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2 Feb

Will Harvard’s recent bionic vaginas revolutionise women’s health?

Medical conditions affecting individuals with vulvas are notoriously understudied, but recent developments in the sector suggests this might be changing

Smear tests. Thrush. IUD insertions. Painful sex. Excruciating UTIs. Hardly per week goes by and not using a friend uttering some criticism about their vulva* – an itch, an ache, an invasive medical procedure. 

A 3rd of individuals with vulvas experience severe reproduction health problems in a given 12 months. Nonetheless, despite the pervasiveness of gynaecological discomfort the world stays chronically under-researched and misunderstood. There are over five times more studies into erectile dysfunction than there are into premenstrual syndrome (PMS), despite the proven fact that over 90 per cent of girls suffer from PMS – with symptoms that may include anxiety, depression and debilitating pain – in comparison with 19 per cent of men who struggle to get it up. It’s no surprise that discrepancies like these are much more pronounced within the healthcare of trans people and women of color.

In 2018, science journalist Rachel E. Gross got here head to head with these systemic failings. She’d been going backwards and forwards to the doctors for a month, but it surely took a cocktail of antibiotics and antifungals for her gynaecologist to finally diagnose her with bacterial vaginosis (BV) – the most typical vaginal condition between the ages of 15-44. By this point, the symptoms had develop into unbearable. It was disrupting her sleep; wrecking her self-esteem. 

There was one last option, her gynaecologist told her. It was “essentially rat poison”. “I used to be just really shocked,” she recalls, “that a gynaecologist who had passed through med school and spent years and years treating women did not have something higher to supply me”. Gross has since written an entire book about vulvas, and the cultural myths which have enshrouded them throughout history (her Instagram handle – @gross_out – reflects a minimum of one).

The original Latin term for the vulva, used until 2019, was pudendum which directly translates as the part to be ashamed of. In Ancient Greece, physicians blamed female suffering on their “wandering wombs”,  a consequence of them not bearing children soon enough. Ovaries were considered female testicles until the seventeenth century, after they got their current name, deriving from the Latin ovarius, literally: “egg-keeper”.

This information gap has left behind a legacy of male-centric healthcare, and a measly understanding of how different treatments affect women and girls. Between 1997 and 2000, the US Food and Drug Administration took 10 drugs off the market resulting from severe unwanted side effects. Eight caused greater health risks in women. “We literally know less about every aspect of female biology in comparison with male biology,” Dr Janine Austin Clayton, an associate director for girls’s health research at the USA National Institutes of Health told The Latest York Times.

But recent developments suggest that things might finally be changing. Last month, scientists at Harvard developed the world’s first ‘vagina-on-a-chip’ – a small device containing live human cells that replicates the cellular environment of the vaginal canal. What’s so promising about this technology is that it offers a controlled environment that’s outside the human body. Scientists can test and retest how different bacteria (and eventually recent treatments) affect the vagina, while not having a willing patient to subject themselves to those experiments.

“That is just the beginning”, Aakanksha Gulati, co-author of the study, told Dazed. “We just began to know one disease called bacterial vaginosis, but we could achieve this rather more with these chips.”

In 2022 alone, scientists developed a lot of potentially life-changing treatments for conditions that predominantly affect women and other people with vaginas. One British lab developed the first antibiotic in 20 years to treat UTIs, while researchers in North Carolina found that a dissolving vaccine may very well be equally effective. 

In the sector of endometriosis, a Texas lab discovered that oleuropein – a natural compound present in olive leaves – may very well be safer and cheaper than current treatment options. Meanwhile, scientists in California studied nearly 400,000 cells and created the primary single-cell RNA-sequencing comparison of endometrial tissues  – essentially a roadmap for researchers around the globe to more effectively diagnose the disease. “It’s jumped us forward an entire recent chapter in our book in learning about endometriosis,” Kate Lawrenson, an associate professor within the Department of Obstetrics and Gynecology at Cedars-Sinai, and co-author of the study told Dazed.

Endometriosis affects as many as 1 in 10 women and people assigned female at birth within the UK, yet it takes an average of seven.5 years for it to be diagnosed. While symptoms include severe pain and excessive bleeding, patients are continuously treated as if their pain is only psychological, with over 75 per cent misdiagnosed with a mental and/or other physical health problem before receiving the proper diagnosis.

Lawrenson believes that a part of what’s slowed progress is the limited cellular data on the condition. “There are only a few places where endometriosis care happens in a centralised place,” she explains. “Someone might see their primary care doctor or their gynaecologist and get different pieces of the puzzle met”. She hopes that the cellular atlas will probably be a game-changer for endometriosis diagnostics and coverings, in addition to shedding light on other conditions that disproportionately affect women, corresponding to immune dysregulation. But to ensure that research progress to ever match that into conditions that affect men, foundational change is required – “to vary how society views women’s experiences of pain and what’s normal and what’s typical”. “That could be a rather more complex issue”, she emphasises.

Science writers like Gross play a very important role in rewriting these narratives; overwriting a legacy of medical bias and creating recent frameworks to know our bodies. “A whole lot of us don’t take into consideration our uterus or ovaries, except in terms of menstruation or baby-making”, she says. “These body parts do greater than produce babies… they’re really essential to pleasure, immunity and regeneration.” 

The proven fact that research into conditions like endometriosis and BV are receiving adequate investment makes her hopeful. It “really shows that a minimum of some subset of the medical community is prioritising female well-being” – beyond making babies. And as we move away from the male-centric model that has dominated medical history for therefore long, all bodies of all genders will profit.

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