Our Bodies, Ourselves (4 page)

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Authors: Boston Women's Health Book Collective

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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 Exercises”
).

Only a thin wall of mucous membrane and connective tissue separates the vagina from the rectum, so you may be able to feel bumps on the back side of your vagina if you have some stool in the rectum.

Now slide your middle finger as far back into your vagina as you can. Notice that your finger goes in toward the small of your back at an angle, not straight up the middle of your body. If you were standing, your vagina would be at about a 45-degree angle to the floor. With your finger you may be able to just feel the deep end of your vagina. This part of the vagina is called the fornix. (Not everyone can reach this; it may help if you bring your knees and chest closer together so your finger can slide in farther.)

A little before the end of the vagina you can feel your cervix. The cervix feels like a nose with a small dimple in its center. The cervix is the part of the uterus, or womb, that extends into the vagina. It is sensitive to pressure but has no nerve endings on the surface. The uterus changes position, color, and shape during the menstrual cycle as well as during puberty and menopause, so you may feel the cervix in a different place from one day to the next. Some days you can barely reach it. The vagina also lengthens slightly during sexual arousal, carrying the cervix deeper into the body.

The dimple in the cervix is the os, or opening into the uterus. The entrance is very small. Normally, only menstrual fluid leaving the uterus, or seminal fluid entering the uterus, passes through the cervix. No tampon, finger, or penis can go up through it, although it is capable of expanding enormously for a baby during labor and birth.

WHERE TO BUY A SPECULUM

Plastic speculums are relatively inexpensive and easy to buy online. The Feminist Women's Health Center (fwhc.org/sale3.htm) sells a self-exam kit for $25 that includes a clear plastic speculum, handheld mirror, small flashlight, lubricant, and “Get the Inside Information” brochure.

CERVIX SELF-EXAM

If you want to see your cervix, find a private, comfortable place with good lighting and gather these supplies: a flashlight, a speculum (a metal or plastic tool used to hold apart the walls of the vagina; see “Where to Buy a Speculum,” above), a lubricant such as such as olive or almond oil, and a hand mirror. Wash your hands, then sit back on a couch, a comfortable chair, or the floor, with pillows behind your back for support. Bend your knees and place your feet wide apart.

Familiarize yourself with the speculum. Different styles work slightly differently. All have two bills and a handle. Use the lever to open the bills until the lock clicks. Be sure you figure out how to release the lock before you insert it.

Put some lubricant on the speculum or your vulva. Hold the speculum in a closed position (with the bills together) with the handle pointing upward. Slide it in gently as far as it will comfortably go. If it hurts, stop. Pull it out and try inserting
it into the vagina sideways, then turn it. Experiment to see what feels most comfortable for you. Keep in mind that your vagina is angled toward your back, not up toward your head. You can put your finger in your vagina to feel where your cervix is and how to direct the speculum.

Once the speculum is inserted, grasp the handle and squeeze the lever toward the handle to open the bills. Some women find that placing the speculum and finding the cervix take some effort. Breathe deeply and manipulate the speculum gently while looking into the mirror. You will be able to see the folds in the vaginal wall, which may look pink, bulbous, and wet. The cervix looks like a rounded or flattened knob about the size of a quarter. If you don't see it, allow the speculum to gently close and shift the angle of insertion before reopening it, or remove the speculum and reinsert it. Focus the light source on the mirror to help you see better. If you want, a friend or partner can help by holding the flashlight and/or the mirror. If you still can't see your cervix, wait a few days and then try again. The position of the cervix shifts during the menstrual cycle, so it may be easier to see at another time.

When you find your cervix, lock open the bills of the speculum. You will see some cervical and vaginal discharges. Depending on where you are in your menstrual cycle, your cervical fluid may range from pasty-white to a clear and stretchy egg-white texture. The cervix itself may be pink and smooth, or it might be uneven, rough, or splotchy. All of these are normal. If you are pregnant, your cervix might have a bluish tint; if you have reached menopause or are breastfeeding, it may be pale. If you are ovulating, the cervix will appear open with clear stretchy mucus sitting in it. The slit or opening in the center is the os, the opening to your uterus.

Recommended Resource:
Beautiful Cervix Project (beautifulcervix.com) was founded by a twenty-five-year-old woman who took photos daily for a month to see how her cervix looked throughout the menstrual cycle. The site grew to include photos submitted by women from age twenty to past sixty. There are images of cervixes during pregnancy and after orgasm. You can also view photos of a Pap test in progress.

You may see small, yellow/white fluid-filled sacs on the cervix that look like little blisters. These are Nabothian cysts and are quite common and do not need any treatment. They are caused by a blockage in the fluid-producing glands of the cervix. Some women have them for years; in other women they come and go. You may also see polyps, pink outgrowths of cervical tissue that dangle on a stalk, looking like a little tongue sticking through the os.

When you are done exploring, unlock and remove the speculum. Some women prefer to remove it after the lock is released but while it's still open; others close the bills first. Clean it afterward with soap and water or rubbing alcohol (isopropyl alcohol) before storing for later use.

Observing the color, size, and shape of your cervix and the changes in your vaginal discharge and cervical fluid during the different stages of your menstrual cycles allows you to learn what is normal for you and can help you recognize when something is wrong. You can do cervical self-exams regularly or during certain phases of your fertility cycle—or maybe just once to check things out.

What's Not Normal

It is normal to have vaginal and cervical fluid, or discharge. However, any of the following found during a self-exam may indicate an infection or another problem.

• Green, gray, or dark yellow discharge

• A significant change in the amount or consistency of discharge

• Any strong odor unusual for you

• Foamy discharge (from gas-producing organisms)

If you find anything that concerns you, see a health-care provider. (For more information, see
Chapter 2
, “Intro to Sexual Health.”)

Internal Organs

The nonpregnant uterus is about the size of a plum. Its thick walls are made of some of the most powerful muscles in the body. It is located between the bladder, which is beneath the abdominal wall, and the rectum, which is near the backbone. The inner walls of the uterus touch each other unless pushed apart by a growing fetus or an abnormal growth. The top of the uterus is called the fundus.

Extending outward and back from each side of the fundus are the two fallopian tubes (also called oviducts; literally, “egg tubes”). They are approximately 4 inches long and look like thin ram's horns facing backward. The connecting opening from the inside of the uterus to the fallopian tubes is as small as a fine needle. The outer end of each tube is fringed (fimbriated) and funnel shaped. The wide end of the funnel wraps partway around the ovary but does not actually attach to it. The fallopian tubes are held in place by connective tissue.

© Nina Reimer

Female pelvic organs (side view)

The ovaries are organs about the size and shape of unshelled almonds, located on either side of and somewhat behind the uterus. They are about 4 or 5 inches below your waist and are held in place by connective tissue. The ovaries have a twofold function: to produce germ cells (eggs) and to produce sex hormones (estrogen, progesterone, testosterone, and many others). The functions of these hormones are only partly understood. The small gap between the ovary and the end of the corresponding tube allows the egg to float freely in the abdominal cavity after it has been released from the ovary. The fingerlike ends (fimbria) of the fallopian tube sweep across the surface of the ovary and wave the egg into the tube after ovulation.

The uterus, fallopian tubes, and ovaries are draped in peritoneum, the thin membrane that lines the inside of the abdominal cavity.

BREASTS

Our breasts make us mammals. Their extraordinary glands produce milk with an incredible capacity to nourish babies' oversize human brains and to fight infection and disease in newborns. Breasts are secondary sex characteristics, which are features that distinguish the sexes but are not directly related to reproduction. Most women think of them as a key component of our sexual selves.

Self-image is often affected by our own and others' reactions to our breasts. Our feelings, both positive and negative, are reinforced by society's obsessive fixation on breasts and the way they are used to sell everything from cars to whiskey. This may make it difficult to think about our breasts as functioning parts of our bodies, especially in a culture that heavily markets breast enlargement/augmentation.

IN TRANSLATION: REDEFINING WOMEN'S BODIES

The logo for Women and Their Bodies, OBOS's partner in Israel

Group:
Women and Their Bodies

Country:
Israel

Resource:
Materials based on
Our Bodies, Ourselves
in Arabic and Hebrew

Website:
ourbodiesourselves.org/programs/network/foreign

In many cultures, the words and images used to describe female bodies and sexualities are negative, derogatory, and oppressive.

This negative discourse reinforces attitudes that endanger the health of women and girls and silences their voices. It also allows a community to justify or ignore practices that are disempowering and prevent women and girls from fully exercising their rights.

Many of Our Bodies Ourselves' global partners encounter this language problem. Here are two examples of women's organizations that effectively changed the tenor in their communities by coining vocabulary that honors women and girls and affirms their sexuality and life experiences.

The cover of a Japanese adaptation of
Our Bodies, Ourselves

Group:
shokado Women's Bookstore

Country:
Japan

Resource:
Materials based on
Our Bodies, Ourselves
in Japanese

Website:
ourbodiesourselves.org/programs/network/foreign

The Jewish and Arab women who together founded Women and Their Bodies, OBOS's global partner in Israel, note that both cultures prize a woman's ability to bear children, and the end of fertility is often seen as bringing despair. Though this attitude has deep historical and political
roots, Women and Their Bodies is concerned about the pressure it places on women to increase the size of their ethnic community by having children. The group is also concerned about social attitudes that affect women who are unable or choose not to have children or are past childbearing age.

Cultural values are often reflected in language. For example, common Hebrew terms for menopause translate to “age of wilting” or being “worn out,” and an Arabic term means “years of despair.” While developing the Hebrew and Arabic adaptations of
Our Bodies, Ourselves
, Women and Their Bodies was determined to use terms that are respectful and celebratory. With support and help from women in the community, the group ultimately settled on the Hebrew “Emtza Ha'hayim,” or “midlife,” and the Arabic “San' al Aman,” which means “years of security or safety.”

In Japanese, words for body parts like vulva, pubic hair, and pubic bone were written using Chinese characters that conveyed “shame” or “shadiness.” Shokado Women's Bookstore, OBOS's partner in Japan, revised these negatively nuanced Chinese characters to create neutral or positive terms for the Japanese adaptation of
Our Bodies, Ourselves.

Since publication, at least one of the terms, “seimo,” which translates to “sexual hair,” has been integrated into some of the latest Japanese dictionaries. There is also a growing tendency in Japanese society to avoid the Chinese characters that convey “shame” or “shadiness.” Instead, the language now increasingly uses neutral characters or “katakana-go”—foreign words turned into Japanese—when talking about male and female bodies. The changes translate into a major improvement, in any language.

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