Dealing with Your Period: Damming the Crimson Tide

Sorry for not posting last week. I was feeling really shitty and just needed to take a sick day from life.  I don't know if I've mentioned this or not, but my husband and I recently moved from San Francisco to Portland, 600 miles from my whole family.  It's been hard, and while PDX is starting to feel more homey, I still miss the Bay Area and all the people there a lot.

Also I'm beginning to think that this whole once-a-week update thing isn't quite working for me.  Sometimes I'll run across something interesting and think, "Hey, I should put that on the Vagina Blog," and then come Friday I'll have totes forgotten about it.  So I'm going to try being more spontaneous with posting - keep doing at least one planned post a week but also have articles and videos and stuff in between as I find them.

Moving on. I posted recently about the mechanics of getting your period.  Now we're going to spend some time talking about what the hell you can do about it, starting with "feminine hygiene products," aka things you put in or near your vagina to keep you from ruining your cute new jeans.

Pads!

He is just so excited about all this.

Pads (aka maxi pads or sanitary napkins, which is a terrible association IMHO) are probably the first period product any of us uses.  They're these oblong sheets of cotton or similarly absorbent material, lined with plastic on the bottom and a bit of adhesive strip.  You stick them on your underwear and they absorb menstrual blood as it seeps out of your body.  Some of them, like our cheerful friend up there, have little "wings" that wrap around the edges of your undies to help prevent leaking over the side. Others have little channels or grooves around the perimeter that help redirect fluid to the center and away from the edges.

Pros:

• Super easy to use. Just stick 'em on and go.
• Good for people who have cramps.
• No risk of TSS (we'll get to that in a second).
• Tons of sizes and styles available.

Cons:

• Can sometimes feel like you're wearing a diaper, and they can show in tight clothing.
• Bulky to carry around.
• Prone to leaking over the edges.
• Hard to play sports or be active while wearing them. You definitely can't swim.
• Not useable if you wear thong or g-string underwear.
• Sometimes they smell, and since you can't flush them, that smell lingers around the trashcan where you dispose of them.

Tampons!

I have never been this cute while covered in blood.

When I discovered tampons as a teenager, it was incredibly liberating. Personally, I hated the feeling of wearing a pad, being all paranoid that someone would point it out, and worrying that it would leak (because at Catholic school, we wore skirts, and that would have been AWFUL).  Tampons are these little cylinders of cotton or other absorbent material that you stick up you vagina where they absorb menstrual fluid as it comes out of your cervix.  Tampons can be inserted directly or with the aid of an applicator (either plastic or cardboard, both very common in the US). Most of them have a little string on the bottom to help with pulling it out.  

Pros:

• When properly inserted, they're practically impossible to feel. And there is no way for someone else to tell you're using one.
• You can swim with one in, and they won't come loose during exercise or other vigorous activity.
• Unlike pads, tampons are flushable (though that's not recommended if you have older pipes). NEVER FLUSH A PLASTIC APPLICATOR. Those things need to be thrown into a trashcan.

Cons:

• There's a bit of a learning curve as you get used to using them.  Some women with smaller vaginal openings, or those with atypical hymens, can find them difficult if not impossible to insert.  Some women are also just uncomfortable "shoving something up there".
• You can't tell when it's "full" just by looking at it, as you can with a pad.
• Can be uncomfortable upon insertion, removal, or while using.  
• There is a very small risk of developing TSS or toxic shock syndrome from leaving a tampon in too long. TSS occurs when certain forms of Staphylococcus bacteria release toxins into the body, causing fever, rash, vomiting, and diarrhea.  It's estimated that only 3-4 out of every 100,000 tampons users will suffer from TSS in a given year, so the odds are very slim.

Menstrual Cups

A beautiful rainbow of things you cram up your vag.

"What's that?" I hear you say, "A third option?"  Yep.  Menstrual cups are becoming more and more common in Europe but haven't made much headway in the US, but they're a great alternative to tampons and pads.  Menstrual cups are silicon or latex cups that you insert into your vagina, over your cervix, where they catch menstrual fluid as it comes out.  They don't absorb anything, just hold it, and need to be removed, rinsed, and reinserted very 12 hours or so.

Pros:

• Nothing to throw away! A menstrual cup can last up to 10 years if taken care of properly, and there are disposable versions that are designed so you only need one for your whole period.  So not only are you not cluttering your trashcan with smelly pads or clogging your pipes with tampons, you're also keeping tons of waste out of landfills each year.
• Because they're reusable, you don't have to buy new ones every month, saving you money in the long run.  Even disposable, single-cycle cups are generally cheaper than a box of tampons or pads.
• They have a great capacity than pads or tampons and, as mentioned above, only need to be removed every 12 hours (as opposed to 6-8 for pads or tampons).
• In addition to absorbing menstrual fluid, tampons also absorb all the healthy natural lubrication that your vagina produces, and can leave you feeling dry and irritated. Cups don't absorb anything, they just collect menstrual fluid, so your vag is free to lubricate and self-clean as normal.

Cons:

• Menstrual cups are more expensive upfront than a box of tampons or pads.  While they will pay for themselves over time, the initial investment can feel like a lot of money.
• There's a much bigger learning curve compared to tampons or pads, and some women have a lot of difficulty inserting or removing a cup.  Using a different size or brand, or using a lubricant for insertion, can help with this but there's always a chance you just won't be able to / comfortable with using one.
• I don't meant to scare you, but I've read stories where a girl just freaking could NOT get her cup out and had to go the ER.  It happens.
• It can take some time to get used to wearing one, as they feel different from tampons.  You shouldn't really be able to feel it if it's inserted properly, but sometimes you just can.  Most menstrual cups have a little pull stick on the bottom to help get it out, and trimming this down (or getting on that has a ball or a ring on the bottom instead) can help make it more comfortable.
• "The Squick Factor." Using a menstrual cups means you get pretty up close and personal with your vagina and with your menstrual fluid.  Getting the cup in and out can require some rooting around inside yourself, which not everyone is comfortable with. You also have to empty and rinse the cup every 12 hours, which means coming in direct contact with the blood and tissue that comes out of your body during your period.  Some of us just get grossed out by it. Oh well.
• Can be hard to find, especially in the US. We're a "disposable economy", preferring to use and then throw away rather than clean and reuse.  For this reason it's often tough to find menstrual cups, though  I've seen them at places like Fred Meyer and Trader Joe's. MenstrualCup.co is a great resource for researching which cup might be right for you, and they ship all over the world.

No matter what type of "feminine hygiene product" you choose to use, ALWAYS HAVE BACKUP. Carry extra pads, panty liners (which are like mini pads, more comfortable but less absorbent), and/or tampons in your purse or bag or backpack, because you never know when you're going to have a leak.  If you choose to use a cup, carry tampons or pantyliners anyway as you get used to it, just in case you need them.  I recommend actually having a backup in every purse or bag you carry with you regularly, because there is nothing worse than your period starting unexpectedly, or springing a leak, and being trapped in the bathroom without any. Making a tampon out of toilet paper sucks.

On that note, carry extras also means you can help out someone else who gets stranded with an unexpected feminine emergency (femergency, if you will).  We've all been there, so help a sister out.

The Hymen and the Virginity Stigma

My post this week was originally going to be about menstrual products - pads, tampons, etc - and their pros and cons and use, but that's going to get pushed back a week because I received a comment on the hymen post that really made my blood boil.  Someone who I really really hope was a spambot left a link to a website selling a "virginity restoration kit," claiming to repair the hymen and restore a woman's virginity so that her "shameful little secret" wouldn't come to light on her wedding night (I've since deleted the comment).

There is so much wrong with this product that I hardly know where to begin.

First of all, I'm picturing something like a bicycle tire repair kit - superglue and patches of vinyl... Which is ridiculous because, as we discussed, the hymen isn't a wall of tissue. It's a stretchy corona of mucus tissue.  The hymen doesn't pop like a punctured tire, letting all that precious virginity leak out.  It gets slowly eroded away through hormone exposure and the movement of daily life, like a cliff on the sea getting worn away by waves.  Inexorable, gradual, and irreversible.

There are definitely surgeons out there who are willing to do a "hymen repair surgery," which involves stitching worn sections of the hymen back together. The thing is, most of these surgeons will readily admit that the stitches fall out, often before the patient even gets to the parking lot because it's "like stitching through butter."  Most women who choose to have such a procedure do so because of religious or societal pressure to prove virginity by bleeding on the wedding night, something that only occurs in less than half of women during their first penetrative sex anyway.

Second of all, the hymen has absolutely nothing to do with virginity.  There is no way to look at woman's hymen and tell whether or not she has had penetrative sex, because again, THE HYMEN DOESN'T POP OR TEAR.  It's not like the safety seal on jar, with the little button that pops up to let you know it's been opened before.

And that's of course assuming an extremely heteronormative view of virginity - that is, one which regards male-and-female penis-in-vagina (PIV) sex as the only type of "real" sex.  What about oral sex? Anal sex? Gay and lesbian sex? Is a lesbian woman who has only ever engaged in sexual acts with women considered a virgin her entire life?  According to the definitions of this "virginity restoration kit", you could have anal sex with a hundred different partners, and engage is lesbian sex morning til night, and you'd still be a virgin.

Does that sound logical to you?  Maybe it does. I went to a Catholic high school, where peers drew very very fine distinctions between what was and what was not sex.  When we discussed anal sex in health class, some people said it was okay because "you're still a virgin."  Same with oral.  Isn't that the distinction that President Clinton made? Oral doesn't count? Well then what does count?  How can you define virginity so narrowly when the definition of sex can vary from person to person?

And what about non-consensual sex? If a girl's first experience with genital sex is rape, should she be shamed about not "being a virgin" any more?  Goddamn, that is some victim-blaming nonsense right there.

Thirdly, where is the male virginity restoration kit?  Shouldn't he be a virgin on the wedding night, too? We hear all this preaching about female virginity and "popping the cherry" (an incredibly misleading euphemism in itself) but where's the male equivalent?  Maybe we should come up with one right now, one that carries the same connotations of something irrevocably lost or broken.  Leave 'em in the comments.

And finally, all of this assumes that having premarital PIV sex is something horrible and shameful, enough that you should drop $29.99 + shipping and handling to shove some make believe up your hooha to keep your new hubby and his family from freaking out.  I have three words for you:

Sex.
Is.
Awesome.

Sex can be fun and hot and random, and it can be sweet and tender and beautiful, it can be rough or silly or awkward or mind-blowing or mediocre. It can be with a guy or a girl, or with multiple people.  It can be with someone you just met or someone you've known for years.  Sex can be vaginal or anal or oral or with fingers or toes or toys.  It can be kinky or vanilla. It can cause bone-shaking orgasm or just be kind of "meh." But there is one thing sex definitely is not, and that's shameful.

Virginity isn't physical, and it's nothing that can be proven by looking at party parts.  Virginity is a state of mind.

Girls ask things like, "If I use a tampon, am I still a virgin?" Well... have you engaged in any physical activity that you regard as sex? If not, then you're a virgin, regardless of what cotton contraption you use to stem the crimson tide.

They ask, "My boyfriend went down on me, am I still a virgin?" Well, do you consider oral sex to be virginity-losing sex? It's all up to you. If you decide that having oral sex means you're still a virgin, then guess what? You are.  Because everyone's definition of "real sex" is different, everyone's definition of virginity is different. Rather than saying you're a virgin or not, be honest with yourself and your partners about your sexual history.  Instead of, "I'm a virgin," say "I've never engaged in PIV sex" or "I've received oral sex but never given it" or whatever list of activities you have or haven't tried.

They ask, "My first time was disappointing, or I was raped, can I be a virgin again and have a do-over?" You can have as many do-overs as you like.  People make a huge deal about a girl losing her virginity, but all it means is that you've had a physical experience you've never had before.  No one talks about "losing your push-up virginity" the first time you do a push-up, or "popping your car cherry" the first time you drive a car. Nothing is lost or broken or destroyed, it's just different.

Ugh. My fingers are getting tired.  I'd like to talk about the whole societal and historical context for virginity, but that's going to have to wait for another day.  Perhaps a mid- or early-week post.  Goddamn spam bots, getting me all riled up.  I need a cocktail and some knitting, and it's not even one in the afternoon here.  For more on defining virginity, check out this awesome Scarleteen article, "Three on Virginity."

All about your period.

I've told my husband several times that menstruation is proof that God does exist, and He hates women.  It hurts, it's kinda gross*, and it makes some of us feel absolutely insane for about a week every month.

Seriously, this isn't fun.

Maybe not every girl feels that way about her period, but I do. Mother Nature's a jerk.

Anyway, let's put my opinions aside, and examine the mechanics of this whole thing.

We've talked a bit about hormones and their effects on puberty, and hormones are also the key players in menstruation.  The menstrual cycle ranges from 21-35 days in adult women, with a wider time variation in adolescents - like 20-45 days.  There are 4 stages of the menstrual cycle, of which a woman's period is only part.

1. Follicular phase
During this phase, there's a rise in FSH (follicle stimulating hormone, which we talked about last post), which stimulates follicles in the ovaries - hence the name of this phase.  These follicles secrete increasing amounts of estradiol and estrogen, which cause a new layer of endometrium to develop; the lining of the uterus will grow and thicken, preparing for potential implantation of a fertilized egg.  The estrogen also stimulates your cervix to create a different kind of mucus.  If you're tracking your cycles as a method of birth control or trying to conceive, this change in mucus is a good indicator that ovulation is about to start.

2. Ovulation
During ovulation, one of those follicles that got all stimulated during the follicular phase will rupture and release its egg, around 12 days after the end of your last period.  There is a huge rise in LH (luteinizing hormone) lasting about 48 hours, which is what causes the follicle to burst.  It appears to be random whether the left or right ovary is involved in ovulation, and sometimes both will release an egg.**  After being released from the ovary, the egg gets swept down the fallopian tube by the little cilia inside it.  If the egg isn't fertilized in a day or two, it will disintegrate or dissolve in the fallopian tube.  If it is fertilized, the egg will immediately begin development and continue its journey, reaching the uterus in about 3 days and implanting in about 3 more.

For some of us, ovulation comes alongside a pain called mittelschmerz ("middle pain" in German), which is pain in the lower abdomen and pelvis.  There are many things that can cause this pain: swelling ovarian follicles, the egg breaking through the ovary wall, contraction of the fallopian tubes as they move the egg along, muscle contractions in the ovary and its ligaments, or blood and other fluids released from the egg follicle as it ruptures.  For some women, the pain is so localized that they can tell which ovary is releasing an egg that month.

3.  Luteal phase
After ovulation, FSH and LH cause the ovarian follicle to develop into this structure called the corpus luteum (hence luteal phase), which releases high levels of progesterone that causes the uterine lining or endometrium to thicken.  If the egg is fertilized, the corpus luteum will continue to release progesterone, maintaining the thick lining of the uterus until the placenta grows to take over the job, at which the corpus luteum decays to become a little lump of scar tissue on the follicle (each ovarian follicle only gets to be the star once).

If the egg is not fertilized, the corpus luteum will stop progesterone production and decay after about 14 days, turning into scar tissue.  The sudden drop in progesterone is what causes the uterine lining to slough off during menstruation.

4. Menstruation
I think this tumblr post defines it best:

Seriously though your period is like coming home one day and finding that your spouse has constructed this entire new baby bedroom inside your house and you have to tell them “Sweetie we don’t have a baby” and then your spouse FLIPS THE FUCK OUT like “The FUCK do you mean we don’t have a baby I DID ALL THIS WORK” and then they spend the next week tearing the whole room apart and throwing it out into the street and screaming at you and then finally when the room is completely gutted they calm down and say “It’s okay hon we’ll have a baby next month” and then they start building the room again AND THIS SHIT KEEPS GOING FOR THE REST OF YOUR LIFE UNTIL YOU HIT LIKE 50 AND THEN YOUR SPOUSE LEAVES YOU BUT NOT BEFORE SETTING THE WHOLE HOUSE ON FIRE SO IT’S NEVER THE SAME AGAIN


The average period lasts between 3 to 5 days and the first couple days are often accompanied by painful cramping ... just everywhere.  All those hormones running around your system can make you kind of crazy (I cry at insurance commercials).  Sorry.  Daily Grace has some tips for survival:

That's it for this week. Stay tuned  for more period survival tips.

*I don't mean to say that having a period is gross - it's a natural process that most women experience and it's just something our bodies do.  It's nothing to be ashamed of or repulsed by. It just trips my own personal
"ick factor." I just find blood gross, even when it's my own, and especially when it's leaking from a place in my body that I'd rather only be used for fun things.

** If both of these eggs get fertilized, they result in fraternal twins.  Fun fact: my dad is a fraternal twin.  Identical (or maternal) twins result when a single egg is fertilized and then splits in two during early development.

Puberty and hormones!

Thanks for putting up with my hiatus last week. The move went well, even with an unexpected new kitty to bring along.  Just a reminder that I'm not going to be posting next Friday either, as it's my BFF's wedding.

So, now, onto today's post topic: puberty and the hormones that cause it.

Hormones are, at their most basic level, chemical signals from one part of your body that tell another part of your body to do something. Organs, glands, and even individual cells can produce hormones, and these hormones can have any effect from changing your metabolism to signalling fight-or-flight response to causing mood swings.  They're the little buggers responsible for PMS (and the menstrual cycle in general), growth spurts, and of course puberty.

Puberty is a progression of physical changes in which a child's body matures into an adult body, capable of reproduction.  Most girls hit puberty between ages 10 and 12, and finish it between 15 and 17.  Within this window, a girl will start menstruating and develop breasts and pubic hair, as well as experience growth spurts and the hardening of the long bones (like the femur in your thigh).

The onset of puberty is signaled by an increased production of a hormone called gonadotropin-releasing hormone (GnRH), which is responsible for the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the pituitary gland.

Basically, a part of your brain called the hypothalamus releases a hormone (GnRH) that tells your pituitary gland to make other hormones (FSH and LH).  These two hormones zip straight to your ovaries and tell them to get started producing estrogen and progesterone.  A specific form of estrogen called estradiol is the dominant hormone in female puberty, and it promotes the growth of the breasts and utuerus.  FSH also tells your ovaries to kick it into gear, causing the maturation of the little follicles inside that will eventually release ovum during ovulation.

The first sign that puberty has started is breast development, which starts around 10.5 years old on average. A hard, tender lump will develop right under the areola and over the next 1.5-2 years will slowly approach their mature size and shape; that starter lump will generally fade back into the rest of the breast tissue at the end of this development.  The areola will also grow in size and darken in color, and the nipple - which is typically an "innie" in children - will change to an "outie."

Another early sign of puberty is the development of pubic hair, which occurs right around the same time, or sometimes even slightly before, the breasts start to grow.  The first pubic hairs usually grow on the labia and then spread up and over the mons pubis, eventually forming the "pubic triangle," and often grows on the top of the inner thighs and close to the abdomen as well.

Next, your lady bits start changing.  The walls of your vagina will go from a bright red to a duller pink, and will also thicken a bit.  Vaginal secretions will change in order to maintain the pH balance - which keeps all the naturally occurring microbes there happy and healthy and fighting infections.  The labia majora and minora will also grow and change in color; the clitoris will grow as well. Shortly after breast development begins, the uterus, ovaries, and ovary follicles increase in size as they prepare to start menstruation.  They reach full functioning size in about 2 years, which is when a girl will typically experience menarchy - that is, her first period... which is fun.

What, wasn't everyone's like this? No? Okay then...

Anywhere between ages 8 and 16 is normal for a girl to start her period, and the length of the menstrual cycle will be unpredictable for the first few years.  Just because you start having your period doesn't necessarily mean you're ovulating - 80% of girls don't actually ovulate for the first year of cycles, 50% for the first three years, and 10% for the first 6 years.  The full nitty-gritty details of menstruation will be covered in the next post (June 7).

Another delightful change in puberty is the shift in body proportion and body fat distribution.  Rising levels of estrogen cause the shape of the pelvic bone to change, widening the hips (which makes a wider birth canal).  Fat tissue rises to a higher percentage than that of males (about 6% more), popping up in the breasts, thighs, hips, butt, pubic mound, and upper arms. This higher level of fat is essential for maintaining and regulating the amounts of hormones needed for the menstrual cycle, which is why girls with low body fat and low weight tend to have more irregular periods.  Those same hormones that regulate the mentsrual cycle are also necessary for bone development, which is why irregular periods correlate highly with osteoporosis (weak and brittle bones).

Self-disclosure time: I'm in recovery from anorexia nervosa.  From age 16 to about 23, I was deeply engrossed in my eating disorder and greatly underweight.  Even on birth control, I had extremely irregular periods, often going 6 months or more without one.  Because of this, I have osteoporosis and osteopenia (which is basically pre-osteoporisis) despite being only in my late 20s.  I've been in recovery for about 4 years now, at a healthy weight and with regular periods (still on birth control) and my bone health is slowly improving, but the damage I did to myself is very real.  Not just to my bones, but to my heart, reproductive system, and other vital organs, which all suffered due to prolonged malnutrition.  I guess what I'm trying to say with this is... be good to yourselves, ladies.

Okay, where was I? Right. The many wonderful changes caused by puberty.

All those hormones running through your body will also change the composition of your sweat, which can make it smell different... which is why oh so many teenagers really can benefit from proper use of soap and deodorant.  These hormones can also cause your skin to produce more oil, leading to zits and full-on acne.  For some of us, these zits and BO will mostly go away as puberty ends, but many times some degree of body odor and break-out will continue into adulthood. Thanks, hormones. Really, you shouldn't have.

Tune in in two weeks for a roadmap of menstruation.ho

Bueller? Bueller?

Hey everyone and anyone,

Remember how I said hubby and I were moving? Yeah, so, we're going to be driving 600 miles with a Uhaul and an angry cat in less than a week, so I kinda have to take a hiatus to pack up the entire house.  Sorry.  Next post will be May 24, and the one after that will have to be June 7 because I will be making that same trip (minus the Uhaul and angry cat) in reverse to go to my BFF's wedding on May 31.

Also.  Uh. Is anyone actually reading this?

Anyone? Anyone?

I see pageviews in the Blogger analytics but with absolutely zero feedback thus far, I have no idea who is reading it or what you think.  So please, please leave a comment. The new house is going to have a ferrous fridge and everything, so I can print out your comments, laminate them, and hang them on the fridge.

Anatomy: Internal reproductive system

Now that we've covered all the details of external genital anatomy, it's time to move on to the inner plumbing.  The internal reproductive system consists of five main parts:

Aww, it's so pretty. Like some sort of pink squid.

The Vagina
Now we're talking about the literal vagina, NOT the common slang meaning of vagina, which usually refers to the vulva.  The vagina is basically a tube that connects the external vulva to the uterus.  In its relaxed state, the vagina is usually a few inches deep, but lengthens during arousal.  It also produces its own handy-dandy lubricants and stretches or contracts to accommodate an inserted penis or other object.  It functions as the birth canal, as well, as its extremely elastic nature allows it to stretch to many times its normal diameter.  The vagina also provides a path for menstrual fluid to leave the body.

The Cervix
If the vagina is like a drawbridge connecting the uterus to the vulva, then the cervix would be the porticullis - it's a seal or valve between the vagina and the uterus.  Most of the time, it's tightly closed, stretching open only during menstruation - which may the cause of some women's cramps, or at least part of it.  During childbirth, the cervix dilates to 10 cm wide, allowing enough space for spawning.

The cervix has two main parts - the side that faces the vagina, and the side that faces the uterus.  These are called the ectocervix and the endocervix, respectively.  The ectocervix (vagina side) is slight rounded and projects about 3 cm into the vaginal canal on average. The opening in the ectocervix is called the external os.    The endocervix (uterus side) is more canal-shaped, as it's basically the inside of the ectocervix, so it's sometimes referred to as the endocervical canal.  The opening in the endocervix is called the interal os.

The Uterus
The uterus is the major organ of female reproduction.  It's roughly pear-shaped and made up of muscle tissue, allowing it to contract during childbirth and menstruation. The uterus is lined with tissue called the endometrium, which grows thick and full of blood vessels during the menstrual cycle.  At the end of the cycle, if you're not pregnant, the endometrial lining will shed, exiting the body through the vagina with the help of small uterine contractions... so this is the bastard that's responsible for your periods.  During pregnancy, the endometrium becomes even thicker and more solid, forming the placenta that provides oxygen and nutrition to the develping embryo.  The uterus itself acts as physical protection for a developing embryo and, during the birth process, contracts to push the baby out.

Fallopian Tubes
The Fallopian tubes, also called the oviducts, are two tubes that lead from the uterus to the ovaries.  These tubes are lined with tiny cilia (wavy hair-like structures) that help the ova travel from the ovaries to the uterus during ovulation.

Above: Eleven doing an interpretive dance of cilia.

 Fertilization (sperm meets egg) usually occurs in the fallopian tube, with the fertilized egg continuing its journey to implant in the uterus, beginning pregnancy.

The Ovaries
The ovaries are a small pair of organs at the end of each Fallopian tube, and are responsible for the production of ova or eggs (singular = ovum).  The ovaries are also a source of estrogen and progesterone, two extremely important hormones related to puberty, menstruation, and pregnancy.

Since we're talking about hormones, I think next week's post will go into more detail about them, specifically how and why they cause puberty.  The week after that we'll go into the menstrual cycle, everyone's favorite monthly kick-in-the-crotch.

Anatomy: The Clitoris

Today's anatomy lesson is going to focus on the clitoris, or clit, the main sensory organ of female sexual arousal.  As we discussed in the vulva anatomy post, the visible portion of the clit is located near the junction of the labia minora and is generally the size and shape of a greenpea  or a bit smaller than a pencil eraser.  This visible bit, called the glans, is wholly or partially covered by the clitoral hood or prepuce.  Again, I encourage you to break out your little mirror and find your clitoris and clitoral hood.

A hand roadmap to the clitoris. 1. Clitoral hood (prepuce); 2. Clitoral glans; 3. Urethral opening;

4. Vulval vestibule; 5. Labia minora; 6. Vaginal opening; 7. Labia majora (hair removed); 8. Perineum

But the clitoris doesn't stop there (contrary to what all my anatomy textbooks said!). While the glans is certainly the most readily apparent part of the clit, it has additional structures that extend through the labia majora and around the vagina opening.The clitoris is a complex structure, with both internal AND external components, and its size and sensitivity can vary greatly from person to person.    The clit as a whole is estimated to have more than 8,000 nerve endings, more than any other place in the human body (even the head of the male penis). 

The internal structures of the clitoris. Note that the clitoral hood and labia minora 

and majora are left transparent in this illustration.

The internal portion of the clitoris forms a wishbone or wing-like structure that contains the corpus cavernosum - spongey erectile tissue similar to that in the shaft of the male penis.  When aroused, these fill with blood and cause clitoral erection. That's right, we get ladyboners.

This totally would be his sex face.

The corpus cavernosum extends several centimeters before branching into a pair of crura (legs) called the crus clitoris.  These crura are concealed behind the labia minora and follow along behind it to meet at the fourchette (the lowest point of the vulva where the labia fade into the perineum or "taint").

Related to the clitoris, but actually a separate structure, are the vestibular bulbs, which are made up of the same erectile tissue.  These bulbs lie close to the crura on either side of the vaginal opening, beneath the labia majora.  When aroused, these bulbs fill with blood and cause the vulva to swell outward.

All right. Now that we know what it IS, let's talk about what it DOES.

The clit apparently exists for one reason: female orgasm.  Unlike the male penis, which is required for reproduction and urination, the clit serves no direct reproductive purpose (as female orgasm isn't required for conception) and no bodily function.  It's a pleasure center.

Just like Robert Downey Jr, it exists just to make you happy.

The majority of women (70-80%) achieve orgasm only through direct clitoral stimulation - that is, fingers or mouth stimulating the clitoral glans, hood, or shaft.  Because the glans itself is so packed with nerve endings, direct contact with it can be uncomfortable or even painful, so many women prefer indirect stimulation of the glans through the hood or labia.

For a long time, famous psychologist and all-around jerk Sigmund Freud postulated that there were 2 types of female orgasm - the clitoral and the vaginal.  He said that the clitoral orgasm was immature and adolescent and that sexually mature women would be able to orgasm through vaginal penetration alone.  His ideas persisted until Alfred Kinsey challenged them during his studies of human sexuality in the 30s, 40s, and 50s.  Kinsey observed female masturbation techniques and found that the vast majority could not orgasm vaginally, and that very few even bothered to insert fingers or objects into their vaginas while masturbating; they focused instead on the clitoris.  He eventually concluded that vaginal orgasms were nearly physiologically impossible because the vagina has so few nerve endings compared to the clitoris.

Later, Masters and Johnson built off Kinsey's research and discovered those crus clitoris which extend behind and within the labia.  They discovered that vaginal orgasms and clitoral orgasms share the exact same stages of physical response, and reasoned that the so-called vaginal orgasm was the result of indirect clitoral stimulation, such as the clitoral hood rubbing the clitoris during penetrative sex and stimulation of the internal portions of the clitoris.

A demonstration.  This is totally his sex face, too.

That seems like a good image to leave you with for this week... Next week, we move on to internal reproductive anatomy.

Anatomy: The Hymen

First things first: please accept my profuse apologies for this post being a full week late. My husband and I were out of town last week looking at houses, as we're moving between states pretty soon, and it's been kind of a busy time.  The next few weeks may see posts being early or late as we prepare to move.

Dear Readers, I am ludicrously excited to do this post. It's the reason I started this blog to begin with, and the whole hymen issue is something that gets my hackles up.  We'll go into the social pressures around female virginity at some point, and the whole "purity" debacle, and what the "first time" is actually like, but I feel that this is one issue where the anatomical facts and the social expectations are of equal importance.  So the hymen gets its own post. Yay!

I've taken classes in human sexuality 3 times in my life: an ongoing "Family Life" course over 5-7th grade, a religious studies elective in my senior year of high school, and a humanities elective during my second year of college.  NONE OF THEM DISCUSSED THE REALITIES OF THE HYMEN.  The college course touched a bit on the atypical hymens, but not one talked about what it really is.

If you're like me, you've grown up hearing phrases like "popping the cherry" as euphemisms for a girl losing her virginity. You've heard of things like a  "torn hymen" and bleeding during sex as proof that it was her first time.  You've seen shows like True Blood, where poor vampire Jessica can't have sex without pain because her crazy vamp healing abilities make her hymen grow back.  You've seen things like Law and Order SVU where they say an intact hymen is proof that rape hasn't occurred.  You've read Game of Thrones and similar stories where a girl's virginity is called into question, so she's examined by doctors or religious elders or midwives to determine if her hymen is still in place.  Perhaps you grew up with a religious background that emphasizes female purity, and have been told that things like tampons can break the hymen.

You probably picture the hymen as something like this:

Ahh Cassandra, yours is the first episode of DW I ever saw.

Or, to use words, you picture it as a thin veil of tissue stretched across your vagina, a barrier or membrane that is torn or popped or broken when you have sex (or use a tampon, if my religious upbringing is to be believed).

And there is a type of hymen (called an imperforate hymen) in which this is the case.

But for most of us, the hymen is just a thin corona of mucusy tissue located an inch or so inside the vaginal opening. It's stretchy, and delicate, and actually wears away over time due to estrogen exposure and physical activity.

Your hymen is a unique snowflake. A beautiful, mucus-y snowflake.

Remember a few weeks ago I asked you to take out a mirror and identify the structures in the vulva anatomy post?  Let's do that again.  Take a look at your vaginal opening (a flashlight may be helpful here) and see if you can identify anything that looks like a ring or crescent or squiggly shape just a bit inside.  That's your hymen.  Just that.  It's nothing that will tear or pop during sex, or that any doctor or priest or midwife could look at and say, "Yep, she's a virgin."  It's just a little flap of tissue, sort of like the webbing at the base of your fingers, only even thinner and stretchier and it fades away over time.

If, however, you do see a solid barrier, or a band of tissue running down the center, or a wall of tissue with one or several small holes in it, we may have a slight problem.  While the hymens picture above are fairly typical and won't cause major problems with things like penetration, menstruation, or tampon use, there are several forms of hymen which can be problematic.

A chart showing typical and atypical hymen forms. The dark bit is the visible opening of the vagina

Image 1 is a "typical" or lunate hymen - thin, crescent-shaped, blocking very little of the vaginal opening.  Image 2 shows a hymen that has shrunk or worn away significantly, leaving only small bits behind.  Image 3 shows the "annular hymen" in which the hymen creates a ring around the entire vaginal opening. This is fairly typical in young children, with the hymen changing shape to images 1 or 2 around puberty, though it may persist into adulthood.  

The first row of hymens are pretty typical and safe and don't generally require any sort of medical intervention to make tampon use, penetrative sex, or menstruation easier.  Though if you have an annular hymen, penetration and tampons may be a bit uncomfortable, in which case you should talk to your doctor.

The hymens in rows 2 and 3, however, can often be very problematic and require minor surgery to correct.

Images 4 and 5 are what are called "septate hymens" meaning there are one or more bands of tissue extending across the vaginal opening - like the spetum in your nose that divides your nostrils.  They tend to be thicker and less elastic than than those hymens in the top row, and can impede tampon use and penetrative sex.  Tampons may become trapped behind the tissue band or be blocked from entering all together, and penetration can cause the bands to rupture (painfully and with quite a bit of bleeding) or may not be able to get through at all.  Sometimes these bands will break on their own or stretch out enough that tampons, fingers, toys, or a penis can fit through on one side, but often you will need help from a medical professional to correct it.

I've heard stories of girls attempting to correct septate hymens through self-surgery. DO NOT ATTEMPT TO DO THIS YOURSELF.  Firstly because the risk of things like infection, nerve damage, and extreme blood loss are extremely high when you don't know what you're doing; and secondly because it's something that can be fixed in minutes by your doctor, usually with only a local anesthetic and usually right there in the office.

Why can't all gynecologists look like David Tennant?

 Seriously.  They just numb you up, snip the bands, and stitch or cauterize the cuts.  It takes less than an hour (some girls have said more like 20 minutes) and recovery is very quick.  No muss, no fuss, you could be using tampons within a few weeks.

Images 6, 7, and 8 show hymens which almost completely block the vaginal opening and thus are generally referred to as semi-imperforate hymens. A cribiform hymen sort of looks like a colander (pasta strainer) - a solid membrane with several small holes in it which allow menstrual fluid to drain.  The labial and microperforate hymens have just one opening - a long narrow one or a single small one, respectively. Any of these three will almost certainly make penetration and tampon use impossible (and any attempts extremely painful) and will need medical intervention.  The surgery is very similar to the one for a septate hymen, but both the procedure and recovery will be a bit longer as there is more tissue being removed.

Image 9 is the most dangerous form of hymen - imperforate.  This is the type of hymen most of us picture, or what we're taught is the typical hymen.  It's that first image of Cassandra.

An imperforate hymen is a bitch indeed.

It's the solid veil of tissue extending across the entire vaginal opening.  It's usually thick, not stretchy, and can be very, very dangerous.

See, if the typical hymen really were the mythical full-barrier hymen, girls would be dropping dead left and right... because menstrual fluid would never be able to escape.  It would just build up inside the uterus and vagina, and would eventually cause sepsis or endometriosis - very painful, very dangerous.

The good news is that the imperforate hymen only occurs in 1-2% of women and can usually be diagnosed at birth or in early infancy.  The other good news is that, whether it's corrected in infancy or adulthood, the procedure for correcting it is simple and low-risk, just as for the other atypical hymen types.  Some doctors will perform the procedure under local anesthetic as for septate or semi-imperforate hymens, but others will recommend you be fully anesthetized (knock out) and have it done in an actual operating room.  It's sort of like popping a balloon, but way gentler and less explosive and in far more sanitary conditions.

Matt Smith is really my 3rd or 4th choice for ideal gyno.

For a first-hand account of the difficulties of an imperforate hymen and the experience of the surgery, check out this article from XOJane: It Happened to Me.

Next week we will take a closer look at the clitoris, which is even more amazing than you may think.

Out if town, post delayed

Sorry everyone, but this week's post is going to be delayed until at least Monday. I'm out of town and forgot my charger, don't have enough battery to write.

Anatomy: Vulva!

Today we're going to discuss external genitalia, or the vulva.  Contrary to popular vernacular, the "vagina" is not the correct term for the sum total of all your lady bits; the vagina itself is only one anatomical structure, and is internal, whereas the vulva is comprised of all the external parts of the female genitals.  If someone says they "shave their vagina," they probably mean vulva, unless they literally stick a razor inside their vaginal opening (which sounds very dangerous and unpleasant and is not recommended).

Warning: There are a lot of pictures and diagrams of female genitals in this post.  None of them are in a sexualized context, but if you're uncomfortable looking at images of ladybits, this probably isn't the post for you.

I strongly recommend finding a mirror (a makeup compact mirror works well for this) and taking a good look at your own genitals, finding all the structures that we'll be discussing in this post.  It's important to become familiar with your own body, not just to improve your comfort in your own skin but because the best way to know when something is wrong is to know what everything looks like when you're healthy. Swelling, color changes, or new bumps can indicate a medical condition that you should get checked out by your doc ASAP.

A very simple diagram of the vulva, which 

we'll be using as our roadmap.

We'll start off with the mons pubis (pubic mound, also known as the mons veneris or "mound of Venus).  This is that little mound right below the stomach and between the tops of the thighs, which even the skimpiest of thongs and bikinis will cover.  It lies directly on top of the pubic bone and is the uppermost part of the vulva. Both genders have a mons pubis, so the term mons veneris is often used to specify the female mons. The fatty tissue of the mons is very sensitive to estrogen levels, so it enlarges during puberty and will continue to fluctuate in size during a woman's menstrual cycle.

A first-person view of the mons pubis.  This woman has

chosen to shave  or wax hers of pubic hair, making the 

shape of the mound clearly visible.

During puberty, pubic hair will start to grow on the mons and labia majora. We will have a much longer and more in-depth look at pubic hair (and society's views on women's pubes specifically) in a later post, but here is a brief run-down on the short-and-curlies. Pubic hair is common to both men and women and begins to grow on the mons pubis during puberty in response to rising levels of androgens (sex hormones).  It is generally coarser, thicker, and darker in color than other body hair, though the thickness, density, and texture varies greatly from person to person. Pubic hair growth spreads as puberty continues, covering not only the mons but also the outer labia and sometimes the top of the inner thighs as well.

Naturally growing pubic hair, not trimmed or shaved.

Notice how it covers the mons, the labia, and some of the thigh.

The mons pubis divides into the labia majora (or outer lips), two fleshy folds of skin that protect the other, more delicate structures of the vulva.  The color of the outer portion of the labia majora is usually fairly close to skin color, though they often darken when you're aroused.  The insides of the folds are usually pink or brownish, but there is considerable variation.

Within the labor majora are the labia minora; while this literally translates to "smaller lips," the labia minora are often quite large and may protrude beyond the majora.

I'm gonna drop some self-esteem on you right now: your labia minora ARE NOT WEIRD.  If the only image you've ever seen of them are in porn or diagrams like the one at the top of this post, you probably thing that labia minora are supposed to be pink, small, and perfectly even.  Hell, labia minora in porn are often so small as to be almost invisible. Like the breasts, each part of the vulva is subject to a wide degree of variation from person to person in terms of size, shape, and color, and the labia minora is no exception.  Yours may be pink or brown or black; they might be long and extend past the outer labia, or short and rest fully within it; they might be thin or thick; they might be perfectly symmetrical or one may be longer, shorter, thinner, fatter, or a different color than the other. And this is TOTALLY NORMAL.  As long as they're not causing you pain or discomfort, there is nothing wrong with your labia. They're awesome.

A few variations of the female vulva.  Note the differences

in pubic hair (shaved, unshaved, and texture), coloration, the different 

shapes of the labia majora, the size variance of the labia minora.  Also, 

the centermost photo shows a clitoral hood piercing.

Okay, moving on.  Where the labia minora meet at the top of the vulva is the clitoris. Ahhh, the clitoris, so glorious, so misunderstood.  As with pubic hair, we're going to have a long look at the clitoris a bit later on, so for now we'll just stick to the portion of it that will be visible during your mirror exam (which you're totally going to do, right? RIGHT???).  The visible portion of the clitoris is called the glans, and is typically about the size of a pea, though they can vary greatly in size.  The clitoral glans is highly sensitive, and contains as many nerve endings as its male counterpart, the glans or head of the penis. The clitoral glans is usually covered by a small fold of skin call the clitoral hood, which retracts to expose the clitoris during arousal.  In women with a larger clitoral glans or a smaller clitoral hood, the clitoral glans may be partially or fully exposed at all times.  The clitoral hood is the female equivalent of the male foreskin, which also protects the sensitive glans.

A photograph of the vulva, showing (1) the clitoral glans hidden

by the clitoral hood and labia minora, and (2) the clitoral glans 

fully exposed.

The area between the labia minora is called the vulvar vestibule and contains the urethral opening and the vaginal opening.  The urethral opening is where urine from the bladder passes out of the body. Yes, this is a separate "hole" from the vagina!  You do not pee out of your vagina, and menstrual fluid does not come out of the same opening as urine.  The urethral opening is located below the clitoris, and the vaginal opening is just below that.  The term "vaginal introitus" is technically more correct than "vaginal opening," as the vagina itself is usually closed or collapsed except during arousal or insertion.  The vaginal introitus is usually partially covered by a thin, stretchy membrane called the hymen.

The hymen is a structure that is widely misunderstood, and many men and women are woefully misinformed as to its nature.  In fact, the hymen and its myths, misinformation, and social implications will be the sole topic of next week's post.

I apologize for this post going up so late (it's nearly 8pm here); it's just been a super busy day. I will do my best to have next week's post up in a more timely fashion.

Anatomy: BREASTS!

Breasts. Boobs, titties, tatas, melons, hooters, cans, jumblies, yabbos, balloons, fun bags, dirty pillows, sweater beasts, knockers. The Girls. The Twins. Thelma and Louise.

Whatever you call them, boobs are pretty great.  They're soft yet firm, bouncy, jiggly, and under a certain set of conditions, can produce fuel for periphery micro-humans.

So, let's start off by talking about development, anatomy, and function.  Human breasts are unique in that they are the only organ not present at birth - they develop instead during puberty, in response to rising levels of estrogen which direct fat deposits to the breasts and cause the milk ducts to grow.  This is also the stage in which the nipple and areola (the dark area of skin around the nipple) enlarge. After menstruation begins, the breasts enter a second stage of development in response to progesterone, which results in maturation of the milk glands (or lobules). The breast doesn't grow as much during this second stage as in the first, but is important later to make lactation possible.

Image courtesy of dentalarticles.com

1. Chest Wall, which separates the chest cavity (containing all the important organs) from the muscle layer above it.

2. Pectoral muscle aka "pecs." This thick, fan shaped muscle makes up the bulk of the chest muscle in males and sits right under the breast in females.

3. Lobules are hollow cavities which are lined with milk-secreting cells.  Each lobule has a duct which connects to the opening in the nipple. 

4. Nipple, the opening through which breast milk is delivered.

5. Areola, the circular area of colored skin surrounding the nipple.

6. Lactiferous ducts carry milk from the lobules to the nipple.

7. Fatty tissue that develops during puberty.

8. Skin layer which keeps all this awesome machinery from showing through.

The primary function of the breasts, as you can probably figure from the diagram above, is to produce milk for infants.  Human beings are mammals, a name which derives from the mammary gland - another name for all the milk-producing lobules present in the breast tissue.

The secondary function of the breasts it to be fabulous and sexy.

Oh River, you sexy thing.

But seriously.  Research suggests that women with larger breasts were viewed as more fertile and more capable of providing enough milk to produce healthy, strong offspring.  Additionally, the large deposits of fatty tissue in the breasts were essential for helping the human fetus develop its awesomely powerful brain.  So your boobs put the FUN in FUNCTIONAL.

Now, if the only breasts you've ever seen have been in movies, porn, and textbooks, you probably think there is only one type of "normal" breast - perky, round, sits high up on the chest, with pretty pink nipples and areolas about the size of a quarter.

NOPE.

Boobs come in a variety of shapes and sizes, and nipples and areolas can be any color from pink to purple to brown to black, and areolas can be so tiny they're invisible or they can cover the majority of the breast.  One breast may be bigger than the other, or they may sit low on the chest wall or hang down.  Nipples can be large and erect or small and flat. And y'know what? THESE ARE ALL NORMAL.

You may have been told by others, or have told yourself, that your boobs are weird or ugly or unattractive.  But they're not.  They're boobs, and they vary in shape and size and coloration the same as any other body part. Breasts change in size and shape through your lifetime, varying with changes in weight, hormones levels, your menstrual cycle, and of course if you choose to get pregnant and/or breastfeed.

The following images are from a wonderful website called the Normal Breast Gallery and show just a small sample of the variations in normal, healthy, beautiful breasts out there.  If you feel self-conscious about your breasts, I strongly encourage you to browse through that gallery and pay attention the enormous variety of forms out there and read the stories of other women and their struggles with body acceptance.

I truly believe that there is no such thing as an ugly boob. Of course, if your breasts are large enough that they cause you pain or discomfort, in which case you may which to speak to your doctor about breast reduction surgery.  The self esteem of many women is intricately tied to their bodies, and breasts play a large role in this, so I feel it's very important to work on appreciating your breasts no matter their size, color, or shape.  If you find that you cannot feel sexy or confident or feminine with your current breasts, there are many options for breast augmentation (enlargement, reshaping, etc) that you can discuss with your doctor. If you have a partner or a friend that says negative things about your breasts (or any part of your body), they probably don't deserve the privilege of seeing them. There is really only one thing your or anyone else should ever say to your breasts: 

Watch this until you believe it.

Seriously.

Next week: external genital anatomy including the mons pubis, pubic hair, and labia.  The clitoris and hymen will have their own posts. 

Welcome to Your Vagina

It's been a while since I originally proposed this idea on reddit, but at last, here is the Vagina Owner's Manual. "Well that's nice," I hear you ask, dear reader, "but what exactly is the VOM?"  Think of it as a comprehensive resource for all things relating to the female experience.  If you have a vagina, want a vagina, or just appreciate vaginas, this blog should have something for you. Basically: it's a sex-positive, female-positive, body-positive resource for reliable information on female anatomy, sexuality, and experience geared towards education and awareness. Upcoming posts will cover:

• Female anatomy
• Myths and misinformation regarding sex and the female body
• STD and pregnancy prevention
• Care and maintenance of your lady parts (dos and don'ts, good gyno info, etc)
• All the glories of the menstrual cycle (and how to make them suck less)
• Becoming more comfortable with your body (including masturbation, because it's awesome)
• Trouble-shooting (common issues and why it's probably not cancer!)
• CONSENT
• Rape culture and slut shaming

And that's just what I've got scribbled in my sketchbook right now (minus a lot of the subcategories and less-than-helpful arrows I  threw in there in an attempt at organization). 

Seriously, look at this thing.

Please feel free to leave questions, comments, concerns, additional topics, and warm fuzzies in the comments for any post; I will do my best to read all of them, even if I don't post a reply, and I'd love to hear what else you would like to get out of the VOM.

I spent a lot of time trying to figure out a good format for what is sure to be a pretty massive undertaking, and ultimately decided that a blog was the best form of delivery - flexible, easy to cross-reference, and more accessible and discreet than a printed copy.  Plus, I'll be able to break it down into smaller, easy-to-manage posts which will be put up at regular intervals, making the endeavor seem a lot less daunting.

Planned posts will happen every Friday, with many of those bullet points above spanning several weeks' worth of posts.  I may occasionally post non-Friday updates about things that catch my attention - responses to questions and comments, useful videos and articles, rants, all that good stuff.

(There will also sometimes be .gifs, many of them Doctor Who-related, and most of those will be David Tennant rather than Matt Smith. I make no apologies for this.)

I'm not gonna lie, I have kind of a filthy mouth.  So there will be swearing and adult language on this blog sometimes.  But there are also going to be detailed images of female anatomy and frank discussion about sex, rape, consent, abortion, STDs, and other mature content.  If you feel that you're grown up enough to look at comparative images of different labia, you're grown up enough to handle the occasional f-bomb.

I hope you're all as excited for this as I am! Next week we'll be starting our anatomy section by looking at BOOBS, because they're wonderful.