Of course, today, women are much more likely to ask, “Why should I have pubic hair?” than they are to ask, “Why do I?” And for millions of them, the answer is a resounding, “I shouldn’t.” Or at least not very much. When it comes to pubic hair, exact numbers are hard to come by, but a locker room survey would likely reveal that most women under thirty, and a great number over it, shave, trim, shape, or wax their pubic hair.
The Brazilian—a style of bikini wax that leaves women with a trim “landing strip” of hair on the pubis, or none at all in a full Brazilian—is one of the most popular treatments in the United States and Britain. A new study suggests that the cultural preference for trim pubic hair is having dire consequences for a pesky parasite that has been freeloading in our personal perfumeries for thousands of years. That’s right: Brazilians are killing Phthirus pubis, also known as the “crab louse” or “pubic louse.”
Pubic lice are generally transmitted through sexual contact, like other so-called sexually transmitted infections, or STIs. A team of British researchers tracked the incidence of pubic lice, chlamydia, and gonorrhea over a six-year period from 1993 to 2003. What did they find? While the incidence of chlamydia and gonorrhea both climbed over the period, the incidence of pubic lice declined, especially around 2000 when Brazilians became more widely sought after in the United Kingdom. It seems that waxing down under is like deforestation, as far as pubic lice are concerned.
Our era is by no means the first time humans have removed body hair, particularly pubic hair. For example, ancient Egyptians, and some prostitutes in fifteenth-and sixteenth-century Europe, are thought to have been fond of pubic hair removal. And although we can’t be sure, they may have done it just to combat pubic lice. Some Europeans actually wore a pubic hair wig, called a merkin, to cover up the shave job and hide the fact that they were trying to prevent the acquisition of the pesky parasites. Today we shave for fashion and, arguably, promote hygiene as a result. Five hundred years ago they shaved for hygiene and covered up for fashion as a result. That’s progress for you. Of course, fashion isn’t the only reason people in some cultures remove pubic hair; millions of Muslim men and women do it for religious reasons.
Incidentally, it’s not only sixteenth-century Europeans who find a thick mound of hair down there more attractive than a clean shave. In Korea, as in some other cultures, pubic hair is an important sign of fertility. But many East Asians, including Koreans, have significantly less prominent body hair than people of Caucasian descent. So Korean women who feel they lack sufficient pubic hair may very well participate in the latest South Korean personal fashion trend: pubic hair transplants.
Pubic hair transplants work like hair transplants to the top of one’s head; hair follicles are surgically removed (usually from the back of the scalp) and transplanted, in much the way a fully grown tree might be planted in your yard. At a cost of about $2,500, is it worth the money? Apparently yes—and Korea is not the only place where having pubic hair may be important.
A 2006 paper published in Aesthetic Plastic Surgery describes a pubic hair transplant that took place in Brazil. This brings us full circle and suggests another possible biological reason for pubic hair: maybe these cultures view abundant pubic hair as a sign of fertility—because that’s exactly what it is. Besides being a perfumery, and a signal of sexual maturity in some cultures, pubic hair may signal that, at least from a fertility perspective, you’re ready for business. This may even explain the popularity of leaving a “landing strip” in Brazil and other places; the completely bare look appears sexually immature to some. And like many rules, the notion of pubic hair as a sign of fertility finds proof in its counterpoint: some genetic conditions that leave a woman sterile, for instance, androgen insensitivity syndrome (AIS), may also leave her with a less than normal amount of pubic hair.
BEYOND THE VAGINAL opening, or introitus, is the vagina. Vagina is Latin for “sheath” or “scabbard”—giving you a pretty clear idea what those old Roman linguists thought about the vagina’s role in the world. Today, of course, we know that the vagina is a highly flexible multipurpose organ that can stretch, contract, and manage its own interior climate in order to meet the task at hand. It facilitates sexual activity and pleasure, conception, childbirth, and general maintenance of the reproductive system and allows for the passage of menstrual fluid and tissue from inside of the uterus.
The vagina extends from a woman’s vulva, where it opens, to the cervix. Like everything else about human anatomy, there’s a lot of variation, but the average vagina is between two and a half to three inches long at rest. But, as we just noted, the vagina is very flexible.
When a woman is aroused, the vagina quickly lengthens, to about four inches or so and will continue to lengthen as a woman becomes more aroused. The walls of the vagina will also expand in width—or contract, as the case may be—in order to provide the right fit for just about any penis, whatever its size. The walls of the vagina also produce moisture to provide lubrication during intercourse and make it more pleasurable. The upper vagina also balloons out, allowing for the puddling of semen after a man’s ejaculation. And, when a woman is ovulating—when the chance of conception and reproduction is at its highest—the cervix actually secretes a specific type of mucus that resembles raw egg white in textural quality.
When a woman becomes pregnant and delivers her baby naturally, the prior shape-changing of the vagina is nothing compared to what comes next. During delivery, not only does the vagina (often called the birth canal at this time) lengthen; it becomes wide enough to allow the baby’s head and body to pass through it, many times wider than it’s ever been at any other time.
The cervix is located at the interior end of the vagina. The word cervix means “neck,” and the cervix is essentially the neck of the uterus. If you were to place a finger into the vagina as far back as you could go, you’ll feel something like the tip of your nose—that’s the tip of the cervix. The cervix acts as a gatekeeper to the uterus, providing a passageway for sperm to enter and menstrual fluid and tissue to exit.
The cervix is also an important part of the vagina’s climate control system, secreting different types of mucus at different stages in the reproductive cycle to help regulate the vaginal environment.
Most of the time the passage from the cervix into the uterus is blocked by thick mucus, but in fertile women it undergoes a slight transformation twice a month, during ovulation and during menstruation. Around the day before a woman’s body gets ready to ovulate, her ovaries flood her body with estrogen. The increased level of hormones prompts the cervical opening, called the os (Latin for mouth), to become more accessible, in preparation for receiving sperm. At the same time, the cervix produces a specialized “fertile” mucus, which is thinner and less acidic (this is the mucus that resembles egg whites), and thus more hospitable to sperm. All this increases the chances that the sperm will find its egg.
During menstruation, the cervical os opens even wider, stretching somewhat to allow menstrual material to flow from the uterus and out of a woman’s body through the vagina. The painful menstrual cramps millions of women experience worldwide are the result of uterine contractions, which help the uterus shed its endometrium, or lining.
Immediately after menstruation, the cervical opening is blocked for several days by cervical mucus that is the opposite of fertile mucus. It is thick and acidic and highly unfriendly to sperm (and usually other uninvited guests such as microbes), and it prevents sperm from entering the cervix and passing into the uterus.
During childbirth the cervix expands dramatically to allow the fetus to leave the uterus and enter the vaginal canal on its way into the world. You’ve probably heard doctors talk about cervical dilation as a measure of how close a woman is to giving birth. This is what they’re talking about, the expansion of the neck of the uterus from closed to a fully dilated ten centimeters, or about four inches.
The cervix has been observed to relax and contract during orgasm, leadin
g some researchers to suggest—prompting much controversy—that it does so in order to suck sperm from the vagina into the uterus. Others dispute this theory, and the scientific jury remains out.
During intercourse, sperm pass through the cervix and into the uterus, seeking a woman’s egg. When a sperm and egg first combine, the single-celled organism is called a zygote. The zygote rapidly divides into a multicelled organism called a morula (named after the Latin morus, or “mulberry,” which it resembles), and then it becomes a blastocyst. When a blastocyst implants into the inner lining of the uterus, or endometrium, it then becomes an embryo, and that’s when the fetus starts using its mother’s resources to fuel its development in earnest.
The uterus is also connected to the Fallopian, or uterine, tubes, which are the twin passageways that eggs follow on their way to the uterus and which sperm follow from the uterus in their search for eggs. Typically, conception takes place in one of the Fallopian tubes. If a blastocyst is impatient, it can implant before it reaches the uterus proper. This is called an ectopic pregnancy, and can result in a serious medical emergency. Unchecked, an ectopic pregnancy can lead to a rupture of the Fallopian tube (and its associated vasculature), hemorrhage, and even death. Fallopian tubes are not the only place that can house an ectopic pregnancy. Though rare, some women have delivered babies (through cesarean sections) who developed completely outside of the uterus.
In a fertile woman, the endometrium of the uterus goes through a monthly cycle of growth, shedding, and regeneration; together with the ovarian cycle of ovum, or egg, development and, release, this is the menstrual cycle.
As a woman approaches ovulation, the endometrium becomes rich with blood vessels and tissue, in preparation for sustaining an embryo. After ovulation, if there is no implantation, the endometrium sheds (all the tissue that grew in preparation for an embryo dies): this is called menstruation. Then the generative process begins again. Of course, if there is implantation, the endometrium doesn’t shed—instead, it provides an interface for the placenta to grow into, nourishment for the growing fetus, and a route out for fetal waste.
Despite their role in shepherding eggs to the uterus, the Fallopian tubes are not directly connected to the ovaries. Rather, they open directly into the abdominal cavity, add this to the long list of reproductive marvels. When an egg is released by an ovary, it floats along inside the chamber that holds the intestines, liver, and so forth until it finds its way into the uterus via the Fallopian tube. Because of the open nature of the Fallopian tubes, there is nothing to stop sperm from actually making their way into a women’s abdomen. It is thought that these “rogue” sperm are likely to be picked up and killed by the cells of a woman’s immune system.
To aid in their role shepherding eggs into the uterus, Fallopian tubes come fitted with fimbriae, special fringelike fronds, at their ends. During ovulation, we think that female sexual hormones spur small hair-like cilia on the fimbriae to beat faster. Cilia, in fact, moonlight as matchmakers beating faster in the presence of sperm in frenzied excitement at the prospect of conceptual union. Just outside the Fallopian tubes, of course, are the female gonads, the ovaries. Every female human is born with a full complement of eggs—individual eggs mature before ovulation. Which means, by the way, that half of every human being’s genetic makeup was actually formed in his or her grandmother: by the time your mother was born, she was carrying the egg that, with your father’s sperm, turned into you.
ABOUT TWO YEARS after the first outward manifestation of puberty, the first appearance of breasts and pubic hair, girls have their first period, known as menarche. In western countries, the average age of menarche is about twelve and a half years. The body fat connection goes both ways, incidentally; just as the burgeoning rates of childhood obesity are linked to earlier puberty, young women with particularly low body fat often have delayed menarche. The body waits until it has sufficient fat stores—enough to support a pregnancy—before starting the menstrual cycle. Similarly, endurance athletes—like female marathoners, for example—and women who are excessively thin may stop having their periods because their body fat is so low. It’s as if their bodies put their menstrual cycles and thus their fertility into hibernation because they recognize they have insufficient resources to properly support a pregnancy.
Cultural treatment of menstruation runs the gamut—from unmentionable curse to celebrated blessing and everything in between. In some places menstrual blood is thought to have magical powers to ward off evil, heal the sick, and guarantee a bountiful harvest. Others believe it can defile religious ceremonies, poison enemies, and ruin a hunt. It all depends where and when you grew up.
The Asante of Ghana have celebrations to honor the life-giving power of menstruating women, while the Kaska (aboriginal Indians from northern Canada) used to relegate them to special huts for the duration of their periods. Some members of the Greek Orthodox Church encourage menstruating women to abstain from taking communion, and Orthodox Jewish law declares a menstruating woman to be niddah, prohibiting sexual intercourse until she has completed her period, waited seven days and then immersed herself in the ritual bath called a mikvah. The ancient Romans and modern Moroccans—as recently as last century—both believed menstrual blood could cure illnesses or treat wounds, while the Mae Enga of New Guinea used it as a poison (rather ineffectively, of course).
In many developed countries today, of course, menstruation is the subject of much advertising, as anyone who has ever watched daytime television is well aware. In 2004, advertising for sanitary products was estimated to be a $3.02 billion market in the United States. But sanitary products are nothing new. The ancient Egyptians are thought to be the original makers of disposable tampons; they used softened papyrus. In the fifth century B.C. Hippocrates, the Greek physician often called the “father of medicine,” wrote of tampons made of lint wrapped around wood. Japanese women used paper tampons and changed them a dozen or so times a day. Women in Africa used various plants and mosses. And the Rungus in Borneo used nothing at all; instead, they sat on platforms of dried moss or bamboo, letting the menstrual fluid flow freely and periodically rinsing themselves and their mats.
According to Nancy Friedman, author of Everything You Must Know About Tampons, despite their long and varied pedigree, tampons fell off the approved list in the United States by the 1930s. They were only used by “women [who] belonged to an exclusive margin of society; they tended to be actresses, athletes, or prostitutes—all dubious professions, in the eyes of ‘respectable’ women.” The sanitary product of choice was a pad or napkin.
The first commercial product was Lister’s Towels, introduced in 1896 by Johnson & Johnson, but it is thought that it failed because advertising feminine products was deemed unseemly at the time. In the early 1920s, Kimberly-Clark offered Kotex (from COtton and TEXtile), but they sold it to retailers with an ingenious marketing plan that worked wonders to overcome social stigma.
In their book Kotex, Kleenex, Huggies: Kimberly-Clark and the Consumer Revolution in American Business, Thomas Heinrich and Bob Batchelor observe:
To make the product available to the woman who was loath to ask a clerk at a drugstore counter to hand her a box of Kotex from the shelf behind him, Kimberly-Clark encouraged merchants to display the product on countertops, enabling the customer to take a box and pay for it with minimal communicative action. Thus Kotex became one of the first self-service items in the history of American retailing. Women took a box and put their money into a container—the clerk was removed from the transaction.
All those early pads weren’t nearly as convenient to use as they are today, by the way—until the introduction of Stayfree and New Freedom pads in 1970, all pads and napkins were actually fitted with a belt.
The modern tampon was invented by Dr. Earl Hass who designed a plug with an applicator but couldn’t get it to market. He tried unsuccessfully to sell it to sanitary pad makers, including Kimberly-Clark and Johnson & Johnson, eventually selling it in 1933
to a Denver businesswoman named Gertrude Tenderich. She started a company, made the first products at home with her sewing machine, and called it Tampax. The latest product to see an increase in popularity, although it was invented in the 1930s along with tampons, is the menstrual cup. It works by collecting the menstrual flow, unlike tampons that absorb it, and is periodically removed and cleaned. For the sake of convenience some manufacturers also produce disposable menstrual cups.
Most women are familiar with the bloating and cramping that often happens in the days leading up to their periods. But menstrual cramps (the technical term is dysmenorrhea) aren’t the only cramps women experience in their menstrual cycles. About one in five women experience a distinctive pain on one side of their abdomen right in the middle of their menstrual cycles. This is called mittelschmerz, from the German for “middle pain”—which is doubly appropriate because it occurs in the middle of the menstrual cycle and you feel it in your middle, or abdomen.
Mittelschmerz isn’t pain related to menstruation, though—it’s pain from ovulation. Ovulation occurs when a follicle stretches the surface of the ovary and then ruptures, releasing an egg into the abdominal cavity. Remember, the ovaries aren’t directly connected to the Fallopian tubes; instead, when everything works right, the fimbriae sweep that egg up and into the tubes. Until very recently, scientists thought that the release of an egg from the ovary happened very quickly, but an accident of surgery has brought that into question. Doctors in Belgium were preparing to conduct a hysterectomy on a forty-five-year-old woman when they noticed she was about to ovulate, and they managed to tape the whole event. Surprisingly, instead of the expected rapid expulsion, the pictures showed ovulation taking place over the course of about fifteen minutes.
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