Read My Lips (11 page)

V-CRAFT: HOST YOUR OWN “DINNER PARTY”!

A vulva-themed party can be fun to host for no other reason than to celebrate our down theres—and what better way to name it than your own “Dinner Party” in honor of Judy Chicago’s famous vulvathemed art installation (more on this later)? If you’re the kind of person who likes to party with purpose, why not host a vulva-themed party as a fundraiser for your local V-Day cast and crew’s production of
The Vagina Monologues
? Or donate the proceeds to the National Vulvodynia Association? Or host in recognition of International GYN Awareness Day (IGAD), celebrated on September 10 or in recognition of Vulvar Health Awareness Month, celebrated each March? Here are some ideas:

1. Make vulva-themed cupcakes by using frosting to draw vulvas or the letter “V” on each cupcake (we recommend frosting some in pink, others in beige or brown or black, and others in red or purple, etc).
   
2. Entertain yourselves by playing pin the clitoris on the vulva! Draw your own poster-sized vulva, equipped with all its parts, and cheer each other on as partygoers put the clitoris in its rightful place.
   
3. Make vulva-themed plates in advance, perhaps at your local paint-your-own-pottery place. In our experience, we were not censored—then again, the vulvas we’ve made on plates have been a bit Georgia O’Keeffe-ish, in that they looked as much like flowers as they did vulvas.
   
4. Give out hand mirrors as party favors along with information about vulvar self-examination.
   
5. Color your vulvas! Set out crayons and pages from the
   Cunt Coloring Book
   and get together and draw your own or your imaginary vulvas.
   

Use your imagination to make this a vulva-positive evening full of good friends, food, and energy.

Give her the words.
When you teach your daughter the names for her body parts, try to teach her the words she will need to talk about and think about her genital body parts. Just as she should know words for her elbows, cheeks, chest, and legs, we feel that young girls should also know the words vulva, vagina, and labia, among others. In her sex-education work, Debby has given puberty talks to a number of girls and their moms (as well as boys and their dads). In these conversations, she has been able to teach girls the names of all their vulva parts, including the clitoris, urethral opening, outer labia, and inner labia. The girls have often been happy to learn that they have a body part that is just about sensation and feeling good (that’s right: without giving them more detail than they may be ready for, it is possible to teach even young girls about the clitoris and its purpose related to pleasure). They’re also often very curious to learn about periods in the years approaching puberty, and having a good sense of the uterus, cervix, and vagina can help them to have more clear conversations with their moms, aunts, sisters, girlfriends, teachers, healthcare providers, or other adult caregivers.

If she itches, get her help.
Because young girls lack estrogen before puberty, they rarely have many vaginal problems, such as yeast infections. However, that doesn’t mean that nothing will ever bother her vagina. If a girl experiences ongoing vaginal itching, she may have a skin disorder affecting her genitals called lichen sclerosus. It can affect babies, children, or adults. Treatment (usually by a topical steroid cream) can often relieve symptoms, such as itching. Unfortunately, some healthcare providers are not familiar with this health condition and may mistakenly wonder if the girl has been sexually abused (sometimes genital symptoms are indeed a sign of sexual abuse). Itching can also be caused by bath products, such as bubble baths, which should be limited during childhood along with staying in a wet bathing suit or exercise clothes too long or not wiping after urinating.

Raising children or otherwise caring for them—whether as a parent, aunt, uncle, babysitter, or teacher—is important work. For more information about books on how to talk to children and teenagers about sexuality and genital-health issues, see the Resources section where we also list books for children to read by themselves or together with a parent or caregiver.

Get her GYN care.
As girls become teenagers, it can be helpful to get them started with gynecological care. The ACOG recommends that sometime between the ages of thirteen and fifteen, young women can benefit from having their first gynecological exam if they haven’t yet had one. Depending on a young woman’s personal health needs, this first visit may only include conversation about menstruation and pubertal changes. The visit may simply help to get her comfortable with her gynecologist and the idea of a future gynecological exam. Then again, if she’s sexually active or experiences various symptoms, her healthcare provider may recommend a pelvic exam. Current ACOG recommendations don’t indicate Pap tests for young women until they are at least twenty-one.

V-PROBLEMS YOU NEED TO KNOW ABOUT

Vulvas and vaginas can be affected by a number of health conditions; some of these produce noticeable symptoms and others do not. Although we’ve mentioned most of these conditions, we want to briefly highlight them here (for more detailed information about vulvovaginal health and medical conditions, we recommend checking out
The V Book
and, of course, speaking with your healthcare provider).
¹

Although yeast, or
candida albicans
(the scientific name for a common type of yeast), are normally found even in healthy vaginas, over-growth of yeast can cause uncomfortable or even painful symptoms for women. As we mentioned earlier, if you suspect you have a
yeast infection
, we recommend checking in with a healthcare provider by telephone or in person for advice before treating yourself with over-the-counter medications, which can sometimes cause more harm than good.

Bacterial infections
and imbalances of the vagina are common reasons why women visit their healthcare providers. Most are easily treatable. However,
bacterial vaginosis
(BV)—a condition in which the normal, healthy balance of the vagina is disrupted and certain bacteria seem to overgrow—is one condition that remains a challenge for many women, their partners, and their healthcare providers. Although some women who have BV are easily treated and never seem to experience a recurrence of their symptoms, other women have recurrent episodes of BV. Common symptoms of BV include itching, pain, burning, vaginal discharge, and genital odor (sometimes the odor is strongest after intercourse). According to the Centers for Disease Control and Prevention (CDC), BV is the most common vaginal infection among women who are of childbearing age.
¹⁶
Women who struggle with recurrent BV may be best helped by meeting with a vulvovaginal specialist who focuses on infections like BV (find one through issvd.org).

Genital warts
are caused by certain strains of the human papillomavirus (HPV). They are usually small and painless. Some healthcare providers recommend a “wait and see” approach to genital warts, as they often do not cause discomfort and frequently go away on their own. Other times, treatment (which can include the use of a topical cream) is recommended. If you have been diagnosed with genital warts, ask your healthcare provider for his or her recommendation. As part of monthly vulvar self-examination, check on the status of your warts: if they increase in number or size, bring this to the attention of your healthcare provider. Don’t be afraid to ask your healthcare provider for their thoughts on biopsying the warts to make sure they are indeed warts and not something else. Also, Gardasil (an HPV vaccine) protects against two strains that cause many cases of genital warts.

Genital herpes
is caused by the herpes simplex virus and, like HPV, can be passed on during oral sex, vaginal sex, or anal sex. Genital herpes lesions can be very painful, perhaps particularly during the initial outbreak. Fortunately, antiviral medications are available that can reduce the frequency and severity of outbreaks.

Vulvodynia
is a term that, according to the National Vulvodynia Association, refers to “chronic vulvar pain without an identifiable cause.” Women may experience pain that’s limited to the vulvar vestibule, which is the area around the vaginal opening. This type has been called
vulvar vestibulitis syndrome
or
localized or provoked vulvodynia
. A second type is called
generalized vulvodynia
and refers to pain at other parts of the vulva, such as the clitoris, labia, and/or vestibule. Women with vulvodynia may experience nearly constant pain or sporadic pain. Other conditions such as allergies, STIs, and genital skin disorders typically need to be ruled out before a diagnosis of vulvodynia is given. Unfortunately, women with vulvodynia often see a number of healthcare providers before receiving a diagnosis.

My experiences with vulvar vestibulitis have really influenced my feelings towards my genitals. I could either choose to be ashamed about this and feel bad about myself for not enjoying vaginal penetration, or I can accept that’s how my genitals are and work with alternative forms of sexual expression while working on exercises to help me relax my vestibule muscles (such as biofeedback).

—
A
LANA,
22, Indiana

There are also a number of skin disorders that can affect a woman’s genitals. One of these is a condition called
lichen sclerosus
(LS), which can affect women (and men) of all ages and can also affect nongenital skin. Women with LS often have white areas of skin on their genitals and may experience genital itching. With treatment (which often consists of topical creams), LS symptoms can often be managed. If a woman does not receive treatment, her vulvar skin may become more fragile and easily torn, and vaginal penetration and intercourse may become uncomfortable or painful.

Although not a v-problem per se, being
hypersensitive or allergic to semen
can certainly affect women’s vulvas and vaginas (as well as have other health effects). If you experience genital irritation, burning, itching, or pain following unprotected intercourse with a man, or other forms of contact with his semen, try having sex with a condom the next time. If you don’t have similar reactions, you might want to ask your healthcare provider about the possibility that you have a seminal allergy or sensitivity. Although rare, some women have severe allergic reactions to semen. Certainly, if you notice any health concerns during or after sex with a partner (such as difficulty swallowing or breathing, or breaking out in hives) seek emergency medical care. This is a relatively new area of research, so semen allergies are not well understood. Some women appear to be allergic to the semen of any man they have sex with; others seem to be allergic to the semen of only a particular man. Still, other women who have never experienced any reactions to men’s semen suddenly develop sensitivities or allergies following a hormonal change, such as giving birth or going through menopause.

Finally, although rare, it is possible for women to develop cancer on their genitals. Early signs of
vulvar cancer
(spelled “vulval cancer” in the United Kingdom and Australia, among other countries) can include chronic itching as well as lumps or bumps on the genitals. This is challenging, as many non-cancerous conditions have similar symptoms. With early detection and treatment, vulvar cancer has a high survival rate. Performing vulvar self-examination can aid in the early detection of vulvar cancer and other conditions, such as
vulvar intraepithelial neoplasia
(VIN, considered a pre-cancerous condition of the vulva). Both vulvar cancer and VIN are linked to HPV. Cigarette smoking also appears to increase the risk of vulvar cancer and VIN. Although vulvar cancer and VIN used to be more often considered conditions of older women, an increasing number of young women have been diagnosed with vulvar cancer and VIN over the past decade.

INTERVIEW WITH KATH MAZZELLA, FOUNDER OF THE GYNAECOLOGICAL AWARENESS INFORMATION NETWORK

Can you tell us a bit about your background and how this work became so important to you?

With a strong family history of cancer, I had an abnormal Pap smear at the age of thirty-nine and eighteen months later, a lump appeared next to my clitoris. Over two years, I consulted two general practitioners and two gynaecologists who said it was common to have lumps in the vulva. I requested for the lump to be removed, which when biopsied was indeed cancer, and the removal of my clitoris, vulva, and lymph glands immediately followed. I was completely unprepared for what I faced personally and in society. The sadness was (is) so indescribable. Women in general are so unsuspecting and uninformed. I felt I had died as a woman and was now just an “it.” In general, I discovered there was a shroud of secrecy and a willingness to suffer in silence with women. In my search for answers, I found the word pudendum (Latin, meaning
female genitalia; one who should and ought to be ashamed; the shameful part of a woman
). Then I noticed women were being taught that the vulva was a vagina and still most think this is so, keeping the pudendum mindset alive. Most viewed the vulva as pornographic and not as an incredible part of our anatomy. What does this say about women when we don’t call our genitalia the correct terminology?

How did you form GAIN?

I met two other women who had radical vulvectomies, and being so isolated, mostly from women in a world that did not speak about “down there” or anything “gynae,” I placed an advertisement in a woman’s magazine. The replies of the women who wanted to pour their hearts out after years and years of suppression and suffering moved me, and I decided I had to find a way to stop this suppression. I noticed the advice being given was mostly from men—I saw a quote by a male gynaecologist—“What women won’t talk about.” I gathered my mother, my sisters, and my friends to help me work out how to form a support group for those too anxious to speak up after enduring such devastation.