Dr. Sherry A. Ross doesn't blush when she uses the word vagina. But the gynecologist, who treats everyone from Reese Witherspoon to Gigi, Bella, and Yolanda Hadid, knows many of the rest of us do. "Sixty percent of women use code names for their vaginas," she says incredulously. "If we can't talk about it, then how can we take care of it?" Ross's mission is to change the dialogue women have about their bodies, to usher in more honesty and dispel the stigma we feel when we talk about female sexual health. "Women are so curious about the vagina, but it's like a separate part of our bodies." Ross says, explaining the hesitation of many of her patients to voice questions they have about their health and sexuality. Her forthcoming book, She-ology, out this spring, covers all the information women need to know.
If you've been holding back from asking your doctor anything about your body, Dr. Sherry has shared her answers to the most commonly unasked questions. There's nothing to be bashful about. Next time you see your gynecologist ask your own questions in person. No matter what you say, it won't be the first time they've heard it!
Q: Does my vagina look normal?
A: Women want to know how large their lips are compared to others, how the color of their skin compares. They want to know how they sized up, just like men have been doing for decades. We're seeing now that one in five women are comparing their vaginas to what they see online on porn sites, and as many as half of women don't like how their vaginas look. If this comes up in a conversation, I like to pull out a mirror and go over what's normal with my patient, to reassure them. It depends what the source of their information is. One 20-year-old girl came in and told me her boyfriend said she had plus-size lips compared to what he'd seen on porn sites. This whole online age has really been damaging to our self-esteem and the vagina's self-esteem. We now think that every vagina should look like Jenna Jameson's. I saw a 16-year-old swim star who, when she would wear her bathing suit would have to tuck in one of her lips because it was about 4 inches long and it would bulge under her bathing suit. This puts the range in perspective. Asking questions is important. Do they get pulled in with intercourse? Do they give you pain when you worked out, or go cycling? In the book I've created a Visual Vaginal Library with photos that let you see what's normal and what's abnormal. Giving women vagina confidence is important.
Q: What's up with my sex drive?
A: For women, our sex drive starts in the brain. That is why our libido is driven by what's happening around us, by job stress, by sleeping, by whether you even like who you're sleeping with, whether they've emptied the trash. There are so many factors that affect our libidos and our arousal. When women come in and say 'I don't have a sex drive' or 'I can't have an orgasm' I often ask, 'How's it going in your relationship?' And that often starts the conversation, but it's not a quick conversation. And our system doesn't allow much time for that. That's in part why I wrote the book. I wanted there to be a good source of information.
Q: How does my vagina smell?
A: Scent and taste are very related. I get both a lot. Ruling out infection, the smell and taste has a lot to do with our diets. Just as there are certain foods, like asparagus, that make our urine have an odor, certain foods, spices, nicotine, alcohol affect the odor and taste of the vagina, which go hand in hand. The care and maintenance of the vagina, of course, also does. Women are confused. We hear the vagina is self-cleaning but we don't really know what that means. You can and you should use a non-fragrant gentle soap on the vagina, inside the lips, and even the entrance up to one or two knuckles but you don't want to douche, where you're clearing out the healthy bacteria that guard against infection. The vagina likes to be acidic so when anything disrupts that balance it can result in an infection.
Q: How can I orgasm more?
A: In one chapter I write about a patient who had multiple orgasms and wanted to know "Am I OK?" On the other side, some women do have problems in the bedroom. Ten to 20 percent don't have orgasms. We speak to the cultural aspect of that, because it's just not talked about. If you've never had an orgasm, you've probably never masturbated. I really think there has to be permission to touch yourself, to know your anatomy. One of the studies I've come across in my research was that 30 percent of female college students didn't know where their clitoris was. You wonder to what extent they've had orgasms. You can't rely on someone else to do it for you. I describe in my book how to masturbate. Vibrators help. The first orgasm you have can be scary. If you don't know what to expect and if you're not patient it can be difficult.
It's another way the porn factor has hurt our society sexually. It's created a lot of insecurity for women physically and emotionally. It's screwed it up for both genders, really. Gail Dines, a psychologist who did a great TED talk on the effect of porn on our youth, says that the average age a child is exposed to pornography is 11 years-old. Another statistic she points to is that porn is viewed monthly more Netflix, Amazon, and Twitter combined. That shocked me. One in five women are comparing themselves to these women. This is the cycle we need to stop.
Q: Is my vagina tight or loose?
A: If you've had kids vaginally, the vagina does change after two or more deliveries, definitely after three. If you have vaginal gas that's a sign it's larger because air is getting into the vagina. If you have discomfort with sex you may be tighter than average. There are exercises you can do to help. Your doctor can assess that.
Q: My hair down there...how does it compare?
A: It's been fun to see the trends come and go. The trend is still less, at least in the under 35's. Now men are asking, "Can you take it all off?" You get varying appreciation for pubic hair. There's the question of what's it's really for. Is it just a cushion? Is it for pheromones? No one knows. Then there are the other trends: tattooing, vajazzling. I've got great photos of that in my book. Of course, there are the risks. There are DIY waxing injuries. I always go back to cleaning. (See above.) Hygiene is the most important thing.
Q: Is my period normal?
A: People tend to ask about their flow when it's heavy and clumpy, and that could potentially be abnormal. It can reflect thyroid abnormalities, for example. Conversely, if you're on the birth control pill, it can be very light. It's so important that a doctor asks about your period. And if they don't ask you, ask them.
Q: Could I have cancer?
A: The chapter that I'm most fond of is the Pink V and it has to do with how cancer affects women's health, and not just their depression but their sexual health and their reproductive health. I think it's an under-discussed topic that really needs more attention. Women who are seeing oncologists have little opportunity to discuss sexual health and what can be done. I see a lot of under 40 year-olds with cancer and it really affects their intimacy.