Great Sex, Naturally

“Electric flesh-arrows … traversing the body.
A rainbow of color strikes the eyelids. A foam of music
falls over the ears. It is the gong of the orgasm.”

As we pointed out in Chapter 1, your body is perfectly designed for great sex. You have all the right ingredients—nerves, hormones, glands, and other physiological components—to reach the highest states of sexual ecstasy. In this chapter, we’ll explore the critical role of your pelvic region, look at what you need to know to intensify sexual pleasure in your genitals and other pelvic organs, and provide you with exercises and various tools for strengthening your pelvis and further enhancing your sexuality. If you experience common challenges that women encounter in this vital area of their bodies—such as vaginal dryness, vaginal or urinary infections, menstrual cramps, or chronic pelvic pain—you’ll also discover many effective natural solutions.

Your pelvis allows you to move through the world with balance, stability, and strength. One of the most dynamic areas of your body, it also allows you to make love, achieve orgasm, menstruate, release eggs for potential new life, and develop a fetus. In addition, it supports your bladder and other vital organs, and enables the elimination of wastes so the rest of your body can operate efficiently. Your pelvis not only is your center of gravity, but also the core of your sexuality, the seat of your genitals, and the site of thousands of nerve endings with no other purpose than to give you sensual pleasure.

In Chinese medicine, your pelvis is also seen as central—an energetic hothouse of chi. All the chi in your body flows through your powerful pelvis; you can nourish this area and resolve many pelvic and sexual issues by increasing the circulation of your chi. As you’ll discover, this may be especially important if you have what’s referred to as “stuck chi” in your pelvic region.

Your body has other erogenous zones, beyond your pelvis and genitalia, that contribute to your sexuality and overall health. But your pelvis is so pivotal, on so many levels, that it merits special focus. Let’s begin by exploring the anatomical nature of your pelvic organs and genitals, and the key roles they play in your sexual health and pleasure.

The framework of your pelvis is composed mainly of the two large hip bones that spread out to support your lower body. Within this structure, an elaborate network of muscles and ligaments works to embrace your internal organs, help hold your body upright, and enhance your sexual functions.

Your pelvic muscles consist of an outer, middle, and inner layer. The outer layer, which lies just beneath your skin, can be imperative for orgasms because it contains parts of your clitoris. (As you’ll discover, your clitoris is more voluminous than you may think.) The muscles that form the middle layer are important for your sexuality not only because they surround your vagina, but also because they give additional support to portions of your clitoris—your clitoral bulbs. Your urethra passes through these middle-layer muscles as well, so keeping them strong can help prevent urinary incontinence.

The inner layer of your pelvic muscles, known as your pelvic diaphragm, includes your pubococcygeal (PC) muscle, which contracts rhythmically when you have orgasms and can contribute to their intensity. (The PC muscle is actually more than one muscle, but is traditionally referred to in the singular, as we do here.) This muscle is also essential for supporting your genital organs and bladder. It runs from the front to the back of your pelvis (from your pubic bone to your anus), and from one side of your pelvis to the other, creating a large bowl-shaped “hammock” that holds up your pelvic organs. If your PC muscle is well toned, it’s tight and supportive; if not, it’s loose and saggy, which can result in incontinence. It can also lead to organ prolapse—a condition in which the structures that normally hold up an organ are no longer sufficiently supportive, and it “falls down.”

Along with your three layers of pelvic muscles, you have multipurpose pelvic ligaments that support your sexuality by connecting your clitoris to your uterus, allowing you to feel deep uterine pleasure during sex and orgasm. In addition, your pelvic ligaments not only structurally support your uterus, but also move it, along with your cervix, up and out of the way during intercourse.

Your sexual organs, the centerpiece of your pelvis, are a wonder of nature, unique in their elegance, complexity, and capacity to bring you to shivering heights of sensual pleasure and profound feelings of spiritual connection and love. With their ability to expand and contract, respond and recoil, welcome and release, they’re delightfully dualistic; partly external and partly internal, both seen and unseen, closely known yet secretive and mysterious. In Chinese medical terms, they’re both yang (outward, in the light, “hot,” and intense), and yin (inward, dark, cool, and protected). Let’s take a closer look at each of your precious sex organs:

—Your vulva. The beautiful outer portion of your feminine organs, your soft, velvety vulva suggests the shape of an orchid in bloom. The term vulva encompasses your labia majora (the large outer lips along the entrance to your vagina), labia minora (your thinner, inner vaginal lips), vaginal opening, external clitoris, and urethral opening. Your vulva contains thousands of nerve endings, includes glands that allow for vaginal lubrication, and provides a protective covering for your inner structures and organs. Your vulva also includes your mons veneris (Latin for “mountain of Venus”), the soft mound over your pubic bone.

—Your clitoris. Perhaps the single clearest anatomical proof that you’re meant to enjoy your sexuality, your clitoris has but one purpose: to give you pleasure. (It may be no coincidence that the words clitoris and climax share a common Indo-European root.) Resting partly on the outside of your body yet nestled inside your protective external labia and hidden beneath its hood, your clitoris contains highly specialized, delicate tissue and between 6,000 and 8,000 touch-sensitive nerve endings—a staggeringly dense concentration compared to other similarly sized parts of your body.

Dictionaries typically define the clitoris as a “small” erectile organ, but you may be surprised and delighted to learn that your clitoris is much larger and more extensive than what you can see externally. Many women believe that the clitoris consists only of the “nub” (the clitoral glans) that protrudes below the pubic bone, along with its cape (the protective clitoral hood, or prepuce). In fact, the visible portions of your clitoris are only the beginning.

Your clitoral anatomy also includes the shaft of your clitoris, which is directly under the glans, and the two wing-shaped “legs,” or crura (crus is the singular), of your clitoris. Your crura, which are made of erectile tissue, support your clitoral shaft and curve downward and to the sides for approximately four inches along your pubic arch. In addition, you have two clitoral “bulbs,” also known as vestibular bulbs, extending downward from your clitoral shaft for three to five inches along both sides of your inner labia and your urethral and vaginal openings. Also made of erectile tissue, your clitoral bulbs become swollen and engorged with blood when you’re aroused. (Erectile tissue generally refers to spongy tissue that expands and becomes firmer when filled with blood. The term is so often associated with a man’s anatomy that some women are surprised to learn they have erectile tissue, too.)

—Your perineum. The area of strong, supportive muscle tissue between your vagina and your anus, your perineum contains your perineal sponge, which becomes engorged with blood and swells up when you’re aroused. For some women, the surface of the central perineum is highly sensitive to touch and is a source of pleasure when stroked or gently massaged.

The perineum has special significance in more than one Eastern tradition. In the chakra system of Hinduism, it’s the location of the Muladhara or root chakra, which is associated with birth, life, safety, sexuality, and your connection with the earth. And in Chinese medicine, the center of your perineum is the site of an important acupressure point called Conception Vessel 1, also known as Hui Yin, which means “meeting of yin.” Your yin (the feminine aspect of your chi, as the Introduction to this book touched on) is concentrated at this point, and pressing on it can strengthen your chi and bring you many health benefits, including enhanced sexual energy.

—Your vagina. The flexible, enfolding tunnel of your vagina extends deeply into your body, and elongates when you’re sexually aroused. As the threshold to your cervix, uterus, fallopian tubes, and ovaries, it’s an especially yin organ—internal, receptive, dark, moist, and resilient. Healthy levels of hormones in your body, particularly estrogen, thicken and “fluff up” the tissues of your vagina, helping maintain their pH levels and support their integrity and elasticity.

Your vagina includes your G-spot (the Grafenberg spot, sometimes referred to as the Goddess spot), well known for its ability to stimulate mind-blowing orgasms. To find your G-spot, use your index or middle finger to reach one to two inches inside your vagina, in the direction of your clitoris; curl your finger upward, and feel along the center of the anterior (front) of your vaginal wall—as if you’re reaching toward the side of your body that your navel is on. (For many women, it’s easier to find the G-spot when aroused, for reasons we’ll explore in the pages ahead.)

—Your urethral sponge, or G-sponge. People are often unaware of the potential role that a woman’s urethral sponge—not to be confused with her perineal sponge—can play in sexual pleasure. Your urethral sponge, the female counterpart of the male prostate gland, is sometimes called the female prostate. Located directly behind your G-spot, it’s made up of erectile tissue and paraurethral glands that assist with your sexual response and arousal. The glands in your urethral sponge can produce fluid resembling male prostatic fluid (although more watery), and as you’ll discover later in this chapter, when sufficiently aroused, some women ejaculate this fluid from their bodies. Because of the close proximity of the urethral sponge to the G-spot, and its notable capacity to enhance arousal, we sometimes refer to it as the G-sponge.

—Your cervix. The narrow entrance at the top of your vagina, your cervix helps create lubrication during sex and provides a passageway for sperm on their way to your uterus. Your os (the opening of your cervix) is very yin—tightly contracted, with a width of only a few millimeters—but also has the capacity to be extremely yang. As the gateway that most of us passed through on our journey into the world, it can expand to an astounding ten centimeters during childbirth.

—Your uterus. Your cervix opens to your uterus, your inner sanctum—and if you procreate, your baby’s first home. Although held in place by ligaments and pelvic muscles, the uterus isn’t static, contrary to what many women think; it can frequently shift position inside your pelvic cavity. During sex it moves upward, away from the internal dance, yet it continues to take part in the performance.

During your menstruating years, your monthly flow keeps you acutely aware of the power and presence of your uterus. Every month, tissue inside your uterus known as the endometrium, stimulated by your hormones, builds a soft, nourishing bed for the prospect of pregnancy. If you don’t become pregnant, you shed and release your endometrial lining as your monthly menstrual flow. If you become pregnant, your uterus expands dramatically; it can grow from a mere two ounces to about two pounds toward the end of pregnancy.

—Your fallopian tubes. From the top portion of your uterus, your fallopian tubes extend gracefully upward toward your ovaries. Every month during your ovulating years a ripe egg, newly released from your ovaries, floats in the small, nebulous inner cavity of your pelvis directly above your fallopian tubes. Like a sea anemone collecting microscopic nutrients in the ocean current, fluttering tentacles at the ends of your fallopian tubes reach, embrace, and gently guide the egg down into the central tube toward your uterus. In Woman: An Intimate Geography, science writer Natalie Angier describes the fallopian tubes as “exquisite, soft and rosy and slim … tipped like a feather duster with a bell of fronds, called fimbriae.” If traveling sperm find their way to the egg, it could become fertilized; although millions of sperm may surround it, only one might become interlocked with the future.

—Your ovaries. Small but powerful glands, your ovaries do even more than produce thousands of eggs with the potential to create new life; they also release estrogen, progesterone, DHEA, and testosterone. All of these hormones can affect your sexuality, your nervous system, and your brain, with far-reaching consequences in your life. Women who have their ovaries removed and don’t take replacement hormones typically report feeling changed in every aspect of their being. In the next chapter, you’ll discover the great impact that hormones released by your ovaries can have on the quality of your life.

A Word about Words: The Power of Naming Your Sexual Parts

For purposes of this book we’ve used the common, usually Latin-derived terms for sexual organs, such as vulva, vagina, clitoris, and penis. These terms are perfectly acceptable, but for some they may inadequately reflect the sense that pelvic anatomy is a sacred area of the body. If you grew up in an atmosphere where words describing genitals were considered “dirty” or shameful, such terms may carry less-than-inspiring connotations.

Other cultural traditions sometimes offer refreshing perspectives on naming parts of sexual anatomy. In the Hindu tradition, for instance, a woman’s genitals (her vulva as well as her vagina) are referred to as her yoni, which in Sanskrit means “abode” or “source.”

The yoni is considered a symbol of the goddess Shakti, who represents female creative power, and is sometimes referred to as the sacred space, divine passage, or temple. In ancient China, a woman’s pubic hair was sometimes described as her fragrant moss, or her black rose.

In some tantric teachings, a woman’s yoni is known as her jade gate, lotus, or lotus valley (fittingly, the English word valley derives from the same root as vulva). Her clitoris may be referred to as her pearl, or bliss pearl, and her anus—in stark contrast with that word’s connotations—as her rosebud. Her partner’s sexual parts likewise have names conveying beautiful or empowering images. His penis may be referred to as the lingam, which in Hinduism is a symbol of male creative energy and is representative of the god Shiva. Tantric teachings sometimes refer to the penis as a tool for healing, wand of light, jade stalk, diamond scepter, or thunderbolt of wisdom; his testicles may be called elixir-filled jewels, his prostate the sacred sector, and his semen the elixir of life.

According to these designations, the sexual act can consist of a man’s wand of light entering a woman’s sacred space, stimulating her bliss pearl, and inducing his jewels to release the elixir of life. What a difference words can make! Imagine living in a culture that consistently honored sexual parts with such names.

Of all the mysteries your pelvis holds, perhaps most awe-inspiring is its potential for multiple modes of ecstasy. Your sexual organs allow you to experience a magnificent variety of indescribable sensations, and the pathways to orgasm can vary widely from one woman to the next. The pace varies as well; some women ride to the crest of the wave with relative ease, while others need more prolonged coaxing.

Even the psychological approach to orgasm differs broadly among women. For example, some women experience orgasm as a purely physical experience with little or no element of sexual fantasy, while for others orgasm is accompanied by elaborate fantasies and visualizations. And it appears that some women may even be able to climax without any physical stimulation; sex researcher Alfred Kinsey famously found that 2 percent of women were able to reach orgasm entirely through fantasy.

A woman’s journey to full arousal also differs considerably from a man’s. A man often feels ready for orgasm relatively quickly, but a woman typically needs more extensive foreplay. Her sexual energy warms up at its own natural tempo, moving gradually from the outer edges of her body toward her sexual center before she’s ready for full arousal and direct stimulation of her sexual organs. And after climax, a woman doesn’t need an extended refractory period, as a man does, before experiencing another orgasm; her body allows her to continue riding the wave with multiple orgasms.

The distinction between the timing of male and female sexual energy can be compared to heating up two differently sized pots of water: A man is like a small pot on a large flame; he heats up quickly, and cools rapidly when the flame subsides. A woman is like a large pot on a small flame; she takes more time to heat up, but stays hot for a longer time.

This difference is reflected in Chinese medicine: as the introduction to this book described, male energy is predominantly yang, hot, and outward; and female energy tends to be yin, cool, and inward. (We’ll explore ways of balancing yin and yang sexual energies later in this book.) For many women to reach orgasm, however, they need to be not only in touch with their feminine, yin energy—which helps them feel relaxed and safe, release control, and surrender to sensual touch—but also with the yang energy that can give them fiery passion and intensity.

As you become aroused, the blood flow to your pelvis increases, engorging your labia, clitoris, and vagina, and you begin to release vaginal lubrication. The tissues of your vulva become, in a sense, more vital and “robust.” In Women’s Anatomy of Arousal, Sheri Winston points out that with arousal your vulva “blooms open like a fleshy fertile flower.” Your clitoris becomes “erect,” much like a man’s penis does but on a different scale, and as your vagina becomes increasingly engorged with fluids, it also expands, becoming longer and wider. At the same time, your PC muscle, which forms the “hammock” that supports your pelvic organs, tightens.

During arousal, with stimulation of your clitoris, vagina, cervix, breasts, or nipples, your body can begin to release oxytocin—the “love hormone” that, as you discovered in Chapter 1, plays a profound role in your ability to bond with your partner. This release may cause vaginal, cervical, and uterine contractions, heightening your arousal. In an escalating feedback loop, continued arousal and stimulation can in turn promote the release of more oxytocin, which can increasingly intensify your contractions and pleasure.

With orgasm, your brain releases a surge of oxytocin that further enhances bonding and releases endorphins that contribute to your experience of all-encompassing euphoria. As your awareness is flooded with pleasure, areas of your brain momentarily disengage from their normal activities. Orgasm is also accompanied by a dramatic increase in your heart rate, an additional surge of blood flow to your pelvic region, an increase in your vagina’s lubrication, and contractions of your pelvic muscles, including intense spasms of your PC muscle at brief intervals. At the same time, many muscles throughout your body contract and quiver. Typically, your vagina and uterus also contract rhythmically, and your clitoris tucks in under its hood.

The changes that naturally take place in your body during orgasm can bring you innumerable health benefits; as we emphasized earlier in this book, not only does great health promote great sex, but great sex promotes great health. Modern research confirms what has been recognized for millennia in Chinese medicine: sex and orgasm are especially good for your health, and women who experience regular orgasms have increased circulation of pelvic chi and greater overall vitality.

Regular orgasms increase your pelvic blood flow, strengthen your pelvic muscles, and stimulate your natural vaginal lubrication (which helps prevent chronic vaginal dryness). According to Barry R. Komisaruk, Carlos Beyer-Flores, and Beverly Whipple in The Science of Orgasm, research shows that they also may enhance your immune system, promote sleep, help prevent heart attacks, reduce stress, provide pain relief, increase pain thresholds, relieve menstrual cramps and migraines, help bring a baby to term in pregnancy, prevent endometriosis, and help decrease your risk of breast cancer. Other research suggests that sex may also help you lose weight, promote reduced blood pressure, lower cholesterol, increase longevity, and improve your sense of well-being.

Women are multiorgasmic, in more ways than one: the female body is not only able to have repeated orgasms with no refractory period, but is also anatomically blessed with more than a single means of reaching climax. For some women, orgasms come in a variety of styles. How many potential pathways to pleasure do women have? Let us count the ways. …

Female orgasms can be clitoral, vaginal, cervical, uterine, or stimulated by the G-spot and culminating in female ejaculation. Clitoral orgasms, probably the most familiar type to many women, are achieved by direct stimulation of the clitoris. Vaginal orgasms typically occur during sex, stimulated by penetration and thrusting of the penis in the vagina. Some women report cervical orgasms—the sensation of orgasm occurring in the cervix, possibly stimulated by deep penetration during sex—although this appears to be far less common than vaginal orgasms. Uterine orgasms appear to be infrequent, too, but some women report sensations of orgasm in the uterus, which may be stimulated by intercourse. Although G-spot ejaculatory orgasms, which we’ll explore below, also seem less common, this is partly because they’re not yet widely recognized.

Different nerves feed each area of the pelvis, so some women may experience any of these five kinds of orgasms at different times, or perhaps simultaneously—in a “blended orgasm” that involves the nerves and sensations for more than one type of orgasm. Each of the various possible combinations of blended orgasm is arguably a separate type unto itself, so the number of ways women can have orgasms is five at the very least, and perhaps far more.

It’s important to realize that there’s no “best” type of orgasm for all women. You may want to explore different possible types, but your body is unique, and whichever you experience naturally is right for you. If you have a single type of orgasm, it doesn’t mean your sexuality is somehow limited or not fully experienced. Many women have exclusively clitoral or vaginal orgasms, with such extremes of pleasure-pulsating sensation that they can’t imagine wanting anything else. If you’re fortunate enough to be orgasmic in the first place, you can’t possibly be “missing” anything; an orgasm is a gift and an anatomical miracle, regardless of which kind you experience.

Just as the type of orgasm varies from one woman to the next, so do its distinguishing characteristics. You may climax with fast, frenzied intensity, or have gradual, gentle orgasms that feel as if you’re gliding in spectacular slow motion over the edge of a waterfall. Women who experience G-spot ejaculatory orgasms often describe them as deeply intense and cathartic. Again, there’s no “right” degree of intensity or universally preferable quality for orgasms—just as every woman certainly doesn’t conform to the four phases of the so-called sexual response cycle (excitement, plateau, orgasm, and resolution) often used to define sexual function—and the best kind of orgasm for you is the kind that your body naturally enjoys.

When people hear the phrase female ejaculation, they sometimes don’t take it seriously—perhaps because they’ve never experienced it and can’t imagine it’s possible. It may also be because female ejaculation continues to be poorly understood—or not understood at all—by many in the medical community. It doesn’t appear in medical texts or curricula, and you can still find any number of “experts” who insist that it’s anatomically impossible, or even that the urethral sponge doesn’t exist. This can be frustrating for women who ejaculate during orgasm and have nowhere to turn for information—or confirmation that they’re perfectly normal.

As recently as the 1980s, it was difficult to find a single self-help book on sex that even mentioned female ejaculation. Today, although more researchers acknowledge its existence (see accompanying sidebar), books broaching the subject remain few and far between. The shortage of information is no doubt compounded by the fact that not all women ejaculate—or are aware that they do—during orgasm.

Because female ejaculation hasn’t yet been adequately elucidated, it deserves extra attention here. Let’s look more closely at what happens when a woman ejaculates during orgasm, what leads up to it, and which organs are involved.

Earlier in this chapter we described how to locate your G-spot, and pointed out that it’s situated directly over your urethral sponge (your G-sponge). In a sense, your G-spot isn’t a separate entity, but simply the place on your vaginal wall where you can most easily reach your G-sponge and stimulate it. Many people don’t realize that the G-spot earned its reputation for triggering orgasmic ecstasy only because pressing on it during arousal means directly stimulating the sponge.

As you become aroused, your G-sponge, which contains erectile tissue and glands, becomes engorged, not only with blood but with the fluid it produces. This is why you can most easily find your G-spot during arousal, by reaching your finger inside your vagina to feel your swollen sponge; you can further stimulate its fluid buildup by pressing directly on the spongy surface via your G-spot. Ejaculation happens when intense contractions of the PC muscle during orgasm “squeeze” the built-up fluid in the sponge into the urethra (which the sponge surrounds and presses closely against) and out of the body through the urethral opening.

The fluid that a woman ejaculates, which has been called amrita, or “female nectar,” has a clear, watery quality and a pleasant, musky smell. It’s not easily confused with the vagina’s naturally secreted lubrication, and noticeably different from urine. But because it emerges from the urethral opening and many women, as well as many doctors, are unaware that it’s produced by paraurethral glands in the G-sponge, it’s often mistakenly believed to be urine.

As mentioned previously in this chapter, the G-sponge is sometimes called the female prostate because it’s the female counterpart of the male prostate gland, and a woman’s ejaculatory fluid resembles male prostatic fluid, although more diluted. It’s worth noting that a man’s ejaculatory fluid correspondingly contains prostatic fluid, which is produced in his prostate.

Depending on the degree of G-sponge stimulation and the intensity of orgasmic muscle contractions, some women release copious amounts of their female nectar. It can spill out in sudden warm gushes that bathe a woman’s vulva, or it can actually squirt like a fountain into the air, projected several inches or more out of her body. Some women release smaller amounts that trickle out less conspicuously.

All women have the potential for ejaculation, but it may require an unusual amount of sexual energy, a high state of arousal, and consistent G-spot stimulation for 20 minutes or longer. When sexual pleasure builds to a sufficient crescendo at orgasm, a woman may arch her back and hold her breath at the point of ejaculation, her pelvic muscles tightening forcefully and propelling her nectar from her body. Some women find that the more G-sponge stimulation they receive, the more ejaculatory they become, and experience multiple ejaculations in sequence without needing a recovery period. It’s also possible for a woman to ejaculate before, after, or without any other type of orgasm.

Some women ejaculate naturally, with no extra G-sponge stimulation. Many may do so without realizing it because they’re distracted by pleasure, or not adequately in touch with their bodies to recognize what’s happening. Many others may be aware of what’s going on but concerned that something is “wrong” with them because of the dearth of information on female ejaculation.

The bottom line: If clear fluid is released from your urethral opening when you’re aroused—whether it dribbles from your vulva or bursts out like a geyser—you have no cause for fear or alarm. To the contrary, this can be a completely healthy part of your sexual response, and a source of immense pleasure.

Is Female Ejaculation “The New G-Spot”?

In some ways, female ejaculation is to today’s generation what the G-spot was to a previous one: an important aspect of female sexuality that many are completely unaware of, few understand, and some consider largely a myth. However, with increasing numbers of women openly describing their experiences of ejaculating, it appears that female ejaculation, once almost a taboo topic among many medical professionals and gynecologists, is finally beginning to emerge from the closet. It seems that it will be just a matter of time, research, and education before it’s no longer widely dismissed as impossible. Female ejaculation is real, and here to stay!

The ancient wisdom of Chinese medicine has a lot to say about your pelvis and sexual health. As you’ve discovered, your pelvis plays a pivotal role as the conduit for all the chi that courses through your body in channels known as meridians. You can nourish your sexuality, resolve many pelvic-health issues, and boost your general health by keeping your chi abundant and flowing smoothly through your pelvis. By following all the steps outlined in Chapters 1 and 2 for creating a sturdy foundation of health, you can keep your chi strong.

If your chi isn’t flowing efficiently, you can develop what’s known as “stuck chi” in your pelvis. This can be caused by poor general health, or emotional issues such as unresolved anger or grief from abuse, miscarriages, or abortions. If you have stuck chi in your pelvis, your meridians can’t bring vital energy to your pelvic organs, and you’re prone to forming masses such as fibroids and ovarian cysts. Stuck chi in your pelvis can also result in abnormal functioning of your pelvic organs, pain, or reduction in the quality of your sex life.

Your pelvis is an energetic vortex because it concentrates not only your chi, but also a special form of chi that originates in your kidneys. For the purposes of this book, we call this type of chi your sexual chi because of its unique, primal connection to your sexuality. According to Chinese medicine, your sexual chi fills your meridians and has powerful therapeutic effects on your entire body, mind, and spirit. For example, it increases your circulation, nurtures your emotions, and reinforces your overall chi. Because of your sexual chi, loving sex that deeply bonds you with your partner has profound healing effects on many levels.

Your sexual chi can be especially healing to the organs and tissues of your pelvis, by flushing your female organs with energy, blood, oxygen, and nutrition. You need abundant sexual chi to maintain a robust sexual appetite; if it’s low, intimacy won’t hold much attraction for you. Chinese medicine teaches that common problems with sex organs, such as chronic vaginal infections, ovarian cysts, or painful menstrual cycles, can be resolved by restoring sexual chi.

You can enhance your capacity for great sex—or replenish your sexual energy if it’s depleted—by tapping into the power of your sexual chi. Because your sexual chi is derived from your entire body, mind, and spirit, you can build it with lifestyle shifts that improve your health and happiness. A balanced lifestyle gives you ample sexual chi, but a life of excess quickly depletes it. As with your overall chi, following the recommendations earlier in this book for creating a strong foundation of health will cultivate your sexual chi.

You can also stimulate your sexual chi with acupressure. Your body stores a vast reservoir of it in your pelvis, at an acupressure point called Ren 6, also known as the Sea of Chi. Another point for enhancing sexual chi, called Kidney 1 (also known as Gushing Spring because it’s traditionally considered an upward-flowing fountain of energy), is found on your foot. To locate both points on your body, see Appendix A. By pressing firmly on these points for a few minutes each day, you can strengthen your sexual chi.

Getting into Your Flow with Acupressure

According to Chinese medicine, you can directly affect the channels of chi that flow through your body by pressing on key points along the courses they follow. When you stimulate your chi with acupressure, it can have systemic effects on your body, mind, spirit, and sexual energy. Acupressure can be thought of as a variation on acupuncture that you can easily apply yourself. To do so, you use your finger to press gently but firmly on a designated point for one to three minutes. This simple technique of applying steady pressure to the point enhances the flow of your chi through it.

You can create greater pelvic health and increase your sexual satisfaction by strengthening, firming, stretching, and releasing your pelvic muscles. Exercises for enhancing sex and boosting pelvic-muscle strength have been recommended in Chinese medicine for centuries. One well-known Chinese manual, The Art of the Bedchamber, instructed women to exercise their pelvic muscles and improve vaginal sensation with “pelvic squeezing” during sex.

According to traditional Chinese medicine, strengthening your pelvic muscles brings chi to your pelvis and improves its flow throughout your body. In addition, if your pelvic muscles are weak and lack tone, your vagina “leaks” your sexual chi, resulting in a reduced sex drive and overall fatigue. When your pelvic muscles are strong, they preserve the healing force of your sexual chi, and use it to maximize the health of your female organs.

The best-known modern exercises for enhancing pleasure and pelvic strength are Kegels. Introduced in the 1940s by physician Arnold Kegel to treat urinary incontinence (the involuntary release of urine), the exercises had the unexpected benefit of also improving women’s sex lives; some who did them regularly reported having orgasms for the first time.

Kegels increase blood flow to your pelvis and keep you connected with your core by familiarizing you with your inner pelvic muscles, particularly your PC muscle. By learning how to contract and relax your PC muscle, you can increase the intensity of your orgasms and literally flex your way to better sex—and also enhance your partner’s pleasure by increasing his sensation as your vagina tightens around his penis.

In addition to preventing and treating urinary incontinence, which we’ll explore later in this chapter, doing Kegels on a regular basis can prevent, alleviate, or reverse pelvic organ prolapse, which occurs if your pelvis doesn’t correctly support an organ. Kegels help with this condition by lifting, toning, and building up your inner pelvic muscles, which (as described in previous pages) include the PC muscle that forms the “hammock” holding up your pelvic organs. This is why Kegels are recommended for women about to give birth, or recovering from a vaginal birth. A woman’s pelvic muscles expand dramatically during childbirth, and afterward can remain stretched and weakened, making her prone to organ prolapse.

You can do Kegels slowly, which develops your slow-twitch muscle fibers, builds your strength and stamina, and promotes your overall pelvic-muscle tone. You can also do them rapidly, which fortifies your fast-twitch fibers. The best results are usually achieved by combining the slow and fast techniques, with more emphasis on the slow.

To do a Kegel, you tighten the muscles you would use if you were trying to stop your flow of urine. (If necessary, try this while urinating; you won’t want to do it often, but experimenting a few times will acquaint you with the muscles you need to use, and what it feels like to contract them.) You’re ready to begin doing Kegels when you’ve learned to contract and relax these muscles.

For starters, here’s a simple Kegel routine you can try: do fast Kegels for two seconds, rest for two seconds, and repeat eight to ten times; then do a slow Kegel that lasts for ten seconds, relax for ten seconds, and repeat eight to ten times. You can do this routine several times a day at your convenience. One of the beauties of Kegels is that they can be done in practically any position—sitting, standing, or lying down—so you can privately practice your “sex flex” almost anytime and anywhere. You can do your Kegels while waiting in line at the store, sitting on a plane, or stuck in traffic. Stoplights were made for them!

Keep practicing this basic routine, and you’ll become a proficient Kegeler before you know it. Later in this book, we’ll explore some exciting advanced techniques that incorporate the use of special cones and weighted devices known as Ben Wa balls, which were first developed in ancient China.

Most women have little trouble mastering Kegels, but some find it difficult to identify and flex their PC muscle. If you’re in this category, the guidance of a physical therapist trained in biofeedback to promote PC-muscle strength can be enormously helpful. A biofeedback probe inserted into your vagina allows you to gauge the duration and strength of your PC contractions. (You can also purchase at-home biofeedback devices, such as the Pelvic Muscle Therapy Program, for under $50.) If you experience spasms or difficulty releasing your inner pelvic muscles, devices known as vaginal dilators, available online or through your physical therapist, can help.

You may need to enhance your experience of sex because of a particular health challenge you face with your pelvis or sexual organs. If you’ve had trouble enjoying sexual pleasure or achieving an orgasm, either by yourself or with a partner, you’re not alone; thousands of women have similar experiences. The good news is that you can overcome many common pelvic- and sexual-health issues, and it can be extremely empowering to discover that you can increase your own capacity for sexual gratification via natural means.

Problems that interfere with sexual enjoyment can have both psychological and physical causes. The psychological causes include untreated anxiety and depression, chronic long-term stress, a history of sexual abuse or trauma, issues pertaining to body image, and self-esteem issues. Women who fear intimacy, or don’t trust their partner enough to release control and allow themselves to have an orgasm, are more prone to sexual difficulties and less likely to experience pleasure in a relationship.

If you have sexual challenges with psychological causes, whatever the issue may be, a therapist can help you uncover patterns in your behavior that may be blocking you from your natural ability to experience sexual satisfaction. With time, you can work through inhibitions you may have about sex.

The physical causes of an unsatisfactory sex life can include painful menstrual cramps; chronic pelvic infections known as vaginitis; vaginal atrophy and dryness (the decrease in size, reduced elasticity, thinning, or increased fragility of tissue that often happens in midlife); urinary incontinence; urinary tract infections; interstitial cystitis; ovarian disorders such as benign cysts or polycystic ovarian syndrome; cervical dysplasia; chronic pelvic pain; and hormone imbalances (which we’ll explore in detail in the next chapter). Some prescription medications, such as antidepressants, blood-pressure medications, and antihistamines, can also decrease your libido and inhibit orgasm.

If you have a condition that prevents you from fully enjoying sex, remember that you are your own expert on your sexuality—the only person with direct experience of your body, mind, and spirit, and intimate knowledge of your entire personal history—and that you can resolve many common problems of the pelvis and sexual organs without drugs or medical intervention. In the pages ahead, you’ll discover numerous ways you can enhance your capacity for pleasure with safe, natural self-help solutions to the sexual-health challenges you’re most likely to face.

You may be surprised to discover that you don’t necessarily have to live through painful menstrual cramping every month. One of the great myths about women’s health in conventional medicine is that menstrual cramps are inevitable—and that it’s perfectly acceptable to take anti-inflammatory drugs or over-the-counter medications like Midol every month to treat the symptoms. By challenging this view and using natural means to alleviate menstrual cramps, you stand a good chance of having pain-free periods—and a time of month you may have once written off as invariably uncomfortable can instead become an opportunity for more pleasurable pursuits.

If you have painful menstruation, or dysmenorrhea, you know it usually happens during the first two to three days of your period. The cramping you experience may be partly due to changes in your hormones and your body’s production of “unfriendly” prostaglandins (hormone-like substances). Some women have painful menstrual cramping because of unusual conditions such as pelvic inflammatory disease, uterine fibroids, ovarian cysts, or other health issues. If you’re not in this category and your cramping is “normal,” the following natural methods are likely to significantly reduce or eliminate your discomfort:

—Western herbs. Ginger and cramp bark (also known by its botanical name, Viburnum opulus) are among the best Western herbs for decreasing menstrual pain. Ginger is most effective as a tea; to relieve cramping, drink three or four cups a day, beginning when your period starts and continuing as needed. Cramp-bark capsules are available in many health-food stores; the recommended dose is 300 mg three times daily.

—Chinese herbal formulas. According to Chinese medicine, menstrual cramps are typically caused by “chi and blood stagnation,” which is associated with feelings of stress and frustration. One of the best-known formulas for the condition, Xiao Yao Wan (also known as Free and Easy Wanderer), is available at some health-food stores and online; for dosage, follow the recommendations on the product label.

—Omega-3 fatty acids. Omega-3 fatty acids can relieve menstrual cramps by helping your body make more “friendly” prostaglandins that reduce pain and inflammation. They are found in fish oil, flax oil, and walnuts.

—Magnesium citrate. For many women, this is a reliable treatment for menstrual cramps. The most effective dose is 600 mg taken a few days before the onset of your period, and continued through the first three days of your period. (Note: Excessive magnesium intake can cause diarrhea.)

—Other supplements. To help keep the cramping away, make sure you’re also getting 400 IU of vitamin E and 1,000 mg of calcium every day.

—Exercise. There’s conflicting research on whether exercise helps reduce menstrual pain, but anecdotal evidence strongly suggests that it can. For many women, a workout a day keeps the cramping away! From the Chinese medical perspective, exercise may resolve menstrual cramps by increasing the circulation of chi in your pelvis and preventing stagnation. You may want to try different kinds of exercise before and during your period to see what works best for you.

—Acupressure. You can also use acupressure to relieve menstrual cramps. At the onset of cramping, you or your partner can press gently on the point known as Spleen 6 and hold for one to three minutes, at least once per hour as needed. To locate this point on your body, see Appendix A.

—Regular sex. For some women, having sex regularly during the rest of the month (when they’re not menstruating) can help alleviate menstrual cramps.

If you have vaginitis, or an inflammation or infection of your vagina, it can seriously interfere with your sex life. Chronic vaginal infections, which are among the most common sexual-health challenges women experience, are often accompanied by pain and itching in both the vagina and vulva. In some cases, there may be only irritation at the vaginal opening; in others, there may also be a vaginal discharge. Overcoming this condition can be extremely liberating, and dramatically enhance your sexuality.

Your vagina has its own dynamic ecology that’s influenced by your lifestyle, diet, immune system, hormones, and other factors. Various microorganisms inhabit your vagina, including both “friendly” and “unfriendly” bacteria and yeast. When you’re healthy, your vagina is naturally self-cleansing and self-regulating; your friendly bacteria hold the unfriendly bacteria and yeast at bay and help keep your vaginal pH (its degree of acidity or alkalinity) at a level that assists in preventing infections.

If you have vaginitis, it’s most likely due to an overgrowth of unfriendly bacteria or yeast. This can happen if you disrupt your vaginal balance by consuming too much sugar or taking too many antibiotics. Unnecessary douching to diminish so-called feminine odors can also make your vagina more vulnerable to infections. In addition, vaginitis can be caused by too much of a good thing: frequent sex can change the pH of your vaginal environment and allow unfriendly bacteria to thrive, because the pH of semen is more alkaline than that of your vagina.

To identify the cause of vaginitis, you need to see a physician for an accurate diagnosis. Although usually the result of an overgrowth of unfriendly bacteria or yeast, it can also be due to a sexually transmitted infection such as trichomoniasis, which is caused by a microscopic parasite. If you have trichomoniasis, you’ll need to take an antibiotic, and your partner will as well.

Many conventional physicians, unaware that you can treat and prevent vaginitis caused by unfriendly bacteria or yeast with natural methods, are far too quick to prescribe drugs that can be counterproductive and further disrupt your vaginal balance. For example, women are frequently prescribed antibiotics for bacterial infections in the vagina, but this often destroys not only the unfriendly bacteria that caused the infection but also the friendly bacteria that could have prevented it from recurring. Antibiotics may seem like a short-term fix, but they often contribute to infections returning.

To treat vaginitis due to unfriendly bacteria or yeast, you want to use natural treatments whenever possible and lifestyle changes that affect your entire body, not just your vagina. If you have chronic vaginitis due to yeast, for instance, you should eat a diet low in sugar, alcohol, and refined carbohydrates. You should also make lifestyle changes such as removing a wet bathing suit soon after swimming (leaving it on could make you more prone to vaginal yeast infection), and avoiding clothing that fits tightly around your lower pelvis; one study showed that you can be three times more likely to experience vaginitis if you wear panty hose.

Let’s look at the most effective natural methods you can use to treat vaginitis caused by overgrowth of unfriendly bacteria or yeast:

—Vaginal douche powder. One of the best natural medicines I’ve prescribed for vaginal bacterial and yeast imbalances is a vaginal douche powder called Tanafem (to obtain it, see Appendix C) consisting of zinc tannates and glycine. It eradicates bacteria and yeast by dehydrating them, and you can get rid of most infections by using it twice daily for a week. Soothing and nonirritating, it can even be applied to reddened, highly inflamed tissues. Mix one scoop in a pint-size douche bag filled with warm water, and douche twice daily for five to ten days, depending on the severity of the infection.

Using vaginal douche powder in conjunction with a sitz bath can help alleviate any external irritation you may have. (A sitz bath is a German term for sitting in a bowl of water to heal and nurture the tissues of the pelvis, or to increase circulation through the pelvis. Many irritations of the vulva can be treated with sitz baths.) Mix one scoop of the powder with warm water in a pan large enough for you to be seated comfortably; place the pan on the floor, and soak your vulva in this bath for 10 to 20 minutes twice a day for five to ten days, depending on the degree of inflammation. (Note: The rust-colored powder may permanently stain the pan, towels, and bath mats.)

—Tea-tree oil. An effective treatment for overgrowth of unfriendly bacteria or yeast, tea-tree oil can be used either as a douche or in the form of vaginal suppositories. (If your vagina is inflamed to the point of being “raw” and red, tea-tree oil shouldn’t be used, as it could be irritating.) For douching, mix ten drops of oil in a pint of warm water and douche; do this twice daily for seven to ten days. For suppositories, place one tea-tree oil suppository in your vagina twice a day for seven to ten days. You may want to wear a menstrual pad, as the oil from the suppositories can leak out.

You can purchase tea-tree-oil vaginal suppositories online or at your local natural-health pharmacy. They’re typically made with cocoa butter or vitamin E, which can be soothing to your vaginal mucosa—your vagina’s protective outer layer of moist tissue. Keep them on hand, and use one whenever you feel the beginning of a vaginal infection; this can nip it in the bud, preventing full-blown vaginitis.

—Goldenseal root. Also known as hydrastis, goldenseal can be used as a douche, as a sitz bath, or as vaginal suppositories to treat vaginal infections. It’s antibacterial, antifungal (which means it kills yeast), and gentle on your tissues. You can find goldenseal root at most herbal dispensaries, often as a powder, capsule, or pill. If you purchase capsules, you can open them and use the contents to make the mixture for your douche or sitz bath.

For a douche or sitz bath, bring four cups of water to a boil, add a tablespoon of goldenseal root, simmer for 15 minutes, strain, and let cool until it’s at a warm temperature, comfortable to douche with or sit in. For douching, use this mixture to douche twice daily for a week. For sitz baths, warm the mixture, pour it into a large pan, and sit in the pan for 10 minutes twice daily for two days.

To use goldenseal vaginal suppositories, place one in your vagina twice daily for a week. You may need to obtain goldenseal suppositories through your naturopathic physician; the ones I recommend, which are in a base of cocoa butter, are well tolerated by most women.

—Chinese herbal wash. You can treat vaginitis caused by bacteria or yeast, and nurture this sensitive yin area of your body with an antipathogenic herbal remedy from a Chinese-herb store. The product Yin-care combines a number of organic Chinese herbs, and makes an effective douche; for information on obtaining it, see Appendix C. Yin-care is recommended for chronic vaginal imbalances, known as “damp heat” conditions in the terminology of traditional Chinese medicine.

For douching, dilute the herbal wash in warm water, following the directions on the product label, and douche twice daily for five days. If you have a chronic or severe infection, mix the herbal wash with an equal amount of water, soak a tampon in the solution, place the tampon in your vagina, and leave it there for three hours; do this twice daily for six days.

—Friendly bacteria vaginal suppositories. If you suffer from bacterial vaginitis, you need to restore your vagina’s bacterial balance with friendly bacteria. Your vagina is healthiest when your friendly bacteria keep the unfriendly elements in check and help maintain your vaginal pH at the right level.

You can purchase over-the-counter suppositories containing friendly vaginal bacteria, known as Lactobacillus acidophilus, but it’s important not to overuse them; you don’t want an overgrowth of friendly bacteria. For most chronic or acute vaginal infections, use one suppository a week for seven weeks. (see Appendix C for information on purchasing friendly bacteria vaginal suppositories.)

To help determine whether vaginitis is caused by bacteria, examine any discharge you may have. If it’s yellow-green with a slightly fishy odor, you most likely have a bacterial infection; if it’s white and curd-like, you probably have a vaginal yeast infection. For a definitive diagnosis, however, you’ll need to see a doctor.

—Cleansing. You can have chronic vaginitis from bacteria or yeast if your immune system isn’t in peak form and your overall health is compromised. Many women with chronic vaginitis also have excessive yeast or unfriendly bacteria in their intestines, the result of an overwhelmed immune system that can’t rally to restore balance between friendly and unfriendly bacteria and yeast. With your Great Sex Detox, the cleanse outlined in Chapter 2, you can recharge the health of your entire body and effectively eradicate vaginitis.

Vaginal dryness is one of the most disconcerting sexual-health challenges you may face. Most women experience it to one degree or another at some time in their lives. If you have vaginal dryness, there’s no mistaking the symptoms, especially if you experience it during sex; insufficient lubrication can be debilitating to your sex life. One woman graphically described the condition to me as “a sensation that my vaginal walls are lined with sandpaper.” Another summed it up as “feeling like I have dust bunnies in my vagina.” Solving vaginal dryness can be one of the most sex-enhancing steps you ever take.

If you experience vaginal dryness at any time in your life, you can benefit immeasurably by using natural lubricants as needed for sex. We’ll cover many of your options for sexual lubricants in detail later in this book.

When vaginal dryness is accompanied by the thinning of the tissue of the vulva and vagina known as atrophy, which often happens during midlife, the condition is referred to as vulvovaginal atrophy or vaginal atrophy and dryness (which we call VAD). The name may sound clinical, but it describes an experience that for many women is all too real. VAD is a silent epidemic that affects millions of women, including up to 60 percent of those in their postmenopausal years.

Your vaginal and vulvar tissues naturally secrete sex-enhancing lubrication, and the secret to your secretions often lies in your estrogen level. VAD is caused by the natural reduction of estrogen throughout your body as you approach midlife; the tissues of your vulva and vagina are uniquely sensitive to this decrease because they’re estrogen-dependent. The drop in estrogen can decrease blood flow to these tissues, and lower their collagen content, and since collagen makes up your connective tissue, this means more tissue breakdown and atrophy. In addition to atrophy, the most noticeable effect of VAD is the reduction of your natural lubrication, and vulvar or vaginal pain that can last for months, or years.

If you have VAD, you may also experience vaginal irritation, itching, tenderness, urinary incontinence, and pain or bleeding during sex. Your symptoms can range from uncomfortable to excruciating, and sex may be out of the question. You may visit a number of gynecologists who prescribe topical steroid creams and vaginal anti-yeast creams—all to no avail. You may conclude that nothing can be done, and resolve to live with your symptoms.

Although both vaginal dryness and VAD are among the most common challenges women experience, VAD is one of the least recognized. There has been a tendency to downplay or ignore it in conventional medicine, which provides no clear explanation for why some women have the condition and some don’t. Since VAD often begins when a woman is in her 40s and continues into postmenopause, conventional doctors sometimes consider it just another unpleasant change that comes with the territory of midlife, a “minor” affliction requiring no special medical attention.

If untreated, VAD can lead to numerous other conditions, including vaginitis. Low estrogen in your vaginal tissues can make you more vulnerable to pH shifts and vaginal infections from unwanted bacteria and yeast. This happens because your vagina and urethra are lined with mucosa—the protective, moist outer barrier that lubricates your tissues and helps prevent vaginal infections from bacteria and yeast, as well as urinary tract infections. When the estrogen level in these tissues drops and your urethral and vaginal tissues become thinner and more fragile with atrophy, your protective mucosal barrier can break down, increasing the potential for bacteria or yeast invasion.

If you suffer from vaginal dryness or VAD, the good news is that there are many ways you can alleviate your symptoms, and you may be able to make them disappear completely. Treating VAD often means mitigating its effects by nourishing and supporting your vulvar and vaginal tissues.

From the perspective of traditional Chinese medicine, the symptoms of vaginal dryness and VAD are by no means an inevitable part of your life; they’re seen as the result of an imbalance in your chi, and inadequate circulation of chi through your pelvis. The underlying causes can be treated with herbs, some blended in ancient formulas that give them synergistic effects—which means they’re more effective in combination than alone. Two of these formulas, included below, can be used to balance your chi, enhance your overall health, and nurture your vulvar and vaginal tissues.

For many women—especially those with severe dryness and great discomfort—using any one treatment alone may not provide the entire solution to VAD. Some find that combining Western methods, such as topical estrogen cream and vitamin E, works best, while others find a blend of Western and Chinese methods most effective. And for many, combining treatments with the lifestyle changes we’ve covered earlier in this book, along with Kegels or other exercises for increasing blood flow to their vaginal tissues, helps treat the underlying deficiency and create change on a deeper level. If you suffer from vaginal dryness or VAD, a multifaceted approach that incorporates lifestyle changes will not only enhance your sexuality by nurturing the tissues of your vulva and vagina, but also build your libido by boosting your overall health.

Let’s look at the most effective natural methods you can use to reduce or eliminate the effects of vaginal dryness and VAD, including three treatments from Chinese medicine. (Note: If you have vaginal dryness but you don’t have VAD, the first two methods—estrogen creams and DHEA suppositories—aren’t recommended, but the others are.)

—Natural estrogen creams. By using a low-dose natural estrogen cream on your vulva and in your vagina, you can rehydrate your tissues, enhance their integrity, and support your urethra. It’s recommended that you use the lowest possible dose of the cream needed. If you have a history of breast cancer or other cancer linked to estrogen, you shouldn’t use an estrogen cream, since even a low dose can stimulate estrogen-related cancer growth.

The best natural estrogen cream to use contains estriol, a type of estrogen that’s much weaker than estradiol and other estrogens commonly used in hormone replacement therapy. As the primary estrogen produced by the body during pregnancy, estriol is “friendlier” than estradiol, and can’t convert in your body into stronger forms of estrogen.

Not only can estriol make an enormous difference in VAD by enhancing the integrity of your protective mucosa and allowing for more lubrication during sex, but it can also help prevent urinary tract infections, which can be common during the years leading up to menopause. In addition, by strengthening the tissues of your urethra, estriol can help prevent urinary incontinence—a common condition in menopausal women who experience VAD.

To use estriol vaginal cream, apply a dose of 2 mg nightly before bed for ten nights by placing a small amount on your fingertip; gently spread the cream on your vulva and in your vagina. After ten nights, taper to 1 mg nightly three times a week. (You can also apply it with a vaginal applicator, if the cream you use comes with one.) After following this protocol for as little as a few weeks, many women report that they no longer experience vulvar or vaginal discomfort, and can have pain-free sex once again.

As an alternative, you can use estriol in the form of vaginal suppositories, which are used much like the cream and in similar doses, except that you insert the suppositories into your vagina. Neither the cream nor the suppositories are available over-the-counter; they’re by prescription only, and should be used under the direction of a licensed naturopathic physician or other qualified holistic doctor.

Since some of the estriol you apply will be absorbed into your system, it’s highly recommended that you use a small amount of natural progesterone simultaneously. This helps to balance the effect of the estriol and prevent the unwanted buildup of the endometrium, or inner lining of your uterus. (If you’ve had a hysterectomy, this isn’t applicable.) In the next chapter, we’ll explore in detail what you need to know about taking progesterone.

—DHEA suppositories. If you can’t use estrogen, you can use the hormone DHEA in the form of vaginal suppositories. This can effectively increase your vaginal moisture and resolve symptoms of VAD, especially if you have vaginal atrophy, without increasing your risk of tissue overgrowth in the inner lining of your uterus that could lead to endometrial cancer.

A 2009 study published in the journal Menopause found that menopausal women with vaginal atrophy who used DHEA vaginal suppositories showed significant improvements in their vaginal symptoms, which included pain during sex, dryness, irritation, and itching. And after three months of using the suppositories, they had no increase in endometrial growth.

To use DHEA vaginal suppositories, insert a 5 mg suppository into your vagina every night before you go to bed. DHEA vaginal suppositories are available by prescription only. (Note: Women with a history of estrogen-related cancer shouldn’t use DHEA.)

—Black-cohosh and wild-yam suppositories. A gentler way to enhance your vulvar and vaginal integrity is with vaginal suppositories containing both black cohosh and wild yam in a natural cocoa-butter base. These can be the answer for vaginal dryness, and a wonderful solution to VAD if you’d rather not use estriol, or any kind of hormone. (They can also be an effective add-on if you use estriol or DHEA, but they don’t completely solve VAD.) Typically, these suppositories also contain some vitamin E.

Although the herb black cohosh doesn’t contain any estrogen, it has active constituents that may have estrogen-like effects on your tissues and can help increase vulvar and vaginal lubrication. Black cohosh has been used by naturopathic doctors for decades to help women through the changes they experience in the years leading up to and beyond midlife. It’s often taken as a pill to help with hot flashes and other symptoms associated with low estrogen.

Wild yam contains active compounds that have progesterone-like effects—and also contains ingredients that have estrogen-like effects. Like black cohosh, it contains no hormones but can give you many of the same benefits.

To use the suppositories, insert one into your vagina every night at bedtime; after two weeks, taper use to two or three times a week to enhance lubrication. For many women, the suppositories are helpful within one or two weeks of use. (see Appendix C for supplier information.) If you have a history of breast cancer, you may be able to use black-cohosh and wild-yam suppositories, but you should check with your doctor first.

—Vitamin E. The unique properties of vitamin E make it especially effective for relieving vaginal dryness and VAD, stimulating your normal mucosa, and decreasing the potential for infection. As with black-cohosh and wild-yam suppositories, vitamin E can also be helpful if you use estriol or DHEA, and if they don’t fully resolve symptoms of VAD.

For an easy home remedy, open a soft 400 IU vitamin E gel capsule with a pin, squeeze the oil onto your fingertip, and apply it directly to your vulva and vaginal tissues. (Vitamin E is also available in liquid form. It’s always best to purchase vitamin E in the form of mixed tocopherols.)

Vitamin E can also reduce vaginal dryness when used as a suppository. The vitamin E vaginal suppository in Appendix C is available in a natural cocoa-butter base that melts at body temperature after you apply it, allowing the vitamin E to cover the tissues of your vulva and vagina. To use, insert one suppository into your vagina with your finger.

Whether you use vitamin E gel capsules or vitamin E vaginal suppositories, you should apply them every night at bedtime for at least two weeks, then taper use to three times a week to keep your vulvar and vaginal tissues hydrated. Many women with vaginal dryness or VAD begin to experience an improvement in their symptoms after using one of these treatments for only a week or two.

For the most effective relief of vaginal dryness experienced during sex, use one of these methods long-term and on a regular basis. Either can also be used before or during sex as a lubricant, although you’ll probably find that the suppositories result in much smoother, more effective lubrication than the gel capsules. In either case, a panty liner is recommended; vitamin E oil may be staining.

—Ba Zhen Wan. Also referred to as “Women’s Precious Pills” or “Women’s Eight Treasure Tea Pills,” Ba Zhen Wan strengthens a type of chi known as Xue. According to Chinese medicine, if you have an imbalance of Xue, your symptoms may include vulvar and vaginal tissues that are pale, undernourished, and devitalized, as well as a faded complexion, heart palpitations, shortness of breath, weak feelings in your limbs, dizziness, a pale tongue, and a faint pulse. (From the perspective of Western medicine, this state may be associated with anemia, painful menstrual cramps, low blood sugar, ulcers or abscesses that don’t heal, and postpartum exhaustion.)

Ba Zhen Wan contains five herbs that work synergistically to balance your chi: poria, licorice, ligusticum, white-peony root, and Angelica sinensis. The recommended dose is two pills two to three times daily, or if in pellet form, eight pellets two to three times daily. (Many companies make Chinese herbal formulas in both pill and pellet form. The pills are larger, approximately five to eight millimeters lengthwise; the small round pellets, or BBs, are typically about three millimeters in diameter.) see Appendix C for a resource.

You can also use acupressure to complement the effects of Ba Zhen Wan and help balance your chi: press firmly on the point called Liver 8 for two minutes once or twice daily. (To locate Liver 8, see Appendix A.)

—Liu Wei Di Huang Wan. Also known as “Six Flavor Tea Pills,” Liu Wei Di Huang Wan is a Chinese herbal formula that builds another type of chi known as kidney and liver yin. It’s used for symptoms that include dry, thinning, or burning vulvar and vaginal tissues, as well as for dry skin, night sweats, hot flashes, hot sensations in the palms of the hands and in the feet, blurred vision, dizziness, ringing in the ears, dark circles under the eyes, constipation, a lack of restful sleep, mental unrest, and frequent urination. A woman with these symptoms also tends to have a dry, reddish tongue and a pulse described in Chinese medicine as “thin”—weak and difficult to feel, as opposed to strong and “full.” (From the standpoint of Western medicine, this condition may be associated with insomnia, perimenopause and menopause, hyperthyroidism, interstitial cystitis, and other health issues.)

Some research has found that Liu Wei Di Huang Wan can increase the release of adrenal hormones that reduce inflammation; other research has shown it can support and balance immune-system functions. The formula combines six synergistic herbs: rehmannia, fructus corni, moutan, dioscoreae, poria, and alismatis. The recommended dose is two pills two to three times daily, or (in pellet form) eight pellets two to three times daily.

To use acupressure to support Liu Wei Di Huang Wan and help balance your chi, press firmly on the point called Spleen 6 (see Appendix A) for two minutes once or twice daily.

—Chinese ginseng. You can use Chinese ginseng, also known as Panax ginseng or Korean ginseng, as a single herb to treat or prevent vaginal dryness or atrophy of your vulvar and vaginal tissues. (Later in this book, you’ll explore Chinese ginseng’s aphrodisiac effects.) Well known in Chinese medicine for its ability to “build yang,” it can be especially effective if you not only have vaginal dryness or VAD but also what’s known as “yang deficiency.” Symptoms of yang deficiency include cold hands and feet, low energy and vitality, low libido, achy joints, sensations of cold in the lower back and knees, and a lack of control of the flow of urine. (From a Western medical perspective, this condition may be associated with arthritis, fatigue, hypothyroidism, adrenal fatigue, obesity, urinary incontinence, depression, and other ailments.)

Chinese ginseng can improve the circulation of chi through your pelvic region, warm and nurture your pelvic tissues, and help maintain the health and vitality of this delicate area of your body. The recommended dose is 200 mg taken two to three times daily. Since Chinese ginseng is a stimulating herb, it may cause insomnia in some women if taken too late in the day.

To use acupressure to support Chinese ginseng and help balance your chi, press firmly on the point called San Jiao 4 (see Appendix A) for two minutes once or twice daily.

Urinary incontinence, or the involuntary release of urine from the bladder, is largely a female affliction; women are five times more likely than men to experience it. Each year, the condition affects many millions of women worldwide. There’s more than one type of urinary incontinence, but the most common type that you may experience, known as stress incontinence, can be prevented or treated naturally. (We’ll address this type here; other types, beyond the scope of this book, require medical attention.) Preventing or treating this condition can vastly improve your ability to enjoy your sexuality.

If you’re a woman with the typical case of urinary incontinence, you’re unable to prevent urine from leaking out of your urethra when pressure is exerted on your abdomen. This can happen often, since the degree of pressure it takes to cause leakage may happen when you sneeze, cough, lift heavy objects, exercise, squat, jump, or laugh. Leakage may also occur during sex, which can put a damper, literally, on your sex life. The condition can be mild, causing an occasional minor embarrassment, or severe, with consequences drastically affecting the quality of your life.

Urinary incontinence can have many causes, but the most common is childbirth. As you discovered earlier in this chapter, after childbirth a woman’s pelvic muscles can remain stretched and weakened, making her more vulnerable to organ prolapse. This can also increase her susceptibility to urinary incontinence.

Another potential cause is the natural hormonal changes you experience leading up to menopause. As the estrogen and testosterone levels in your body decline, some of the tissues in your pelvic muscles, including those that support your bladder and urethra, may become weaker, making them less able to prevent leakage. At the same time, your dropping estrogen level affects estrogen receptors in your nerve tissue in ways that can elevate sensitivity and lead to increased urge to urinate.

Kegels can be effective not only for preventing urinary incontinence but also for treating it; they strengthen and firm the muscles that support your lower pelvis, urethra, and bladder. Earlier in this chapter we described how to do Kegels, and you may already be well on your way to becoming a master Kegeler. Keep practicing the recommended routine, whether or not you have urinary incontinence: you may prevent it from ever developing—or be surprised by how successfully you can reverse the symptoms. Rapid Kegels, which develop the fast-twitch fibers in your pelvic muscles, can be especially helpful in preventing urinary incontinence triggered by sudden abdominal pressure like coughing or sneezing. If you’re one of the many women who suffer from urinary incontinence, give extra attention to your fast-Kegel skills.

There’s a good chance you’ve had a urinary tract infection (UTI) at some point in your life. They’re among the most common female health concerns, affecting millions of women every year. You may have experienced recurring UTIs; about 20 percent of women who have a UTI have a second one, and some 30 percent of those women have a third.

Women often develop UTIs after having sex, as a result of tissue irritation at the urethral opening or vagina, which is why UTIs are sometimes referred to as “honeymoon cystitis.” (In this context, cystitis is a term linked with some types of UTIs.) Many women with UTIs are repeatedly prescribed antibiotics by conventional doctors. This may cause their symptoms to disappear for a time, only to return again when they have sex. Antibiotics are sometimes necessary, but when too quickly prescribed, they can contribute to the development of UTIs by killing off the friendly bacteria in your vagina, vulva, and urethra that help prevent UTIs.

Every day, you’re exposed to the type of bacteria that causes UTIs. You normally fight them off, but a number of factors can make you more susceptible and allow them to invade your urethra and bladder. In addition to tissue irritation from sex and the inappropriate use of antibiotics, common causes of UTIs include dehydration, general stress on your immune system, and your dietary choices.

UTIs are unpleasant, and can wreak havoc on your sex life because their disagreeable symptoms can cause apprehension about recurrent infections. Symptoms include pain or burning sensations while urinating, pressure in your bladder or urethra, an urgency to urinate, frequent urination, and blood in the urine. The good news is that there’s a lot that you can do to assist your body in naturally preventing UTIs, and thereby enormously enhance your ability to enjoy sex. Let’s look at the lifestyle measures you can take to help keep yourself UTI-free:

—Use adequate lubrication during sex. This can make all the difference in whether or not your vulvar tissues become irritated. Later in this book, we’ll explore your options for using sexual lubricants in detail.

—Urinate after you have sex. UTIs may gain a foothold in your urethra during sex; with this simple preventive measure, you decrease their chances. Emptying your bladder naturally cleanses unwanted bacteria from your urethra and bladder.

—Drink plenty of water. This prevents dehydration, helps keep your tissues moisturized (including your vaginal tissues), and gives you the advantage over undesirable bacteria. Your daily intake of water in ounces should equal about half the weight of your body in pounds, but you may need more in a hot climate, or if you perspire a lot from exercise—or from sex.

—Choose the right diet. Avoid sugar and alcohol, both of which can make you more UTI-prone. A diet high in sugar can make you especially vulnerable. Following the Great Sex Diet outlined in Chapter 2 will help you steer clear of UTIs.

—Avoid using soap on your urethra. Soap can irritate your delicate vulvar tissue, change its pH, and create favorable conditions for unfriendly bacteria. You don’t need to apply soap directly to your vulva; instead, you can simply wash it with warm water.

—Decrease possible tissue irritation. If you have vaginitis, use the methods we’ve covered in the previous pages to treat the condition as soon as it develops. Many women develop UTIs in conjunction with, or as a result of, vaginitis.

—Manage your stress. If you’re under chronic stress, you become more vulnerable to many types of illness and infection, including UTIs. Women who have recurrent UTIs often become much less susceptible when they make lifestyle changes that reduce stress.

—Use estrogen cream if you’re menopausal. Vaginal dryness, which you’re most likely to experience in your 40s or later, also affects your urethral tissues and makes you more vulnerable to UTIs. By using a natural estrogen cream containing estriol, as recommended earlier in this chapter for VAD, you can enhance the integrity of your urethral tissues and help prevent UTIs.

Some women are more prone to UTIs than others. If you’ve made all the right lifestyle choices, but find that you still have a tendency to develop UTIs, drinking two or three cups of marshmallow root tea on a daily basis can soothe the tissues of your urethra and bladder and help prevent recurrent UTIs. To make the tea, add two tablespoons of marshmallow root to four cups of boiling water, simmer for 15 minutes, and strain.

If you tend to get UTIs after sex, you can also drink a half-teaspoon of D-mannose (available at most health-food stores), a natural sugar found in cranberries and pineapples, dissolved in a cup of water before or after you have sex. This helps eliminate unwanted bacteria from your urethra and bladder.

UTIs should always be treated as quickly as possible; if untreated, they can soon lead to a kidney infection, which is a more serious condition, so antibiotics may be necessary. If you develop a UTI, you should have a urine test done by your naturopathic physician or medical doctor. For a resource on treating UTIs naturally, see Appendix C.

Interstitial cystitis, a chronic inflammation of the bladder wall, is often misdiagnosed as a UTI or bladder infection. The symptoms can be similar: pain or burning sensations in the bladder during or after urination, an urgency to urinate that may be intolerable, frequent urination, or pelvic pain. As with a UTI, the symptoms of interstitial cystitis can be intense, and treatment can radically improve your life—and your sex life. But unlike a UTI, with interstitial cystitis your urine test is normal and doesn’t show any bacteria.

The cause of interstitial cystitis is unknown to Western medicine, but it may be due to disruption of the mucous membranes of the bladder, resulting from recurrent UTIs. Other causes may include environmental toxins, unidentified infections, autoimmune conditions, or (in some people) a defect in the bladder wall.

Like UTIs, interstitial cystitis is a predominantly female condition: nine out of ten people who have it are women. The condition can lead to chronic irritation of the bladder wall, and many women with interstitial cystitis have food sensitivities that provoke their symptoms.

If you have interstitial cystitis, your diagnosis will probably be made by an urologist who does an exam of your bladder wall, called a cystoscopy. Other tests may include a biopsy and a potassium chloride sensitivity test. The conventional treatment typically includes prescription drugs that affect the bladder wall, local medication, and pharmaceutical pain medications.

There are natural alternatives for treating interstitial cystitis and restoring the quality of your sex life without drugs. It’s a complicated health issue that often calls for a multitiered solution, but with patience and perseverance you can reduce or eliminate the symptoms over time. You can begin treating interstitial cystitis by applying the following recommendations.

—Soothe your bladder wall. Drinking two or three cups of marshmallow root tea each day can mollify the mucous membranes of your bladder and urethra, and support the lining of your urinary tract. To make the tea, use the recipe recommended above for UTIs.

—Remove irritating foods from your diet. Avoiding foods that aggravate your symptoms, especially those that cause allergies and/or to which you are intolerant, is essential to treating interstitial cystitis. Your naturopathic doctor can order a blood test to determine these foods.

—Support the lining of your bladder. You can help restore your bladder lining by taking glucosamine sulfate as a dietary supplement. The recommended dose is 500 mg three times daily.

—Maintain an alkaline-forming diet. An alkaline-forming diet helps reduce the bladder pain of interstitial cystitis by keeping your urine alkaline. (see Appendix C for a resource on eating an alkaline-forming diet.) In addition, you can take 500 mg of calcium carbonate three times daily, or a quarter-teaspoon of baking soda twice daily.

—Make sure you get adequate fluids. By staying hydrated, you keep your urine diluted, which can reduce your symptoms; concentrated urine can irritate your bladder wall.

—Prevent UTIs. Interstitial cystitis makes you more vulnerable to urinary tract infections, which in turn can exacerbate your condition. Implement the measures recommended above for avoiding UTIs.

If you follow these recommendations consistently but your condition doesn’t improve, see Appendix B to find a naturopathic doctor for further guidance. You may benefit from treatment with N-acetylglucosamine (NAG), which helps restore your bladder wall and decrease bladder pain. Homeopathic remedies, including cantharis, apis, and sarsasparilla, can treat painful urination and the urge to urinate. Physical therapy of your pelvic muscles, biofeedback, bladder retraining, diet therapy, stress reduction, and other techniques can reduce bladder pain and increase control over your bladder. If you’re menopausal, your doctor may also recommend estriol cream or black-cohosh vaginal suppositories to support your tissues.

You may additionally benefit from traditional Chinese medicine, which treats interstitial cystitis by working with your chi. (Although Western medicine hasn’t identified the underlying cause of the condition, in Chinese medicine it’s seen as a chi imbalance.) Acupuncture and Chinese herbal medicines can decrease the pain associated with interstitial cystitis by stimulating the flow of chi through your pelvis and nourishing your yin and yang.

During your menstrual cycles your ovaries normally form small cysts, known as benign cysts because they’re usually harmless and cause no symptoms. They often disappear on their own, but some may grow larger to the point that they compromise your health, as well as your sex life, and you need medical attention. An annual exam is recommended so your doctor can check for unusual cyst development; if any other ovarian mass is detected, a test will be done to rule out cancerous growth.

If you consistently develop benign cysts, they may cause sharp, intense pain during your ovulation. In this scenario, you’ll most likely benefit from a hormone evaluation, which can help you prevent cysts by giving you information you need to balance your hormones. If you have frequent benign cysts, you also need to improve the circulation of blood and lymph in your pelvis. In addition, you can help prevent or treat cysts naturally, and boost the health of your ovaries at the same time, with the following.

—Vitamins and diet. Taking your daily multivitamin, eating foods containing vitamin A and beta-carotene, and adding flax and fish oils to your diet can all help prevent benign ovarian cysts.

—Turska’s formula. A traditional Western herbal remedy, Turska’s formula is an effective treatment for ovarian cysts. It isn’t available as an over-the-counter product; you need to get a prescription from your naturopathic physician. (see Appendix B.)

—Chinese herbal formulas. By improving the flow of chi through your pelvis, Chinese herbal remedies can help prevent or treat ovarian cysts. A practitioner of Chinese medicine who specializes in herbal remedies can prepare a specific formula to match your unique symptoms.

—Topical treatments. Castor oil packs can help treat ovarian cysts by improving circulation of blood and lymph through your pelvis. see Appendix C for a resource on making castor oil packs.

Another ovarian challenge you may face is the condition known as polycystic ovarian syndrome, or PCOS. Many women have never heard of PCOS and have no idea what it is, but if you’ve experienced it you probably know its effects all too well. PCOS is linked with abnormal menstrual cycles, female infertility, weight gain, insulin resistance (a prediabetic condition), and other conditions, and may affect as many as 10 percent of women under age 45. Overcoming PCOS, as with frequent benign cysts, can greatly benefit sexuality and overall health.

In most cases, women with PCOS don’t efficiently convert testosterone to estrogen in their bodies, resulting in an excess of testosterone. They often have irregular ovulation (or don’t ovulate at all); an above-average number of ovarian cysts; or symptoms of hyperandrogenism, which may include head-hair loss, acne, or an increase of facial hair.

If you have PCOS, many natural treatments can help. Let’s look at some of the most effective steps you can take to treat the condition.

—Foods and dietary substances. By including flax seeds, soy, and nettle root tea in your diet, you can increase your SHBG (sex hormone binding globulin), a protein that binds hormones so that you don’t have too many active hormones in circulation. This helps reduce the elevated testosterone associated with PCOS.

—Saw palmetto. An herb often recommended to prevent male prostate enlargement, saw palmetto can be an effective treatment for women who have PCOS with symptoms of acne and hair loss. The recommended daily dose is 320 mg of a standardized extract of saw palmetto.

—Spearmint tea. Research shows that women with PCOS who drink a cup of spearmint tea twice daily for five days during the first two weeks of their menstrual cycles have a significant drop in their testosterone levels. They also have an increase in estrogen and other hormones that can help reverse PCOS.

—Dietary and lifestyle changes. If you have PCOS you can benefit from changes in your diet and lifestyle, especially if you also have insulin resistance. By combining a low-carbohydrate diet with an hour of aerobic exercise each day, you can significantly reduce some long-term effects of PCOS linked with insulin resistance, including diabetes and heart disease.

—Chromium. Dietary supplementation with this mineral can help decrease insulin resistance in women with PCOS, which in turn will make PCOS more manageable. The recommended daily dose is 500 mcg, but up to 2,000 mcg can be taken daily.

—Acupuncture. Research shows that acupuncture can benefit women with PCOS and infertility by helping to regulate their menstrual cycles and increasing their rate of pregnancies. If you have PCOS with infertility, see Appendix B for information on finding an acupuncturist.

If you have cervical dysplasia, or abnormal changes in your cervical cells, it can be distressing, because cervical dysplasia is a potential precursor to cervical cancer. Some women with the condition undergo a surgical procedure known as cervical conization, which removes external tissue from the cervix. Despite this, the condition may return, and the procedure may be repeated multiple times to no avail. Cervical dysplasia can mean frequent visits to the doctor, many uncomfortable medical procedures, and lots of concern about spreading the virus that can cause the condition to your partner (he can become a carrier of the virus, which is contagious through sexual contact, and with some strains of it, he can get genital warts)—all of which can disrupt the quality of your sex life and compromise your experience of pleasure. For some women, cervical dysplasia might well be renamed cervical displeasure.

Cervical dysplasia is frequently caused by human papillomavirus, which is sexually transmitted. In addition to practicing safe sex (see Appendix G), you may be able to prevent cervical dysplasia, or heal your cervix if you have the condition, by keeping your immune system in top form. Preventing or treating cervical dysplasia can make a big difference in your sexual health, and one of the best ways to do so is by following the lifestyle, diet, and supplement recommendations in Chapter 2. You can also prevent or treat cervical dysplasia with the following:

—Indole-3-carbinol. Eat lots of cruciferous vegetables, which are high in indole-3-carbinol, or take 300 mg of indole-3-carbinol as a supplement daily. This helps lower your body’s production of “unfriendly” estrogens, which in excess can stimulate estrogen receptors in your cervix and increase abnormal cell growth. Indole-3-carbinol also promotes “friendly” estrogens that don’t increase the growth of abnormal cervical cells.

—Folic acid. An important B vitamin for cell reproduction, folic acid is helpful in preventing and treating abnormal growth of cervical cells. It can prevent abnormal cervical-cell changes from progressing, particularly in women who have been on birth-control pills. Most daily multivitamins contain 800 mcg of folic acid; for long-term prevention of abnormal cervical cells, take between 800 and 2,400 mcg daily.

—Vitamin C. To prevent abnormal cervical cell changes, take 2,000 mg daily; for treating the condition, take up to 6,000 mg daily for three months or more. (Note: Excessive vitamin C can cause diarrhea.)

—Alpha lipoic acid. To prevent abnormal cervical-cell changes, take 100 mg daily; for treatment, take up to 200 mg daily for three months or more.

—Mixed carotenoids. Mixed carotenoids combine alpha-carotene, beta-carotene, lutein, and other carotenoids. To prevent abnormal cervical-cell changes, take 50,000 IU daily; for treatment, take 150,000 IU daily for three months or more.

—Chinese herbal formulas. Supporting your immune system with Chinese herbs can balance your chi and help prevent or treat abnormal cervical-cell changes. A number of Chinese herbal formulas can also help restore cervical tissue that contains abnormal cells. A qualified practitioner of Chinese herbal medicine (see Appendix B) can prepare a formula suited to your personal needs.

—Escharotic treatment. Escharotic treatment is an herbal and nutritional therapy that has been used by naturopathic doctors for many years to treat women with abnormal cervical cells, as well as to prevent recurrences of the condition. Therapy typically consists of weekly treatments for three to five weeks, depending on the degree of abnormal cell growth and other factors. To determine if escharotic treatment is appropriate for you, consult a licensed naturopathic physician. (see Appendix B.)

A number of conditions categorized under the general term pelvic pain can interfere with your ability to enjoy sex. Pelvic pain can be experienced in your vulva, your vagina, or elsewhere in your pelvis. It can be caused by many factors, and some types of pelvic pain can be a challenge to diagnose and treat. If you suffer from the condition, solving it can transform your sex life; getting past pelvic pain unburdens your libido, freeing it up to replace the pangs of pain with welcome waves of well-being.

You may have experienced acute pelvic pain—for example, if your partner’s penis makes sudden contact with your cervix during sex. But pelvic pain can also be chronic; if you have a history of pelvic surgery, or if you’ve had a difficult labor, you may be prone to a chronically tight, shortened PC muscle, resulting in pain with intercourse. Other conditions associated with pelvic pain include vulvodynia (chronic pain at the vulva), vulvovestibulitis (chronic inflammation of the vulva and vaginal opening), and vaginismus (painful spasms and contractions in the vagina).

The topic of pelvic pain can involve complex issues that go beyond the reach of this chapter; there are numerous resources, as well as support groups, for women suffering from these conditions. However, if you experience pelvic pain, especially vulvar pain, there’s one method of treatment you should know about—a unique do-it-yourself approach that can be highly effective, and that too few women are aware of, known as vaginal steam baths. Not only can this method relieve or cure pelvic pain, but it’s also a soothing, nourishing way to connect with your sexuality and femininity.

Vaginal steam baths, which have been used traditionally in Korea and parts of South America, provide you with numerous other potential benefits. They can help decrease skin inflammation if you have a vulvar yeast infection, and help heal your tissues if you’ve had an episiotomy, vulvar biopsy, or other surgical procedure in or near your vulva. They can also loosen and relax your PC muscle, promote increased circulation, and may allow for easier penetration with intercourse if you have a condition associated with pelvic pain.

Vaginal steam baths are easy to do, and you can make each bath different by including various herbs or essential oils for added benefits. To get started, boil four cups of filtered water and pour it into a large stainless-steel or glass bowl. Add any herbs or essential oils you’d like to use, as described below, then place the bowl beneath a patio chair, or other type of chair with openings or slats in the seat, so you can sit with your naked vulva exposed to the steam. (Vaginal steam baths might be more aptly named vulvar steam baths, since the steam doesn’t reach your vagina, which is internal.) Alternatively, you can place the bowl in a toilet, after turning off the toilet’s water source and flushing to empty the water.

Before exposing your delicate vulvar tissues to the steam, test it carefully with your inner wrist so you won’t burn yourself. Once you’ve established a comfortable temperature, stay seated in your steam bath, allowing your vulva and entire pelvis to relax, for about 15 minutes or until the steam subsides. For treating most kinds of pelvic pain, it’s recommended that you do steam baths at least once a day for a week, and continue as needed to relieve your symptoms. To provide extra healing benefits, you can add the following herbs and essential oils, alone or in combination, to your steam baths:

—Red clover. This plant has been used in Western herbal medicine for decades to strengthen and tone the pelvic organs and tissues; it’s often recommended to help prepare the uterus for childbirth. Sprinkle one teaspoon of dried or fresh red clover into your steam bath.

—Oregano and tea-tree oil combined. To relieve pelvic pain and itching related to a vulvar yeast infection, add one teaspoon of dried oregano, or one drop of oregano oil, and two drops of tea-tree oil to your steam bath. Both of these herbs have potent antifungal properties. (For a vulvar yeast infection, steam at least twice daily.)

—Rose essential oil. To alleviate vulvar discomfort and moisten your skin and tissues, add three drops of this essential oil to your steam bath. Rose essential oil is also used in aromatherapy to treat physical and emotional imbalances. Physically, it’s recommended for low libido, infertility, and heavy menstrual bleeding. On an emotional level, it’s recommended as a calming and harmonizing agent, and also as a catalyst to create an atmosphere of safety for bringing feelings about sexuality and self-esteem to the surface.

—Lavender essential oil. An anti-inflammatory that promotes tissue healing, this essential oil is also used in aromatherapy to promote both physical health (especially for your skin) and emotional harmony (to induce calmness, relieve nervous tension, and support your capacity for love and appreciation of beauty). To enhance your steam bath with lavender’s healing effects, add three drops of lavender essential oil.

—Rose and lavender essential oils combined. Adding three drops of each of these essential oils to your steam bath can have a synergistic effect that’s especially helpful in treating vulvar pain. (Even if you don’t have pain, this treatment is recommended as a nurturing experience for this sensitive part of your body, particularly if you feel emotionally disconnected from your pelvis and sexuality.)

—Red clover, lavender, calendula, and chamomile combined. To relieve and gently heal any vulvar inflammation or dryness, add one teaspoon of each of these herbs, as either dried or fresh flowers, to your steam bath. Along with the benefits of red clover outlined above, lavender, calendula, and chamomile all have anti-inflammatory and soothing effects on the delicate tissues of your vulva (and they also make a beautiful floating bouquet).

In this chapter, we’ve delved into the fabulous anatomy of your pelvis—the diverse, dynamic region of your body that allows you to experience sex, reach orgasm, menstruate, release eggs, grow a fetus, and more. You’ve discovered exercises and other tools for strengthening your sexual core, enhancing the health of your phenomenal feminine organs, and maximizing your many-splendored potential for pleasure. You’ve also discovered natural, sex-boosting solutions to common challenges that you may encounter in this most vital area of your body.

As you’ve seen throughout this chapter, not only does your pelvis play a pivotal role in your capacity for pleasure, but it’s also the nucleus of your chi and central to your overall health. Now that we’ve explored the keys for optimizing the health of your sexual core, we’re ready to begin a new passage in our journey. In the next chapter, we’ll explore the rich realm of your hormones, and all that you can do to boost your libido and well-being by enhancing your hormonal health. As we move forward, the tools and insights you’ve discovered thus far will merge with many other discoveries you’ll make.