Sunday longread: Let’s talk about our sexual health

Eva O’Beirne interviews Dr Caroline West on the stigma surrounding women’s sexual health in Ireland

It is estimated that 3 out of 4 women will experience thrush in their lifetime. Around two thirds will get a urinary tract infection (UTI) and one third will have a form of bacterial vaginosis. With such high incidences rates, one would expect the health system to have an abundance of information available with campaigns that highlight the importance of sexual health. Instead, the opposite is the reality in Ireland today with little to no public awareness about sexual health and hardly any mention of them in the Social and Personal Health Education (SPHE) and Relationships and Sexuality Education (RSE) programmes. Women are often left in a spiralling panic, self diagnosing themselves on the internet, unsure as to what is causing them pain or discomfort. Speaking to Trinity News over Zoom, Dr Caroline West details how the Irish health services can do better to support women’s sexual health.

A self-described “advocate for pleasure and healthy, consentual sex”, West explains that the lack of awareness around thrush, UTIs and other vaginal health issues is not solely due to a lack of knowledge around sexual health and sex. West also suggests that this lack of awareness is because Irish people do not know how to communicate with each other about said issues. West completed her PhD in Sexuality Studies in 2020. She also holds a Master’s degree in Sexuality Studies and a Higher Diploma in Psychoanalytic Studies. When asked as to when she first became interested in studying sex and sexuality, West points out the difficult juxtaposition that exists between Irish people and their sexuality as her inspiration. “I suppose I was interested in the fact that Irish people have sex yet are very reluctant to talk about it. I was born during the time where Magdalene laundries were still operating. It was incredibly strange to be singing about ‘girl power’ along with bands such as the Spice Girls, meanwhile these horrors were happening.” 

“People are so obsessed with having what is called ‘the right kind of sex’, when there is no one correct way to have sex.”

West is certainly no stranger to discussing sexual health and in particular how Irish people have sex; she is the host of the Glow West podcast, which explores sexuality, the body and health issues. She is also currently a sex and relationship expert for the Elaine Show and Evoke.ie. West describes her hope to break down the stigmas surrounding sex and sexual health. “People are so obsessed with having what is called ‘the right kind of sex’, when there is no one correct way to have sex.”

West explains how attitudes toward sex have changed since she started her first degree in UCD in 2000, noting how negatively sex was portrayed in Ireland then. “It appeared horrible and terrifying. There wasn’t any space for it to be fun let alone enjoyable.” West admits that attitudes towards sex and relationships have developed greatly since she started studying in 2000, but she also notes how forms of Catholic guilt creep into Irish society. “There’s still a long-lasting fear surrounding sex and sexuality. I think that Irish people are great at engaging in casual sex, but where they fall down is engaging in authentic sex.” West described authentic sex as sex where the particpants are happy, safe, have a pleasureable experience and also communicate with each other throughout. “I think if Ireland had comprehensive sex education, it would normalise a lot of areas of sex and hence improve communication.”

West describes how pleasure is non-existent in RSE with no mention of the clitoris.

Continuing on from that point, West was quick to point out the necessary changes that need to be implemented to the current RSE and SPHE curriculums in Ireland. West describes how pleasure is non-existent in RSE with no mention of the clitoris. “We go from absolutely nothing in school, straight to porn. The groundwork is of course providing clear and helpful information to students while they are in school but encouraging healthy conversations about sex is just as important.” West lists increased teacher training, a younger introduction of the topic of consent and more inclusivity of the LGBTQ+ community as just some of the ways the Department of Education could improve the syllabus in order to equip its students for a healthier and happier life. West also highlights the need for more guidance on healthy relationships and what abuse looks like as many young people experience abuse unknowingly. “We don’t know what the red and green flags are and we can accidentally accept a toxic relationship as a normal one.”

Throughout the interview, West wholeheartedly agreed that there is not enough awareness surrounding UTIs, thrush, and other vaginal problems in Ireland, stating that there is plenty of space for a campaign by the HSE. “We see so much misinformation being spread about these issues and about good sex practices. There’s countless examples in porn when it changes from anal sex to vaginal sex – that’s nearly a guaranteed UTI.” The normalisation of good sexual health appears to be the key to raising awareness. 

In West’s opinion, an accessible, fun and colourful campaign could help thousands of women understand their bodies better and prevent unnecessary suffering. “I’d love to see a campaign that not only teaches you what they are, but also how to prevent reinfection or recurrences. Something as simple as letting women know that UTI antibiotics will more than likely cause you to have thrush, that cranberry juice will definitely not cure your UTI.” The issue of scaremongering and shame can often prevent women from seeking medical advice when faced with symptoms they have never seen, or heard of, before. West notes there almost seems to be an expectation that women deal with these issues alone as no one, not even the sexual health programmes, acknowledge their existence.

If they are shaming you or stigmatizing, then they do not deserve to have access to your body.

West acknowledges that many women do not know how to address their partners about sexual health issues as often they are afraid of rejection. She explained that your partner having a negative reaction to an issue you may be experiencing is never your fault, “it just shows that they have to mature when it comes to talking about your sex life. If they are shaming you or stigmatizing, then they do not deserve to have access to your body.” West emphasises that due to gaps in communication between those who are having sex, health issues such as STIs can arise. “Not talking about problems that are affecting you won’t make them go away.” 

The interview then turned to the subject of positivity surrounding female sexual health in Ireland. West feels frustrated with regard to other long-term vaginal issues such as endometriosis and vaginismus and how frequent misdiagnosis occurs. “It’s making people aware of what can go wrong, what can happen. It’s not in a scare-mongering way, instead it will prevent people suffering in silence.” She then acknowledged how much misogyny is ingrained in women’s healthcare, describing the nonconsensual “husband’s stitch” where women would be sewn up tighter after giving birth, as well as hysterectomies and symphysiotomies (the breaking of a woman’s pelvis during labour). “Women were treated like second-class citizens and continue to be treated so in certain ways. The government agencies need to step up and use these scandals as a reason to educate, empower and treat women better. They need to realise that change is necessary.”

When asked if Ireland would be ready for a campaign on UTIs, thrush, bacterial vaginosis and other female health issues, West was certain that the Irish population could handle it, despite the backlash that was attached to the Tampax and Tea advertisement in July 2020. West was quick to point out how those who complained about the ad in question would never be sexual health advocates.“84 people are not representative of the majority of the population. If we’re okay with ads about constipation and diarrhoea, we should be okay with ads about UTIs and thrush.” As women’s health issues are often swept under the carpet, West agreed that the HSE must make a conscious effort to raise awareness, especially after the tragedy that was the 2018 CervicalCheck scandal. Women’s health, especially their sexual health, has been abandoned in Ireland for too long. 

West then recommended several resources for those looking for sexual health advice. MySexualWellbeing.ie was her first recommendation followed by TheSTIProject.com. She notes that MySexualHealth.ie provides more inclusive sexual health information, particularly for those who are LGBTQ+. Of course, West also has her own podcast, Glow West, which facilitates calm, rational and mature conversations about sex and relationships. “It’s the sex-ed that a lot of us didn’t recieve in school, think of it as sex education but for adults.”

The interview was wrapped up with West detailing her goals for the upcoming year. “I would like my podcast to grow and to get the message out there that sex is okay and that sexual wellness should be a part of our day to day lives.” She also hopes to spread more awareness around healthy relationships and communication as it’s a topic a lot of Irish people struggle with. “When we learn to communicate with each other we will have a better functioning society as a whole.” On a lighter note, West finished the interview with one short wish of “more orgasms and sexual pleasure for all”, a sentiment that most would agree with.

Eva O'Beirne

Eva O'Beirne is the Deputy Life Editor of Trinity News and a Junior Sophister History student.