The Vagina Bible: The Vulva and the Vagina—separating the Myth from the Medicine by gynecologist Jennifer Gunter is a lively, educational guide separating information from misinformation, presented in a clear, smart, sassy style.
“There’s a lot of money in vaginal shame,” writes Jen Gunter. She is known as the clever and outspoken OB/GYN on Twitter (@DrJenGunter—follow her!) who challenges celebrities and companies trying to sell us unneeded (and sometimes harmful) solutions for invented problems. She rips their claims and substitutes solid facts. All of this book is educational, revealing, and empowering. Examples:
- “[T]he other problem with doctors not asking about sex is women who have medical conditions that interfere with their sex life, typically conditions that cause pain with sex, end up minimized. Many women suffer for years not realizing they have a medical problem that has a diagnosis and treatment.”
- “It is hard to overestimate the damage done by Sigmund Freud in popularizing the myth of the vaginal orgasm. Only one third of women are capable of achieving orgasm with penile penetration alone…so the idea that everyone should be having orgasms this way results in two thirds of women believing there is something wrong with their sexual wiring when really they are perfect. Not orgasming with unassisted penile penetration is not a flaw, it’s a feature.”
- “MRI studies looking at anatomy during heterosexual sex reveal that the clitoris can be compressed by the penis, which is why some women can orgasm with penile penetration.”
- “Vulvar cleansing has never been studied. That is interesting, considering the array of products that claim to be gynecologist tested or approved…Some of these washes make claims they can reduce bacterial vaginosis (BV). They can’t. An external wash cannot possibly impact the inside of the vagina, and washing internally with one of these products (some women do that—please don’t) could definitely increase your risk of BV by killing good bacteria or irritating the vaginal mucosa.”
Parts of The Vagina Bible are so hilarious that you’ll want—as I did—to read them aloud to a companion:
- “Almost every woman has been told at least once…to wear white cotton underwear as a medical recommendation to prevent yeast infections and other vaginal mayhem. This makes it sound as if vaginas and vulvas are accidents waiting to happen. The vulva can handle urine, feces, and blood, and vaginas can handle blood, ejaculate, and a baby, so this idea that a black lace thong is the harbinger to a vaginal or vulvar apocalypse is absurd.”
- “I have read about plastic surgeons who do labiaplasty [surgical reduction of the labia minora] so women can look ‘sleeker in so-called athleisure wear.’ I know some people call this look ‘camel toe,’ but I prefer ‘labial cleavage,’ and the answer is not surgery—it is better-fitting athletic wear.”
- “I’ve stared at more male butt cracks (gluteal clefts) than I care to remember…What I never hear is that men should seek out plastic surgeons to get their gluteal clefts sewn shut. I also can’t imagine a similar industry for men that profits from surgically trimming penises so they look better in tight jeans.”
The second half of this book is a serious, comprehensive, scientific resource about infections, conditions, symptoms, and treatments. Dr. Gunter has been treating vulvar and vaginal diseases for nearly 30 years. If you have discomfort, pain, or other symptoms that might be a medical issue, read the relevant chapters of this book, then, armed with this information, take it to your doctor.
This guidebook to the care and functioning of the vulva and vagina by cheeky gynecologist Jen Gunter should be on your bookshelf. Thank you, Dr. Gunter, for this much-needed resource: The Vagina Bible.
Their elation dims when they attempt penetration and discover that their vaginas feel too dry and fragile for comfort if they try to accept a penis (or sometimes even fingers).
There are several reasons that vaginal fragility, tightness, discomfort, or pain can happen (which I discuss in my books, Naked at Our Age and The Ultimate Guide to Sex after 50). With age, especially if you’re sexually inactive, the vaginal tissues thin and there’s less blood flow to the genitals, causing dryness and fragility, known as vaginal atrophy. A separate but related problem is that the pelvic floor can lose its ability to relax, and in its contracted state, the vaginal opening feels too tight to admit a penis or a larger-than-slim sex toy.
Here’s how Ellen Barnard, co-owner of A Woman’s Touch sexuality resource center, helps women distinguish between menopause-related vaginal dryness and atrophy and “high tone pelvic floor dysfunction” that can be caused by the lack of blood flow to the genitals after menopause:
If you feel like your skin is very dry, fragile and tears easily then you have vaginal dryness and atrophy. You may experience tearing during penetrative sex and find a little bit of pink discharge after sex. If you feel like the skin is stretching or tearing at the opening of the vagina that is another sign of vaginal atrophy. A good quality, long lasting lubricant relieves your symptoms, and the Vaginal Renewal program will provide further relief and comfort both during daily activities and during sex.
If you engage in penetrative sex and your partner feels like they “hit a wall” either at the opening of the vagina or about 1-1/2 inches inside, or you feel pain deep inside the vagina with deeper penetration you may have an over-tight pelvic floor. The pelvic floor is made up of 3 layers of muscles. After menopause, those muscles can tighten up and not relax because there is not enough blood going to them once estrogen is no longer present.
If this happens to you then your first step is to see a pelvic floor therapist and get an evaluation of your pelvic floor muscles. If you have over-tight muscles the therapist can work with you to get them relaxed and learn appropriate exercises so you can consciously relax them once the therapy is over.
The Vaginal Renewal program may or may not help your pelvic floor muscles, so it is important to get additional help if the description above sounds like what happens to you.
Part of this program is at least one orgasm a week (you don’t need a partner for that!) and internal massage using vibration. Yes, really. Internal massage with vibration brings blood flow to the vagina and helps strengthen the tissues. If you’re so tight that insertion hurts, slim wands (a.k.a. dilators) will help. These start very slim and progress in graduated sizes as your body adapts and is able to accept more. Barnard adds,
A set of dilators may be used to treat the involuntary tightening of the outermost layer of the pelvic floor that happens with a condition called vaginismus, or when you have high tone pelvic floor dysfunction (over tightening of the pelvic floor muscles that surround the vagina) in the outermost, middle and/or deep layers of the pelvic floor. You would work with a pelvic floor therapist to use the dilators to help you learn how to relax with progressively larger dilators inside the vagina. This work may be accompanied by other work such as psychotherapy when the tightening is caused by pain or trauma; meditation; and relaxation breathing in the case of high tone pelvic floor dysfunction.
It used to be a hassle to even find vaginal dilators, but A Woman’s Touch has done the research and development and created FDA-registered, therapeutic vibrating wands that are ideal for the Vaginal Renewal program:
|Sizes 2 and 1|
The FeMani Vibrating Massage Wand is made of smooth, durable, medical-grade ABS plastic and comes in three graduated widths: Size 1 (3/4″ diameter), Size 2 (1″ diameter), and Size 3 (1-3/8″ diameter).
Order two sizes in a kit with one silicone controller (detachable handle that controls the vibrations). These vibrating wands use AAA or AA batteries (included), depending on the size.
To figure out the size that’s right for you, A Woman’s Touch recommends this:
Determine how many lubricated fingers you can insert into your vagina when you are not aroused. For one finger, choose the 1 & 2 set, for two fingers choose the 2 & 3 set. If you are unsure or between sizes, we recommend choosing the smaller choice, which will still provide the beneficial massage without the potential strain or discomfort of being too big.
Using vibrating wands is a process for your own sexual health and the health of a relationship you might have now or in the future–and it can be extremely pleasurable, besides!
If you’ve read my book, Naked at Our Age, or the advice given on this blog, I hope you’ve noticed the valuable information contributed by Ellen Barnard and Myrtle Wilhite, MD, co-owners of A Woman’s Touch. They are brilliant sex educators and compassionate human beings who devote themselves to women’s sexual health and pleasure, with a special emphasis on helping women with sexual pain and limitations.
I wanted to let you know how much I benefited from your workshop. Using some things that were discussed, the Vaginal Renewal Program you recommended, your books that I purchased (I went straight to chapter 11 — “When Sex Hurts” — in Naked at our Age), and some steamy stories from Ageless Erotica, I was able to have penetrative intercourse for the first time in 4-1/2 months. It can only get better from here and hubs is very happy.
I’m including this testimonial here not only because she specifically mentioned AWT’s Vaginal Renewal Program, but also because much of what I know about vaginal pain and self-help solutions I learned from Ellen and Myrtle. I consult and quote them often, and you’ve benefited from their expertise several times on this blog as well as throughout the pages of Naked at Our Age.
Ellen and Myrtle have been working for years on developing the best sexual health internal massage wand for women who have pain and/or limitations with penetration and with medical internal exams due to aging, cancer, or other issues. They (and we) were dissatisfied by the wands — aka vaginal dilators — that were available to women with sexual pain, either from doctors or online.
After years of research, they’ve designed and tested the FeMani Wellness Sexual Health Massage Wand, which has been perfected to their high standards. FeMani Wellness Sexual Health Massage Wand is ready for manufacturing — but their funds have run out.
That’s why I’m appealing to you. These amazing educators have been (and continue to be) generous with their expertise, helping anyone who needs them. Can you be generous to them now? You’ll be helping yourself and many other women who will be able to have comfortable, pleasurable sex because of these tools.
If you’ve been helped by the expertise of Ellen and Myrtle, either through my books or elsewhere, or you just want to help other women, can you assist with a donation of any size?* Go here to learn more.
* You know I don’t use this blog for fund-raising appeals. You may not know that I turn down about one worthy project a week, because I know you come here for senior sex news and views, not to be asked for money. But this project and these people are so special in our world that I had to make an exception.
Frustrated in Florida, age 61, had not had sex for nearly 12 years, until recently. She wrote in an email to me:
Apparently one’s vagina does change after not using it for a long period of time. I always thought sex was like riding a bicycle, but it is not. One can’t just get back on and ride! I experienced such pain during the attempted penetration that we had to stop. What a disappointing and embarrassing moment. My partner was very understanding, however I was just frustrated and disappointed.
I went to my GYN for an examination soon after and explained my circumstances. She gave me a thorough exam and said although I had many tiny lacerations and redness, my vagina seemed normal. She explained how one’s vaginal lining becomes thin after menopause and her advise was to abstain from sex for two weeks, using lubrication to aid in healing.
When we engaged in sex again, very gently, I was once again disappointed with the level of pain even though using lots of lubrication. We once again had to stop.
So now I am wondering if there is some way I can stretch my vagina for it seems like it has shrunk. (Perhaps it is just my imagination running wild!)
Have you had anyone else write you with a similar problem and if so is there a solution? For your information I have never been on hormones and my partner’s penis is of normal size.
No, it’s not your imagination, and yes, it’s true that the vagina will seem to shrink after a long period of abstinence, especially after menopause, and penetration will be painful or sometimes impossible. You’ll find a helpful chapter in my book, Naked at Our Age: Talking Out Loud About Senior Sex and several other posts about vaginal pain on this blog.
I’m disappointed that your gynecologist is not this helpful. Telling you you’re “normal” while you have lacerations and pain is not helpful, is it? Most doctors do not know how to diagnose or treat vaginal pain, and it ‘s wise ask for a referral to a sexual pain specialist.
Please read Vaginal Renewal Program by Myrtle Wilhite, M.D., at A Woman’s Touch, a wonderful sexuality resource center in Madison, WI. It tells you step by step how to massage and stretch your vagina. Here’s an abridged version:
* External Moisturizing and Massage: Increase the suppleness and blood circulation of the skin of your vulva and vagina with a five- to ten-minute massage with a moisturizing sexual lubricant like Liquid Silk®, a water-based lotion that will soak in and moisturize your skin, won’t get sticky, and will help you massage with very little friction.
Push in to the skin with circular strokes, and massage what’s underneath the skin, rather than brushing across the skin. Include the inner lips, the hood of the clitoris, the head of the clitoris and the perineum.
To complete your external massage, massage into the opening of the vaginal canal, using the same circular strokes. The massage itself does not need to be self-sexual in any way, but if that is comfortable for you, by all means explore these sensations.
* Internal Vaginal Massage: To massage inside your vaginal canal, we suggest using a lucite dildo which is very smooth and will not cause friction or tearing. Choose your size based upon how many fingers you can comfortably insert into the opening of your vagina.
After a session of external vulva massage, apply the same massage to the inner surfaces of your vagina with your dildo with lubricant applied on both skin and dildo. Rather than pushing the dildo in and out, use a circular massage movement. You are increasing skin flexibility so that your body can adjust to comfortable sexual penetration if you choose it.
You might also choose to use a slim vibrator for massaging the vaginal walls. Coat it in Liquid Silk and then insert it gently. Turn it on and let it run for about five minutes. You don’t need to move it around, just lie there and let it do its work.
* Orgasm: For women who stop having orgasms, the blood vessels literally can get out of shape, preventing future orgasms. If you are able to bring yourself to orgasm, do so at least once a week (for the rest of your life — seriously). This is preventive maintenance of your body.
* Kegel Relaxation: Kegels increase both the strength and flexibility of your pelvic floor muscles. Pay attention to the relaxation and deep breath part of the exercise. Learning to relax your pelvic floor will help you to avoid tensing up before penetration. (Read A Woman’s Touch’s Step-by-Step Kegels in this article about pelvic floor health.)
In my earlier book, Better Than I Ever Expected: Straight Talk about Sex After Sixty, I had interviewed a 75-year-old woman who had been celibate for 38 years and was in a new relationship. She was unable to have intercourse because her vagina had dried and narrowed to the point that penetration was impossible. She sought help from her gynecologist (a wonderful woman who bought dozens of copies of Better Than I Ever Expected to give to her patients!), who helped her.
Best wishes for a joyful resolution to this problem — please keep me posted.