January 5, 2016

Let’s Talk about Vaginal Atrophy.



My friend, Lauren, once told me of her ex-husband’s surly old maid aunt whose vagina closed up.

“What?!” I exclaimed in horror. “Well, she didn’t use it,” Lauren contemplated for a moment, “so I guess it just closed up. I don’t know.”

Years later, my sister brought up vaginal atrophy.

“What?!” I exclaimed in horror. “Does your vagina just, like, petrify?” And I thought of Lauren’s ex-husband’s aunt with her closed-up vagina and realized it had atrophied. What a f*cking nightmare to contemplate.


Part I


During my first pregnancy, I did everything I was supposed to do: I quit drinking coffee and alcohol, I consumed a healthy, high-fiber diet, I went to prenatal aerobic classes, I rode my bike, I went on long hikes, and I went to Lamaze classes, during which my husband would not pay attention and very quietly crack jokes. One time we were asked to stop laughing and to participate.

But nothing really prepared me for childbirth and what followed. Actually, Dave Barry wrote a very enlightening book, called “Childbirth and Other Hazards of Sex: How to Make a Tiny Person in Only 9 Months, with Tools You Probably Have around the Home,” which all expectant parents should read.

When I arrived at Framingham Union Hospital, in Massachusetts, late on a frigid Saturday night in January, my doctor examined me and found I was four centimeters dilated. He patted me on the knee. “Come and get me when she’s fully dilated, I’ll be down the hall,” he told the nurse. He looked at me and said with empathy, “This could take all night.”

Two hours later, I was fully dilated. The nurse called the doctor, and he came. He told me to push with the next contraction.

I pushed.

The doctor patted me on the knee. “Come and get me when the baby crowns,” he told the nurse. He looked at me and said with compassion, “This could take a couple of hours.”

Nobody ever explained to me that I had to push like I was taking a giant dump. When the doctor left, the nurse said, “You’re holding back, you have to push with your rectum, with all you got.”

“Ohhh, I get it,” I replied. “Just push with everything, like I’m going to the bathroom.” I was raised real proper; we spoke in euphemisms.

“Yep, that’s right, and don’t worry. It’ll be fine.”

“But. What if something comes out? I mean, that I don’t want to come out?”

“Don’t worry; it’ll be fine!”

Well, I hoped so—that would be a messy embarrassment. With the next contraction, I pushed and didn’t hold back.

My baby crowned.

“Pant!” the nurse instructed me. She glanced over her shoulder at a second nurse who had just arrived. “Try not to push; we have to go find the doctor.” Then they disappeared out the door.

“Great,” I thought. To my left, my husband watched Paul McCartney on MTV and munched on roasted sunflower seeds I had thoughtfully packed with his snack, the smell of which was nauseating me. To my right, nurses ran out the door to find my doctor. I was left alone, for all practical purposes. My bottom was suspended slightly over the edge of a birthing bed, nothing but the cold, hard floor beneath it. I panted while maintaining a precarious hold on the baby at the tip of my vagina.

Beyond my television-watching husband’s head, I could see snow falling in the flood lights outside of the windows. I am from the Deep South; snow will always remain magical to me, something I grew up praying for every cold winter night. I found such comfort in the snow falling at the moment of my first child’s birth.

The doctor and two nurses materialized, and one of the nurses said, “Wait! Do you want me to get a mirror so you can see?”

“Yes,” I replied, between puffs of air. After all, what kind of mother would not want to watch her child tumbling out into the world?

She returned in a jiffy with an over-the-bathroom-sink sized mirror and asked me to instruct her as to its position as she tilted it at a certain angle. “It’s fine,” I said. “You can see?” she asked, adjusting the tilt anyway. “Yes,” I lied. I don’t think I had my glasses on, and I was poised to give birth any second now—I really couldn’t concentrate well on the mirror.

With the third push, my little bitty son was born in the wee dark hours of a snowy winter morning. He was tiny; too tiny, and in my violent pushing not only did I tear my perineum, but I sent my poor tiny newborn crashing out of my cervix, through my vaginal canal, where I held him while his father watched the telly and the nurses searched for a mirror, and into the world.

On the left side of his miniature, cone-shaped head was a hematoma about the size of a navel orange.

I felt he needed to be put back in the oven for some more baking. But no, that was not possible. Instead of feeling joyful, I felt guilty and afraid.

Did I not adequately nurture him in utero?

And now what? How would I keep this helpless creature alive now that I had ejected him into the world?

I held him to my breast, but he didn’t respond. He was uninterested. Certainly, they would not let him die here, in the hospital.

There was no need to worry. He was fine; small at five pounds, ten ounces, but just big enough to be out. Once we were home, I was to wake him up every two hours during the day and nurse him until his two week check-up.

Secretly, I was terrified.

My vagina hurt. I had ripped, and they had stitched me up. I wanted one of those sitz baths they talked so much about in prenatal classes.

“May I have a sitz bath?” I asked the nurse. “A what?” the nurse responded, with a scowl. “A sitz bath, you know, one of those shallow, warm baths that soothe your aching bottom.”

“I’ll ask the doctor.” And out she went. But I could tell that she did not know what I was talking about.

She came back later. “I’ve run your sitz bath,” she said.

Oh! I was excited. This was going to feel good.

The nurse whisked my baby off to the nursery in his clear, plastic, baby-holder-on-wheels (Be careful with that precious cargo you are so routinely hauling off!). She returned and led me down the hall and into a bathroom area. She pointed me in the direction of a low tub with water. It was the size and shape of a stand-up shower. In fact, I thought maybe she had filled the floor of a shower with water, and I was less excited. Apprehensive, even. It seemed less than clean. But I was grateful for her efforts and obediently sat in the tepid water hoping not to catch a fungus.

The sitz bath was a big disappointment.

Back in the room, my baby agreed to half-heartedly suck on my nipple. Didn’t I need him to latch on and suck to stimulate the coming of the milk? Isn’t sucking supposed to be an instinct, a reflex? I was worried about his lack of enthusiasm. How was I going to keep him alive?

Then, over the course of the day, my milk came in. My small breasts transformed into rocket torpedoes. When my tiny son managed to latch on to one of my nipples at the tip of one of these rock-hard missiles and start to suck, my uterus would contract and send a tidal wave of warm blood into my double major-serious maxi-pads, held gingerly in place with a belt, like in the 50’s.

Next, the sucking would stimulate the let-down reflex, as sensational and intense as an orgasm, and milk would gush into my unsuspecting, trusting newborn’s mouth with the force of a fire hose. He would start choking, and the milk from that nipple would spray my choking newborn in his tiny red face, while milk from the other nipple was shooting clear across the room.

I needed a shower. I wiped my little baby’s face, rolled him to the nursery, and set off to the showers armed with my giant bra and pads for my nipples, and huge sanitary napkins for my vagina.

I stood under the forceful stream. I let the hot water splash upon my aching breasts, as I gently massaged the taut, lumpy skin. Ahhhh. I washed the sticky blood from between my legs. Feeling soothed and refreshed, I turned off the faucet.

Oops! Here comes the milk, dripping—no, running—down my clean, giant breasts. I rinsed them off and leaned forward to pat them dry, reaching for my armor as milk spilled onto the floor of the shower.

Once secured in my double-padded nursing brazier, I noticed the warm blood running down my clean legs. I repeated the routine of my top half on my bottom half, and was finally clean and dry for a moment, and ready to start again.

The next day, they let us go home. Actually, they made us go home; I would have stayed. I didn’t know how to do this! How negligent of them to send us home with this helpless baby. They just let us walk out the door with a baby.

How would I keep him alive?


Part II

Raising My Children

We took our baby home and managed not to kill him—we even nurtured him. It came naturally, after all. A lot of work, but it happened all by itself. By the time our son was two years old, I would find myself caught up in negotiations with him, as to when he should get in the bath, what he should eat, when he should go to bed.

Childbirth turned out to be relatively easy.

We had two more children. After the second, I decided it would be reasonable to have only four, instead of the five I had imagined.

During labor with the third, which was practically a breeze, it struck me in the midst of this one, long, contraction, that no matter how much humankind progressed, women were still going through labor and childbirth. We were, after all, primitive on the most basic level, no matter how much progress we made. Our instincts were also primitive, and sound, if we would only listen to them.

It also occurred to me that simply because I found giving birth and nurturing babies to be the most amazing, mind-blowing experience ever, I couldn’t just keep on doing it. That would be purely egotistic and selfish, not to mention irresponsible. I decided three was enough.

As for raising my children, well I didn’t, not really. They just grew, and I somehow managed to keep them alive. It’s all kind of a blur.

They are still alive, thank God, or the universe—whatever force takes responsibility for luck—and have set off to conquer the world. They are the smartest, funniest, most talented, unconventional human beings I know. They are my favorite people.


Part III


When I was 37 years old, after we moved our family from Paris, France (not Texas) to Louisville, Kentucky and I was going through a very traumatic separation and divorce, I started truly observing my cycle.

I noted with diligence the first day of my period on my calendar. When I started feeling like a worthless piece of sh*t, I developed the presence of mind to check my calendar. Yup, I would start to bleed in three to five days.

Three to five days before my period started, I sensed the world crumbling around me. Nothing had changed, but everything seemed hopeless: I would despair, I was worthless.

During our marriage, this is when I should have never spoken.

But, alas, the irony is that it is also a time when one loses perspective and feels the urgent need to set things straight.

I’m not saying you should not discuss issues and work through conflict; I’m just saying you should not do this while you are PMSing. Or at least I shouldn’t, and other women I have spoken to have come to the same conclusion. Even if you are fortunate enough to have a very wise, compassionate partner, this creates new, real problems. It can be very hurtful—I know this.

I learned to lay low during PMS and to especially not react to my feelings of worthlessness and despair, and to not project them onto someone close to me. I developed discipline and self-control to make sure I didn’t speak. “Just don’t speak,” I would remind myself. Which meant, don’t address any issues. Just be quiet, be patient. Wait.

Writing my thoughts during this time could be helpful and productive. Then later, when I was feeling more hopeful and optimistic and life wasn’t so bad—it was even good—I could read through it, extract the pith, and address the issues in a productive way.

I paid close attention to my cycle, and I learned to respect and honor the role hormones played in my life.

By the time I learned this, my husband was gone (he had issues of his own, it wasn’t just me). The knowledge I’ve acquired has nonetheless served me generously, in other relationships and in life. It has helped me cope with my depression and anxiety.

“Let it wash over you,” I say to my children, regarding anxiety and depression. “Like a wave in the ocean, just before it breaks. You can stand there, and let it knock you down, or you can dive headlong into it, and let it wash over you. When you come out on the other side, you are standing in calm waters. Remember, you are alive. That is why you can feel.”


Part IV

Menopause and My Vagina

I digress, but only slightly—back to the topic of understanding my hormone-governed cycle, and the role it plays in my well-being and the general well-being of loved ones close to me.

Here’s the thing: as soon as I have it all figured out, it changes!

Let’s take my vagina, for example, and its evolution—its journey to menopause. This is, after all, inextricably connected to my hormones and cycle.

One day, when I was in my late 30’s after I had figured out to shut the f*ck up when I am PMSing and to not consider suicide as an option (nothing had changed since the day before dammit, why was everything all of a sudden so hopeless?), I removed a tampon by gently tugging on a string, and out came two tampons!

Wow! Had they reproduced in my vagina? Am I so absent-minded as to have forgotten to take out one before stuffing in another?

Or, had my vagina become a vacuum, sucking up nearby objects? What else could be in there? Had I misplaced anything recently? My vagina could be full of keys, BIC Pens and Chap Stick! Who knows?

Around about this time I was unemployed, and every idea I had transformed into a potential money-maker. I needed desperately to figure out a way to earn a living. It made me chuckle to imagine the endless number of enticing goodies that could be attached to a string and stored in a vagina for gift-giving: a confection, a piece of jewelry, a sex toy—it was marketable.

Seriously, though, my vagina did (and still does) take on the aspects of a shop vac. I know this because I can be standing around someplace in a dress, or a bath robe, and then, with no warning, warm water runs down my leg.

It’s the bath water.

This does not happen conveniently right after the bath, when I am naked in the bathroom drying myself with a handy towel. It happens sometime later. Fortunately, I have never been in an embarrassing situation when my vagina releases the bath water, but it’s only a matter of time.

At some point in my 47th year, I decided I would honor the first day of my period every month by staying home. I figured, what did women do 200 years ago? Wear a diaper? Sponges? One thing for sure it seems, they could not go far from home—their lives were clearly and practically dictated by their cycle. They had to think of it, plan around it.

Ah ha! I finally got it. Without wanting to go back to the dark ages for women, I did want to find a good reason to just stay still. For a day, only one day out of the month!

I went out and bought dark red sheets. Why hadn’t I thought of this before? I always bled on my sheets at least once during my menstrual cycle. I would go and get a jelly doughnut from Krispy Kreme on the first day of my period every month and get in bed—in my red tent—with my doughnut and a big, hot cup of café au lait, a can of writing implements, a notebook, a stack of post cards, some stationery, books, and the newspaper.

This was going to be fun! I couldn’t wait.

And then, I stopped bleeding. Well, I stopped bleeding regularly, and it went on like that for two years until I stopped bleeding entirely. By shortly after my 50th birthday, I had reached menopause.

I was out of estrogen.

Yay! No more birth control.

I decided to celebrate. I invited my three wonderful children over, we poured glasses of red wine, and I balanced my diaphragm on the head of a squeak toy for a dog which was a small nun—a perfect size and shape for the task—where I punctured it with a long sewing needle. Cheers!

And then, over the next few years, my vagina shrank. The very tunnel that expelled three full-size babies and into which I could place, unknowingly, numerous objects began to lose its supple qualities. It started to become a much less accommodating space, though its shop vac function remained securely intact.

That’s when I remembered (gulp) vaginal atrophy. The surly, spinster aunt. How could this be happening to me? Just when we have it all figured out, and don’t have to worry about birth control, the penis goes flaccid and the vagina turns to stone. This is not a fortunate coincidence. And beware! You do not know it is happening unless you use your vagina.

Here is an online definition of vaginal atrophy, by Mayo Clinic staff.

First, I would like to officially spearhead a campaign to have the name of this condition changed in the medical journals and dictionaries. Suggestions for a new term include: “Wisdom” or “Independence” or “Autonomy.” We could say that we have entered a phase in our lives of Vaginal Autonomy. Meaning, “Do not try to put anything big in my vagina.”

All of the possible solutions for restoring my vagina to its previous welcoming and hospitable state are costly and not covered by my fabulous $5000 deductible insurance policy.

I tried cream, but that was messy, and I was not disciplined about applying it regularly, so it did no good.

I tried a plastic ring that you place at your cervix which releases estrogen over a period of time. That didn’t work.

Then my friend told me about a simple, not messy, vaginal tablet—a small pill you feed to your vagina from the end of an applicator, which dispenses it from the grip of a tiny claw.

By this time, I was single again, having successfully chased off another man—it wasn’t because of PMS, but that’s another story. More important for the moment was: How would I try out my new vagina?

I didn’t want to order any, ahem, appliances or devices from the internet, because I didn’t want the Supreme Intelligence to know that about me and use it to target me with all sorts of really depressing old-person marketing. I didn’t want to go to 7th and Hill, not alone, anyway. What if I ran into someone I knew, or a client?

Then, one day, I was shopping at the ValuMarket and found myself fondling the cucumbers. Yes! What a perfect idea. I carefully picked the right size and shape and included it in my purchases. When I got home, I washed it and placed it on a tea towel on the counter to dry.

“What’s the cucumber for?” my daughter asked when she arrived a few minutes later to grab a bite between classes.

This was a perfectly normal question in my house. My kids knew that for any item or ingredient in my kitchen, I could have some extravagant plan conjured in my brain. Which I had, only it didn’t involve eating it—or at least, not right off.

“Well it’s to eat, of course!” I lied. She would have understood, but no, I couldn’t go there with my hungry daughter. It would have been awkward.

Suffice it to say, and I won’t divulge any elaborate details as I am pushing the envelope already with TMI, that my new vagina works just fine.

What next, dammit??

First, we have to figure out what to do with our deflated bodies after delivering a child. Then we have to figure out how to keep the child alive. After that, we have to figure out why we feel worthless much of the time, and we must learn to not speak at all during those periods.

Once we’ve got this nailed, we discover things in our vaginas we didn’t even know were there. And we were probably the ones to put them there! Just when we get everything figured out, and we don’t have to worry about birth control, we learn that our vaginas are turning to stone.

What a journey! How can you not almost laugh? It’s almost funny.

Don’t succumb to the absurdity and despair! I notice women who are older than I—in the grocery store, at work, walking in the park—and I know they know. They have acquired Wisdom, because look at them—they glow! And they keep going, with grace and dignity.

“Grace and dignity,” I tell myself. “Grace and dignity.”



Menopause: Madness or Muse? ~ Carrie Dinow

Author: Charlotte Whitty

Editor: Erin Lawson

Images:  Flickr/simpleinsomnia  //  Flickr/rbmay




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