Read My Lips (12 page)

Which GAIN/IGAD-related accomplishments are you most proud of and why?

1. After being treated like I was a crazy woman for speaking out as I did, the global letters of support for my vision for an International GYN Awareness Day is one of my greatest accomplishments.
   
2. Gaining Australian of the Year Professor Ian Frazer as GAIN Patron.
   
3. Giving voice to a woman who had her clitoris and vulva removed by a deranged gynecologist—getting the media involved and seeing legislation changed to offer more protection.
   
4. That I stood my own ground and didn’t take no for an answer, and the empowerment I felt so that others can do the same.
   
5. Recipient of six awards, including the Order of Australia.
   

What do you wish more women knew about their vulval health?

I wish women could be more accepting that the vulva is a very important part of the body where life begins and it is so very, very precious. The more they understand about the vulva, the more empowering, for confidence lies within this knowledge.

What can women do to help raise awareness in their own communities?

As the vulva is still in the background of women’s health, women could assist in their own communities by celebrating the International GYN Awareness Day—September 10—annually and making it fun and informative would give a good platform to raising a positive aspect to vulval health. All they have to do is to draw together medical practitioners and people from the community, invite a guest speaker to speak on a GYN-related topic, and sit around the table together and talk about it.

Men need the support just as much as the women. By inviting people to speak openly, we are allowing them the opportunity to receive the support they need, and it empowers everyone. Also by breaking down those barriers between medical professionals and their patients, a greater quality of care and treatment can be gained which benefits everyone.

For more information about Kath and her very important work, please check out Gynaecological Awareness Information Network (GAIN), Inc. (
www.gain.org.au
and
www.kathmazzella.com
).

OPENING UP: VAGINAL DILATORS

Vaginal dilators are sometimes described as “medical dildos.” They often come in sets of five or six with the smallest being about the size of an adult’s pinky finger and the largest being longer and thicker than an average-sized penis. Dilators may be used by women who have experienced vaginal narrowing or pain as a result of side effects from cancer treatments (such as pelvic radiation). They are also sometimes used as part of a larger treatment plan for women with vaginismus, vulvodynia, or other vulvovaginal pain conditions. In addition, some women who have very small vaginas—as is sometimes the case with women who have a condition called androgen insensitivity syndrome (AIS)—find that using dilators can help them stretch their vaginas. Surgeons may also suggest that their patients who have male-to-female sex-reassignment surgery use dilators to help stretch their “neo-vagina” (the surgically created vagina).

Dilators can be purchased online or through some healthcare providers and sex therapists. Some women use dilators in order to overcome a pain disorder that keeps them from having sex with a partner. Others use a dilator to prevent sexual-function problems or to treat sexual side effects. Still, these are not the only reasons why dilator use can be helpful or important.

As mentioned, some cancer treatments can result in a woman’s vagina narrowing substantially. Not only can this make sexual intercourse feel difficult, if not impossible, but it can also make it very difficult for a healthcare provider to properly examine a woman’s vagina and cervix during a GYN exam. This is particularly important as healthcare providers will want to be able to properly view and examine the cervix so that they can make sure that a woman does not develop or have a recurrence of cervical cancer, among other issues. Dilator therapy can help women maintain their vaginal patency (a fancy term that basically means vaginal flexibility and tone, allowing it to open enough to be viewed during exams).

How It Works

Dilators can be used in many different ways. Women who use them as part of a treatment plan recommended by a healthcare provider or sex therapist should ask their provider/therapist for specific recommendations. Generally speaking, women are advised to begin with the smallest dilator and partially insert it into their vagina, often with water-based lubricant applied to the dilator to ease penetration. Women may move it in and out if they want, but often, they will just leave it there for ten minutes or longer so that the vagina gets used to accommodating an object of that size. As that size becomes more comfortable, women may be advised to move to the next size and repeat the cycle until she has gotten to the size that she, in consultation with her healthcare provider, has decided she wants to use. For some women, the process of moving through the dilator sizes takes weeks. For others, it takes months. Similarly, some women insert the dilator while lying down and reading or watching television, while other women make dilator use a part of masturbation or sex play with a partner. There are many different ways that women experience dilator use. See the Resources section for shops that may carry dilators.

YOUR HEALTHY HOOHA

Although there are many things that can go wrong with the vulva and vagina, there are also many things that can go right. Every day, you have opportunities to care for your genital parts—to wash them carefully, to wear clothes that let them breathe, to choose partners and doctors that take care of them, and to love them so much that you take the time to check them out every now and then just to make sure they’re all right. This is the best that we can ask of ourselves. And if something does go wrong, we hope that the information in this chapter helps you figure out how to get the help and, if relevant, the treatment that you need. Here’s to looking forward to a world of healthy vulvas and vaginas!

TEST YOUR VQ

1. Pantyliners are best used

a. every day

b. whenever vaginal discharge is present

c. only when a woman is menstruating

d. all of the above

2. Aside from yeast infections, vaginal itching may be caused by

a. ingredients in lubricants

b. bath products

c. wearing tight, restrictive clothing that traps moisture

d. all of the above

3. Current recommendations are for young women to have their first gynecological exam

a. by age twelve

b. between the ages of thirteen and fifteen

c. at age eighteen

d. at age twenty-one

Answers

1. c

2. d

3. b

• 3 •

Vulvalicious

Vulvas and Vaginas in Bed

In spite of the significant efforts and good intentions of highly dedicated genital admirers, the vulva and vagina remain a mystery for many—especially when it comes to sex and pleasure. In some ways, this is not terribly shocking, given that women’s bodies and sexual response are not fully understood even by scientists and medical doctors. In other ways, it’s quite sad to not be able to unlock the pleasures of parts we live with on a daily basis.

Unfortunately, a lack of knowledge about women’s bodies and sexuality can pose challenges for people’s sexual lives. Women may feel frustrated if they don’t know how they like to be touched on their genitals or where they liked to be touched. They may feel guilty or embarrassed about masturbating, even though most women masturbate.
¹
Also, many men and women who have sex with women feel equally mystified about women’s bodies. They may not be sure how to touch or lick their girlfriend or wife in order to please her sexually.

It’s really weird living with genitals I don’t like the look of in general. I like the feeling of intercourse/masturbation, but when I am with a woman, I feel bad that I don’t want to reciprocate anything. I’m also scared that after seeing me give birth, my husband’s not going to want to go down there.

—
L
ILLY,
23, California

In the first chapter, we took an introductory look at the parts of the vulva and vagina. We learned, for example, that the clitoris is an incredibly nerve-rich part of a woman’s body, packed with about eight thousand nerve endings in a pretty small space. Yet, as fabulous as the clitoris’s potential role during sex may be, it’s certainly not the only part of the vulva or vagina that’s relevant to sex or sensual pleasure. Each and every part of women’s genitals has some level of erotic potential or role to play in sexual play or sexual response.

In this chapter, we will provide you with information about the vulva, vagina, and sex—including a few tips related to sex toys—so that you can feel confident in and out of bed, whether you’re pleasuring yourself or showing your partner what you find most enjoyable or erotic.

THE AGE OF CLIT-ARIUS

The clitoris is highly sensitive thanks to all the nerve endings inside of it, but there’s more to it than nerves. The clitoris was first scientifically detailed in its full size and glory in 1998,
²
which means that the scientific study of the clitoris is actually quite young.

I wish more women would think beyond the clitoris. We make jokes about men who can’t find it or similar when, really, the whole area is so sensitive. We are missing out if we just encourage our partners to go for the high point every time, not to mention risking pain thinking the glans is all she wrote.

—
J
EAN,
32, New Mexico

Sure, we knew about the clitoris long before 1998, but—outside of progressive feminist health books and medical circles—it was more commonly thought of as a little nubby thing that was small and mostly on the outside of the body. Following on the heels of earlier work, Dr. Helen O’Connell’s team
²
published anatomical evidence that showed that the clitoris is much larger than meets the eye and that it is made up of a variety of parts, like the crura (which are two branches that extend backward into the body and swell during sexual arousal) and the bulbs of the clitoris.
²
This got people thinking about the clitoris and about women’s sexuality more generally. The size and placement of the clitoris means that the clitoris can be stimulated from various types of touch. One can stimulate the glans clitoris (the part one can see from the outside) with fingers or a vibrator during masturbation alone or with a partner. The glans clitoris can also be stimulated with a tongue, lips, or fingers during cunnilingus, as it often responds to light touch. Also, the inside parts of the clitoris can be indirectly stimulated during vaginal penetration with fingers, a partner’s penis, or a sex toy such as a dildo or vibrator. Because some clitoral parts are deeper inside the body, firm pressure may be a better option for internal stimulation of the clitoris.

I never liked any part of being a woman, especially my genitals, until I was 19 and in my second year of college. After seeing
The Vagina Monologues
and breaking away from my home town and family’s negative view of women and their sexuality, I began to look into these things for myself. I unfortunately did not begin masturbating until I was 19, and finally had sexual experiences when I was 20. Since I am only interested and attracted to women, I had a somewhat good and helpful idea of what to do during my first sexual experiences since as a woman, I know what women might generally like.

—
D
AWN,
20, Ohio

As such, vaginal penetration can deliver both vaginal stimulation as well as stimulation of the inside branches of the clitoris (the crura)—and, if you remember from chapter 1—it’s this indirect way of stimulating the clitoris through the vaginal walls that may be what’s at the heart of the G-spot. After all, when a woman becomes sexually excited and aroused, blood flows to her pelvic area and genitals. The clitoris becomes enlarged during this process, which can make the area more easily stimulated and more sensitive to stimulation.

The clitoris isn’t the only part to change in response to sexy times. More recently, Dr. O’Connell—after further study of the clitoris and women’s genital parts—came to another conclusion. She noted that the clitoris doesn’t seem to function in a vacuum. Rather, she suggested we consider using the term “clitoral complex” to describe the unique interplay among the clitoris, vagina, and urethra.
³
If one of these parts is moved, then the other parts move and are thus stimulated as well, though not in a uniform way. Let’s take penilevaginal intercourse as an example. When a man’s penis and a woman’s vagina are in intercourse, her vagina expands to accommodate his penis. Thus, the vagina is affected—it gets bigger and is stimulated on all of its walls. But the inside parts of the clitoris are likely stimulated, too, and the urethra is pushed a bit upward, as well. This is an important way of thinking about women’s bodies because it takes us away from a simplistic model of sex, in which only the vagina is stimulated during intercourse, to a more complex way of thinking about sex, in which the vagina, urethra, and clitoris are all stimulated and impacted during intercourse.