Re-educate yourself about a part of the body shrouded in confusion and myth: the female genitalia.

Half of the human population possesses a vagina. A quarter of the world menstruates. And yet, the female sex organs have long been misunderstood, ignored, or shamed. Sex education classes in school teach very little about sexual health; when they do, it’s likely tangled in misinformation. Even usage of the word “vagina” is a linguistic error – what we usually mean is the “vulva.” And as feminist psychologist Harriet Lerner wrote, “What is not named does not exist.”

Examining everything from the hymen to menopause, author Lynn Enright set out to disentangle fact from patriarchal fiction while also offering her own stories of womanhood. These blinks don’t always present clear answers because even today, most of the medical research available is based on studies of men, by men. Instead, they teach us how to reacquaint ourselves with the female anatomy and reveal how women’s relationships with their bodies have been influenced and distorted by culture and society throughout history.

And just a quick disclaimer before we begin: Blink 3 describes an incident of sexual assault.

In these blinks, you’ll learn

what the hymen really is;
why heterosexual culture has mistakenly put the vaginal orgasm on a pedestal; and
everything you never knew about menopause.
Sex education curriculums around the world are flawed, which can lead to dire consequences.

In the Middle Ages, many of the tens of thousands of women killed in the European and American witch trials were midwives. They were killed for providing contraception, abortion care, and sexual health information to women. And with a male-dominated medical profession, female healers were seen as a threat to patriarchal systems.

Knowing about women’s health and sexuality has always been transgressive. The field of medicine has only recently opened up to include women, but there is still a severe lack of research on female sexual health. The author found that even a simple Google search often showed results laced with lies, myths and mistruths. So even when women are actually “educated” on their own sexual health, most of what they think they know might not be true.

Take one 2016 study of a thousand British women for example. Forty percent were unable to correctly identify the vagina, and 60 percent were unable to identify the vulva. Ignorance can be harmful. If a woman doesn’t know what a normal vulva looks like because she doesn’t know what the vulva is, how can she be aware of any potentially dangerous changes?

The key message here is: Sex education curriculums around the world are flawed, which can lead to dire consequences.

At the moment, countries that have sex education programs in schools tend to focus on contraception. This centers around the male orgasm, teaching only how to deal with its fallout. Lucy Emmerson, the director of the UK’s Sex Education Forum, calls this the “period, pills, and pregnancy” approach.

According to Emmerson, the state of sex education in English schools is dismal. She estimates that only around 1 in 15 schools teach the subject in a sex-positive way, discussing both female and male pleasure with accurate lessons on anatomy. But this is usually thanks to the initiatives of one particularly dedicated teacher or health worker – not a countrywide policy. And in the US, the state of sex education is far worse. Only 13 of the 50 states even require sex education to be medically accurate.

Sex education should be thorough and complex, opening up discussion about consent, gender roles, LGBTQ+ sex and relationships, fertility, and women’s pleasure. So does a model of such a curriculum exist?

It does! In the Netherlands, sex education is sex-positive. Children begin learning about relationships, their anatomy, and how to keep their bodies safe at age four. Later, students also learn about pleasure and equality, as well as reproductive health. Because of this approach, teenagers are reportedly having sex later. The country’s pregnancy rate is eight times lower than in the US and five times lower than in the UK. What’s more, a study that looked at the early sexual experiences of 400 American and Dutch women from similar backgrounds showed that American women are more likely to feel pressured into having sex for the first time, while Dutch women are more likely to first be in a respectful and loving relationship.
We must learn about our sex organs to combat widespread misinformation about women’s health and sexuality.

So what exactly is the vulva? Usually mislabeled as the vagina, the vulva comprises the clitoris, the mons pubis, the inner and outer labia, and the vaginal and urethral openings.

Many women are unaware of this difference, or they’ll say “vagina” since it’s more common. Even the author used to say “vagina” instead of “vulva” because she felt the latter was just a little too pedantic. But she reconsidered her own erasure of the word. She decided that using “vagina” in place of “vulva” reduced all of a woman’s sexuality to a hole. Feminist psychologist Harriet Lerner referred to this as a “psychic genital mutilation.”

The key message here is: We must learn about our sex organs to combat widespread misinformation about women’s health and sexuality.

For many of us, a re-education is necessary. Let’s begin with the outer sex organs. Within the vulva, the mons pubis is the mass of fatty tissue covering the pubic bone. Hair grows on the mons pubis, outer labia, and anus. The inner labia are hairless, covered in a mucus membrane, and often asymmetrical. Many women are self-conscious about the length of their labia, but a 2018 Swiss study of women aged 15 to 84 showed that the length of inner labia ranged greatly – from 2 to 10 cm. The clitoris, which will be explored in detail later, is the only organ in the human body whose sole function is to provide sexual pleasure and arousal.

The vagina is not actually a hole; it’s a muscular tube with two walls that press against each other and can expand immensely. It is enclosed and self-cleaning. The Bartholin’s glands are on one side of the vaginal opening; during arousal, they may release fluid into the vagina. The Skene’s glands are located at the opening of the urethra. Some women produce fluid here and therefore ejaculate, or “squirt,” when they orgasm.

The inner sex organs include the uterus, or the womb – an organ the size of a small pear. Like the vagina, it has powerful muscular walls that press against each other. During pregnancy, they expand dramatically. The cervix is the part of the uterus that extends into the vagina. Its opening is a tiny hole, through which menstrual blood or seminal fluid can pass. It dilates to allow a baby to pass through the uterus to the vagina.

On either side of the uterus are the ovaries: two almond-sized balls that store and mature eggs, as well as produce hormones that regulate the menstrual cycle. When an egg is released from an ovary, it passes through the fallopian tube. Here, it might meet a sperm, become fertilized, and travel to the uterus. If not, it disintegrates.
The misrepresentation of the hymen disempowers women.

As a teenager, the author was frustrated with her vagina. She was unable to insert a tampon; even though she’d been taught that she had a protective hymen covering her vaginal opening, it didn’t feel right. The prospect of asking her doctor to inspect her vagina felt impossible. She lived in Ireland, a Catholic country that wouldn’t legalize abortion for another two decades – a country that viewed women’s sexuality as something shameful.

She remained ignorant about her body and avoided physical intimacy all throughout her teens. Then, when she was 19, she fell asleep drunk at a party and was sexually assaulted.

She woke up with her pants full of blood and the realization that she’d been penetrated for the first time, violently and without consent. Fifteen years later, she still doesn’t truly know what the physiology of her vagina was before the assault. But she does know that this ignorance about her body meant she had little autonomy.

The key message here is: The misrepresentation of the hymen disempowers women.

We are taught from an early age that the hymen is associated with female purity. It’s imagined as a sheath protecting the opening of the vagina. But this is false.

While they do vary from woman to woman, hymens are not taut, pierceable membranes. The hymen actually consists of thin folds of mucous membrane that most often form a crescent-shaped crown around the vaginal opening. For some, it forms a ring. Less often, there’s a thicker membrane. This highly unusual imperforate hymen does look more like the mythical transparent seal. It can be dangerous, requiring surgical intervention. And some women don’t have hymens at all.

The author believes that because the hymen has no biological function, it’s been made into a symbol of virginity around the world – part of an agenda to control female sexuality. Some cultures, for example, place extra emphasis on a woman’s virginity as a commodity to be passed from family to family. If a woman doesn’t bleed on her wedding night, she’s shunned, shamed, and in some cases, killed for her perceived impurity. Her family may also be ostracized.

For this reason, “fake hymens” containing dye or animal blood are sold online. They’re meant to burst during sex. Many clinics in the Middle East and around the world, including the UK, also perform operations that can make it seem like a woman’s hymen has been broken during intercourse and cause her to bleed. In the next blink, we will explore another part of the female anatomy that has been subject to inaccuracies rooted in misogyny: the clitoris.
In a society that discourages women’s pleasure, the clitoris has long been neglected or brutally eliminated.

The clitoris is often omitted in sex education classrooms and has been brushed off by scientists as a frivolous subject of research. As a result, many women don’t know about the sex organ that provides them sexual pleasure. In addition, the clitoris has been subjected to violence around the world.

Millions of women had long been aware of their clitoris, but it was only given its scientific name in the seventeenth century. It took another 200 years for the inner and outer clitoris to be drawn comprehensively, with its visible glans and clitoral hood and the shaft underneath the vulva’s tissue that split into two legs, or crura.

Fast forward to 1993, when Australia’s first female urologist Helen O’Connell made a significant discovery. She uncovered that our understanding of the clitoris had been wrong; it was actually much, much larger than we had thought.

The key message here is: In a society that discourages women’s pleasure, the clitoris has long been neglected or brutally eliminated.

This late discovery mostly comes down to social factors. O’Connell was inspired to research the clitoris when she realized that extra care was given to protect male sexual function when removing the prostate. But women weren’t afforded the same care during pelvic surgery. It was a guessing game. No male doctor had cared enough about female sexual health to research the blood and nerve supply of the clitoris the way they had for the prostate.

Until O’Connell pioneered research by dissecting cadavers and using photography to capture its structure, we didn’t know that a clitoris could range from 5 to 12 cm and swell by 50 to 300 percent when engorged. We didn’t know how the clitoris interacted with the front walls of the vagina, or that it could be stimulated by vaginal penetration. And yet, these findings have still not made their way into mainstream education.

The minimization and neglect of women’s pleasure is caused by a deep inequality between the sexes. This is also at the root of Female Genital Mutilation (FGM). There are various types of FGM, and they are all violent, harmful procedures that cut or injure some or all of the female genitalia. FGM is predominantly performed in 30 countries across Africa, the Middle East, and Asia. It has been performed on approximately 200 million girls and women.

Fortunately, resistance to FGM is growing. When a ten-year-old Somalian girl named Deeqa Dahir Nuur died in 2018 after a vein was unintentionally severed during FGM, the country’s attorney general pursued a prosecution for the first time in the country’s history. Furthermore, Deputy Prime Minister Mahdi Mohammed Gulaid publicly condemned the practice of FGM in Somalia. This was particularly significant in a country in which 98 percent of women have undergone the procedure and 65 percent of women support the practice.
Talking about the female orgasm can free it from mystery and neglect.

For the author, orgasms were wrapped up in various iterations of shame for most of her life. It started with being ashamed of wanting an orgasm. There was no discussion of the female orgasm or of female masturbation at school. She began to experiment with touching herself despite a female peer telling her “girls who masturbate are sick.”

She continued to masturbate, but she couldn’t manage an orgasm; this triggered another reason to feel ashamed. Finally, as she got older and successfully orgasmed through clitorial stimulation, she felt shame for being unable to achieve what the world considered the “right kind” of orgasm – a vaginal orgasm.

The key message here is: Talking about the female orgasm can free it from mystery and neglect.

Heterosexual culture has determined that the orgasms reached through penetrative sex are superior, even though 50 to 75 percent of women can’t orgasm solely through penetration. This idealization of the vaginal orgasm is a new phenomenon and unsupported by science.

It all started with psychoanalyst Sigmund Freud. In the early twentieth century, he claimed that the clitoral orgasm was sexually “immature” – a sign of mental health issues – while the vaginal orgasm indicated sexual maturity. Since then, scientific research has shown that there are countless ways to reach orgasm. The clitoris can be stimulated outside the glans, and different types of stimulation produce different types of orgasms.

Freud’s take on the female orgasm continues to hold up because it dovetails neatly with patriarchal values. It places the focus on the penis during intercourse and prioritizes sex that is conducive to the heterosexual male orgasm.

So, instead of pointlessly categorizing orgasms, we should focus on closing the “orgasm gap.” A major 2017 study in the US showed that sexually active, heterosexual women have fewer orgasms than any other demographic. Only 65 percent report reaching orgasm during sex, compared with 95 percent of heterosexual men and 86 percent of lesbian women. Heterosexual women fare even worse during casual encounters. A large-scale study showed that only 11 percent of North American female college students orgasm during a “hookup.”

Many women feel more comfortable directing their partners when they’re in a relationship. This may explain the cultural assumption that women are less interested in casual sex. What they’re actually uninterested in is unsatisfying sex.

Since the study of female sexuality has been neglected for so long, it’s no wonder that the female orgasm is so enigmatic. But being aware of its many manifestations and talking about it can help women close the orgasm gap.
People with vaginas endure unnecessary shame and suffering caused by taboo, ignorance, and oversight.

In 2017, the UK’s National Institute for Health and Care Excellence, or NICE, formally declared that doctors must listen to women who have symptoms of endometriosis. Endometriosis is an agonizing disease in which tissue similar to the endometrium, which lines the uterus, grows outside of the womb. Every month that a woman isn’t pregnant, the tissue bleeds, causing her chronic pain.

The physical suffering caused by endometriosis can wreck a woman’s life. It can affect her career and her relationships. It can also cause depression and anxiety. If left untreated, her organs can become fused and cause infertility. And yet, as highlighted by the advisory deemed necessary by NICE, women’s pain often isn’t taken seriously. In fact, it takes an average of seven to eight years to be diagnosed with endometriosis.

The key message here is: People with vaginas endure unnecessary shame and suffering caused by taboo, ignorance, and oversight.

In the 1970s and 80s, writer Hilary Mantel was met with skepticism while trying to get treatment for her endometriosis. She later learned that textbooks described endometriosis patients as white, middle-class career women in their thirties who were “anxious perfectionists.” According to Mantel, they were viewed as “well-educated nags” but were still more likely to receive correct diagnoses than less privileged women.

Women are more likely to be considered hysterical than legitimately in pain. According to data from the US and Europe, women wait longer than men do for treatment in the ER and often receive prescriptions for sedatives rather than pain medication. This cavalier attitude toward women’s suffering isn’t based in any science. We don’t have data comparing women’s and men’s reactions to pain.

Women also suffer emotionally at the behest of a culture that aims to convince them that their vulvas are flawed. For example, a bald vulva is now totally normalized in the West as a result of becoming the standard in pornography. Half of all women in the UK under 35 regularly get waxed, removing all or most of their pubic hair.

The author isn’t totally convinced that the removal of pubic hair is the most pressing feminist issue. Labiaplasty, on the other hand, is a much more extreme measure taken to eliminate perceived flaws in one’s vulva. It involves the modification of the inner labia, usually to trim its length, and is the fastest-growing type of plastic surgery.

Vulvas are considered so taboo and private that it’s unusual to see them outside of porn. This has meant that generations of women and men have grown up with flawed ideas of what constitutes a “normal,” attractive vulva.

Life will improve for the almost two billion people who menstruate if we tackle the stigma around periods.

For many girls, getting their period for the first time is an unnecessarily traumatic experience. In 2017, 1 out of 4 girls in the UK felt totally unprepared for the start of their period while 1 in 7 didn’t know what was happening to them.

Even girls who are prepared and informed are often upset the first time they menstruate. But maybe a girl’s first period feels especially horrible because it represents an induction into a culture bound by strict gender roles. It marks the loss of innocence and the beginning of being seen as a sexual object or a vessel for carrying babies.

The key message here is: Life will improve for the almost two billion people who menstruate if we tackle the stigma around periods.

A period happens after the endometrium thickens in the womb and doesn’t receive a fertilized egg. Then, it sheds and is expelled through the vagina.

There are plenty of biological reasons why periods are considered dreadful. They’re bloody, messy, and often painful affairs. Many women experience cramps during their periods as the muscular wall of the uterus forcefully contracts to shed its lining. This may temporarily cut off the blood supply to the womb. The pain is caused by tissues in the womb releasing chemicals as a result of the lack of oxygen.

Most women also suffer from premenstrual syndrome, or PMS; symptoms include bloating, mood swings, and depression. Moreover, 5 to 8 percent of women suffer from premenstrual dysphoric disorder, or PMDD, which causes more extreme anxiety, depression, and lethargy.

The secrecy and shame surrounding periods undoubtedly intensifies suffering. Some communities in Nepal, for example, still subscribe to the ancient Hindu belief that menstruating women are toxic and will poison food and kill crops. So when women in this community have their periods, they are banished to huts. This tradition is dangerous, and there have been many reports of rape and death. One woman died from asphyxiation after starting a fire to keep warm. Another died after a poisonous snake bit her.

When poverty is combined with periods, women face even greater difficulties. And period poverty is widespread. In 2017, a charity in Leeds reported that girls were missing school because they couldn’t afford sanitary pads and tampons. In 2015, a Kenyan study found that 10 percent of the 15-year-old girls questioned by researchers engaged in prostitution to be able to afford sanitary pads.

When people are more open about periods – and more women and people who have periods are in positions of power – more work will likely be done to ease their biological discomfort.
The current conversation surrounding fertility and pregnancy undermines women.

If you’ve ever taken hormonal contraception, you’re probably familiar with the possible side effects. Weight gain, depression, a decreased libido, the possibility of developing potentially deadly blood clots, and an increased likelihood of getting breast cancer are only some of the things that might await you if you choose to take it. But sometimes, it can feel like there’s not much of a choice.

After all, the only forms of male contraception that currently exist are condoms – which most couples in long-term relationships prefer not to use – or vasectomies. These are meant to be permanent and are only advisable for men who don’t want children in the future.

Hormonal contraception is currently only available to women. There have been multiple drug trials for male hormonal contraception, but they’ve been repeatedly halted. Why? Because men complained about the side effects – the same side effects regularly experienced by women around the world.

The key message here is: The current conversation surrounding fertility and pregnancy undermines women.

Like contraception, the discussion around fertility is unfairly focused on women. Many women do worry about putting off pregnancy, despite economic factors and the cost of childcare forcing people to delay parenthood.

But fertility is complex. It’s not just about a woman’s “biological clock.” In fact, for half of all couples who experience infertility unrelated to age, the cause is abnormal semen quality or male sexual dysfunction. Sperm count is falling worldwide; not only do we not know why, this basic fact is not common knowledge. This reality offends the male ego and the idea of male virility – so male infertility is simply a no-go.

Pregnancy has also been flattened into a standard story. Until her friends started having children, the author hadn’t heard any detailed pregnancy or birthing stories. She was surprised to learn just how much pregnancy and childbirth experiences vary from woman to woman.

Hearing a range of birth stories can help people anticipate the things that might happen during labor. For example, sometimes an episiotomy is necessary. That’s when a cut is made in the perineum, the area of skin and muscle between the vagina and anus. Although they’re not always necessary and can have serious implications on women’s health, episiotomies are sometimes performed without consultation or consent from the person in labor.

To avoid situations like this, it can be helpful to make a birth plan. This outlines the specific needs of a woman, trans, or non-binary person during childbirth, which can grant confidence and autonomy.
The conversation about women’s sexual health must be inclusive of all people with vaginas.

A recent study found that a quarter of women have considered leaving their jobs due to menopausal symptoms. Is menopause really that bad? Bad enough to quit your job? For some women, it can be. Coupled with ageism, misogyny, and a lack of discussion, many women feel unsupported and embarrassed in the workplace.

Consider the fact that, as women age, we hear their stories less often. This means that we rarely hear about menopause at all.

So what is menopause, besides the end of menstruation and the beginning of hot flashes? Technically, menopause is when a woman hasn’t menstruated for 12 consecutive months. But we use the term menopausal to refer to any time a woman exhibits symptoms – often for years before and after. Women generally stop menstruating in their forties and fifties. Sometimes it’s abrupt, sometimes it’s more gradual. But that’s not the whole story.

The key message here is: The conversation about women’s sexual health must be inclusive of all people with vaginas.

After menopause, a woman’s ovaries stop producing progesterone and oestrogen. These hormones are instead produced at lower levels in other areas of the body, which can result in the vulva, urethra, and vagina becoming significantly drier. This often causes depression and low self-esteem.

Hot flashes are the hallmark symptom of menopause. These are spells of sweating and dizziness that can last a few minutes or longer. Other symptoms include reduced or absent sex drive, insomnia, memory problems, hairy skin, acne, recurring cystitis, UTIs, anxiety, panic attacks, and more. Eight out of ten women experience some menopausal symptoms, while 25 percent of women have severe symptoms.

Furthermore, a third of women don’t go to their doctors to treat these symptoms, many of which become chronic. Instead, they suffer in silence – perhaps because they don’t trust that their pain will be taken seriously.

Along with menopausal women, the experiences of trans people are also often erased.

Cis people sometimes mistakenly assume that trans people either have, or plan to have, gender-confirmation surgery. But gender dysphoria affects different trans people differently. One US study showed that 14 percent of trans women and 72 percent of trans men in the US don’t want full gender confirmation surgery. Some trans people will only medically transition, and some will opt for top surgery but not bottom. These are deeply personal choices. We must remember that not all girls and women have a vagina – and not everyone with a vagina is a girl or a woman.

Strict gender roles trap us in our biology, minimize our experiences, and hold us all back. A re-education of sexual and reproductive health must acknowledge that we are more than our genitals and our gender.
Final summary

The key message in these blinks:

Good sex education is compassionate and complex. It teaches students not only about contraception, but also about relationships and women’s sexual pleasure. The hymen is not a seal – it’s made up of thin folds of mucous membrane – and the clitoris is much more expansive than was once thought. Sharing our experiences can help us re-teach each other and empower us to tackle the stigma and shame surrounding periods, orgasms, fertility, and menopause.

What to read next: Period Power, by Maisie Hill

Now that you know so much about the vagina and women’s sexual health, perhaps you’d like to zoom in and learn more about menstruation. Period Power is the ultimate guide to periods, hormones, and reproductive health. In these blinks, you’ll learn how your menstrual cycle affects your mood, sleep, and energy levels – and how to track your period to anchor yourself through life’s changes.

Last modified: December 2, 2020