Breaking the silence: when ‘common’ doesn’t mean ‘normal’

Dr Ana Belén Rizo

How many women have been told, 'It’s just part of getting older', 'it’s normal after having children', or 'it’s simply menopause'?

As a gynaecologist, these are some of the most common phrases I hear in my consulting room. They are also some of the reasons why so many women continue to live with symptoms that affect their health, their confidence and their quality of life without ever asking for help.

I often describe these as “the symptoms of silence.”

They are not one specific condition. They are the symptoms women experience but rarely talk about because they have been taught to believe they are simply part of being a woman.

Urinary leakage after childbirth. Pain during sex. Vaginal dryness. Vulval conditions. Loss of sexual desire. Persistent pelvic pain. Bladder symptoms during menopause.

These problems are common. But common does not mean normal. This is probably the single most important message I would like every woman to remember.

Just because something is common does not mean it should be accepted.

I have seen the impact that silence can have. When women live with symptoms for years without seeking help, those symptoms often begin to affect much more than their physical health. They can influence self-confidence, intimate relationships, work, exercise, and emotional wellbeing. That is why starting the conversation is often the most important step towards recovery.

One of the greatest challenges in women's health today is not simply developing new treatments; it is encouraging women to believe that they have the right to ask for help.

For far too long, intimate symptoms have been surrounded by embarrassment and silence. Many women apologise before telling me what they are experiencing. Others lower their voice. Some even begin by saying, 'this is probably silly...'. It never is. There should be no shame in talking about our bodies.

Modern gynaecology has changed enormously over the last decade. Today we understand much more about hormones, pelvic floor function, vulval health, bladder symptoms and sexual wellbeing. This means we can care for women in a much more individual way than ever before because every woman is different, every body is different, and every stage of life is different. That is why I believe there is rarely one single cause and rarely one single solution.

Good healthcare begins with listening. Before we think about treatments, we need to understand the woman sitting in front of us.

For some women, reassurance is enough. Others benefit from lifestyle changes, pelvic floor physiotherapy or hormonal treatment. Others may be suitable for newer regenerative therapies, which are becoming an exciting part of modern gynaecology when used appropriately and supported by evidence.

After recently relocating to Cork with my family, I have been struck by how warm and welcoming this community has been. I feel privileged to continue my work here.

If there is one message I hope every woman takes from this article, it is this: If something doesn't feel right, don't suffer in silence. You do not need to know exactly what is causing your symptoms. You do not need to have the perfect words. Simply saying, 'something doesn't feel right,' is enough to begin the conversation.

No woman should feel embarrassed to ask for help. No woman should believe that pain, bladder leakage or sexual discomfort are simply things she has to accept. And no woman should ever feel she has to suffer in silence, because silence has symptoms, but so does hope, and sometimes the first step towards healing is simply finding the confidence to speak.