Elizabeth G. Stewart - The V Book: A Doctors Guide to Complete Vulvovaginal Health

Elizabeth Gunther Stewart, M.D., FACOG, a Boston-based gynecologist, is director of the Stewart-Forbes Vulvovaginal Specialty Service at Harvard Vanguard Medical Associates. Dr. Stewart is also Assistant Professor of Obstetrics and Gynecology at Harvard Medical School and a member of Brigham and Women's Hospital staff. She speaks extensively about vulvovaginal disease to medical professionals. Her perspectives as a full-time vulvovaginal practitioner, a researcher, and a teacher shape her prominence as one of the leading voices advocating the emerging importance of her specialty. This book is an extension of her lectures, her clinical experience with patients, and patient-education materials she has prepared for them.

Paula Spencer specializes in health and family subjects for Woman's Day, Glamour, Parenting, Baby Talk, USA Weekend, and other publications. She is the author of four books on pregnancy and parenting, including Everything ELSE You Need to Know When You're Expecting (St. Martin's Press).

The Mind Why V Health Starts Here

V aginais hardly a household word.Vulva and clitoris might as

well belong to another language. They are blushers, vaguely subversive, not ready for prime time. They hide behind pet names and euphemisms (my privates, Pookie, down there) if they're called anything at all. And then there's vestibule. That word's easy to say only because 99 out of 100 women have no idea that they have one, let alone where it is or what it does. (Don't worry. I'll show you later.) I feel pretty sure that a man would not allow some important part of his terrain to go uncharted for so long.

Believe it or not, even medical professionals can be uncomfortable about V terms. My own vulvar specialty practice in Boston is called the Stewart-Forbes Specialty Service. It's named after me and my nurse-practitioner partner, Diana Parks-Forbes, because at the time we were deliberating about what to call it, no one in the medical group's administration wanted the word vulva or vagina in the name. As a result, I surprise many new patients when I first walk into the exam room. You're a woman! they'll exclaim. They expected a gentleman named Stewart Forbes. The practice's vague name is hardly helpful to me professionally, either. Whenever I write a business letter or call a colleague, I always have to clarify that I represent the Stewart-Forbes Vulvovaginal Specialty Service. (Even so, Dr. Stewart Forbes gets lots of letters!)

I wish everyone could be matter-of-fact about the Vs. How much better my lifeand your healthmight be.

The first step to being comfortable with your body, after all, is being comfortable thinking about it (if not talking about it). That's why I say that V health starts in your head. As a physician, I'm a big believer in liberation biology, to use the term coined by Mary Carlson, associate professor of psychiatry and neurobiology at Harvard Medical School. That means using biological information to help you understand your body, shake your hang-ups, and take charge of your full potential as a woman. In V terms, that means recognizing that the vulva and vagina are healthy parts of the body to be protected from disease, explored and treasured in responsible sexual life, esteemed for childbearing. I'd like for every woman to feel free enough to learn her way around her own body, free enough to talk easily to her doctor if a problem crops up.

Why are we so awkward about such commonplace body parts? Reticence about the vulva and vagina is nothing new. I'm no anthropologist or historian, but I do know that a veil has been draped over these parts for not merely a few generations but thousands of years. Knowing this past helps explain where our collective mind-set is today. Moreover, such information points the way to where our thinking ought to go.

So let's start at the beginning.

Once upon a time people did not feel negatively about the vulva and vagina. Tens of thousands of years ago, the beautiful design of the vulva

was something celebrated, even revered. The yoni, a symbol of the female genitalia, took many forms. Flowers, fruits, a triangle, and a double-pointed oval shape were all used to depict the vulva. Yoni is a Sanskrit word for womb, origin, source, sacred placehonoring the vulva's role as birthplace, bringer of life. Today the word yoni enjoys a renaissance as a way to refer to female genitalia, although its use is hardly widespread.