Vol. 2 - Learn your body
Before you can understand why something isn't functioning they way you want, it is important to understand how it works. So, get prepared to be either curious, uncomfortable, bored, or re-informed (or all). Consider this a brief introduction into Female Sex Ed 101.
Instead of giving you a full course (or many courses), I am going to try to highlight the important aspects of understanding how our female bodies work. Sexual health and anatomy are more complicated then my brief introduction, but I want to share my Cliff-note's version with you.
Name that part...Women come in all shapes and sizes. I figure you probably know that. And since we have been dealing with breast cancer, I know you understand we have breasts (sensual spots & milk factories). We also have...
- Fallopian Tubes (travel tubes for eggs).
- Ovaries (hormone function & egg control).
- Uterus (baby short term housing).
- Cervix (gateway from vagina to uterus).
- Vagina (potential space-maker for sex, childbirth, & menstrual flow).
- Clitoris (sexual pleasure, stimulation).
Sure there are other important external and internal organs, but this is a good start.
While women are fertile they have a monthly cycle.
Women, how we cycle...
Ovaries release an egg(s) each month. The egg travels down the fallopian tube into the uterus, and for a few days is fertile. This is when it may be possible to get pregnant. The uterus (wanting to prep) builds a thick lining to help prepare for the possibility of pregnancy. During this time, sperm would have to travel from your vagina, past your cervix, into the uterus ... leading to a whole different complex reproductive process that I am going to skip.
If the egg is not fertilized, which is most of the time, the uterus' thick lining is not necessary. It sheds getting passed through the cervix and out via the vagina. Aka: menstruation, period, or any other name you use to describe the bleeding mess that makes wearing white difficult. Then you get a break until it starts all over again.
This cycle happens monthly and is pretty much controlled by hormones.
Hormones, more than just our moods...Hormones are important for sexual and reproductive health. Hormones are released in multiple ways (Pituitary, Ovaries, etc). They are a complicated system and like most everything in our bodies need to be in perfect balance or we have problems. However, think of them this way:
- Estrogen: puberty maker, maintains reproductive organs (also metabolism, vaginal lubrication, bone resorption)
- Testosterone/Androgen: sexual arousal (libido)
- Progesterone: baby aid (preps uterus & mammary glands, sex drive)
Normally females stop releasing eggs around age 50, so there is no real "need" for hormones. So, hormones begin to decline. Hence, menopause. Since hormones do more than just help make babies, women have some pretty hard core side effects. If you look at what some of the hormones do, it is easy to see why menopause can lead to sexual problems for women. Often women will take hormone supplements or therapy or creams to help aid in menopausal problems.
* I like how some big sexual health side effects
are left off estrogen & progesterone... argh...
By understanding our hormones, it becomes easier to understand why estrogen and progesterone are often involved in breast cancer, for people with hormone-receptor-positive cancers. Estrogen promotes female's breasts during our sexual development and regulates our reproductive organs. Progesterone also deals with mammary gland development, especially the breasts during pregnancy (milk production, lactation, breastfeeding, etc).
It is also easy to see why blocking these hormones (breast cancer's hormone therapy) can cause a lot of unexpected and unwanted side effects.
Putting it all together...
How our bodies function sexually is more than just anatomy and hormones. Really it is how all that comes together, combined with our emotional response towards sex. In my studies, I had to read about the sexual response cycle (thanks to some ground breaking research by Masters & Johnson many years ago).
The sexual response cycle describes physical and emotional stages that occur during sexual activity.
- Excitement (think of it as the start of foreplay, things are starting to feel good)
- Plateau (think of it as foreplay up to the point of orgasm, intensified feeling good)
- Orgasm (think of it as orgasm, climax)
- Resolution (think of it as over, time to snuggle, nap, or back to reality)
During the excitement and plateau stage the body begins to react positively to stimulation. Normally the clitoris will become highly sensitive, nipples will become erect, muscle tension builds, and the vagina will lubricate and expand. Breast cancer affects both of these stages.
I mean we already have had our breasts cut or removed, and now a large portion of women with breast cancer are pushed into hormone loss/blocking from chemotherapy and hormone therapy. So, I am just going to come out and say it, estrogen-loss is a big problem. Estrogen makes the vagina moist, flexible, and aroused.
Everyone's sexual response cycle is unique to them - which is why it is important to understand more about your own needs and responses. Also, finding ways to counteract loss of estrogen is important. I will get into these issues later, but for now these stages require certain functioning hormones to help aid in sexual satisfaction.
In one of my college courses about sex, I heard an example about the vagina that has always stayed with me. Think of the vagina as a glove. When the glove is not being used it is potential space. When the glove is being used it opens to accommodate the hand, the potential space is filled. The vagina is potential space.
Sex, to be pleasurable, needs the vagina to expand (or it will hurt), to become wet (or it will hurt), to become flexible (or it will hurt). And if sex hurts, it becomes less desirable. Less desirable to an already lowered sex drive means more problems.
The Big O...The orgasm. Often allusive, challenging, or mysterious (often due to lack of how female genitalia works)... an orgasm is worth the effort. And it can be effort to achieve one.
An orgasm is when the muscles around the genitals contract, then release muscle tension, and the nervous system sends pleasure signals to the brain. A woman can have none, one, or multiple orgasms. A woman can have orgasms from just vaginal penetration, but around 80% of women need stimulation directly to the clitoris.
Because we want orgasms, it is important to understand the female genitals. The female genitalia is made up of the clitoris (female penis), urethra (where we pee) & vagina (potential space), which are all protected by the inner lips, which is protected by the outer lips. All of these organs together are called the vulva. Finally, the perineum is the space between the vulva and anus.
While I have already described how the vagina is potential space, the clitoris has over 8,000 sensory nerve endings. That is often more nerve ending than a penis. So, the clitoris is our version of a man's penis... but even more sensitive. I really want to go on about the male/female organ similarities, and how we all start out as girls, but I need to stay on topic... and that is hard for me to do... so back to the point...
Really our sexual organ is the clitoris and not the vagina.The clitoris, like the penis, has a head and shaft. And just like the penis, it is stimulated via stroking (like masturbation or oral stimulation). Often the head is overly sensitive, so some women prefer to be touch near, but not directly on the clitoris.
The vagina is also unique to each woman. You may have more nerve endings towards the first 1" to 4" of the vaginal canal. Or feel greater satisfaction towards the front near the bladder wall (g-spot). Or towards the back of the vagina wall. Some women has no really sexual stimulation from it while other do.
Orgasms can be helped by fantasy, a healthy imagination, sex toys, or by stimulating other erogenous zones. Erogenous touch can be almost anywhere on your body. Every one is different (feet, neck, arm, leg, toe... basically it can be anywhere). The only way to learn is to try... and I will get to that at a later blog post too.
Of course, orgasm is harder to reach as we age or with menopause or due to breast cancer side effects!
I realize that this has not provided a simple solution (and there are so many more issues, meaning the solution will most likely be a complex answer addressing physical and emotional facets to the problem - and don't forget you have a partner with their own set of issues). However, before I start offering tips, I wanted to make sure that the first step was to address how your body actually works.
While Sex Ed 101 is important and hopefully you understand your body better, some of the most important factors to sex are communication & attitude... which I will talk about in the next Let's Talk about Sex blog post...