Vagina: A New Biography Page 3

  I scheduled the surgery. After a four-hour operation, I awoke, hideously groggy, in a hospital bed, the owner of this metal plate contraption, which fastened the vertebrae of my lower back together with four bolts. I had a vertical scar down my back that my boyfriend—in an effort to reassure me—described, referring to the punk rock band, as “very Nine-Inch Nails.” All these changes seemed like very minor issues compared with the hope I now had of regaining the lost aspects of my mind and of my creative life, via my now-decompressed pelvic nerve.

  After three months I was allowed to make love again. I felt better but not completely recovered; I knew that neural regeneration, if it were to happen, could take many months. I continued to recuperate steadily for six months, eager but also scared to find out what would happen, if anything, to my mind once my pelvic nerve was really free of obstruction again. Would the nerve fully recover? And, more important—would my mind fully recover? Would I feel again that emotional joy, sense again that union among all things?

  Thanks to Dr. Babu and perhaps to whoever in the cosmos may have taken my call, I had a complete neural recovery, which was not something any of the team had taken for granted. This particular kind of neural compression, though not unheard of, is seldom written about outside of medical journals, and I am a walking control group for the study of the effect of impulses from the pelvic nerve on the female brain. Because of how scant information is on this subject, I feel I owe it to women to put down on paper what happened next.

  As my lost pelvic sensation slowly returned, my lost states of consciousness also returned. Slowly but steadily, as internal sensation reawakened, and as the “blended” clitoral/vaginal kind of orgasms that I had been more used to, returned to me, sex became emotional for me again. Sexual recovery for me was like that transition in The Wizard of Oz in which Dorothy goes from black-and-white Kansas to colorful, magical Oz. Slowly, after orgasm, I once again saw light flowing into the world around me. I began to have, once again, a wave of sociability pass over me after lovemaking—to want to talk and laugh. Gradually, I reexperienced the sense of deep emotional union, of postcoital creative euphoria, of joy with one’s self and with one’s lover, of confidence and volubility and the sense that all was well in some existential way, that I thought I had lost forever.

  I began again, after lovemaking, to experience the sense of heightened interconnectedness, which the Romantic poets and painters called “the Sublime”: that sense of a spiritual dimension that unites all things—hints of a sense of all things shivering with light. That, to my immense happiness, returned. It was enough for me to have glimpses of it once again from time to time.

  I remember being again in the small upstairs bedroom of the little cottage upstate; my partner and I had just made love. I looked out of the window at the trees tossing their new leaves and the wind lifting their branches in great waves, and it all looked like an intensely choreographed dance, in which all of nature was expressing something. The moving grasses, the sweeping tree branches, the birds calling from invisible locations in the dappled shadows, seemed, again, all to be in communication with one another. I thought: it is back.

  From this experience a journey began: to understand what had happened to my mind, and to better understand the female body and female sexuality.

  In the following two years, I learned a great deal more than I had known before—which was not difficult, as, like most women, I had known nothing at all—about the female pelvic nerve. And it turns out that in some ways it is the secret to everything related to femininity itself.

  When I use the term vagina in this book, I am using it somewhat differently from its technical definition. The medical meaning of vagina is just “the introitus,” the vaginal opening, one of many inadequate words related to this subject. I am using it, unless I specify otherwise, to mean something that we, weirdly, have no one single word for: that is, for the entire female sex organ, from labia to clitoris to introitus to mouth of cervix.

  Even defined in that more inclusive way, we still tend to think of the vagina in limited terms: as the parts we can see and touch on the surface of our bodies, between our legs: the vulva, the inner labia, and the clitoris—or the parts we can touch when we explore inside our bodies with our fingers—the vaginal canal. We have been terribly misconceiving the vagina by restricting our understanding of it to these surfaces of the skin, and to these inward membranes.

  The vulva, clitoris, and vagina are just the most superficial surfaces of what is really going on with us. The real activity is literally far, and far more complexly, under these tactile surfaces. The vulva, clitoris, and vagina are actually best understood as the surface of an ocean that is shot through with vibrant networks of underwater lightning—intricate and fragile, individually varied neural pathways. All these networks are continually sending their impulses to the spinal cord and brain, which then send new impulses back down through other fibers in the same nerves to produce various effects. This dense set of neural pathways extends throughout the entire pelvis, far underneath that outer vulvar skin and inner vaginal skin (though this last phrase, too, is not, medically, technically accurate: the skin inside the vagina is called, in one of the many unpleasant terms we have to refer to something so lovely, mucous membrane or mucosa).

  You can see from the Netter images online that your gorgeous, complicated netting of neural pathways is connected to your spinal cord.3 These neural pathways are continually “lighting up,” as neurologists put it, with electrical impulses—depending on what is happening to your clitoris, vulva, and vagina.

  Let me use a second metaphor. Imagine that you found a tangle of seaweed on the edge of the shore and lifted it. The heaviest parts rest on the sand in a mesh, but some skeins extend vertically. This neural network is shaped like that: it looks like a tangled skein of a hundred thousand golden threads that has been drawn upward. The mass of it gathers in the pelvis, but strands from the same network extend upward to the spinal cord and brain. Netter image 3093 shows this.4

  The pelvic nerve in humans branches out of sacral vertebrae numbers four and five, or S4 and S5, which are vertebrae in your lower back. From there, it branches again into the three far-reaching neural pathways, which I mentioned earlier, that extend throughout your pelvis: one originating in the clitoris; one in the walls of the vagina; and one in the cervix. Another network of nerves originates along your perineum and anus. Among the many incredible things about your incredible pelvic nerve and its lovely multiple branches is that, as we saw, it is completely unique for every individual woman on earth—no two women are alike.

  As you can see from the Netter images, the female pelvic neural network is highly complex. Its intense complexity is a reason that there is so much variability in women’s sexual wiring. In contrast, the male pelvic neural network, which concludes in a comparatively very regular, almost schematized, grid of neural pathways, a circle of pleasure around the penis, seems to be much simpler. This greater sexual neural complexity in women is because we have both reproductive and sexual parts, such as the cervix and uterus, that men don’t have.

  There are many more neural networks extending from the female pelvis into the spinal cord than extend from the networks in the penis to the spinal cord. You can see this in the Netter images titled “Innervation of External Genitalia” and “Perineum, Innervation of Female Reproductive Organs,” and “Innervation of Male Reproductive Organs.”5 Clearly the female neural network is far more diffuse than the male and has a lot more going on: in women, there is a tangle of neural activity at the top of the uterus, at the sides of the vagina, at the top of the rectum, at the top of the bladder, at the clitoris, and along the perineum. There are fewer distinct tangles of neural activity in the male pelvis. (The perineum is the skin between your anus and your vagina: let me stress again that one entire and distinct sexual neural network originates for women right here in the perineum, and it is this sexual neural network that, as one physician who read this section pointed ou
t with alarm, “is routinely cut during an episiotomy for a difficult delivery.” As I reported in Misconceptions: Truth, Lies and the Unexpected on the Journey to Motherhood, in America and Western Europe, unnecessary episiotomies are routinely performed for normal deliveries that would not require them if it were not for the economics of hospital time pressures, and of the litigation pressures on hospitals as well. In America and Western Europe, unsurprisingly, many women report diminished sexual sensation after childbirth, and especially after undergoing an episiotomy, though they are almost never informed by hospitals or physicians that an episiotomy will sever a sexual nerve system.)6

  By looking at the pattern of the neural networks in the Netter images, and in the illustrations here, you see that women are designed to receive pleasure, and experience triggers to orgasm, from skillful caressing and rhythmic pressure of all kinds over many, many parts of their bodies. The pornographic model of intercourse—even our culture’s conventional model of intercourse, which is quick, goal-oriented, linear, and focused on stimulation of perhaps one or two areas of a woman’s body—is just not going to do it for many women, or at least not in a very profound way, because it involves such a superficial part of the potential of women’s neurological sexual response systems.

  For some women, a lot of neural pathways originate in the clitoris, and these women’s vaginas will be less “innervated”—less dense with nerves. A woman in this group may like clitoral stimulation a lot, and not get as much from penetration. Some women have lots of innervation in their vaginas, and climax easily from penetration alone. Another woman may have a lot of neural pathway terminations in the perineal or anal area; she may like anal sex and even be able to have an orgasm from it, while it may leave a differently wired woman completely cold, or even in pain. Some women’s pelvic neural wiring will be closer to the surface, making it easier for them to reach orgasm; other women’s neural wiring may be more submerged in their bodies, driving them and their partners to need to be more patient and inventive, as they must seek a more elusive climax.

  Culture and upbringing definitely have a role in how you climax and can affect whether you climax easily or not, but that is not all there is to it. This discourse heaps vast unnecessary guilt and shame on millions of women or, conversely, depending on their tastes, leads them to feel slightly perverted. Do you feel like you’re imposing on your lover because (unlike his last girlfriend) you really need that “extra” oral sex from him? Are you embarrassed that you may wish you could ask for stimulation of both orifices when you make love? Does it sometimes take you longer than you’d like to climax, or is climax sometimes even elusive? Hey: it may not be due to your grandmother who made sure you slept with your hands on top of the covers, or to those censorious nuns in middle school; you are not any less sexual a being, or even, necessarily, any more inhibited, than his last girlfriend. Whatever it is you like and need in bed—as a woman, with all that variability—these preferences may just be due to your physical wiring.

  2

  Your Dreamy Autonomic Nervous System

  My heart flutters in my breast,

  whenever I look quickly, for a moment—

  I say nothing . . . my ears roar,

  cold heat rushes down me,

  I am greener than grass

  to myself I seem

  needing but little to die . . .

  —Sappho, “Fragment”

  For women, sexual response involves entering an altered state of consciousness. This transformation depends on your dreamy autonomic nervous system, or what scientists call the “ANS.” This system, which controls all the smooth muscle contractions in your body, contains both the sympathetic and parasympathetic divisions; it affects what your body does beyond your conscious control. The two divisions work in tandem. In women, the biology of arousal is more delicate than most of us understand, and it depends significantly on this sensitive, magical, slowly calmed, and easily inhibited system.

  Arousal precedes orgasm, of course. In order for the pelvic neural network to do its crazy work, the autonomic nervous system first has to do its work. Researchers Cindy Meston and Boris Gorzalka discovered in 1996 that the female sympathetic nervous system (SNS) was crucially involved in whether or not female arousal was successful, or even possible.1

  The autonomic nervous system prepares the way for the neural impulses that will travel from vagina, clitoris, and labia to the brain, and this fascinating system regulates a woman’s responses to the relaxation and stimulation provided by “the Goddess Array,” the set of behaviors a lover uses to arouse his or her partner. The ANS has to do with responses we can’t consciously control: it manages many of the physical reactions that are connected to arousal and orgasm, including respiration, blushing, the flushing of skin, the filling of the corpora cavernosa—the spongy tissue in the vagina that engorges with blood to produce the “erection” of the clitoris—the filling of the vaginal walls with blood that is necessary for vaginal lubrication, the increase in heart rate, the dilation of pupils, and so on.

  The brain affects the ANS, which in turn affects the vagina, which is why if you are a woman, you can think of a lover, become aroused, and find yourself wet. But the vagina also affects the brain, which in turn affects the ANS. It is a constant feedback loop. A positively experienced touch to the clitoris or vagina sends a signal to the ANS to stir up a complex series of subtle changes in the woman’s body. That one touch, if it continues to be careful and skillful and responsive to the woman’s reactions, changes a woman’s breathing—causing her to start breathing more heavily, or panting; it raises her heart rate and thus her circulation rate, which in turn causes her skin to flush, her nipples to become erect, and her whole body to become more sensitive. Her raised heartbeat, if her lover’s stimulation remains careful and attentive, sends blood shooting rhythmically into her vaginal blood vessels—the elaborate circulatory throughway distributed throughout the labia, around the vagina, and deep inside her pelvis—swelling them. This swelling expands both her inner and outer labia, which makes both layers of flesh more sensitive to pleasure; it engorges and extends the clitoris, allowing it to transmit pleasure far more keenly than otherwise; and it helps the walls of her vagina to become slick with lubrication.

  This optimal activation of her ANS makes a woman eager for lovemaking and able to experience it in all its dimensions. But for this process to be complete, and thus truly fulfilling, the stimulation must be unhurried and carefully attuned to how the woman is responding. The process requires attention and time. And, as we will see, relaxation heightens the ideal activation of the ANS—and “bad stress” interferes with it.

  “The full melting response” or “high orgasm” in women—which I would define (though our language around female sexual response is so inadequate) as that kind of orgasm that most intensely induces the most complete possible trance state and that most involves all the body systems, so that afterward the woman feels the most replete and also experiences the highest level possible for her of the positive brain chemicals’ activities—is truly possible only when the ANS is optimally activated. In our culture we all know about engaging the pelvic neural network, which is what we are raised to think of when we think of “sex” (though our general understanding of even this network is, as we saw, too superficial). But full sexual and emotional release for women centers on an idea that is foreign to our discussion of sex: activation. The ideal is an activation of the whole female autonomic system—of respiration, lubrication, and heart rate—which in turn affects vaginal engorgement, muscular contraction, and orgasmic release: external stimuli as a woman thinks of sex elicit anticipator/dopamine release, and opioids and oxytocin are released by her orgasm. Most people in our culture are not raised to pay much attention to reading a woman’s “activation” levels. If a woman’s ANS response is ignored, she can have intercourse and even climax; but she won’t necessarily feel released, transported, fulfilled, or in love, because only a superficial part of her c
apacity to respond has been made love to, or engaged.

  The ANS also responds to a woman’s sense of safety or danger. It sends the signals to the brain and then to the body that one is safe, so one can relax, eat, and digest; or relax and sleep; or relax and make love. The “relaxation response,” a powerful phenomenon identified in the West by Dr. Herbert Benson in 1975 (but well known in many Eastern cultures), takes place when you relax to the point that your brain facilitates the ANS’s healing work—and promotes the effectiveness of the things your body does that are not under your conscious control.2 By now there are literally hundreds of studies showing the power of the relaxation response in bringing the human body and mind benefits ranging from better healing after surgery, to improved focus, to lower rates of heart disease.

  Several recent studies show that the relaxation response is even more important to female arousal than we have realized before now. As we saw, Dr. Georgiadis and his team’s MRI study showed that as a woman approaches closer and closer to orgasm, her brain centers for behavioral regulation become deactivated.3 One could say that she actually becomes, biochemically, a wild woman or a maenad. She becomes so disinhibited and impervious to pain that it is as if she is in a state of altered consciousness. Women in “high” orgasm go more deeply into this trance state than at any other time. Judgment is suspended in this state, and women do not even feel pain in the same ways as in normal consciousness.

  The ANS gets you to that point; it lets a woman relax, breathe deeply, flush, fill with blood in all the right places, get the high-focus energy of activated dopamine, and go eventually—safely—into the kind of trance state described above. Simultaneously she experiences the most intense kind of pelvic contractions, which leave her exhausted, spent, and basking in big jolts of opioids and oxytocin—bliss and fondness—bringing these in turn into her life and into her relationships.