Our Bodies, Ourselves

Judy Norsigian

• Publisher: Atria Books
• Year: 2011
• ISBN:
  9781439196656
• Topic: Medizin
• Subtopic: Allgemeine Gesundheit

THE BESTSELLING WOMEN'S HEALTH CLASSIC—INFORMING AND INSPIRING WOMEN ACROSS GENERATIONS Hailed by The New York Times as a "feminist classic, " this comprehensive guide to all aspects of women's sexuality and reproductive health—including menopause, birth control, childbirth, sexual health, sexual orientation, gender identity, mental health, and overall wellbeing—changed the women's health movement around the world and remains as important and relevant as ever. Providing detailed and empowering information on women's reproductive health and sexuality, this latest edition of Our Bodies, Ourselves shows how to find and access health information and offers additional resources and stories to educate women about health care injustices and inspires them to work collectively to address them. Including the latest vital information on: -Changes in the health care system—especially how health care reform affects women and how to get the care you need. -Safer sex—how to engage in pleasurable, satisfying sexual experiences while protecting your health and the health of your partner. -Environmental health risks—including minimizing exposure to everyday pollutants that endanger reproductive health. -Body image—resisting negative media stereotypes and embracing healthier approaches to looking and feeling good. -Local and global activism—using social media and organizing tactics to build community and advocate for policies that improve women's lives. -As well as crucial information about gender identity, sexual orientation, birth control, abortion, pregnancy and birth, perimenopause, and sexuality and sexual health as we age. Together with its companion website, OurBodiesOurselves.org, Our Bodies, Ourselves is a one-stop resource that belongs on the bookshelves of women of all ages.

Bodies and Identities

CHAPTER 1 Our Female Bodies: Sexual Anatomy, Reproduction, and the Menstrual Cycle

Learning about our sexual anatomy and observing and exploring our bodies are good ways to become more comfortable with ourselves and our sexuality. These are also good ways to learn what is normal for each of us and to become aware of changes and potential problems. Understanding the way our sexual and reproductive systems work, how they interact with other body functions, and how they are influenced by our lifestyle, environment, and general well-being can help us enhance sexual pleasure, reduce the risk of some health problems, and make informed reproductive decisions.

We are often far less familiar with the appearance and function of our sexual and reproductive organs than we are with other parts of our bodies. This chapter aims to change this. The first part discusses female sexual anatomy, including reproductive and sexual organs both inside and outside the body.* It names the body parts and explains where they are and what they do.

The second part of the chapter covers menstruation and fertility awareness. It explains how the menstrual cycle works; the commonalities, differences, and variations in women’s cycles; and the physical and emotional changes some women experience. It also addresses how reproduction occurs.

SEXUAL AND REPRODUCTIVE ORGANS: ANATOMY (STRUCTURE) AND PHYSIOLOGY (FUNCTION)

The following descriptions will be much clearer if you look at your genitals with a hand mirror while you read the text and look at the diagrams. Make sure you have enough time and privacy to feel relaxed. Try squatting on the floor and putting the mirror between your feet. If you are uncomfortable in that position, sit as far forward on the edge of a chair as you comfortably can, separate your legs, and put the mirror between them. If you’re having a hard time seeing, try aiming a flashlight at your genitals or at the mirror.

The appearance, shape, and size of genitals vary from person to person as much as the shape and size of other body parts. There is a wide range of what is considered normal. By observing your own body, you will learn what is normal for you.

First, you will see your vulva—all the female external organs you can see outside your body. The vulva includes the mons pubis (Latin for “pubic mound”), labia majora (outer lips), labia minora (inner lips), clitoris, and the external openings of the urethra and vagina. People often confuse the vulva with the vagina. The vagina, also known as the birth canal, is on the inside of your body. Only the opening of the vagina (introitus) can be seen from the outside.

Unless you shave or wax around your vulva, the most obvious feature you will see is the pubic hair, the first wisps of which are one of the early signs of puberty. After menopause, the hair thins out. Pubic hair covers the soft fatty tissue called the mons (also mons veneris, mound of Venus, or mons pubis).† The mons lies over the pubic symphysis. This is the joint of the pubic bones, which are part of the pelvis, or hip girdle. You can feel the pubic bones beneath the mons pubis.

As you spread your legs, you can see in the mirror that the hair continues between your legs and probably around your anus. The anus is the outside opening of the rectum (the end of the large intestine, or colon).

The fatty tissue of the mons pubis also continues between your legs to form two labia majora, the outer lips of the vulva. You can feel that the hair-covered labia majora are also fatty, like the mons. The size and appearance of the labia majora differ considerably among women. In some, the skin of the outer lips is darker. The labia majora surround the labia minora (the inner lips of the vulva). The labia minora are hairless and very sensitive to touch.

As you gently spread apart the inner lips, you can see that they protect a delicate area between them. This is the vestibule. Look more closely at it. Starting from the front, right below the mons you will see the inner lips joining to form a soft fold of skin, or hood, over and covering the glans, or tip of the clitoris. Gently pull up the hood to see the glans. The glans is the spot most sensitive to sexual stimulation. Many people confuse the glans with the entire clitoris, but it is simply the most visible part. Let the hood slide back, and extending from the hood up to the pubic symphysis, you can now feel a hardish, rubbery, movable rod right under the skin. It is sometimes sexually stimulating when touched. This is the body or shaft of the clitoris. It is connected to the bone by a suspensory ligament. You cannot feel this ligament or the next few organs described, but they are all important in sexual arousal and orgasm.

© Casserine Toussaint

THE VULVA

At the point where you no longer feel the shaft of the clitoris, it divides into two parts, spreading out wishbone fashion but at a much wider angle, to form the crura (singular: crus), the two anchoring wing tips of erectile tissue that attach to the pelvic bones. The crura of the clitoris are about 3 inches long. Starting from where the shaft and crura meet, and continuing down along the sides of the vestibule, are two bundles of erectile tissue called the bulbs of the vestibule.

The bulbs, along with the whole clitoris (glans, shaft, crura), become firm and filled with blood during sexual arousal, as do the walls of the vagina. Both the crura of the clitoris and the bulbs of the vestibule are covered in muscle tissue. This muscle helps to create tension and fullness during arousal and contracts during orgasm, playing an important role in the involuntary spasms felt at that time. The clitoris and vestibular bulbs are the only organs in the body solely for sexual sensation and arousal.

© Casserine Toussaint

DETAILS OF THE CLITORIS

(Dotted lines indicate areas inside the body.)

The clitoris is similar in origin and function to the penis. All female and male organs, including sexual and reproductive organs, are developed from the same embryonic tissue. In fact, female and male fetuses are identical during the first six weeks of development. The glans of the clitoris corresponds to the glans of the penis, and the labia majora correspond to the scrotum.

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In some cultures, there is a practice of female genital cutting—removing a girl’s clitoris and sometimes even sewing the labia together. For more information, see “Female Genital Cutting.”

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The Bartholin’s glands are two small rounded bodies on either side of the vaginal opening near the bottom of the vestibule. They secrete a small amount of fluid during arousal. Usually you cannot see or feel them.

If you keep the inner lips spread and pull the hood of the clitoris back again, you will notice that the inner lips attach to the underside of the clitoris. Right below this attachment you will see a small dot or slit. This is the urinary opening, the outer opening of the urethra, a short (about an inch and a half), thin tube leading to your bladder. Below the opening of the urethra is the vaginal opening (introitus).

Around the vaginal opening you may be able to see the remains of the hymen, also known as the vaginal corona. This is a thin membrane just inside the vaginal opening, partially blocking the opening but almost never covering it completely. Vaginal coronas come in widely varying sizes and shapes. For most women they stretch easily—by a tampon, as well as a finger, a penis, or a dildo. Even after the hymen has been stretched, little folds of tissue remain.

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VAGINAL CORONA (OR WHAT YOU MAY KNOW AS THE HYMEN)*

© Nina Reimer

The vaginal corona—generally known as the hymen but renamed by a Swedish sexual rights group in an attempt to dispel many of the myths surrounding hymens—is made up of thin, elastic folds of mucous membrane located just inside the entrance to the vagina. The vaginal corona has no known function; it is probably a remnant of fetal development.

Many people wrongly believe that the vaginal corona is a thick membrane that entirely covers a woman’s vaginal opening and ruptures when you have intercourse or any kind of insertive vaginal sex the first time. The myth goes like this: If a bride doesn’t bleed from a ruptured hymen on her wedding night, this means that she has had sex and isn’t a “virgin.” This is not true.

* Content is adapted from The Vaginal Corona, a booklet created by the Swedish Association for Sexuality Education, rfsu.se/en/Engelska/Sex-and-Politics/Hymen-renamed-vaginal-corona.

The mucous membrane that makes up the vaginal corona may be tightly or more loosely folded. It may be slightly pink, almost transparent, but if it is thicker it may look a little paler or whitish. The vaginal corona may resemble the petals of a flower, or it may look like a jigsaw piece or a half-moon. It may be insignificant or even completely absent at birth.

The vaginal corona may tear or thin out during exercise, masturbation, tampon use, or any other form of vaginal penetration. Because of this, no one can look at a woman’s vaginal corona and know whether she has had vaginal intercourse, or even whether she has masturbated.

In rare cases, the hymen covers the entire vaginal opening. This is called an imperforate or microperforate hymen. Young women with an imperforate hymen will experience monthly cramping and discomfort without the appearance of menstrual blood. In these cases, the hymen can be surgically opened to release accumulated menstrual fluid and to permit tampon insertion or other forms of vaginal penetration. More commonly, a hymen band may be present across the vaginal opening, allowing menstruation but preventing tampon insertion. If the opening is very small or partially obstructed, minor surgery can correct this.

Since the vaginal corona isn’t a brittle membrane, the sensation when you first stretch out the mucous tissue folds—whether you’re inserting a tampon, masturbating, or having insertive sex—is a highly individual experience. Some women feel no pain at all, while others, with a thicker or more extensive vaginal corona, have some pain. There may be minor tears in the mucous folds that hurt, and sometimes there may be a little bleeding.

The Swedish Association for Sexuality Education (RFSU), the sexual rights group that coined the term vaginal corona, notes, “The mythical status of the hymen has caused far too much harm for far too long,” and the hymen has wrongly been “portrayed as the boundary between guilt and innocence.”1 For more information, see “Virginity.”

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If you’re comfortable doing so, slowly put a finger or two inside your vagina. If it hurts or you have trouble, take a deep breath and relax. You may be pushing at an awkward angle, your vagina may be dry, or you may be unconsciously tensing the muscles owing to fear of discomfort. Try shifting positions and using a lubricant such as olive or almond oil (not perfumed body lotion). Notice how the vaginal walls, which were touching each other, spread around your fingers and hug them. Feel the soft folds of mucous membrane. These folds allow the vagina to stretch and to mold itself around what might be inside it: fingers, a tampon, a penis, or a baby during childbirth.

© Hazel Hankin

The walls of the vagina may vary from almost dry to very wet. Some women naturally have wetter or drier vaginas. Wetness increases with sexual arousal. How wet your vagina is also changes during different parts of your menstrual cycle and over your lifetime. The vagina is likely to be drier before puberty, during breastfeeding, and after menopause, as well as during that part of the menstrual cycle right before and after the flow. Wetter times occur around ovulation, during pregnancy, and during sexual arousal.

Push gently all around against the walls of the vagina and notice where the walls feel particularly sensitive to touch. For some women this sensitivity occurs only in the area closest to the vaginal opening; in others it occurs in most or all of the vagina. About a third of the way up from the vaginal opening, on the anterior (front) wall of the vagina (the side toward your abdomen), is an area known as the Gräfenberg spot, or G-spot. Many women experience intensely pleasurable sensations when this area is stimulated. There are differences of opinion over whether the G-spot is a distinct anatomical structure or whether the pleasure some women feel when the area is stimulated is due to its closeness to the bulbs of the clitoris. (For more information, see “The G-Spot.”)

Now put your finger halfway in and try to grip your finger with your vagina. You are contracting the pelvic floor muscles. These muscles hold the pelvic organs in place and provide support for your other organs all the way up to your diaphragm, which is stretched across the bottom of your rib cage. Some women do Kegel exercises to strengthen the pelvic floor muscles (to learn more, see “How to Do Kegel E...