“I’m having a problem — down there.”
“My good girl is itchy.”
“My v-jay-jay hurts.”
“My huh-huh isn’t right.”
Saying the word “vagina” out loud, even to your doctor, appears to be one of the final frontiers when it comes to taboo topics. My patients have no problem saying “bladder,” “breasts,” or “throat.” But when it comes to discussing specifics about genitals, some women just can’t spit out the words.
And women who can’t comfortably say the word “vagina” have an even harder time talking about a vagina that is dry, painful, bleeding, or the source of incredible agony. So it’s not just saying the word: It’s the very topic that many women have trouble with, No one hesitates to say to a friend, “I keep getting these headaches,” “I’m not sleeping very well lately,” or “I’m a little worried about my swollen feet.”
But when was the last time you admitted to a coworker, “My vagina smells funny,” or had the courage to say to a close friend, “Barbara, my vagina has been really dry lately. How’s yours?”
And while I am obviously very comfortable saying the word vagina out loud (my husband often says that the word “vagina” gets tossed around at our dinner table more than the salad), I know better than to say it when I appear on national TV shows if I want to be invited back.
As more than one producer has told me, “Say vagina once and viewers will cringe; say it twice and they’ll change the channel.”
Vulva, Vagina: They’re Not the Same
I applaud efforts to normalize the word vagina, but I would like to take it a step further.
Ninety percent of the time, when a woman talks about her vagina, she’s really talking about her vulva — the external genital tissues — as opposed to the internal structure that no one but a gynecologist sees. When a woman tells me she has a sore or a rash on her vagina, 100 percent of the time the sore is actually on her vulva. When a woman complains that she does not have a “pretty” vagina (a whole other topic), she’s almost always referring to her labia, which anatomically is part of her vulva, not her vagina.
It’s a sad truth that most women not only can’t say the words out loud — they also don’t have basic knowledge of their own anatomy.
Guys, of course, have the distinct advantage of being able to inspect their genitalia with essentially no effort on their part. For women, not only is it a little more mysterious, but they also have not been given “permission” to explore or understand their sexual body parts.
In her fine book, Girls & Sex: Navigating the Complicated New Landscape, Peggy Orenstein explores this issue. She describes a culture in which boys have an expectation of and feel entitled to sexual pleasure, but young girls typically have sex for their partner’s pleasure as opposed to their own. Orenstein attributes much of this to mothers who have not had the “talk” with their daughters about sexuality.
I agree in principle, but as I pointed out in my letter to the editor of The New York Times, the mothers need to be educated about their own anatomy and their own pleasure before they can pass that information on to their daughters.
We still live in a society in which “good girls” are not supposed to be sexual, feel pleasure, or acknowledge that they have genitals — much less know, or say, the proper anatomic terms out loud. There’s nothing wrong with the majority of women who’ve never had an orgasm; they’re often just not aware that clitoral stimulation, not vaginal intercourse, is required for most women to climax. Furthermore, they don’t know where their clitoris is.
When I wrote Sex Rx: Hormones, Health, and Your Best Sex Ever, I dedicated the first chapter, “Taboo Topics: Let’s Talk,” to exploring this theme. If we don’t start normalizing and saying words like vagina, vulva, and clitoris, too many women will not have the tools they need to ensure sexual pleasure.
Even worse, they will not have the language — or the comfort level — to talk to their doctors about their pain and inability to have an orgasm, and about the absence of desire that is so prevalent and so distressing to so many women.
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