Humans, a few primates, and one type of bat are among the unlucky chosen ones.
What is "period poverty" and why is it relevant to every person with a period
Nina: Period poverty is when girls and women cannot afford proper sanitary products, causing them to have to stay home from school or work. This leads to them falling behind and losing opportunities, in fact, reproducing or worsening their already unfortunate economic situations. So period poverty is one of the real obstacles facing girls from poor families. Luckily, it seems that the activism on this topic is leading to real political change.
Ellen: In the UK, 18-year-old Amika George has been leading a campaign to make sanitary products free for children on free school meal programs, for example. In the US, you have a similar movement with #menstrualequity. We are big fans of this work and it couldn’t have come sooner. It is important that every woman knows about this and speaks up, because there is so much stigma around periods that it is nearly impossible for disadvantaged women to get the politicians to listen if we’re not all in on this.
Nina: Period poverty is about female solidarity, about saying that we all bleed and we will not let that stop us from living full lives. Periods are our greatest super power – we can bleed a whole week every month without dying!
Do you have any doctor-approved period hacks that bleeders like us can do to save time, money, or stress? Spill!
Ellen: Use analgesics correctly to suffer less! It’s more effective to use ibuprofen or aspirin (non-steroidal anti-inflammatory drugs or NSAIDs), than paracetamol or acetaminophen.
That’s because period pains are caused by a group of signal substances called prostaglandins that tell your uterus to contract. Prostaglandins are made by enzymes called COX. Ibuprofen and aspirin block the COX-enzymes and thus, stop the production of pain-causing prostaglandins. Paracetamol and acetaminophen do not seem to have the same COX-effect in the body and that is why they have less effect on period pains.
Nina: Also, a lot of women wait until the pain is at its peak before they use NSAIDs or other painkillers. If you do that, the body will have already produced tons of prostaglandins and the pain won't go away. You need to block the enzymes early on to have a good effect. So if you normally have really strong pains, start as soon as you notice that your period is underway or even better, start the day before you expect it.
Take the analgesics as described on the package during the whole period you usually have intense pains, for example, the first two days of your period. That way, most women will actually need less painkillers, because you use it more efficiently.
Just an important reminder – painkillers are not candy. Never take more than described on the package unless instructed by a doctor, and if you have diseases like stomach ulcers or kidney disease, consult your physician for help.