Monthly Archives: November 2011

your vagina is smart and it knows what to do

working with vagina-having folks all day at the clinic, i am often reminded of the jarring lack of accurate, body-positive and sex-positive vagina information out there in the world. i am reminded of the significant portion of my own life i spent thinking of my vagina as the strange and rather unpleasant center of some mysterious world that i didn’t understand and didn’t particularly care to. i would like people to have better information about vaginas than i had. so i started this blog and, with the zeal of a new midwife-to-be, i hereby present you with a mishmash of vagina 101 that comes directly from my clinical experience in the past week, all grounded in the central truth that your vagina is smart and it knows what to do. if you already know all this about your vagina, yay! that’s fantastic. feel free to pass the info on to someone who doesn’t.

also, if you have a vagina and use another word for it, please feel free to substitute that word every time you see “vagina” in this piece. i myself call my vagina “my junk” or “my business.” for me, i find vagina too formal and gendered a name for that part of myself. but i’m not trying to force that on anyone else, so i just stuck with “vagina” and i will let you take it from there.

here we go!

1. your vagina is self-cleaning

it’s true! the vagina knows how to keep itself clean and healthy. all it needs is a nice rinse with water and it’s good to go. using anything else to clean the vagina tends to freak it out and mess with its natural balance. this can lead to irritation, itching, yeast infections, etc. some good rules for keeping your vagina clean and happy: always wipe from front to back after going to the bathroom, avoid put anything scented or harsh (strong soaps, bubble bath, “hygiene” sprays) on or in your vagina, avoid scrubbing the outside of your vagina (when washing you can just use your hand to separate the folds for rinsing), don’t scrub the inside of your vagina (ouch!), avoid douching or inserting any “hygiene” product into your vagina, and make sure that any scented shower products you use on your hair or body are fully rinsed off so they don’t collect in or on your vagina and cause problems. also, go pee before and after sex to avoid a UTI from unfamiliar bacteria getting into your urethra.

2. your vagina wants room to breathe

another key to good vaginal health is air circulation. we all spend most of our days with our vaginas covered by several layers of clothing, which is fine and good and all that, but does lead to en environment of trapped moisture. accordingly, we need to give our vaginas down time here and there to breathe some fresh air. a good first step toward this is making sure all your underwear has a nice, cotton, breathable crotch. the rest of your panties can be drenched in lace if you like that, but the crotch itself should be cotton. another easy thing you can do is make sleeping time free vagina time. instead of wearing regular underwear to bed, wear a nice loose pair of boxers or nothing at all. your vagina will thank you.

3. your vagina makes discharge and that’s normal

vaginal discharge is an important part of keeping vaginas clean and healthy. without discharge our vaginas would be sad and dry. life in general and sex in particular would be uncomfortable without it. you can expect to see discharge in your underwear. it’s normal! your discharge will vary in texture, smell, and amount throughout your cycle. it will also be affected by any sort of hormonal contraceptive you may use (whether to prevent pregnancy or manage period problems), and it changes over the lifespan. since no one tells us discharge is normal, it can seem strange, annoying, or dirty. it can have us totally convinced that something is wrong with us. but usually nothing is wrong with us, we just have smart vaginas! that said, vaginal discharge can also act as a warning system to let us know something is wrong. go see your NP, midwife, or doc if you notice that your discharge: smells super fishy, is super chunky, is an unusual color, is super frothy, etc. on a similar but unrelated note, you may find the occasional bump in the vicinity of your vagina. yes, this bump could be a sign of warts or herpes or syphilis. but it could just as easily be an ingrown hair or a totally non-threatening little sebaceous cyst (similar to a zit and i know it’s gross to think of zits on our genitals but there are glands down there so stuff happens). try to stay calm and seek the advice of your provider if needed.

4. your vagina likes lube

your vagina likes lube so much that it makes its own. your vagina likes lube so much that it is overjoyed when you provide it with extra. many of us who keep a big bottle of lube by the side of the bed consider it an absolute must have for sex. but many folks have never tried it. trust us and our big bottles of lube – everything is lovelier and safer with plentiful lubrication! that is my big message about lube. but some important sub-points: choose a good lube, and don’t use lube as a substitute for listening to your body.

choosing a lube: in a pinch, any water-based lube will do just fine. you can grab a bottle at the grocery store or get some free at planned parenthood or whatever clinic you go to. but in the long term, get a good lube. in general, i consider a good lube one that: does not contain glycerin or suger or  fragrances or chemical sweeteners for taste (all common lube ingredients that can promote yeast infections), is long lasting, and feels good to the people using it. there are also different lubes for different kinds of sex. for example, a thicker lube is required for anal sex. if you are lucky to have a good sex-positive sex toy shop in your area, they usually have a big lube bar with descriptions of each lube, sample bottles to try out (only on your fingers, of course!), and plenty of tissue to wipe the sampled lubes off of your fingers. if there isn’t a good place in your area you can shop online: or are good places to start. a few warnings to keep in mind: always use a lube that is either water-based or silicone-based (don’t use oil-based stuff like lotion, vaseline, crisco), and don’t use a silicone-based lube with silicone sex toys.

listening to your body: vaginas make lube when we are aroused. when we desire sex or intimacy or make outs or whatever, when we are playing around with someone and enjoying it, or when we are thinking about playing around with someone and enjoying it, our vaginas make lube. that’s what we call being wet. if your vagina is not making lube in these situations, its worth stopping to think about what might be going on. it could be any number of things. but it is very important to take a moment to see if your body is trying to tell you something. maybe you are nervous or scared or are just not all about being sexual at that particular moment. maybe you’re not actually that into the person you are messing around with, or the things that they wanna do. maybe not enough time and energy is being put into foreplay or teasing. whatever it is, it deserves your attention. you never have to have sex you don’t want to have. on the other hand, if you are totally into it and still having trouble getting wet, then it’s worth a chat with your NP, midwife, or doc. they can help you figure out what’s going on and help get you back on a path toward well-lubricated and joyful sexy times.

5. your vagina has some special needs if you are post-menopausal or gender-variant and on testosterone

without a steady supply of estrogen, the tissue of your vagina goes through some big changes. the skin can thin out, become less plump and moist, and tear more easily. this is called “atrophic vaginitis” – it means the cells that make up your tissues are shrinking and getting more dry. this can make sex painful, or leave you with a sense of uncomfortable dryness throughout the day. post-menopausal women can consider combined hormone therapy and/or ask their provider for a daily estrogen cream that will make the vaginal tissue more pliant and healthy. for gender-variant folks who take testosterone, topical estrogen is also a good option. since it is not systemic, it does not counteract the testosterone you are taking. with a little estrogen your vagina may be much happier. but even if you have no interest in estrogen cream, please check in with your NP, midwife, or doc if you are having pain with sex or unexplained vaginal bleeding after your periods have stopped due to either menopause or T. these could be signs of larger issues that need to be ruled out.

ok, the end!

well, not the end at all. i have so much more to say about the care of vaginas but i think this is plenty for the day, and this blog post is way longer than i wanted it to be. let me sign off with this:

trust your vagina. it is smart and it knows what to do.


this tiny tranny is gonna be a midwife someday!

says one of my roomies: “i’ve learned more about vaginas in the past few months hearing about your clinicals than i’ver ever known in my life. you should make a blog. you can call it Simon’s Vagina Rx.”

so, i followed her advice and i made a blog!

but i didn’t call it Simon’s Vagina Rx.

instead i called it Boi Midwife, because that’s me.

first post coming soon: “you’re vagina is smart and knows what to do.”