Keep on Learning

Remember in middle school (we called it junior high in those days) when the boys and the girls were shepherded into separate rooms for those awkward films? It might have been presented by the gym teacher or the guidance counselor; maybe your school was large enough to have a health teacher who presided as we were introduced to the signs and effects of puberty—and the dangers of acting on urges.

My conversations with women lately have reminded me that while we take great pains to introduce our younger selves to their biology, we don’t quite follow through. In the sex ed I’m familiar with, the story stops with the fertile years. We don’t introduce the full cycle we can all expect to experience if we only live long enough.

Yes, breasts bud and menstrual cycles begin. We have children, or we don’t; we may have illnesses or surgeries. At some point, the cocktail of hormones shifts, and the parts of our bodies once prepared for reproduction begin to change once more. Our periods become unpredictable and eventually stop (a year without defines menopause). Our tissues become dryer, more fragile, less elastic. Without care and attention—and often in spite of them—our vulvovaginal tissues atrophy, which means they actually shrink.

And where do we learn this? Not in a gym or a cafeteria with a hundred of our same-sex classmates! For too many of us, we learn it only through our own experience, at a point in life when there aren’t many people we’re talking to about sex. We’re tempted to think this is an odd thing that’s happening only to us. We’re a little embarrassed, maybe a little ashamed.

There’s so much more common about our experience than most women think! If only there were a middle school for midlife, so we could all get together and learn about this next phase of physical transitions. As we thought (or it was hoped we were thinking) back in the original sex ed, knowing what’s ahead is the first step in making good decisions and taking charge of our own sexual health.

I haven’t yet figured out where to offer my midlife sex ed classes, or how to get busy women to attend! So I’ll keep having conversations with women one on one in my practice and through the MiddlesexMD website. I hope you’ll be having conversations, too, because even without the awkward films, we’re all in this together.

Our "Recipe"; the ARHP Assessment

Did you know that the whole idea behind MiddlesexMD is based on a recipe? You could call it the MiddlesexMD formula for really juicy sex. Officially, we call it “our recipe for women’s sexual health.”

We think our recipe is so important that our entire website is organized around what we’ve identified, after a lot of thought and research, as the five necessary ingredients for a satisfying love life at midlife. You can add your flavor of whipped cream and lingerie, but if those five ingredients aren’t in place, sex just won’t work very well.

These ingredients may be surprising (knowledge? emotional intimacy?), and some are unique to our stage of life (vaginal comfort, genital sensation, pelvic tone). We try to help you understand why they’re important and to give you tools and tips for understanding what they are and for incorporating them into your life.

Here’s a tool someone at a recent conference told us about; it reaches the same destination by a different path. It’s a fun quiz put together by the Association of Reproductive Health Professionals (ARHP). Sounds like place to get blood drawn, I know, but behind that bland façade is a sexy little quiz that reinforces a lot of the thinking behind our recipe.

To start, click on your age in the circle that says, “It [sex] could be better…” The questions cover a range of life issues, from physical health to libido to emotional well-being—because, as we’ve said, sex involves all our parts, including our psyche and our emotions.

While the assessment tool is meant to be light and fun, it also delivers good advice. Be honest with your answers (who’s looking, anyway?), and you’ll get some targeted, useful information to improve your sex life. And maybe the rest of your life.

You’ll discover, for example, that about 20 percent of women (of all ages) have a hard time getting turned on, and that it’s one of the most common sexual complaints. That a woman’s sexual response is complicated and affected by things like self-image and stress. (Click on the right-side box that explains how men and women are different.) The tool reassures you that most women can’t orgasm with penis-in-vagina sex alone, but need clitoral stimulation as well.

Nothing earth-shaking, but some nice reinforcement and some good tips. Take the quiz. Read the results, then dig around in MiddlesexMD for more in-depth information. We have lots of information about pain during sex. And we’ve certainly explored the female sexual response cycle. We’ve clarified the difference between moisturizers and lubricants, and we sell them both in our shop.

So, use the assessment as a fun way to pinpoint areas you might need to work on in your sex life, and then dig into our blog and website for the meat and potatoes.

Our Bodies, Ourselves—40 Years Later

Maybe you remember reading Our Bodies, Ourselves in the 1970s. Maybe for you, as for me, it demystified your own anatomy. Maybe that knowledge empowered you with a sense of self-determination. For a few people, as for me, it was liberating and challenging enough to inspire a career in medicine.

And even if you don’t remember reading the book, you were probably affected anyway by the changes toward women’s health care that it ignited.  “Women were treated as ‘small men who have babies,’” says Dr. Susan Love, a well-know surgeon and breast cancer specialist. “Men were the model, and women were sort of this extra thing.”

Our Bodies, Ourselves challenged that paradigm. With explicit, well-researched, and no-nonsense information about women’s bodies and their sexual and medical issues, the book “changed the basic discourse” within medical circles and cultures around the world.

This approach was revolutionary. The book began in quintessential female style, almost literally around the kitchen table when a group of women began meeting during the summer of 1969 to research their collective questions about women’s health. They compiled a 193-page course called “Women and Their Bodies.” The first book under the present title was published in 1971 and quickly sold 250,000 copies. It was, apparently, a topic whose time had come.

Our Bodies, Ourselves turned 40 this autumn. The Boston Women’s Health Book Collective—which grew from that first group of girlfriends—has now published several books targeted toward various demographics, including Our Bodies, Ourselves: Menopause, so the generation that came of age during that seminal edition can grow old with this one.

While health issues have changed (HIV/AIDS wasn’t around in 1971, for starters), the perennial appeal of Our Bodies, Ourselves, which now includes the book, the website, and the collective—the group of women who run the whole shebang and who work together to compile the books—remains strong. The group is marking this milestone with a new edition, which includes entries from over 300 contributors.

Even in this post-feminist, technological era, where health information is a few clicks away and women are more strongly represented in medicine than ever, Our Bodies, Ourselves remains a practical, “girlfriend” guide for women. It may (and has) been argued that it created a new genre.

“The legacy of Our Bodies, Ourselves is that it spawned a whole new kind of book,” said Courtney E. Martin, an editor at in a recent interview, “like your best friend sitting down in a room with you and telling you about your body and how it works without any embarrassment.”

Kind of like this blog, we hope.