Read My Lips (7 page)

TEST YOUR VQ

1. The inside branches of the clitoris are called

a. crura

b. cure-alls

c. cumulus

d. coochies

2. The five vaginal shapes are the heart, parallel sides, conical, pumpkin seed, and the

a. cat

b. tiger

c. bee

d. slug

3. During sexual arousal, a woman’s vagina may increase in size due to a process called

a. vaginal camping

b. vaginal tenting

c. vaginal awesomeness

d. vaginal carousing

Answers

1. a

2. d

3. b

• 2 •

A Healthy, Happy Vulva

Taking Care Down There

As children, we learn how to care for our bodies. We learn that exercise is good for our bones, our muscles, and our hearts. Eating fruits and vegetables is good for our bodies as a whole, as they deliver important vitamins and minerals. We also learn about good hygiene: for example, we learn not to pick our nose (at least in public) and that washing hands can prevent colds. And, over time, we learn what’s normal about our bodies and what’s not. We learn that waking up with sleep in our eyes is a common, healthy occurrence (our eyes need a way to clean themselves out). But we also learn that constant runny noses or coughs are often a sign that we’re sick and may need to go to the doctor. We learn these things from our parents and our teachers; perhaps you remember talking about “food groups” in kindergarten or in an elementary school health class. Your physical education teacher may have encouraged you to try running or walking for exercise or to find a sport that you enjoy or are good at. Growing up, we had numerous ways to learn how to care for our bodies and our health.

Curiously, girls and young women learn little about how to care for their genitals beyond the basic potty-training rules of wiping and then washing one’s hands. Can you imagine if we women learned information about how to care for our vulvas and vaginas? What if our parents, sisters, or teachers shared information about healthy genital care with girls and young women? What if we could share this information out in the open as if it were just as important as other kinds of health information?

All too often, when girls or women learn how to care for their vulvas and vaginas, it’s done with shades of secrecy or taboo. Fifth- and sixth-grade girls are frequently separated from the boys so that they can watch a video about periods and how babies are made (the boys may be outside playing sports or in another room, learning about their own pubertal development). Although there may be some benefits to girls and boys being separated so that they can learn about their sex-specific parts, there may also be some benefit in bringing them together that day, or on another day, to talk and learn about these topics together as a group. After all, boys and girls could benefit from talking with each other about the changes they’ll be experiencing over the next few years. Both sexes could learn to talk with respect and compassion about otherwise mysterious topics such as menstruation and erections.

9 REASONS TO LOVE YOUR VULVA AND VAGINA

1. It makes it easier to use non-applicator tampons.
   
2. It makes it easier to use birth-control methods like diaphragms and NuvaRing.
   
3. It might make you feel more comfortable filming your own birth experience video, should you give birth one day.
   
4. You may be more comfortable talking with your healthcare provider about your genital health.
   
5. You may be more open to receiving cunnilingus. Or just plain into it.
   
6. It could enhance your masturbation to watch yourself in the mirror.
   
7. Your vagina and vulva will be with you forever, so you may as well make friends.
   
8. The vagina can be warm and wet to touch, which can feel good.
   
9. During a self-exam in front of a mirror, it can be fun to make your vulva “talk” by squishing the labia together.
   

There should be no shame in learning about vulvar and vaginal health. After all, everyone with a vulva and vagina probably wants them to be healthy. Here in this chapter, we’ll identify health challenges faced by vulvas and vaginas worldwide and identify key steps that you can take—starting today—toward vulvar and vaginal wellness. That said, we only have room enough to devote one chapter to vulvar and vaginal health issues, so you should consider this a brief overview rather than everything you will ever need to know about genital health. For more extensive information about genital-health issues, we recommend reading
The V Book
¹
(see Resources).

WHAT WE’RE MADE OF

The vulva is a highly sensitive area of women’s bodies. Men’s genitals are almost completely covered in skin. This skin acts as a protective barrier to the outside world against common irritants and other things that could otherwise harm the genitals. The only opening that men have on their penis is the urethral opening (through which they urinate and ejaculate), and it’s a pretty small opening, so not much is going to get through it.

Women, however, have the urethral opening and the vaginal opening, with the latter being significantly larger than the tiny little urethral opening. As such, we’re more exposed to the outside world and its many irritants. Also, the vulvar skin is more sensitive and vulnerable to irritation than men’s genital skin, so it can be helpful to learn the best way to care for our genital parts. Because genitals and sexual health are such taboo topics in many cultures, many girls and young women don’t receive accurate information about how to care for their vulvas and vaginas. It’s not necessarily the fault of their mothers, aunts, or grandmothers—after all, many women in older generations never learned much about how to care for their genitals, either. We hope to change that. We hope to give you enough information about how to care for your vulva and vagina so that you feel confident about caring for yourself and sharing this information with your girlfriends as well as with your mom, sister, daughter, niece, grandmother, or neighbor. Even if you don’t want to have explicit conversations with friends or family members about v-parts, you can always recommend this or other vulva/vagina-friendly books to them.

VULVA SELF-EXAMINATION: HOW TO CHECK YOURSELF OUT DOWN THERE

One of the simplest and most important ways that you can care for your vulva is to get to know it well. Just as you can care for your skin by checking for suspicious moles or other indications of skin cancer, you can care for your vulva by looking at it about once each month as part of a vulvar self-examination (VSE).
What you will need:

• A well-lit room (if the room’s not brightly lit, a flashlight will help)
  
• A mirror (a self-standing mirror, or one you can lean against the wall, may save you from inverting into some awkward positions)
  
• Self-love and an open-mind
  

Here’s how:

1. Find at least ten minutes of time when you’re unlikely to be interrupted by children, roommates, a partner, the doorbell, or your favorite TV show that’s about to come on.
   
2. In a well-lit room, find a comfortable position in front of your mirror. The angle that you sit at will change the way your vulva appears, so make sure it is a position in which you feel comfortable sitting and exploring. For many women, sitting up on the bed or against a wall with a pillow behind one’s back for comfort or support is a helpful position for VSE.
   
3. Open your legs enough so that you can clearly see all of your vulva parts.
   
4. Starting at the top of your genitals (the mons pubis), look at and touch each of your genital parts: the mons, clitoral hood, glans clitoris, labia majora, inner labia, the area around the vaginal entrance, and the perineum. If you are able to view the perianal area (the area around your anus), look at and touch this area as well. Run your fingers through any hair-covered areas so that you can see the skin beneath the hair.
   
5. Notice what looks and feels normal for you. When you examine your genitals each month, look for any areas that appear to have become darker or lighter, red, itchy, or painful. If you notice any genital changes, discomfort, pain, or new lumps or bumps, ask your healthcare provider about these changes. Chronic itching is also a symptom that should always be brought to the attention of one’s healthcare provider.
   

By performing monthly VSE, you can become familiar with what is normal for your own personal genitals. As every woman is different, this can be an important part of noticing changes that may be related to sexually transmissible infections (such as genital warts), benign skin conditions (such as lichen sclerosus, a skin condition that is often marked by white patches of genital skin), or vulvar cancer that, though rare, has a high survival rate when caught and treated in an early stage. If the size of your genital parts changes, this too is something that you should share with your healthcare provider. Although it’s common, for example, for the clitoris to temporarily increase in size when a woman is feeling sexually aroused or after she has just had sex, it is not normal for an adult woman’s clitoris to grow substantially bigger (unless she is taking testosterone). In some cases, an enlarged clitoris is a sign of cancer, such as ovarian cancer or adrenal cancer, so it should always be brought to the attention of one’s healthcare provider at the earliest opportunity. Or to put it more simply: if your clitoris looks bigger, let your healthcare provider know. Although there are benign reasons for your clitoris to get bigger that have nothing to do with cancer, these are indeed things that should be ruled out. By becoming familiar with your personal “normal” in terms of the shapes, sizes, coloration, and feel of your vulvar parts, you will be better situated to take care of your health and well being.

I really resent that I’m supposed to either fear or love my genitals. They’re annoying and frustrating, and I don’t feel it’s necessary to have strong feelings either way. I am not a bad feminist because I don’t love my genitals.

—
J
AIME
, MtF (no surgery), 24, Massachusetts

VULVA AND VAGINA SELF-CARE

Caring for your genital parts involves learning how to tweak some of our most basic daily activities in vulva- and vagina-friendly ways. Here are some tips related to basic hygiene and self-care that can help your lady parts stay happy and healthy.

Wiping

As a child or teenager, you may have been taught to wipe from front to back (the front being toward your clitoris and the back being the anus). Such directions are meant to keep bacteria from the anal opening away from the vagina, as the vagina can be quite sensitive. Generally speaking, it’s good advice to wipe from front to back for this reason.

As for what to wipe with, most healthcare providers recommend using regular, unfragranced toilet paper rather than moist wipes (such as those intended for cleaning babies during a diaper change). Moist wipes may have chemicals in them that can irritate the vulvar skin or leave the genitals wet for longer than they need to be. If you prefer to use a moist wipe (some women keep these at home and/or carry these in their purses for wiping when using public bathrooms), ask your healthcare provider to recommend a brand that is unlikely to cause genital irritation when used regularly. Finally, some women use a water bidet to clean after using the bathroom. Patting oneself dry afterward with toilet paper can be helpful, as keeping the genitals wet for too long can cause irritation.

Vaginal Discharge

The uterus, cervix, and vagina produce natural discharge that comes out of the vagina. This is generally called “vaginal discharge” even though the fluids coming out may be coming from the vaginal walls, cervix, or uterus. This is one way in which women’s bodies clean themselves. Vaginal discharge is completely natural, and it often changes appearance throughout a woman’s menstrual cycle. It may be clear, milky white, or have a slight yellow tinge to it. Sometimes it seems clear and thin. Other times, women notice that their discharge is more clumpy, possibly even leaving little clear or white clumps in their underwear or on the pubic hair closest to their vaginal opening. It’s also not uncommon to notice white or light yellow stains on one’s underwear. Darker yellow or green discharge or stains may indicate an infection and should be brought to the attention of one’s healthcare provider.

If you find that your body produces excessive discharge, we recommend asking your healthcare provider about it. He or she can test you for vaginal infections, including sexually transmissible infections (STIs) that can cause increases in vaginal discharge. After all, some STIs don’t have many noticeable symptoms. One woman that Debby knows of noticed that she was experiencing more vaginal wetness than usual, which she attributed to being highly sexually aroused, or horny. When she learned that she had gonorrhea, she was surprised, but it all made sense. This isn’t to say that vaginal wetness is always a bad thing (it’s not) or that it’s never a sign of arousal (often, it is) but if you experience vaginal discharge that is unusual in some way for you, please do bring it to the attention of a healthcare provider. Try to avoid using pantyliners, pads, tampons, or other menstrual products as a way to keep vaginal discharge in check. Menstrual products are only intended for use during a woman’s period (i.e., on the days that she is bleeding). Wearing pads or pantyliners too often can irritate the vulva, especially if the pads or pantyliners are fragranced. And wearing tampons on non-period days can make the vagina feel drier and cause irritation as well, so save your period products for your period days! Your body and your wallet will thank you.