The UK is well known for having one of the best, most developed health care systems in the world. But that doesn’t mean there’s not room for improvement. When drawing inspiration from other countries, we don't even have to look too far from home. In fact, as our neighbours across the Channel are particularly good at providing women with more inclusive and tailored gynaecological care, something we really should be taking notes on. We quizzed Dr Christilla Nevi, a French Medical Gynaecologist based in London who provides care for patients of all nationalities at Twenty-five Harley Street Day Clinic about some of the differences between France and UK when it comes to women’s health.
1. Postnatal care for women
Bladder incontinence and a weak pelvic floor tend to go hand-in-hand with childbirth and pregnancy but the important thing to remember is that it can be treated (and even prevented). In France, women are prescribed physiotherapy sessions at every 8 week check up post-birth. Social Security fund up to twenty sessions for every woman in order to tone and strengthen their weakened pelvic floor.
In the UK, not only is this not readily available to women on the NHS, but often the effects pregnancy and childbirth has on the pelvic floor aren't even discussed. This can leave a lot of women feeling embarrassed and uncomfortable, unaware that actually there's a lot that can be done for them.
The local health authorities in France also send new mothers information about what benefits are available to them and how often they should bring their child in for check-ups.
2. Gynaecology appointments start from adolescence
In the UK, smear tests are offered to women from the age of 25, however in France it's common practise to start seeing a gynaecologist when they're teenagers. This may not affect the rates of cervical cancer but could help spot it earlier, particularly for girls who become sexually active. This also gives girls a safe place to discuss contraception and other gynaecological issues without pressure or judgement from parents.
3. Women have yearly check ups
In France, it's regular practice to visit your gynaecologist annually. In the UK, it's more likely for you to go to your GP with a problem, and then be referred to a specialist for further investigation. It's unusual for British women to have check-ups (other than the recommended smear tests which can be performed at most GP surgeries anyway) unless they experience a specific issue.
The benefit of regular visits is that they can highlight any problems before they become more serious, even if you didn't realise anything was wrong. Like the smear test, early diagnosis is essential for many gynaecological conditions, and will lead to more successful treatment in most cases.
4. In France there are two different kind of gynaecologists
In the UK, you go to your GP or Nurse practitioner if you have issues with periods or vaginal infections. In France, you would go straight to a medical gynaecologist – the same person you see for your yearly checks. In the UK, all our gynaecologists have a surgical background – they are qualified to perform operations. With a medical gynaecologist, you get to discuss health problems together and decide what options you have. If necessary, your medical gynaecologist can refer you on to a gynaecologist surgeon. Patients can build up trust with their medical gynaecologist and come to the right decision together whether they go surgery or try other strategies.
5. The French recognise the importance of vaginal flora
French medical Gynaecologists big on balance – vaginal flora balance, to be precise. Vaginal flora is bacteria that maintains a healthy, balanced environment in the vagina. It’s essential to get right if you want to avoid discomfort. A lot of women mistake any discomfort as thrush, and use over the counter medication without consulting their doctor. But it’s vital to get the right diagnosis so you can be treated accordingly. A French medical gynaecologist will usually examine you and take swabs to rule out STDs (which can be hidden by thrush).
They will also check for a condition called bacterial vaginosis (BV) which is caused by an imbalance in vaginal flora. If the vagina becomes too alkaline, the quality or amount of ‘good’ bacteria can fall allowing other bacteria to proliferate. Although half of BV cases don't present with symptoms, when it does it can cause an unusual, often foul-smelling discharge. BV is a very common condition in the UK, thought to affect roughly a third of women at some point in their life. It can be treated by medications. Medical gynaecologist recommend only using unperfumed soaps around the vulva area (never directly in the vagina), avoiding wipes, shared hot tubs and ensuring your tampons aren’t too absorbent for your flow.
Maybe if we took inspiration from our friends over the Channel and put more emphasis on regulating our vaginal flora, we'd see a lot fewer cases of BV and similar conditions.