EVE S SECRETS

beat slowing to a quiver, his feet clenched and his leg muscles in spasm. It is only then that the male ejaculates semen from his cloaca (not his clitoris) on to the female's everted cloaca. Significantly, studies have shown that it is stimulation of the male's clitoris that is responsible for ejaculation. Whether or not stimulation of the female's clitoris is a factor in whether she everts her cloaca or accepts his sperm for fertilisation has not been looked at. However, the behaviour of these birds does underline the importance of clitoral stimulation for both sexes if successful sexual reproduction is to occur.

The way ahead

What this chapter has hopefully shown is the importance of the clitoris in ensuring sex is pleasurable - and hence more likely to be successful, rather than deadly, in terms of sexual reproduction. However, there is still a lot that needs to be learnt about female genitalia (both outside and in). One area that has not received much attention at all is the innervation of female genitalia, presumably because sexual arousal has until now not been seen as being important in terms of successful sexual reproduction. However, female genitalia are understood to be well supplied with sensory nerves. It's known, for instance, that stimulation around the clitoris, labia, vaginal opening, lower vagina and perineum is picked up primarily by the pudendal nerve, while the pelvic nerve transmits sensations from the vagina, urethra, prostate and cervix. The hypogastric and vagus nerves are also involved in triggering and maintaining female sexual arousal, and ultimately orgasm (as we'll see later).

Critically, though, the precise nature and location of all branches of these essential sensory genital nerves is not known. This means that these arousal-promoting nerves cannot be spared if a woman has to undergo any form of pelvic surgery. In contrast, nerve- and hence erection- and arousal-sparing surgery is a routine part of any pelvic operation on men. In this respect, as in many others, knowledge of female sexual anatomy and function still lags far behind that of male sexual anatomy and function. However, with increased awareness of the importance of the clitoris in supporting female sexual arousal and non-traumatic (i.e. successful) sexual intercourse, it is hoped that this will change in the near future.

One remaining controversy hanging over the clitoris in the twenty-first century is its name - and what it represents. Some groups are pushing to redefine the clitoris so that this one word encompasses many other parts of female sexual anatomy. Their desire is to see the clitoris as being composed of eighteen parts - including the inner labia, hymen, vestibular bulbs and pelvic floor muscles. Considering that female genitalia have been reduced so much in terms of stature and function in the past, I am

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loath to call these eighteen parts a clitoris. It is also, I believe, misleading and confusing to do this. It would be a step back, rather than forwards. The understanding of female genitalia needs to be expanded by words and images, not reduced in order to please some idea of what is politically correct.

I also feel uneasy that the desire to rename objects - such as insisting on the Fallopian tubes being the egg tubes, because Fallopius was a man, and the tubes are women's property - smacks of previous cultures' attempts to rewrite history to their liking. The Egyptians chiselled out hieroglyphs in an attempt to force their people to forget prior religions or ideas - today we try to alter language. Yet acknowledging history is essential, whether it is the history of anatomy or the history of language. What is important regarding the clitoris is appreciating its actual structure; understanding how the clitoris works in glorious concert with the rest of a woman's genitalia - outside and in; and realising that female and male genitalia are more similar than not - and that extends to their core role in sexual reproduction and pleasure.

Note

All the measurements given in this chapter relate to the handful of cadaver clitorises dissected in the name of research. They refer to the averages from both pre- and post-menopausal women. Importantly, these measurements should not be read as being set in stone, or as absolutes, or norms. Not enough research has yet been done to give any such lengths with certainty. Plus, all women vary, as do all men.

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A hungering maw. A gluttonous gullet. A toothed, voracious, ravenous, greedy chasm. Vagina dentata - the vagina with teeth - is an ancient anxious image that flows through folklore, mythology, literature, art and humankind's dreamworld. For many the most powerful of all vaginal myths and superstitions, the vagina dentata is also, perhaps, the most common. Its prevalence around the globe is stunning. Snapping and snarling, emasculating and mutilating men, the myth of the vagina dentata is to be found from North to South America, across Africa, and in India and Europe too. The omnipotence of this motif of the devouring vagina has also survived millennia, with many cultures' creation mythology imbued with castrating and deadly images. The first women of the Chaco Indians were said to have teeth in their vaginas with which they ate, and men could not approach them until the Chaco hero, Caroucho, broke the teeth out.

The Yanomamo of South America say that one of the first beings on earth was a woman whose vagina became a toothed mouth and cut off her partner's penis. In Polynesia, Hine-nui-te-po, the goddess of the underworld and the first female on earth, from whose womb all others fell, uses her vagina to slay Maui, the Polynesian hero. Maui crawls into Hine-nui-te-po's vagina in the hope of returning to her womb, thus cheating death and winning immortality. Instead, he is bitten in two by her vagina's snapping, lightning-generating flint edges, and so, because of his defeat by the goddess' vagina, all other mortals must die.

Psychology suggests that sexual folklore seethes with stories of snapping vaginal teeth because of male fears about what lies within the dark, unknowable, unseeable mysterious space that is the interior of the vagina. Others view vagina dentata images as the embodiment of masculine angst before the insatiable vortex of female sexual energy. In the stories themselves, the origin of female genital fangs and the reasons underlying their sometimes deadly behaviour are not always explained. In some, sources both material and spiritual are blamed. One North American Indian myth tells of how a meat-eating fish inhabits the vagina of the Terrible Mother. In the Middle Ages, Christian authorities pointed the

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finger at the moon and magic when trying to find an explanation for the so-called fact of witches stealing men's penises with their vaginal teeth.

The following fable from the Mehinaku, a tropical-forest-dwelling tribe of Brazil, intimates a male role in vaginal dentition:

In ancient times, there was an angry man who constantly berated others. One evening, a woman took many shells - they looked just like teeth - and put them in her inner labia. Later, when it got dark, the man wanted to have sex. 'Oh, she is beautiful,' he thought. The woman was pretending to sleep. 'Let's have sex,' he said. Oh, but his penis was big. In it went... it went all the way in ... Tsyuu! The vagina cut his penis right off, and he died right there, in the hammock.

This story, like many others, ends in the castration and death of the male.

In some folk legends, notably those of the Navajo and Apache, deadly toothed vaginas go one step further, and are described as detached organs, walking around independently and biting as they go. Just like the Baubo figurines described earlier, this is the vagina personified, but this time more terrifying - with teeth. For instance, New Mexico Jicarilla Apaches tell of a time when only four women in the world possessed vaginas. These women, known as the Vagina girls', had the form of women, but were in essence vaginas. They were also the daughters of a murderous monster called Kicking Monster.

Picture the scene. According to the legend, the house that the four vagina girls lived in was full of other vaginas, all hanging around on the walls. And understandably perhaps, rumours about the vagina girls and their house brought many men along the road to their door. But once there the men would be met by Kicking Monster, kicked into the house, never to return. This continued, so the story goes, with man after man disappearing, apparently swallowed up in the house of the four vagina girls with vaginas hanging from the walls. Enter Killer-of-Enemies, the marvellous boy hero:

Outwitting Kicking Monster, Killer-of-Enemies entered the house, and the four vagina girls approached him, craving intercourse. But he asked: "Where have all the men gone who were kicked into this place?' 'We ate them up,' they said, 'because we like to do that'; and they attempted to embrace him. But he held them off, shouting, 'Keep away. This is no way to use the vagina.' And he told them, 'First I must give you some medicine, which you have never tasted before, medicine made of sour berries; and then I'll do what you ask.' Whereupon he gave them sour berries of four kinds to eat. 'The vagina,' he said, 'is always sweet when you do like this.' The berries puckered their mouths, so that finally they could not chew at all, but only swallowed. They liked it very much, though ... When Killer-of-Enemies had come to them, they had had strong teeth with

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which they had eaten their victims. But this medicine destroyed their teeth entirely.

Gruesomely, it is the removal of vaginal teeth (symbolising the devouring aspect of female sexuality) by brave male heroes that is a core component of many dentata stories. Pincers, flints, a piece of string, the berry medicine of Killer-of-Enemies, iron tongs, rocks and rods that are as thick or long as a penis, are all used as excision tools in a bid to tame the toothed vagina and create a compliant woman. Tellingly, in some instances it is only after a woman has had her teeth pulled - that is, she is tamed by having her spirit and insatiable threatening sexuality broken - that a man will marry her. In this sense, pulling vaginal teeth is a metaphor for how some men would like to make women meek and biddable, remoulded in a shape defined by them. In these stories, instead of shaming her into submission, physical means are used to tame her sexuality. The following depiction of dental extraction comes from India:

There was a Rakshasa's [demon's] daughter who had teeth in her vagina. When she saw a man, she would turn into a pretty girl, seduce him, cut off his penis, eat it herself and give the rest of his body to her tigers. One day she met seven brothers in the jungle and married the eldest so that she could sleep with them all. After some time she took the eldest boy to where the tigers lived, made him lie with her, cut off his penis, ate it and gave his body to the tigers. In the same way she killed six of the brothers till only the youngest one was left. When his turn came, the god who helped him sent him a dream. 'If you go with the girl,' said the god, 'make an iron tube, put it into her vagina and break her teeth.' The boy did this ...

Fashioning hard phallic weapons that will never be flaccid in the face of female genitalia is also a common thread in these vagina dentata myths. Presumably this relates to male fears of women's seemingly insatiable sexual nature, their ability to enjoy orgasm after orgasm with their genitalia when men may only be able to manage one before becoming limp. I'm sure it's no coincidence that sharp-edged devouring teeth are the female weapon of choice - they stand in stark opposition to male fears of a soft, impotent penis. Creating an alternative tool is at the heart of another story of seven siblings and their efforts to remove a woman's vaginal teeth. This is one of the Pre-Columbian myths of North American Indians, and is depicted in explicit eleventh-century ceramic Pueblo artwork (see Figure 5.1). This Mimbres myth bowl illustrates the final brother's efforts to remove a woman's vaginal teeth with a false penis made out of oak and hickory. Re-enactments of vagina tooth smashing can be found in some cultures' rituals. In Navajo and Apache folklore,

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Figure 5.1 The vagina dentata: round the world, art and myth tell of how men may meet their end if they dare to venture inside the deadly toothed vagina.

Monster-Slayer kills Filled Vagina, one of the more ferocious of her species, who mates with cacti, with a club. Today, the Pueblo and other native North Americans use a carved wooden phallus to symbolically break a vagina woman's teeth.

Not only teeth, but snakes and dragons too

Intriguingly, teeth are not the only terrifying object to be found in woman's extra orifice. Snakes also stream from the deep, dark, invisible vaginal interior in folklore and legend. Vagina snakes, so these stories relate, can bite off a man's penis, poison it, or kill the man. Some serpents lurk solely in the vaginas of virgins, and sting only the first man to venture inside. Among the Tembu it is said that women who crave sexual excitement may attract demonic serpents called Inyoka, who come to live in their vaginas and give them pleasure. Women can then send out their vagina snakes to bite any men they dislike, or those who don't pay attention to them. In Polynesia, where there are no snakes, voracious vagina eels come into play. In one tale from the Tuamotos Islands, the eels in a woman called Faumea's vagina kill all men. However, she teaches the

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hero, Tagaroa, how to entice them outside, and so he sleeps with her in safety.

It seems that fears of what lies inside the vagina have allowed men's imaginations to run riot over the centuries. Men of Malekula talk mysteriously of a vagina spirit, called 'that which draws us to it so that it may devour us'. Hungry dragons too are often to be found inside the vagina of folklore and myth, and some have speculated that the many legends of brave heroes killing dragons with sharp-edged teeth are spin-offs from the original dragons in the vagina idea. If this is the case, good old St George, for killing England's symbolic vagina/female spirit. Vaginal teeth can also be metaphoric, as revealed by the Muslim belief that the vagina can 'bite off' a man's eye-beam, resulting in blindness for the man who is brave enough to look deep into its depths. It is said that a sultan of Damascus lost his sight in this manner, and had to travel to Sardinia to be cured by a miracle-working statue of the Virgin Mary - whose vagina is, of course, safely veiled by her ever-permanent hymen.

Apparently not content with arming the vagina with all things devouring and venomous, many cultures fill their mythology with stories of gruesome creatures that are women above, but hell-beasts below. The Greeks told of lustful she-demons born of the Libyan snake-goddess Lamia. Their name - laminae- means either 'lecherous vaginas' or 'gluttonous gullets'. Or how about the Naginis, Indian figures which are cobras from the waist down and goddesses from the waist up, or the Echidna, which appear as pretty nymphs on top and slithering snakes beneath. Even William Shakespeare had his King Lear fulminating in this way about women, suggesting that what is below is bad, and revealing his deepest fears about females. Lear, in his madness, cries:

Down from the waist they are Centaurs,

Though women all above:

But to the girdle do the Gods inherit,

Beneath is all the fiends':

There's hell, there's darkness, there is the

sulphurous pit, Burning, scalding ...

This angry, terrified view of women, what is below their waists and between their legs, is deeply disturbing. And yet it is one that is painted over and over again. It also pops up in interpretations of one of the classic Greek myths, the story of Pandora, whose name means 'the all-giving' or gift to all'. According to Greek mythology, Pandora was the world's first woman and the one to blame for all the 'ills that beset men'. Her crime? It's said that she opened a box or vessel which contained all the evils of the world, letting them out and leaving only hope remaining inside. Does

, 4^Vfl, fO: . <a<> Ki'Ahr An ll^ ^ a h ifaMJt'^ „

Figure 5.2 Pandora's box as envisaged by Paul Klee.

Pandora's box have genitalic connections? Well, some have certainly read it as a symbol of female genitalia. The artist Abraham van Diepenbeeck placed Pandora's vessel suggestively over her vagina, and, of course, box is slang for the vagina. Paul Klee's twentieth-century response to the centuries-old myth is more vaginally overt. Facing straight on, he painted Pandora's box as female genitalia, as a casket with oval carvings, complete with evil vulval vapours being emitted from the genital cleft (see Figure 5.2). This extraordinary drawing also depicts Pandora's vessel with handles resembling Fallopian tubes, and a base ridged like the muscular interior of the vagina.

The inside view

So what is the inside story? Thankfully, although myth may tell of a mouth with sharp dentition, ready to snap up and spit out unwelcome intruders, or a male vision of fear and hell, science has something else to say about what lies within the vaginal walls. After centuries of misunderstanding the vagina, of either ignoring it or calling it variously a royal highway, a passive vessel, and even essentially devoid of sensitivity, a new view is emerging. First of all, there are no teeth, snakes or dragons. And unlike the empty, dead space envisaged by early thinkers, the interior of the vagina is anything but a passive black hole. Instead, science reveals an amazing, expanding, contracting, sensitive muscular organ, where mul-

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tiple erogenous zones rub shoulders with a remarkably robust pathogen defence system. In fact, flexibility or fluidity, not unyielding dentition, is the vagina s key design concept.

Have you ever considered that a woman's vagina is teeming and overflowing with life? Or that a veritable biological soup thrives here in this exquisitely balanced environment? Maybe not, but this is, in fact, the scenario inside female genitalia. Why should this be? The answer lies in what the vagina represents. Just like the mouth, or any open orifice, the vagina provides potential pathogens (disease-causing agents) with an avenue to the interior of the body. Moreover, the vaginal gateway heads the route to the rest of a female's reproductive organs, the crown jewels of a species' survival. It's not surprising, therefore, that like the mouth, with its super salival defence system, backed up by mucous membranes and tonsils and teeth, the vagina too has a very potent protection structure in place. But that is not all. The vagina is not just about defending against disease. It has another crucial and yet distinct role - enabling access to some, but not all, intruders. Depending on the situation, a woman's vagina needs to be capable of acting as both bodyguard and bouncer. To be able to perform in this perfectly poised, polar manner, the vaginal interior, or lumen, needs a wondrous environment. Snakes or sharp teeth are not the answer. On the contrary, the vaginal solution is a wet, moist and fluid one.

The joys of mucus

Mucus is the vagina's major medium. Defined as a protective secretion, mucus is the means by which the vaginal interior maintains its integrity in the face of all comers. Without the never-ending exuding of fluids, the vagina would not able to function effectively. For not only does mucus provide lubrication during sexual activity, it also acts as a selective barrier against pathogens, and supports a cornucopia of essential organisms. Yet despite its indispensability, mucus, more often than not, gets a bad name. Slimy, gloopy, gummy, oozing from clefts and crevices, the nasal brand is tarred with the slang word 'snot' while the vaginal variety suffers with the useless, demeaning designation of 'discharge'. In many cultures, vaginal discharge equals dirt, often translating as such in language. Moist, wet, well-lubricated genitals are viewed by some as disgusting, polluting and to be avoided.

In some central and southern African countries, a dry vagina is promoted as the genitalic gold standard - as rated by men. Women use concoctions of salts and herbs in a bid to fulfil this strange male desire for an arid vagina. One study of intravaginal practices in Zimbabwe revealed that more than 85 per cent of women have used drying salts at

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least once. Horrifically, however, the dry sex that men are said to crave leads inevitably to chafing and cracking of the vaginal walls, leaving women at risk of infection. As previously noted, it is now recognised that it is only when there are abrasions or damage to the mucosal lining of the vagina that viruses, such as HIV, can infect a woman. That is, if there is no damage to the vaginal wall, infection cannot occur as immune cells are not exposed to the virus. Zimbabwe, frighteningly, has one of the world's highest rates of HIV infection, a fact which is without doubt in part explained by the craze for moistureless sex.

However, there is another very disturbing aspect here. Many, if not all, vaginal contraceptives actually contain chemicals, such as nonoxynol-9, that damage the mucosal layer of the vagina, leaving it open to infection. It seems astoundingly bad science to me that this situation exists, that a chemical that damages female genitalia can be used as a common vaginal contraceptive. What's more, the appalling fact is that nonoxynol-9 is the major ingredient of such contraceptives as contraceptive jelly. When used in conjunction with a diaphragm, nonoxynol-9 is placed in direct contact with the cervix, which is even more easily damaged than the vagina. This is because cervical cells are extremely thin (only one cell thick), fragile and easily damaged. If nonoxynol-9 damages the vaginal cell wall, which is far more dense, sturdy and resilient than the cervix (the surface layer of squamous epithelium vaginal cells is up to 16-30 cells deep), then what level of damage is nonoxynol-9 doing to the cervix? In my own experience, using a diaphragm and contraceptive jelly with the major ingredient nonoxynol-9 led to regular cervical bleeding and severe abrasion to the cervix. When I stopped placing nonoxynol-9 in direct regular contact with my cervix, the bleeding stopped and the abrasions healed.

But back to mucus. Importantly, there is no one fount of female mucus. Instead, female fluids well up and flow from a variety of vaginal sources, coming together to form a cocktail of secretions. Both external and internal genitalia contribute. In the mix are fluids from the Bartholin's (or major vestibular) glands, which sit at five and seven o'clock to the entrance to the vagina, as well as those from the nearby minor vestibular glands. A woman's prostate gland (sometimes called Skene's or paraurethral glands) also furnishes fluids, as do the vaginal walls, both as a result of sexual arousal and as vaginal wall cells are shed. Mucus cascading cyclically from a woman's cervix coalesces with fluids from the uterus and Fallopian tubes above. Cervical mucus comes in columnar flows and together with uterine or endometrial secretions, is the major ingredient of female mucus. However, secretions from the sweat glands and oil-producing sebaceous glands situated in the smooth, glossy skin of a woman's inner labia also blend in, as does mucus from newly discovered

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interlabial glands, about which very little is yet known. The end result is a potent, heady and dynamic brew.

One of the reasons why the precise number and nature of the constituents of vaginal mucus is as yet unclear is the lack of research done in this area. However, there are thousands of micro-organisms thriving in this flora. Mucus is plump full of them. Among them are sugars, proteins, acids of all sorts, simple and complex alcohols, bacteria and antibodies. All these molecules and many more as yet unidentified flow into and are supported by the vagina's mucoid environment. This bountiful fluid is also in continual flux, depending on a woman's menstrual cycle, her sexual arousal and activity, her physical and mental well-being, even the food she eats. In many ways, a woman's vaginal mucus is a barometer of herself and her lifestyle.

For many mucosal compounds, the major role appears to be one of defence, of making sure that this warm, moist ecosystem does not become a haven for disease. Indeed, it is argued that female genitals have their own separate immune system, courtesy of mucosal secretions. Mucus protects in a variety of manners, not least by lubricating vaginal tissues. This viscous moving fluid acts as a physical barrier as its continual slow flow down and out of the vagina prevents micro-organisms from attaching to the cell walls of a woman's vagina. It can also block indirectly, by providing bacteria with a false receptor or target to bind to.

Female genital mucus also supports an ace team of defensive agents. This mucosal posse includes molecules such as lysozyme, which punctures bacterial cell walls; lactoferrin, which mops up the iron that some micro-organisms need to grow; several classes of virus-neutralising antibodies; defensins or antimicrobial peptides; and phagocytic cells, which can engulf and swallow all intruders, including sperm. One cervically produced antibody, secretory immunoglobulin A (IgA), works like a killer sheepdog - rounding bacterial particles up into one coherent mass, and then preparing them for ingestion and digestion by phagocytic cells. Another cervical fluid constituent - a protein called secretory leukocyte protease inhibitor (SLPI) - has been shown to play a critical role in wound healing by reversing tissue damage and hastening healing. Its uses seem manifold - with evidence suggesting that it has anti-inflammatory, antifungal, anti-bacterial and anti-viral properties.

The need for a tart vagina

Curiously, centuries ago vaginal pH was thought to be important in determining the sex of any child conceived - acid (low pH) for a boy, alkaline (high pH) for a girl. Sadly, this is an ancient scientific theory that has yet to be proven. However, vaginal pH is of vital importance for

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women, but its significance lies in ensuring a healthy vagina. In fact, maintaining vaginal pH is an important way in which some organisms within vaginal mucus keep potential pathogens at bay. In the healthy premenopausal woman, vaginal pH should remain low, hovering around pH 4.0. That is, it's best to be acidic, or tart, but not as tart as a lemon (pH 2.0). More like a glass of good red wine. Keeping to this level of acidity is key because it determines a 'healthy' balance of vaginal microorganisms, or flora, in vaginal mucus. That is, an acidic vagina keeps numbers or ratios of micro-organisms in check. In contrast, a too alkaline environment tends to result in an overabundance of some micro-organisms, which can then become pathogenic (disease-causing) agents. Low pH is also good for the cervix, as it protects the extremely thin and fragile cervical cells from damage.

Quirkily, the guardians of low vaginal pH are a particular type of bacteria, lactobacilli, which occur naturally in the vagina. This may seem surprising, as bacteria are a type of micro-organism that often get a bad name. In fact, when first discovered at the end of the nineteenth century, the many varieties of vaginal bacteria were incorrectly viewed as unclean, disease-causing agents. But bacteria, be they the vaginal variety or not, do not deserve their negative press. As with many things in life, striking the right balance is what is important, and this is true for all types of bacteria too. Too few vaginal lactobacilli can result in a rise in pH to alkaline levels, and the flourishing of micro-organisms (with their increased numbers making them potentially pathogenic). Crucially, the best way for a woman to keep her lactobacilli at the healthiest levels is to lead as healthy a lifestyle as possible. That's all you have to do, and your vagina will do the rest naturally. However, dousing the vagina in man-made chemicals, such as those contained in so-called vaginal douches, deodorants and wipes, is not recommended ever, as this removes the vagina's natural defences.

Sperm bodyguard and bouncer

The story of what happens to sperm inside female genitalia highlights how vital a woman's vaginal environment is. This is because having an acidic vagina is critical in removing unwanted or surplus sperm. For human sperm, the vagina represents an extremely hostile and lethal environment, and prolonged sperm survival is not possible under these selectively acidic conditions (twenty minutes is the maximum). Out of the sixty million or more sperm contained in one human ejaculate, most will die in the vagina. The buffering or balancing effects of seminal plasma (the medium in which ejaculated sperm are suspended) offers some protection to sperm against the acidic conditions in which they find themselves. However, its effects are limited - following sperm ejaculation in the

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vagina, vaginal pH rises to between pH 5.5 and pH 7.0, but this shift to a more sperm-friendly flora is transient. Within at least two hours, a legion of lactobacilli will have tipped vaginal pH back in the female's favour.

Once deposited in the vagina, if human sperm are not killed by the acidic conditions, engulfed and eaten by marauding phagocytic cells or simply ejected by the woman, they face another challenge - cervical mucus. Produced primarily by glands in the top half of the cervix, cervical mucus creates a dense mucoid plug which essentially fills the uterine cervix. And from there columns of mucus cascade ceaselessly down into the vagina, averaging around 20-60 mg a day. This cervical mucus has a crucial reproductive role - namely, acting as a very effective biological barrier, or sperm bouncer.

When faced with this mucus, sperm have a problem. It seems they are incapable of passing through, round, over or under this formidable mucoid material. They have met their match, and the next stage underlines this. Unable to overcome this viscous hurdle, sperm are then swept out of the vagina, escorted off the premises by the slow, unstoppable flow of bouncer cervical mucus. There is, however, one sticking point in this scenario. Cervical mucus is mercurial, and does not always act as a sperm bouncer. In fact, on some days of the month, cervical mucus undergoes a compete role reversal, metamorphosing, dramatically, into a sperm bodyguard.

For just a few days every month - typically from about two to three days prior to ovulation, and up to twenty-four hours post-ovulation -cervical mucus becomes sperm's major ally in its fertilisation quest. While other elements of the vaginal environment rush to repel the newcomers, bodyguard mucus moves to embrace them. The difference between bouncer mucus and mid-cycle bodyguard mucus is immediately apparent in other ways too. Visually the change in consistency, sheen and colour is stunning. What was an opaque milky-white glutinous fluid mass of limited elasticity (maximum extended length about 2.5 cm) transforms into a glistening, translucent, silky and seemingly endlessly stretchy amorphous substance (some say it's like egg white). Mucus columns of between 7 and 10 cm in length are not uncommon.

This extreme stretchiness of mid-cycle mucus is one of its key characteristics, and, indeed, has given rise to the term 'spinnbarkeit' - that is, the capacity of cervical mucus to elongate. Another feature (noted by scientists) is that this fertile mucus forms a fern pattern when dried. This is because of its high salt content. However, for women monitoring their fertility, the point to remember is that the more stretchy and akin to egg white the mucus, the closer you are to ovulating. Another thing to look out for is that production is scaled up too. At mid-cycle, ten times more mucus - 600 mg - streams forth daily. This increased mucus flow pre-

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ceding egg release is also accompanied by changes in a woman's cervix. The external os (mouth) opens up to around 4 mm in diameter between twenty-four and forty-eight hours before ovulation - a move that is believed to enhance the likelihood of conception occurring.

Research shows that mid-cycle bodyguard mucus can both shepherd and shelter sperm, offering a safe passage out of the vagina through the cervix and into the uterus, as well as a safe alkaline harbour. If sperm are lucky enough to land near a column of mid-cycle mucus, they appear to be sucked inside the mucus structure. And when enveloped in these mucus arms, genital contractions are believed to draw sperm nestled in their mucus environment up into the cervix and uterus. Incredibly, it seems that cervical mucus can support human sperm for prolonged periods of time, as research shows that sperm sequestered in folds of cervical mucus, or cervical crypts, can survive, remaining motile, for between five and eight days (uterine fluids may also play a role in this support).

It's now appreciated that fluctuations in the levels of circulating hormones are the driving force behind the physical changes in mucus which make bouncer mucus impenetrable to sperm, and result in bodyguard mucus drawing sperm passively in. Increasing levels of oestrogen in the days preceding ovulation result in the structure of cervical mucus becoming one of parallel filaments of long mucin molecules, with canals in between along which sperm can travel. However, post-ovulation, increasing levels of progesterone disrupt this ordered structure, and the filaments form a criss-cross matrix through which sperm cannot traverse.

Mid-cycle bodyguard mucus also has another vital reproduction role to play. And this time it's a selective one. The microstructure of mucus reveals how this selection could function. Critically, the canals or channels separating one parallel mucus section from another are extremely thin. At between 0.5 and 0.8 jum they are smaller than a sperm head, making any movement through this mucus a very tight squeeze for sperm. Indeed, experiments with human mucus show it bulging and stretching around sperm. However, the precise importance of forcing sperm to be in such close proximity to cervical mucus is as yet uncertain.

One intriguing idea is that this extreme proximity forces necessary interactions between mucus and sperm, perhaps preparing sperm for fertilisation by shearing certain seminal components from their surfaces. Recognition is another exciting suggestion, as it is known that this enforced closeness does play a sperm-screening role, with mid-cycle cervical mucus acting as a biological filter, sorting the normally shaped sperm from the morphologically abnormal ones. However, recognition may involve far more than just sorting shapes; selecting a complementary genetic partner may also form part of cervical mucus' multiple functions.

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Scientists are just at the start of understanding how the female genital tract as a whole, including mucus, selects a female's Mr Right Sperm.

Reading the vagina

Penis size, it is said, is a prime concern for many, if not all, men. And this male obsession with genital size is not, it seems, confined to the phallus. Around the world, estimating and classifying vaginal size and attempting to map out the internal contours of the vagina has proved to be irresistible to men, often with eye-opening and entertaining results. In the west, the desire to put a name to a woman's genital landmarks has led to some wonderful medical monickers. There's 'the fold of Shaw', 'the pouch of Douglas', 'the column rugarum', 'the hollow of modesty', 'the canal of Nuck' and 'the elastic sac of Sappey'. These titles were, of course, all bestowed and imposed by men. Today they seem ridiculous, and are, in the main, obsolete.

Outside the west, Arabic, Indian, Japanese and Chinese cultures provide beautifully detailed and inventive information on the interior of the vagina, and how it has been perceived. For example, the Arabic erotic manual, The Perfumed Garden, written by Sheikh Nefzaoui, details thirty-eight varieties of vagina, and thirty-five types of penis. Vaginal descriptions include, el aride, 'the large one' - a thick and fleshy vagina; el harrab, 'the fugitive' - a small and tight vagina that is also short; and el mokaour, 'the bottomless', a name referring to a deep vagina, one that is lengthier than usual. The possessor of this larger vagina, The Perfumed Garden points out, needs a particular partner or position to truly arouse and satisfy her fully.

Ancient Japanese culture, in the sacred text The Sutra of Secret Bliss, also describes differently sized vaginas, associating them with one of the recognised five elements of life - earth, water, fire, air and ether (heaven). The Daikoku is the dark earth vagina, one that envelops and holds the penis; the Mizu-tembo is the moist water vagina, with a small opening and a wide interior, while the Bon-tembo is the celestial vagina - most beautiful and fragrant. This variety of vagina is also known as the Dragon's Pearl, because its tight opening and narrow passage lead to a pearl-like womb. Poetically, it is said that anyone fortunate enough to enter a vagina like this cries out in ecstasy.

India's famous sex manual, the Kama Sutra, provides a particularly detailed look at both sexes' genitals. This book, depicting the erotic science of ancient Indian culture, arranged women and men in terms of their sexual characteristics. That is, classifying them by the size of their genitalia, their force of passion or carnal desire and 'their moment of sexual impulse' (the time factor). For women, this classification, which was

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written by men, results in four orders, three "temperaments and three kinds. Each of these ten categories describes the characteristics of the particular vagina, and the Kama Sutra also gives advice on the sexual compatibility of women and men in terms of their sexual characteristics. Vaginal length or depth is revealed by the three kinds of women, and is as follows:

1) The tnigri (female gazelle) or harini (doe) is the woman with a deep-set vagina (six fingers deep) that is cool as the moon and has the pleasant scent of a lotus flower.

2) The vadama or ashvini (mare) is the woman with a vagina nine fingers deep, with freely flowing yellow juices and the scent of sesame.

3) The karini (she-elephant) is the woman with a vagina twelve fingers deep with abundant juices that smell like elephant's musk.

Mesmerisingly, many other methods of describing or classifying the vagina exist. Tantric texts divide the vagina into six regions governed by different Indian goddesses - Kali, Tara, Chinnamasta, Matangi, Lakshmi and Sodasi. Meanwhile some eastern texts describe the lower vulval portion of a woman's vagina as having the following four properties: 'First, it looks like the tip of an elephant's trunk; second, it is twisted, like the turns on a shell; third, it is closed up, as if by something soft; and fourth, it opens and closes like a lotus flower.'

If you want to read the vagina, there is also the option of using the ancient Chinese art of reflexology. Using this viewpoint, the lower third of the vagina and the vaginal opening correspond to the kidneys, the central third the liver, and the uppermost third of the vaginal chamber the spleen and pancreas. The cervix, meanwhile, corresponds to the heart and lungs. This way of looking at the vagina also stresses the importance of stimulating each portion of female genitalia - from the kidneys up to the heart and lungs - shallowly and deeply and circling from side to side if a woman is to be truly satisfied and sexually energised. It sounds good to me.

The Palace of Delight

Looking at the various systems employed over the centuries to classify and understand the interior of the vagina, it's hard not to get the feeling that genital measurement isn't perhaps a particular male metier, as some vaginal dimensions are somewhat startling. Chinese sexual manuals, such as the Taoist text The Wondrous Discourse of Su Mi, detail how vaginas come in eight different varieties - each determined by the depth of the vaginal interior, and each 2.5 cm longer than the previous. However,

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some, such as the Zither String, seem surprisingly short, while others, like the North Pole, are somewhat on the lengthy side. In ascending size, the Eight Valleys, as they are known, are:

1) The Zither String or Lute String (ch'in-hsien), 0-2.5 cm

2) The Water-caltrop Teeth or Water-chestnut Teeth (ling-ch'ih), 5 cm

3) The Peaceful Valley or Little Stream {fo-hsi), 7.5 cm

4) The Dark Pearl or Mysterious Pearl (hsiian-chu), 10 cm

5) The Valley Seed or Valley Proper (ku-shih), 12.5 cm

6) The Palace of Delight or Deep Chamber (yu-ch'ueh), 15 cm

7) The Inner Door or Gate of Prosperity {k'un-hu), 17.5 cm

8) The North Pole {pei-chi), 20 cm

Chinese sexual manuals also classified the relative position of the vulva -be it high (in a forward/upward location), that is, placed more ventrally or towards the belly, to the middle, or low (lower on the perineum).

So what is the average length of the vagina? Importantly, what the above ancient measurements do not articulate is that the interior of the vagina cannot be calibrated in this way - with just one length. For every woman, the ventral or anterior wall of her vagina - the belly side - is shorter than the opposing, posterior, wall (adjacent to the rectum). This is because the cervix, which sits at the apex of the vagina, projects down into the vagina, making the ventral vaginal wall shorter than the other. (The twin arch-like spaces that are created between the vagina wall and the curving cervix are known as the anterior and posterior fornices -singular, fornix - a word that is said to derive from the habit in Roman times of prostitutes renting vaulted or arched basements for them and their clients to fornicate in - the Latin word for arch being fornix).

And the average length from vaginal entrance to fornix and cervix? Most recently, average vaginal length (when not sexually aroused) has been placed anywhere between 7 and 12.5 cm, with the posterior length of the vagina from 1.5 to 3.5 cm longer than the ventral vaginal wall. Importantly, just as all penises vary enormously in size, so too do all vaginas. There is no standard. And just as all penises lengthen when aroused and erect, so too do all vaginas, as we shall see.

The fabulous shape-shifter

While all women have an intrinsic vaginal size, vaginal structure and volume can be altered. The key characteristic of the vagina is, after all, flexibility. And this flexibility in shape derives from the fact that the vagina is, in essence, a fibromuscular tube. Strategically placed muscles encircle and form its length and breadth. Hence the vagina can constrict or be

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constricted, dilate and change internal pressure. In fact, courtesy of her richly innervated and sensitive genital musculature, a woman's vagina is anything but a passive, unresponsive organ. This fact is demonstrated remarkably eloquently by the miracle of childbirth.

Mind-blowingly and eye-wateringly, the vagina expands to at least ten times its normal size during the delivery of a typical bouncing baby. The cervix, too, must dilate to a great degree, becoming as wide as the vagina is long. For the cervix, this amazing feat of distension can only be achieved by the prior softening of cervical tissue, and results in a permanent visual record of childbirth. In a woman who has not experienced childbirth via vaginal delivery, the os, the extremely slim opening of the cervix to the uterus, appears as a small dimple in the middle of the circular cervix. After vaginal delivery, this indentation takes on a special character, like the upward curve of a smile, or the wink of an eye, if you will. A smiling, winking cervix is the sure sign of a woman who has brought a child into the world vaginally.

The fantastic flexible nature of the vagina is also immediately obvious during sexual arousal and intercourse - a fact that was recognised and appreciated by western men of science over three hundred years ago. While Reinier de Graaf reckoned the vagina to be '6, 7, 8 or 9 finger-breadths long', he also observed in his pioneering work The Generative Organs of Women that: 'During coitus it applies itself everywhere to the penis and accommodates itself along every dimension in such a way that its concave shape becomes one with the convex shape of the penis ... During childbirth it adopts yet another shape ...' De Graaf was also quite astute in noting that it was sexual arousal that had a strong effect, commenting how 'during coitus it shortens, lengthens, constricts and dilates more or less according to the degree of the woman's excitement'. Delightfully, under the chapter heading ' Concerning the Vagina of the Uterus', the Dutchman enthuses, rhapsodises even, how:

The woman's vagina in fact is so cleverly constructed that it will accommodate itself to each and every penis; it will go out to meet a short one, retire before a long one, dilate for a fat one, and constrict for a thin one. Nature has taken account of every variety of penis and so there is no need solicitously to seek a scabbard the same size as your knife... Every man can thus come together with every woman and every woman with every man, if there is compatibility in other respects ...

The importance of females possessing powerful shape-changing genitalic musculature is highlighted by the ways in which a vast array of other species use their vaginal muscles, in particular to improve their reproductive success. Female hyaenas, as we've seen, need pelvic muscles robust

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enough to retract their elongated clitoris back to create an internal vagina. Many insects have vaginal (bursa) muscles steely enough that they can prevent copulation occurring or force out an unwanted member. The vaginal muscles of honey bees are thought to be responsible for triggering the male's ejaculation, while the male marsh-dwelling bug, Hebrus pus-illus, must rely on the strong milking action of the female's genital muscles to suck sperm from his phallus. Genital musculature also underlies the routeing of sperm to storage or disposal sites, or ovaries, in many insect species.

Muscles, muscles, muscles

The effects of possessing strong vaginal muscles can be just as stunning in humans. Today, fine vaginal muscle control is most directly in evidence within the shows of the sex industry. Smoking cigarettes, firing ping pong balls, writing messages, opening bottles, even picking up sushi with chopsticks - vaginas can perform all these feats and more. However, while these cunning stunts may be financially rewarding for women and titillating for men, the human vagina's impressive muscularity was not designed with bottles, balls and cigarettes in mind.

It is in the ancient teachings of eastern cultures that another, more sensual and mutually pleasure-oriented role is seen for a woman's vaginal muscles. Pompoir (a Tamil term) or bhaga asana (from the Sanskrit) are two of the names given to the vaginal technique of embracing and locking the penis and keeping it in a prolonged erection by means of the vaginal musculature alone. For men, pompoir is an exercise in penile passivity, as all that moves is the vaginal muscles. Using the pelvic floor muscles in this way has been seen for centuries as a way of enhancing sexual pleasure for both partners and controlling sexual timing. It is also enjoyed as an intensely pleasurable means of self-stimulation by women, and it is in this particular pose that a famous statue of the Indian goddess Kameshvari is thought to be sitting in the town of Bheraghat.

In the sixteenth-century Indian erotic manual the Ananga Ranga, written by Kalyanamalla, a woman who has mastered the sexual and pleasure potential of her pelvic muscles is known as a kabbazah, which is an Arabic word meaning 'holder' or 'clasp'. The 1885 translation of the Ananga Ranga, by Richard Burton, describes the muscular art of the kabbazah and pompoir as follows:

This is the most sought-after feminine response of all. She must close and constrict the yoni (vagina) until it holds the lingam (penis), as with a finger, opening and shutting at her pleasure, and finally acting as the hand of the Indian Gopala-girl, who milks the cow. This can be learned only by long

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practice, and especially by throwing the will into the part affected. Her husband will then value her above all women, nor would he exchange her for the most beautiful queen in the Three Worlds.

Even Islam's Muhammad is reported to have said: 'Allah made intercourse so pleasurable and attractive that it is imperative to enjoy sex fully with every nerve and muscle.'

The contractile vaginal talents of many women are described throughout history and literature. Ancient Greece's famous courtesans, the hetaira, are famed for being able to split a clay phallus with their vaginal muscles. This was a test of their genital strength and skill. Such talents are also among those ascribed to Diane de Poitiers (1499-1566), the mistress of King Henry II of France, to explain the fact that she was, shockingly to some, twenty years older than her royal partner. French author Gustave Flaubert enthuses about his encounters with the professional prostitutes exiled in the Egyptian town of Esneh: 'her cunt milking me was just like rolls of velvet -1 felt ferocious'. Across the globe, Shilihong was a Shanghai sex worker famed for her exceptional control of her vaginal muscles. She is said to have been able to move a man's penis in and out of her simply by contracting and relaxing her muscles, a movement that bestowed a sucking-like sensation. Wonderfully, the 'Shanghai squeeze' of Wallis Simpson is said to be one of the reasons why Britain lost a king in 1936. Mrs Simpson, it was noted, 'had the ability to make a matchstick feel like a Havana cigar'.

The importance of education

The erotic and sexual techniques of this muscular vaginal artistry are still to be found today - but only in those women who choose to train their vaginal muscles. In India, vaginal exercises are known as Sahajoli, and for some girls they are taught from childhood, first by their mother and later by a Tantric guru. Sahajoli also form part of the training of Devadasis, Indian temple dancers. Such vaginal exercises are practised by devotees of Tantric or sexual yoga, and are designed to enhance sexual pleasure. They include abdominal and pelvic flexes (mudra) as well as muscle locks (bandhas), and some, such as the Mula Bandha, can work for men too.

The ability to exercise vaginal muscle control is viewed as a key vaginal quality in Polynesia's Marquesan society. The Marquesans refer to vaginal contractions as naninani, and women who have the strength and staying power to retain control over multiple squeezes during repeated sex sessions are, not surprisingly, revered. Moreover, great emphasis is also placed on particular pelvic movements during sex, which, it is said, play a major part in the mutual pleasures of sexual intercourse. The Marquesan

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term for this sensual pelvic motion is tamure, named for the Tahitian dance of the same name, which features movements resembling those of sexual intercourse.

Significantly, the capacity to move the pelvis in a particular way during sex is not the sole province of women. Marquesan men are expected to be able to roll with it too, and perhaps this is why sex commonly ends with the orgasms of both parties. Marquesan women apparently have no problems reaching orgasm, be it simultaneous or not. It's obvious that vaginal muscle control is one key to this orgasmic art (as is male participation), but sex education is also a vital factor. Tellingly, on reaching puberty, Marquesan girls and boys receive sexual instruction - girls from their grandmothers or women of their grandmothers' generation, and boys from an older woman. Their education involves positions, techniques of sexual stimulation and general sexual hygiene. Sadly, though, this way of educating appears to be on the decline.

The sexual heart

Considering the potential strength and dexterity of her vaginal embrace, it is not surprising to find that a woman's genital musculature is complex. Criss-crossing, encircling, embedding, pulling, grasping, tugging and pushing, together this muscular network enables all a female's internal pelvic organs - urethra, vagina, uterus and rectum - to remain in the right place, and perform all their functions. These muscles surround and penetrate the vaginal walls, tying the vagina into the pelvic structures. Three groups of muscles are today recognised as enclosing and surrounding the length of the vagina (see Figure 5.3 and Table 5.1). They are - in ascending order - the muscles of the perineal body (the small muscular mass that fits between the floor of the vagina and the rectum), the muscles of the urogenital diaphragm, and the muscles of the pelvic floor, or diaphragm.

These muscular groups effectively divide the vagina into three compartments - the upper, the area above the pelvic floor; the middle, which is encircled by muscles from both the pelvic floor and the urogenital diaphragm; and the lower, associated with the perineal body musculature. Interestingly, this division of the vagina into three areas as defined by muscle groups tallies with Taoist teachings on vaginal muscular control. When able to isolate and flex these groups of muscles at will, as a result of mastering Taoist sexual techniques, women are then able to move two small mineral eggs (2.5 cm in diameter) within their vagina in different directions, or bring them together with a bang.

Looking at the drawings of Leonardo da Vinci, you can see that the Italian artist was fascinated by the musculature of the lower vagina, in

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bulb

suspensory ligament

vaginal opening

anus

urethra

schiocavernosus muscle

bulbospongiosus muscle

urogenital diaphragm

transverse perineal muscle

levator ani

levator an

anal sphincter N tailbone

Outer layer

bulb

inner lips

ischiocavernosus outer

muscle lips

levator ani

urogenital diaphragm

bulbospongiosus muscle

urethra

vaginal opening

Middle layer

urethra

vagina

levator ani

(the levator ani group of pelvic muscles

includes the pubococcygeus (PC) muscle

and the iliococcygeus)

Front view

Inner layer

Figure 5.3 A woman's vaginal musculature is impressive, complex and powerful, and comes in three distinct groups or layers. Use them, don't lose them.

particular the muscles of the perineal area. Amongst his numerous sketches of the human body are ones of the muscles around the anus, which focus on their circular petal-like external appearance. Tellingly, he called these muscles 'the gatekeeper of the castle'. Da Vinci's gatekeeper muscles of the perineal body include ones that support the vagina from side to side, others that constrict the anus, as Well as muscles that cover the crura or legs of the clitoris and one that covers the vestibular bulbs. This latter muscle also loops round and surrounds the vaginal opening, and when

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Table 5.1 Vaginal Musculature

Perineal body • anal constrictors ('the gatekeepers of the castle')

• superficial transverse (provide support from side to side)

• bulbospongiosus or musculus constrictor cunni, covers the vestibular bulbs and surrounds the vaginal opening

• ischiocavernosus - the clitoral muscles

Urogenital diaphragm • deep transverse perineal muscle (provides support from side to side)

• constrictor of the urethra (sphincter urethrae)

Pelvic floor • pubococcygeus (PC), runs from the pubic bone

to the coccyx. Part of the PC is known as the puborectalis.

• iliococcygeus (IC)

• coccygeus ( ischiococcygeus)

Together the PC, the IC and the urethral and rectal muscles are known as the levator ani group (meaning literally 'to raise the anus'). The bulbospongiosus muscle is sometimes referred to as the bulbocavernosus.

Adapted from Lowndes Sevely, Josephine, Eve's Secrets: A New Theory of Female Sexuality, New York: Random House, 1987.

contracted, constricts the lower vagina, in particular making the opening of the vagina smaller. It is now known as the bulbospongiosus muscle, but was previously called the musculus constrictor cunni, for obvious reasons. The clitoral muscles (the ischiocavernosus muscles) also alter on arousal, contracting as the clitoris fills with blood and becomes erect. This movement pulls the clitoris into closer contact with the vagina, and is seen as the crown of the clitoris raises, typically arching back under the clitoral hood. Above the perineal body are the muscles of the urogenital diaphragm - which again support the vagina from side to side, and also constrict the urethra.

The group of muscles known as the pelvic floor, or diaphragm, is the set that has received the most public attention. This is the muscle group that women are recommended to exercise post-childbirth or to help with sexual arousal or incontinence problems. As a group, the pelvic floor forms a sheet of muscle slung intimately round the middle section of the pelvic organs. A side view reveals the funnel or cone-shaped structure. The most famous pelvic floor muscle is the pubococcygeus muscle, PC for short. Its name reveals where it runs from - the pubic bone - and where it runs to - the coccyx, the tail end of the spine. In animals, the PC muscle

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is the one that wags the tail. The PC muscle, together with the other pelvic muscles in this group, act to support the pelvic organs (the urethra, vagina and rectum in women), and also assist in maintaining continence when bouts of coughing, sneezing or muscular activity raise intra-abdominal pressure. During pregnancy, the pelvic floor group must also support the combined weight of the uterus and the unborn child.

While the PC muscle is a principal player in the pelvic floor grouping, it does not act alone. Rather it works in glorious concert with its surrounding group of muscles and those adjoining. Together a woman's genital muscles orchestrate the delicate caressing or harder grasping action of the vaginal chamber. The rhythm goes something like this. As the PC muscle contracts, another portion of the pelvic floor muscle, the closely related puborectalis, contracts too. Together the effect is to narrow, elongate and partially straighten the lower two thirds of the vagina. As this happens the upper part of the vagina, including the fornices (arches) around the cervix, widens and balloons, with a resultant lowering of pressure. Closer to the vaginal entrance, the bulbospongiosus muscle also contracts. Because this muscle encircles the vaginal entrance, vaginal pressure in the lower third is higher than in the middle third - and the pressure in the middle third is higher than that of the upper. Taken as a muscular whole, with its three distinct groupings of muscles clasping, contracting and expanding, it is not too difficult to understand why the vagina has been described as a sexual heart. Or to envisage the vagina effectively milking the phallus with a grasping, pulsing grip.

Use it, dont lose it

Disappointingly, though, decades of leading a sedentary lifestyle, sitting and slouching on the closest easy chair or sofa, instead of squatting on your haunches, means that for many people - women and men alike, and not just post-childbirth - their pelvic muscles are slack. Like any other muscle, if you don't use it, you'll lose it. However, just as the muscle mass of an individual's biceps or pectorals can be strengthened and sculpted as a result of regular exercise, so too can a person's pelvic muscles. The result of such exercise is an organ with exquisite muscle control.

There are also health benefits. In both sexes improved strength and control of the pelvic floor muscles results in improved urinary and faecal continence. Levels of sexual arousal and performance are enhanced too. Indeed, for many women, simply contracting and relaxing their vaginal muscles if they are strong enough is sufficient to trigger orgasm. In men, improving pelvic muscle strength has been shown to reverse a diagnosis of impotence. In women, research shows that the strength of a woman's pelvic muscles ranges from 2 or 3 microvolts to 20 or 30. On average,

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women can produce a 9-10 microvolt contraction; however, below the average stress and urge incontinence are increasingly more likely. But above the average, women can look forward to an increasing likelihood of multiple orgasms in proportion to muscle strength.

A word of caution should be sounded, though, regarding the practice of exercising pelvic muscles. Learning to work a muscular group can be tricky, not least because most women are unable to see their own muscles move. Kegel exercises are often recommended for women. However, the original pelvic floor exercises, as devised by Californian gynaecologist Dr Arnold Kegel in 1951, are markedly different from those typically promoted today. Kegel's original workout involved the insertion of a resistive and compressible device inside the vagina. Contraction of the pelvic floor muscles resulted in a reduction in volume of the resistive device which was shown as a pressure reading on an external handheld meter. This was the Kegel perineometer. Only in this way, Kegel reasoned -by providing resistance to work against and some form of feedback about what was happening internally - could women increase their awareness of their pelvic floor muscles, and appreciate and enjoy the muscles' gain in strength. Kegel even made casts of vaginas, called mulages, to illustrate the effects of diligent use of his perineometer. This Kegel perineometer, it is argued, was the world's first biofeedback device.

Today, electronic biofeedback instruments or a specialised physiotherapist can help those with particularly weak pelvic muscles. Regular exercise with a readable resistive device is also recommended - or try a partner's penis. However, the simple squeeze against nothing routines that bear Kegel's name are not as effective. They provide neither resistance to work against or any feedback on what is happening, i.e., is it working and am I improving? All too often a different muscle group is flexed too, or the right muscle group is contracted but not relaxed properly, which can lead to chronic pelvic tension and persistent pain.

The shape of things to come

Flexing the vagina's muscles is integral to sexual arousal because this simple action can reroute circulating blood, pulling it rapidly into the capillaries of the surrounding vaginal walls. This increase in blood flow causes the walls to billow with blood, and their blood volume increases too. This is vasocongestion (vaso - denoting blood) of the vaginal walls. Vaginal vasocongestion then has two knock-on effects on a woman's vaginal walls - they lubricate and they lengthen. Lubrication first. Associations between the vagina, sexual arousal and wetness have existed for many years - the inner lips of the vagina were known since the first century as nymphae - water goddesses in Greek - while in ancient Greek

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comedies, male actors playing female roles wore bags of fluid to denote genital excitement. In Japan, the word for sexual intercourse is nure, meaning to grow wet.

However, despite this history, in particular an accurate description by Reinier de Graaf in 1672, the idea that the walls of a woman's vagina exuded fluid during sexual arousal was not widely accepted until over three hundred years later. Viewpoints only began to change when William Masters wrote his seminal paper, 'The Sexual Response of the Human Female: Vaginal Lubrication in 1959. Masters noted that as sexual excitement rose, as a result of either physical or mental activity, a 'sweating' reaction occurred on the surface of the vaginal walls.

Individual droplets of a lubricating material suddenly appear scattered over the rugal folds of the normal vaginal architecture. These individual droplets present a picture somewhat akin to that of a perspiration-beaded forehead. With continued increase of sexual tension the droplets coalesce to form a smooth, glistening coating for the entire vaginal wall. This sweating reaction progresses to establish complete vaginal lubrication early in the excitement phase of the human female's sexual response cycle.

Significantly, the vaginal wall lubrication reaction is an incredibly rapid one. The lubricating fluid, or transudate, can appear between ten and thirty seconds after the initial perception of sexual excitement, but can disappear as rapidly if excitement does too. It's now recognised that the production of this lubricating fluid is a result of the vaginal walls becoming thickened and engorged with blood. However, it should be said that sexual arousal is not the only method of production. Many kinds of muscular activity, if they bring the pelvic muscles into play, have this lubricating effect. I know that a Saturday morning wake-up work-out at the gym will always result in increased levels of vaginal lubrication. At the end of such a session, I am most definitely not sexually excited, but I am very physically aroused and wet - from both sweat and vagina juices. How a woman's vaginal walls lengthen during sexual arousal and intercourse is a topic that has also only recently been fully appreciated -visually, that is. Experiments in the 1960s by Masters and Virginia Johnson suggested that the walls of the vagina enlarged during sexual excitement. Unfortunately, the fact that they used an artificial penis to achieve this effect was said to mar the legitimacy of their observations. Ultrasound experiments in the early 1990s also pointed to the vaginal walls growing in size, in particular the anterior (stomach-side) wall. However, it wasn't until the turn of the twentieth century that Magnetic Resonance Imaging (MRI) provided the first clear pictures of the shape-changing nature of the vagina. MRI gives a snapshot, or dynamic image, of a person's insides,

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including their soft tissues, and as it is also non-invasive, to the extent that probes and monitors are not placed inside the vagina, it can be said to be the truest representation to date of how sexual arousal and intercourse affects the vagina. Only a handful of studies have so far been conducted, but these highlight the vagina's extreme flexibility and erectile capacity. One experiment recorded anterior vaginal length leaping from 7.5 cm in the non-excited state to 15 cm when aroused, a 50 per cent increase - quite impressive. Posterior vaginal length grew too, expanding from 11 cm to between 13 and 15 cm. In comparison, vaginal length in chimpanzees is estimated to be around 12.6 cm when unaroused, but leaps to 16.9 cm during arousal, and with external sexual skin fully swollen.

Importantly, increased vaginal lubrication and length are not the only internal changes that can be felt in female genital tissue during sexual arousal. The erectile tissue surrounding the urethra - the spongiosum -transforms too, becoming engorged with blood at heightened levels of sexual excitement (this is the same type of erectile tissue that surrounds a male's urethra). In a woman, the urethra is typically between 3 and 4 cm long, and runs from the neck of the bladder to the urethral glans -the point where the urethra exits the body, below the clitoris and just above the vaginal opening. The erectile spongiosum or urethral tissue completely encircles the urinary passageway and runs its entire length. In breadth, it measures between 2.5 and 3.5 cm, and is slightly thicker towards the neck of the bladder, and thinner towards the glans.

When a woman is aroused, the swelling of the spongiosum can be felt through the anterior or ventral (stomach) wall of the vagina. This is possible because of the very close relationship between the erectile urethral tissue and the ventral vaginal wall. The lower edge of the urethral glans defines the upper opening of the vagina, while the base of the urethral tissue comprises part of the ventral vaginal wall. Indeed, it could be said that the urethra and its surrounding spongy erectile tissue and musculature are inseparable from the vagina because the floor of the urethra is the ceiling of the vagina.

Hair pins for girls, bullets for boys

Just as the spongiosum tissue surrounding a man's urethra is erotically sensitive to pressure changes (such as those of a clasping hand or vagina), so too is a female's corresponding urethral tissue. Many women experience intense pleasure from stimulation of their urethra - either indirectly, via the ventral vaginal wall, or directly, by touching the urethral glans. A woman's glans and carina (the lower edge of the glans) is incredibly sensitive, and careful caressing can be just as arousing for women as it

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can for men. The rubbing of a man's corona over a woman's carina, as part of very shallow gentle thrusting, is a particularly intense and erotic sensation for many women. Some women also enjoy the sensations of internal urethral stimulation - although it should be said that extreme caution is advised here. Items such as hair pins have been lost in the ecstasy of orgasm, ending up in the bladder, with possible serious health consequences. Medical history also records the case of a man who chose to indulge in urethral stimulation with a rifle bullet - which also ended Up in his bladder.

Although the erotic potential of female urethral tissue was understood by many individuals as an integral part of their sexual geography, it wasn't until the middle of the twentieth century that such sensations were noted by the academic community. The person who pointed this out - Ernst Grafenberg - was a very forward- and free-thinking gynaecologist. Born in 1881, Grafenberg was a pioneer of research into female sexual reproduction and pleasure. A German gynaecologist, his work covered a multitude of aspects of the physiology of reproduction. He was the first to describe the physical connection between the stimulation of the growth of an ovarian follicle and that of the lining of the uterus, the endometrium. (However, it is not his name that forms the term Graafian follicle, but that of Reinier de Graaf, who also studied the developing follicle.) Grafenberg was also the first to describe the cyclical variation of the acidity of vaginal secretions, and published in 1918, a twenty-nine page paper on vaginal secretions. Some credit him with developing the first test for ovulation. To add to this, he was a leader in the production of birth control methods, developing the interuterine device (IUD), the Grafenberg ring in 1928, and later collaborating on the plastic cervical cap.

However, it wasn't until the last decade of his life that Grafenberg started a revolution in how the female urethra and its surrounding structures are viewed. In 1950, in the International Journal of Sexology, he published a ground-breaking article entitled 'The Role of the Urethra in Female Orgasm'. In this, he pointed out the pleasure women derive from stimulation of this organ: 'Analogous to the male urethra, the female urethra also seems to be surrounded by erectile tissues ... In the course of sexual stimulation, the female urethra begins to enlarge and can be felt easily. It swells out greatly at the end of orgasm.' Grafenberg also noted how the 'floor' of the urethra is the 'ceiling' of the ventral vaginal wall and how: 'An erotic zone could always be demonstrated on the anterior wall of the vagina along the course of the urethra. Even when there was a good response in the entire vagina, this particular area was more easily stimulated by the finger than the other areas of the vagina.'

Interestingly, Grafenberg found that the most sensitive part of the

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anterior vaginal wall for the women in his study lay 3-4 cm inside the vagina - in the vicinity of the posterior urethra, just around where the urethra becomes the neck of the bladder. This is the area that over thirty years later was renamed the Grafenberg spot, or G spot, and is celebrated in the best-selling book The G Spot and Other Discoveries About Human Sexuality.

The vexing question of vaginal sensitivity

Grafenberg's work was viewed as highly controversial for two main reasons. First of all, he pointed out that the urethra was surrounded by erectile tissue, just as the male urethra is. Secondly, he highlighted how sensitive the interior of the vagina is. These comments on vaginal sensitivity went against the thinking of the time - which had tended to underline the supposed insensitivity of the vagina and the urethra. Indeed, many people today still claim that the interior of the vagina is insensitive. They are incorrect in their assumptions and, as we shall see, their claims are based on biased theories and flawed science. First of all, the idea of the vagina as insensitive has its roots in eighteenth- and nineteenth-century misogynistic and hypocritical notions of females being creatures devoid of all sexual sensitivities. Women, the great minds of these times opined, were not much bothered by sexual feelings. This view was promoted despite plenty of evidence to the contrary.

The idea of the unresponsive, insensitive vagina was also, unfortunately, given some credence by twentieth-century studies. Crazily, this research proclaimed that on the basis of the Q-tip test, or cotton wool bud test, the vagina was not very sensitive. It may be true that touching the tip of a cotton wool bud to the vagina's walls won't elicit much sensation, but that's hardly surprising or a robust touch test. Sex consists of far more than the touch of a Q-tip. What these studies did show, but failed for some reason to highlight, was the vagina's sensitivity to vibration and pressure.

In fact Grafenberg was correct about the sensitivity of the urethra and the interior of the vagina. Recent research has shown that female genitalia are profoundly innervated (by the pudendal, pelvic, hypogastric and vagus nerves) and capable of detecting vibration, touch and pressure changes, in particular deep pressure. Tactile stimulation of the extremely sensitive external genital skin produces one type of sensation, while deep-pressure proprioceptive receptors within the perineal and vaginal musculature produce exquisite sensations too - either as a result of contraction of muscles or their distension by a penis, fingers, vibrator or whatever. Visceral sensory receptors are also thought to convey arousal and orgasm sensations to the brain. This means the vagina is deliciously responsive

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to the low throb of slow strokes, the hard, persistent pressure of deep thrusts, or just simply squeezing the vaginal muscles.

Grafenberg was also correct about the particular sensitivity of the anterior vaginal wall. Recent studies into its microstructure and sensitivity have pointed to geographical differences in the innervation of the vaginal chamber. The deeper you go inside the vagina the more nerve fibres there are in the walls, with the anterior wall much more densely packed with vaginal nerves than the posterior one. There are also specific differences in the number and nature of nerve fibres found in the area of the anterior vaginal wall adjacent to the bladder neck. These include an extreme number of richly innervated vessels, plus the presence of yet-to-be-explained giant coiled corpuscle-like structures.

The revelation that the microstructure of a woman's vaginal walls suggests that they are far more sensitive than previously recognised is not surprising to me. I know the ability of my vagina to feel the merest flicker of movement when I am joyously and deeply aroused. One of the sweetest sensations of life is the delicate, pulsatile, tickling feeling of my man orgasming inside me. I don't know whether it's the ejaculatory spurt of semen or the contractile quiver of orgasm that I feel, but whichever it is, it's divine.

The female prostate

Some things, it seems, never change. For instance, the tissue surrounding the female urethra is still a subject of enormous controversy, more than fifty years after Grafenberg published his pioneering article. Today, though, the furore is focused on the fact that the tissue surrounding a woman's urethra is more than just erotically sensitive and erectile. Surprisingly, it is also secretory as a result of numerous glandular structures traversing its length and embedded in it. These glands and their connecting ducts empty their contents into the urethral passageway, and together the complex of secreting structures and its associated smooth musculature are known as the female prostate (see Figure 5.4). At the start of the twenty-first century, however, the above sentence is not accepted by all scientists. The tale of the female prostate is one that, in part, parallels that of its sister, the clitoris. It is a story of anatomical parts found and lost and found again. And like the clitoris, despite a wealth of evidence to the contrary, the idea that the female prostate may be a functioning part of a female's reproductive anatomy is doubted.

Pertinently, the presence of a female prostate has not always been denied. In fact, the existence of the female prostate was accepted for nearly two millennia - and only became a matter of dispute at the end of the nineteenth century. Greek anatomist Galen (130-200 ce) was one of the

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spongiosum

^ v bladder female

vagina

clitoris

urethra

vaginal opening

Figure 5.4 The female prostate: the sprawling complex of glands and connecting ducts that is the female prostate can extend along the urethra.

first western scientists to explore the attributes of the female prostate, writing in Book 14 of his work On the Usefulness of the Parts that women as well as men have 'prostatael Galen also commented on the possible function of the female prostate and its secretions in relation to reproduction, saying: 'the fluid in her [the female's] prostatae is unconcocted and thin. This contributes nothing to the generation of offspring.' Over 1,500 years later, in his ground-breaking manuscript The Generative Organs of Women, Reinier de Graaf recorded the first detailed dissection and description of a woman's prostate, and agrees with Galen's suggestion that a woman's prostate is analogous to that of a man.

In fact, it wasn't until 1880 that medical opinion on the set of glands and ducts that make up the female prostate began to alter. Prior to this, it was generally accepted that women had a prostate too. The description of an American gynaecologist, Alexander Skene, was the catalyst for the volte-face, which changed the female prostate's terminology as well. Skene, for some reason, chose to focus on just two of the many glands of the female prostate. The two glands he picked are typically larger than others, and are depicted clearly in the drawings by de Graaf in 1672. However, Skene chose to ignore this, and instead claimed the discovery for his own, naming the glands, in a very original manner, as Skene's glands.

From then on in, the idea that the female possessed a prostate fell out of fashion. Subsequent discoveries of other glands and ducts surrounding the urethra were dubbed paraurethral glands (para - meaning beside or near). Moreover, this demoting of the female prostate to Skene's or paraurethral glands coincided with the female prostate being labelled as a vestigial, or non-functioning remnant of an organ. The result - women had Skene's glands, not prostates, and if they did have prostates this was

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a non-functioning remnant. Today the term 'urethral sponge' is also used to describe the erectile spongiosum tissue surrounding the urethra and its intertwined set of secretory glands and ducts.

Spot the difference

Women, however, do have a prostate and it is a functioning reproductive organ. And significantly, women are not the only females to possess functioning, secreting prostates. Well-developed prostates can be found in females from at least four different mammalian orders: Insectivora (including shrews, moles and hedgehogs), Chiroptera (bats), Rodentia (including rats, mice and squirrels) and Lagomorpha (hares and rabbits). The size of the prostate in these species varies, but all produce secretions, although the function of these female prostatic fluids in reproduction remains unknown.

Critically, at the end of the 1990s, the debate over whether the female prostate was merely a vestigial or non-functioning organ was squashed when research on its ultrastructure revealed that just as in the postpuberal male, the prostatic glands in the adult female display mature secretory and basal cells, which are hormone-dependent. Studies have also recently pointed to the female prostate's neuroendocrine function, as it produces, like the male prostate, the neurotransmitter serotonin. There is also evidence showing the cyclical nature of urethral and prostate tissue. This cycle, with a rhythm of 30±5 days, reveals that during the luteal or secretory phase of a woman's menstrual cycle (the fourteen or so days post-ovulation up to the start of the next period), the thickness of urethral tissue decreases, an effect which can weaken the mechanism by which the urethra closes. However, despite such structural, histological, animal and endocrine evidence to the contrary, many scientists continue to refute that women have a functioning prostate.

So what does the male prostate have that the female prostate doesn't? Why does its existence get to be acknowledged, and the female's is challenged? The male prostate is, in essence, a small walnut- or chestnut-shaped structure that surrounds the urethra at the bladder neck. Unlike the female prostate, which can be felt and stimulated through the roof of the vagina, the male prostate can only be directly felt through the rectum, as it nestles between the bladder and the rectum. Stimulation of the prostate through the rectum is an essential part of sexual pleasure for many men. The male prostate is also indirectly stimulated as a result of the pressures involved in thrusting in sexual activity, and can be felt throbbing at the base of the penis during ejaculatory orgasm. Stimulation of the male prostate causes both emission and ejaculation of prostatic fluids. Like the female prostate it is comprised of glands, ducts and smooth

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a)

vagina

fornices

corpus spongiosum

corpora cavernosa

urethra

female prostate

bulbs (spongiosum tissue)

vaginal opening

male prostate

urethra

Figure 5.5 The female and male prostate compared: a) the female prostate is more diffuse while b) the male prostate is more concentrated in one area. Both surround the urethra.

muscle. These structural similarities are not surprising because both organs develop from the same portion of embryonic tissue - the urogenital sinus.

The differences between the two sexes' prostates can be seen in the number and style of dispersion of glands and connecting ducts. While the female prostate has fewer glands than the male's, it has far more ducts, forty or more, which are spread along the length of the urethra (see Figure 5.5a). The male prostate's glands and ducts (between ten to twenty) are concentrated together and interlaced with smooth muscle tissue, producing a greater expulsive force on ejaculation (see Figure 5.5b). This

Non-erect

spongiosum

vagina

clitoris

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fornices

spongiosum

clitoris

urethra

vaginal opening

fornices

urethra

vaginal opening

Figure 5.6 The female prostate: a) when unaroused it can be difficult to feel prostatic tissue through the anterior vaginal wall but b) when aroused, the engorged female prostate can often be felt bulging and swelling into the vagina.

difference in arrangement parallels the development of the tissue that forms the external genitalia of women and men (as previously mentioned). In females, this genital tissue tends to open out as it develops, forming the clitoris, urethra, vagina and labia, whereas that of the male comes together, with all the component parts in one external structure - the penis.

For the male prostate, the result is a small, 2.5 cm structure of glands and ducts, which empty their contents in one area. Conversely, in the female, the prostate is a sprawling network of glands and ducts, traversing and embedded in the length of the erectile and erotically sensitive urethral spongiosum tissue, and opening into the urethra at different points. And when some women are aroused, this grouping of glands and ducts can be felt swelling and pushing against the anterior vaginal wall (see Figure 5.6). For some individuals this prostate protrusion is small, say bean-sized; in others it is larger, and, over time, is suggested to increase in size the more stimulation it receives.

Significantly, research shows that some women have a higher concentration of glands and ducts at the bladder neck; some a higher concentration adjacent to the urethral glans, while others have tissue distributed fairly equally along the length of the urethra (see Figure 5.7). It is this variation in distribution of female prostatic tissue that may help to explain why, despite hours, days, months and sometimes even years of trying, many women are not able to locate their prostate (or G spot). For some women, erotic sensitivity will be concentrated in one zone of the anterior vaginal wall; for others it will b£ more spread out. Some will have little prostatic tissue. This is not surprising. Women differ. We are not all the same.

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prostatic ducts

urethra

a)

vaginal wall

urethral opening

prostatic ducts

b)

urethral opening

c)

urethral opening

vaginal wall

Figure 5.7 The three main types of distribution of female prostatic tissue in women: a) the most typical arrangement (66 per cent) is with prostatic tissue clustered closer to the urethral glans or opening; b) in 10 per cent of women the main body of prostatic tissue is concentrated adjacent to the bladder neck and c) 6 per cent of women have prostatic tissue distributed along the urethra (Adapted from drawings of wax models of the human female prostate by Huffman, J.W., 1948).

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The largest study to date of female prostatic tissue identified prostatic tissue in 90 per cent of all cases. This study also found that the most frequently occurring of the three prostate styles (66 per cent) is that where the cluster of tissue is closer to the urethral glans (just inside the vagina). The research also revealed that only 10 per cent of women have prostatic tissue concentrated in the area adjacent to the bladder neck, and the remainder have the more diffuse arrangement, along the urethra. A further 8 per cent of women in the study were characterised as having 'rudimentary' prostatic tissue. Considering these results, it is not surprising that the majority of women have been unable to find their prostate or G spot, as most instructions send women off on a wild-goose chase -looking for it too far inside their vagina, or just in one place. Realising the erotic and erectile potential of the whole stretch of anterior vaginal wall and urethra would seem to be a far more helpful pointer for women (and men) seeking pleasure.

A fluid fascination

So why do women and men possess this reproductive organ called a prostate? For men, theories of prostatic function stem from the secretion that prostatic tissue oozes into the urethra throughout sexual arousal. This secretion forms part of the drop of glistening fluid that can typically be seen on the tip of the glans (the urethral opening) of an erect penis. However, for most men, the prostate's continual resting secretions are not its most prominent role. This is reserved for when the prostate fires into action - during ejaculation. At this point, the muscles surrounding the prostate spasm, pushing the prostate's contents into the urethra, where they combine with sperm from the testicles (via the muscular vas deferens tubes), plus fluids from the bulbourethral glands (Cowper's glands) and the seminal vesicles. Together these fluids constitute male semen - about 70 per cent of the total volume comes from the seminal vesicles, and roughly 30 per cent from the prostate. Tests show that prostatic fluid contains a rich mixture of molecules, including zinc, magnesium, citric acid, amino acids, enzymes and prostaglandins.

This fluid from a man's chestnut-shaped prostate gland is said to be responsible for giving semen its characteristic smell. And coincidentally, the smell of chestnuts has a semen-like odour, a fact which has been recognised and commented on through the centuries, and which inspired the story, 'La Fleur de Chataignier', by the Marquis de Sade. This sweet chestnut smell is attributed to the presence of the chemical 1-pyrroline, which is also found in male pubic sweat. One speculation regarding the role of prostatic fluid is that it may serve to buffer, or protect, sperm from the toxic effects of urine in the urethra, or the harshly acidic conditions

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when deposited within the vagina. Another suggestion is that ingredients of prostatic fluid may serve to improve sperm motility by making sure sperm don't remain stuck, clogged up in the urethra. In the male mole rat, the prostate is known to have sex-attractant properties. However, the precise function of male prostatic fluid in human reproduction remains unknown.

How does a woman's prostatic fluid compare? Visually, female prostatic fluid is a milky white opalescent liquid. Drops of female fluid can be seen glistening on a woman's urethral glans during sexual arousal, just as the male variety can be viewed on a man's glans. The chemical make-up of the two prostatic fluids is similar too. Like male prostatic fluid, its components include large amounts of the enzyme prostate-specific phosphatase (PSAP), plus other enzymes and some urea and creatinine. The precise composition is as yet undefined, although it has recently been recognised that female prostatic fluid also contains the sugar, fructose, which a man's seminal vesicles produce. The recognition in the 1980s of the female prostate as a rich source of PSAP has had important ramifications for the forensic and medicolegal professions. Prior to this, alleged cases of male rape or sexual assault were bolstered by the presence of PSAP in vaginal fluids or on a female's clothing, as it was believed that females did not produce this enzyme. Today, the presence of PSAP cannot be used as evidence in this way.

Another product of both male and female prostates - prostate-specific antigen (PSA) - has been found to be key in the diagnosis of disease. Since the discovery that raised levels of PSA can indicate cancers of the male prostate at an early stage, PSA testing has become a crucial part of cancer screening programmes for men. Raised PSA levels can also be indicative of tumours of the female prostate, although this cancer is far rarer than male prostate cancer. It is also now suggested that recurrent urinary tract infections or cystitis may well be inflammation of the prostate, or prostatitis - the name for inflammation of the male prostate.

When women gush

Although arguments about the existence of the female prostate have in the main been quelled by recent research investigating the organ's ultrastructure, there remains one major area of controversy highlighted by Grafenberg's 1950 paper on the role of the urethra in female orgasm. This polemic is the ability of the female prostate to expel pleasurably and often orgasmically, in large gushes or spurts, quantities of prostatic fluid via the urethra. Grafenberg described the phenomenon as follows:

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Occasionally the production of fluids is so profuse that a large towel has to be spread under the woman to prevent the bedsheets getting soiled ... If there is the opportunity to observe the orgasm of such women, one can see large quantities of a clear, transparent fluid are expelled not from the vulva, but out of the urethra in gushes ... In the cases observed by us, the fluid was examined and it had no urinary character. I am inclined to believe that urine reported to be expelled during female orgasm is not urine, but only secretions of the interurethral glands correlated with the erotogenic zone along the urethra in the anterior vaginal wall.

He adds that sometimes the production of fluid is so abundant that 'the female partner is inclined to compare it with the ejaculation of the male'.

At the start of the twenty-first century, the idea of female ejaculation -the emission of prostatic fluids under pressure from the urethra - is still highly controversial. On one side are the scientists who have published scientific papers in support of female ejaculation. On the other are those who deny the existence of female ejaculation, and usually of the female prostate too. There are also advocates in film and literature. For example, in 2002, a Japanese film entitled Warm Water under a Red Bridge had at its centre a woman who 'gushes more water than Moby Dick' every time she has an orgasm.

And then there are the women and men who have direct and enjoyable experiences of female ejaculation in all its glory. I am one of them. The first time I was fortunate enough to see a fellow female ejaculate was an eye- and mind-opener for me. The spurting force of the fluid, its abundance, its musky aroma, its very appearance and existence - these all made me marvel and wonder. I am most definitely not the first to have been amazed in this way. The idea that women can, and do, expel prostatic fluids forcefully when sexually aroused is an age-old one - with written evidence flowing back over two millennia and more.

In the east, descriptions of female ejaculation can be found in the ancient sex manuals of China, Japan and India. And in many cases, a clear distinction is highlighted between the wetness or slipperiness of lubrication, and the fluids of ejaculation. The book Secret Instructions Concerning the Jade Chamber, which provides advice on flirting, the selection of sexual partners, and pretty much every aspect of sexual contact, has this to say:

[The yellow emperor asked] 'How can I become aware of the joyfulness of the woman?' Replied the Immaculate Girl: there are five signs, five desires, and ten movements. By looking at these changes you will become aware of what is happening in her body. The first of the five signs is called 'reddened face'; if you

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see this you slowly unite with her. The second is called 'breasts hard and nose perspiring'; then slowly insert the jade stalk [penis]. The third is called 'throat dry and saliva blocked'; then slowly agitate her. The fourth is called 'slippery vagina'; then slowly go in more deeply. The fifth is called 'the genitals transmit fluid' [female ejaculation]; then slowly withdraw from her.

A similar passage is to be found in the book Secret Methods of the Plain Girl which teaches that 'Her 'jade gate' becomes moist and slippery; then the man should plunge into her very deeply. Finally copious emissions from her 'inner heart' begin to exude outwards.' It is believed that the areas within the vagina that the Chinese called 'the little stream' or 'the black pearl' refer to the female prostate, while it was known as 'the skin of the earthworm' to the Japanese. Other Chinese terms include 'palace of yin', which refers to the place where the orgasmic secretion known as 'moon flower medicine' is situated.

Indian sexological texts dating from the eleventh century onwards also refer to the female prostate and its ejaculatory role. The Ananga Ranga describes in some detail female genital anatomy, and refers to the especially erotically sensitive area of the vagina, the saspanda nadi, which when stimulated results in the production of copious quantities of 'love juice'. One earlier description of female ejaculation can be found in the seventh-century Kamasastra text, in a work of the poet Amaru called the Amarusataka. Other descriptions can be found in the Pancasayaka (eleventh century), Jayamangala (Yasodhara's commentary on the Kama Sutra from the thirteenth century), the Ratirahasya (thirteenth century), as well as the late Kamasastra work Smaradipika. Tantric texts also talk of a third erotic emission from female genitalia, as well as vaginal lubrication and cervical secretions.

The problem of female seed

The western world, too, has had a long and deep fascination with the emission of vaginal fluids. Major medical works from Aristotle onwards (4 bce) refer to the female emission of copious quantities of seed. In Aristotle's time, physical evidence taught that both women and men produced genital fluids during sexual arousal. The question was how to interpret this. The answer arrived at was that emitting fluids, be it semen, sweat, breast milk or blood, maintained balance within the body. Sexual intercourse, therefore, with its many fluid by-products, was a very good way of achieving harmony or equilibrium.

Ancient thinking also held that body fluids could be converted, and tried to pin down their source and nature. Aristotle talks of women and men with fair complexions ejaculating more copiously than their darker

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peers. This, he said, was because those with "darker complexions are typically hairier. He notes that a dry, bland diet leaves one deficient in ejaculate, compared with anyone enjoying watery, pungent victuals. He also talks of women emitting violently (proiesthai) into the vagina during orgasm. While observing the differences in ejaculate, Aristotle adds that both women and men are tired after ejaculation. Galen comments that the semen of a man is always thicker and hotter than a woman's because women are intrinsically less hot or perfect than men; for instance, they do not have sufficient 'heat' to unfurl their internal penis.

One of the main arguments against the accuracy of historical descriptions of female ejaculation is that descriptions of female seed, semen or sperm (sperma muliebris) could refer to any of the many aspects of female genital secretions - cervical, vaginal wall, etc. However, some texts by western writers describe ejaculation and the source of this female semen in such detail that there is little room for doubt as to what they are referring to. Take Aristotle, for example:

The path along which the semen passes in women is of the following nature: they [women] possess a tube {kaulos) - like the penis of the male, but inside the body - and they breathe through this by a small duct which is placed above the place through which women urinate. This is why, when they are eager to make love, this place is not in the same state as it was before they were excited.

Galen too makes the distinction between the increased secretion of vaginal fluids as a result of sexual excitement, and the ejection of fluid at orgasm or heightened levels of arousal. In On the Usefulness of the Parts he comments:

The fluid in her 'parastatae' is unconcocted and thin. This contributes nothing to the generation of offspring. Properly, then, it is poured outside when it has done its service ... This liquid not only stimulates to the sexual act but also is able to give pleasure and moisten the passageway as it escapes. It manifestly flows from women as they experience the greatest pleasure in coitus, when it is perceptibly shed upon the male pudendum; indeed, such an outflow seems to give a certain pleasure even to eunuchs.

Reinier de Graaf provides the clearest insight. He devotes a whole chapter, 'Concerning the "Semen" of Women, to the issue of female seed, describing how 'women are beset by nocturnal pollutions just as much as men, and both in widows and maidens who suffer from hysterical fits, thick and copious quantities of semen pour from the genital parts if these are tickled'. However, de Graaf also describes the urethra and the prostate

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and, critically, recognises and details all the possible different sources of vaginal fluids, as well as depicting the particular way in which fluid is emitted from the prostate via the urethra.

He describes the prostatic fluid as coming 'in one gush so to speak', and answers his critics as to where this fluid is from, explaining: 'The first-mentioned ducts [rediscovered as Skene's glands] ... and the outlet of the urinary passage receive their fluid from the female "parastatae", or rather the thick membranous body around the urinary passage.' De Graaf also strives to find a function for female ejaculation, suggesting that:

The function of the 'prostatae' is to generate a pituito-serous juice which makes women more libidinous with its pungency and saltiness and lubricates their sexual parts in agreeable fashion during intercourse. This liquid was not designed by Nature to moisten the urethra (as some people think). The ducts are so placed at the outlet of the urethra that the liquid does not touch it as it rushes out.

He adds that 'the discharge from the female "prostatae" causes as much pleasure as does that from the male "prostatae".'

The ethics of expelling seed

The issue of female seed raised an interesting debate within the western medical profession, and one that would rage for years, from Hippocrates onwards. It would eventually result in the invention of the vibrator, as we'll see. Because wisdom held that emission of fluids was beneficial for health, the opposite stood too - retention of fluids could induce ill health in both women and men. This belief was accepted until well into the nineteenth century, and its long history means that medical literature is full of references to female seed - and the best way to release it. Treatments for the afflictions caused by retained female seed - called in various centuries suffocation exsemine retento, suffocation of the womb or mother, hysteria and green sickness - typically involved a midwife rubbing inside the vagina with scented oil, the insertion into the vagina of penis-shaped objects, or prescribed sexual intercourse (there is an urban legend from the seventeenth century relating to an attractive young doctor).

Texts record that young widows, and virgins of marriageable age, were those most likely to suffer from semen retention. One ballad, 'The Maid's Complaint for Want of a Dildoul', has the sixteen-year-old virgin narrator singing of how she will do anything 'for a dil doul, dil doul, dil doul doul'. Another late-seventeenth-century ballad, 'A Remedy for the Green Sickness', relates how:

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A handsome buxom lass

Lay panting on her bed.

She look't as green as grass

And mournfully she said

Unless I have some lusty lad to ease me of my pain

I cannot live

I sigh and grieve

My life I now disdain.

This medical practice of female-pleasuring raised serious questions of ethics. Were the doctors of the day acting morally or not in removing seed from young, unmarried women, especially when sexual pleasure or orgasm accompanied the expulsion? Or was it simply their medical duty because retained semen, according to seventeenth-century thinking, degenerated into a poison of considerable strength - equivalent to the venom of a mad dog, serpent or scorpion? To practise female expulsion of seed or not became the focus of animated debate in medical circles at the start of the 1600s. In 1627, one doctor, the French physician Francois Ranchin, wrote that the debate of 'Whether One Is Allowed to Rub the Vulva of Women in Hysterical Paroxysm' was one that was Very serious and extremely important'. However, while he acknowledged that there were good arguments to show that it 'is a well proven therapy', and that 'it is inhuman to recommend against the use of that salutary method', Ranchin came down on the moral side of the fence. 'We, however, following the teaching of the theologians, hold friction of this kind to be abominable and damnable, particularly in virgins, since such pollution may spoil virginity,' he declared.

Do all women ejaculate?

Another argument that the nay-sayers of female ejaculation like to bandy about is the question of why the phenomenon is one that only some women experience. However, while every woman's sexual response is unique, there are some compelling explanations for why this maybe. First of all, statistics vary as to the percentage of women who experience female ejaculation. Some American studies estimate 10 per cent of the population, others 40 or 68 per cent. Numbers also fluctuate when it comes to estimating the amount of fluid excreted - values range from 3 ml to 5 ml, with 10 to 15 ml appearing to be typical. These sorts of variances, in particular the fact that not all women visibly expel fluid under pressure from their urethra during sexual arousal and/or orgasm, provide the major arguments against the possibility of female ejaculation occurring. However, as every scientist knows, just because a process does not occur in all people equally does not mean it cannot exist at all.

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Significantly, it is not just medical, historical and sexual texts that point to the occurrence of female ejaculation. An awareness of the role of the female's urethra and prostate in sexual arousal is found in many cultures. Tradition dictates that the eligible women of the Batoro of Uganda are taught by the older women of the village to ejaculate. This custom is known as kachapati, or 'spray the wall'. The Mohave Indians of the American West believe that women ejaculate, as do Trobiand Islanders and the Trukese people of the South Pacific. One study of the sexual behaviour of the Trukese reported: 'Coitus is phrased by several of our informants as a contest between the man and the woman, a matter of the man restraining his orgasm until the woman has achieved hers. Female orgasm is commonly signalled by urination, although failing this a woman still gives adequate indication of its onset.'

For the Trukese and other Micronesians, female sexual arousal is characterised by 'urination before and during the climax' (it is not uncommon for female ejeculation to be confused initially with urination). Mangaian men differentiate between a woman's orgasms and the point during intensely pleasurable sex sessions during which 'a woman thinks she's urinating - but that's not urine', it is 'another type' of sensation. The Ponapese people of the South Pacific gave this advice about conception: 'If a Ponapese man wishes to impregnate his principal wife, he first stimulates her to the point where she urinates and only then proceeds to have intercourse with her.'

One explanation for why not all women visibly ejaculate hinges on the strength of a woman's pelvic muscles. Women with strong pelvic muscles, it is suggested, experience more forceful muscle contractions during sexual arousal and orgasm, and it is this muscular force that pressures the prostate glands to give up their fluid. Studies have backed this up, showing that the PC muscle contractions of female ejaculators were significantly stronger than (almost double) those who did not expel fluid forcefully. Those women with stronger pelvic muscles also experienced significantly stronger voluntary uterine contractions. The strength of a man's pelvic muscles may also play a role. Strong male pelvic muscles, so the theory goes, result in a penis which, when erect, angles right up against the man's stomach, at an angle which is more effective for anterior wall stimulation.

Getting the angle right

The sexual position adopted by women and men is also mooted as playing a part in who ejaculates and who doesn't. It is argued, by some, that there are disadvantages for humans in face-to-face sexual positions - namely, that the anterior wall of the vagina is not as stimulated as in a rear

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entry position, that typically used by quadrupeds. For the majority of quadrupeds, the opening of the vagina is just under the tail, making doggy style the easiest option. This is not the case, though, for all mammals, as we have seen. Some, including elephants, bonobos and humans, have vaginas that have shifted position. Instead of lying approximately parallel with the spine (as in cats and dogs), the vagina has swung forwards towards the stomach side, changing the angle of entry. For a woman standing up, the first two fifths of her vagina angles back at approximately 30 degrees to the vertical (when unaroused), the middle two fifths at 55 degrees and the final fifth at 10 degrees, tracing an approximate S shape. This change in angles can sometimes make it difficult for a woman inserting a tampon. One trick is to insert the tip with the index finger, and then push the rest of the tampon in with the thumb. This thumb technique works better because it fortuitously provides the particular vaginal angle needed. Try it.

The changed angle of vaginal entry may be one reason why humans and bonobos can and do enjoy sexual intercourse in a variety of positions - female on top, male on top, as well as rear entry and many more. Curiously, bonobos seem to prefer face-to-face sex. Female bonobos have been seen manoeuvring their male partners into their favourite position, and astonishingly, bonobos have developed a gestural sign language to communicate the sexual positioning desired. However, for large lumbering elephants, changing sexual position is not as easy. A female elephant's perineum is half a metre long, and this awkward entry angle results in sex being a delicate and risky business for elephants. Perhaps this is why they often take to the water to enjoy sex.

Lack of stimulation of the anterior wall could certainly be a factor in suppressing female ejaculation; however, the length of stimulation time rather than an absence of stimulation due to position is likely to be the culprit with face-to-face sex. Recent MRI pictures of sexual intercourse reveal that, contrary to previous expectations, face-to-face sex can result in the anterior wall being preferentially stimulated. Indeed face-to-face sex could be said to provide a circular kind of stimulation. As both (and it's important that it's both) women and men thrust towards each other, their thrusts are felt and transmitted through their genitals, as both pressure and touch sensations. Men feel the thrust and clasp of the vagina through their clitoral tissue, and urethra and spongiosum tissue, with the deep-pressure sensations of thrusting reverberating all the way through to the prostate. For women, tactile and pressure stimulation is felt as the penis presses up against both the cervix and the anterior vaginal wall, in turn pushing against the prostate, spongiosum, urethra and through to the clitoris, which is stimulated from both inside and outside, in face-to-face sex, as the clitoral crown rubs against the man's body. These MRI

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studies also illustrate beautifully how, with increased stimulation, the anterior vaginal wall swells, lengthening and bulging into the vaginal interior.

Finally, a new and radical theory of female ejaculation is that most, if not all, women do ejaculate prostatic fluid, but that in many women this fluid, or part of it, is not expelled outside the body. Rather it is pushed back down the urethra the other way - into the bladder. In other words, it is ejaculated, but in a retrograde manner. This change of ejaculation direction, retrograde ejaculation, is not uncommon in men, and is directly related to lax or ineffective pelvic musculature. This results in a lack of closure of the internal bladder valve and ejected semen is forced backward into the bladder. Could this be occurring in women too?

In an effort to find out whether female retrograde ejaculation was a possibility, female urine - both pre-orgasm and post-orgasm - was analysed to see whether it contained the prostatic marker prostate-specific antigen (PSA). Twenty-four women were involved in the study, and six of these women had their ejaculate analysed too. The women involved in the study masturbated to orgasm and had not had any sexual contact with men for at least two days. The results were startling. PSA was not detected in pre-orgasmic urine; however, it was detected in significant amounts in post-orgasmic urine in 75 per cent of the women, suggesting that the female prostate actively secretes fluids during sexual arousal and/or orgasm, and that retrograde ejaculation of prostatic secretions is not uncommon. Out of the six women who provided ejaculation samples, PSA was present in all of them, the average value being 6.06 ng/ml (nanogram/millilitre). The mean PSA value in post-orgasmic retrograde ejaculation samples was 0.09 ng/ml.

Spurting the sperm away

The big question that remains to be answered about female ejaculation of prostatic fluid revolves around what its evolutionary purpose could be. Female prostatic fluid seems too saline to have a vaginal lubrication function, plus its production tends to peak and spurt with or approaching orgasm, not at the onset of arousal. Female ejaculation, however, does not necessarily coincide with orgasm. Some women ejaculate before orgasm, some during and some after. While there is no general pattern regarding timing of expulsion, one characteristic of female ejaculatory behaviour is the 'bearing down' or pushing out muscular motion associated with it, where the cervix and vagina push downwards and forwards sometimes with enough force to eject not only prostatic fluid, but probing penises or fingers too.

There is also consensus on the stimulation required to produce female

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ejaculation of prostatic fluids. A rhythmic deep-pressure stimulation is needed - provided either by rhythmic thrusting or rubbing against the anterior vaginal wall. Tentative strokes are out. This stimulation picture is consistent with the stimulation required by the male prostate - which is provided either by the stimulus of thrusting movements during sexual intercourse, or by direct pressure applied in the rectum via fingers, penises or whatever takes your fancy.

Important hints as to the female prostate's role come from the nature of semen itself- which in all species is a complex viscous mix of chemicals and sperm. A male's prostate is just one of a number of accessory glands which add their contents to the ejaculated semen and sperm package. In men, these accessory glands are the prostate, the seminal vesicles and Cowper's glands. In other species there can be more or fewer. It's now known that the products of these accessory glands perform a variety of functions designed to improve the male's reproductive success. Some seminal ingredients protect sperm on their passage out of the urethra; for example, pre-ejaculate serves to neutralise the acidity of the urethra, after urine has passed down it. Others in the seminal mix, such as the sugar fructose, are thought to make sperm more motile, ensuring a smooth exit out of male genitalia, while some ingredients can trigger female genital muscle contractions, or even increase female fecundity by stimulating ovulation.

From an evolutionary perspective, male accessory gland products represent different attempts by males to persuade females to keep and use their sperm after they have deposited it. They are biological adaptations for survival of the species through sexual reproduction. However, females of all species have many tricks up their sleeves when it comes to getting rid of unwanted sperm, as detailed earlier. In this context, could the female prostate provide a co-evolutionary response to the male's accessory gland products? Could the female's prostatic fluid improve her prospects of removing surplus or unwanted sperm?

Significantly, it is not just women who eject a fluid from their genitalia during and after sexual activity. Many females of other species do too. Indeed, the female's initial response to insemination by the male in the majority of mammals, insects, spiders and birds is to spurt back seminal material, utilising her strong genital musculature. However, there is a question mark hanging over what precisely it is that the female is ejecting. Typically female ejection studies comment that the material is apparently semen or presumably semen. The vast majority of studies that have analysed the material have looked only for the presence of sperm. It is possible that female prostatic fluids are present; however, detailed analyses of all the components of ejected fluid, and who contributed them, have not yet been performed. Fascinatingly, though, one study that has inves-

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tigated the role of the female in contributing genital fluids found that females do add to ejected material. This study of the fruit fly, Drosophila mettleri, found that females make a significant contribution to ejected sperm (in this case sperm sacs). This is also the case with female rats, who shed their vaginal lining in order to aid in the removal of sperm plugs.

If female genital fluids (perhaps prostatic) are typically present in the ejected material from females of many species, what role are they playing? One strong possibility is that female prostatic fluid may help to wash away sperm. Sperm, as anybody who has come in close contact with it knows, is typically thick and sticky, especially in mammals and birds, and is perfect for clinging in the crevices and folds of female reproductive tracts. Indeed, it is speculated that the very viscous nature of some species' sperm is an adaptation to make it difficult for females to eject and reject it. If this is the case, a co-evolutionary response from the female to produce some 'lubricant' to ease sperm ejection would make perfect evolutionary sense. The saline nature of female prostatic fluid could help to remove this stubborn spermatic substance, especially if produced under pressure, and in combination with a muscular bearing down of the genitalia. Other ingredients of female prostatic fluid, such as fructose and PSA, suggest such a sperm removal role. In males, fructose is thought to aid the smooth passage of sperm out of male genitalia, while PSA is known to participate in the liquefaction of sperm.

The idea that females use prostatic or genital fluids to help rid themselves of unwanted sperm, be it from the immediate or previous partner, has important implications for sexual reproduction strategies. Humans are one of the very few species which attempt to practise serial monogamy; other mammals enjoy the pleasures of multiple partners. While for monogamous women today prostatic fluid expulsions may not perform a reproductive function, for females with multiple sexual partners, whether or not they ejaculate and wash away a current or previous partner's sperm could have a direct influence on whose sperm they retain and ultimately use to fertilise their eggs. If this is the case, then males could attempt to swing the balance back in their favour by persuading (i.e. stimulating) females to eject previous males' sperm prior to depositing their own. Curiously, this is what the males of some species have been found to do -they copulate with or sexually stimulate the female until she ejects any previously stored sperm.

Dunnocks and damselflies provide two examples of how this can occur. Female dunnocks, a species of bird, typically copulate up to several hundred times per clutch, when just a couple of copulations would do, so for a male to have a chance at being a father he must be able to persuade her to get rid of any other male's sperm. Consequently, the male's approach focuses on performing sufficient foreplay dunnock-style,

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before sperm transferral. For dunnocks, foreplay means poking and pecking at the ruddy tumescent exterior of the female's cloaca - her combined urethra, vagina and anus. As the male continues to stimulate her externally, the female's cloaca becomes pinker and more distended, and from time to time can be seen making strong pumping movements. It is during these pumping movements that small droplets of what is presumed to be sperm only emerge. When the male sees these droplets appear he inspects them closely, and only after this inspection will he transfer his sperm. Elsewhere, detailed work on one species of damselfly has shown that part of the intricate internal architecture of the female genitalia comprises a cuticular plate bearing mechanoreceptive sensilla. If, and only if, the male can distort this genital plate with his aedeagus (insect phallus) during copulation, will the female eject previously stored sperm. Is this the damselfly's equivalent of a G spot?

Interestingly, the behaviour of the male dunnock and damselfly in their attempts to be the ones to fertilise their respective females' eggs recalls the previously noted conception advice of the South Pacific Pon-apese people, who practise polygamy: 'If a Ponapese man wishes to impregnate his principal wife, he first stimulates her to the point where she urinates and only then proceeds to have intercourse with her.'

Perhaps the Ponapese wisdom is correct. Confirmation of the female prostate's role in sexual reproduction will only come if further research into the prostatic secretions of females of many species is carried out, including analysing the significance of its rich and heady musky aroma. It would also be helpful to understand more about the make-up of vaginal mucus and fluids in relation to sexual health and reproduction. Sadly, the current status of such research lags far behind equivalent studies of male seminal fluids. However, despite the lack of scientific focus on female sexual fluids, one thing is certain. With not a tooth, a sharp edge or a snake in sight, the nature of the vagina is fluid in every sense of the word -flexible, flowing, mutable, mercurial, sinuous, shape-shifting, protean and wet.

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Adultery, the art of misbehaving genitally, has been frowned upon by human societies throughout history. The punishments typically meted out for this sexual malpractice range from the obvious and straight-to-the-point practice of chopping off the offending genitalia, to the seemingly more subtle act of mutilating or amputating an adulterer's nose. However, nasal dismemberment, which on first sight may not appear to be a punishment that fits the crime, is, historians and anthropologists record, a surprisingly common penalty for enjoying the pleasures of sex with someone other than your spouse.

Roman poet Virgil (70-19 bce), in his epic poem the Aeneid, describes how female and male adulterers were castigated by nasal castration. Anthropology texts from the early twentieth century detail how among the Ashanti of Ghana, and in Afghanistan, an adulteress was chastised by the severing of her nose, whereas in Samoa, an insulted and jealous husband would bite his wife's nose off. Not just nasal amputation, but ears, lips and scalp too were taken as part of the tribal customs of indigenous North Americans. For women of the Baiga tribe of northern India, both the nose and the clitoris were lopped off by wrathful husbands. Meanwhile, such was the prevalence of nasal dismemberment in ancient India (it was the official punishment for adultery) that Indian physicians developed surgical methods for reconstructing the nose. Early Indian medical texts detail how the technique was to use a skin flap from the forehead to form a new nose.

Intriguingly, associations between the nose and a person's genitals are not restricted to adultery and amputation in antiquity. On the contrary, naso-genital connections span centuries of art, literature and science too. In his Physiognomica, Aristotle alleges a link between lechery and the shape of the nose. During Roman times, the nose was read as a symbol for the genitals in a number of ways. For men, a large nose was seen to signify an equally ample penis, a correlation that still has resonance for some today. For these individuals, the phallic cast of a man's nose coupled with the scrotal aspect of a man's cleft chin is not viewed as a coincidence. Astonishingly, the licentious Roman emperor Heliogabalus (218-22 ce) reportedly welcomed into his sex club only those men who were deemed

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to be nasuti By this he apparently meant those men whose nose suggested their penis would be acceptable to women, i.e. those whose nose made the grade, genitally speaking, Not surprisingly, ancient caricatures often depict male noses with a distinctly phallic appearance. And by the Middle Ages and for several hundred years afterwards it was commonplace to describe the shape of the nose as portending the size of the penis.

Such beliefs remained strong well into the seventeenth century, despite the efforts of anatomists such as Reinier de Graaf to expose them as erroneous. In his work The Generative Organs of Men y de Graaf insists that the naso-genital size correspondence is not so, writing: 'In dissecting cadavers, anatomists not infrequently observe the opposite', adding, for clarification of his viewpoint, 'Even if this were so ... sexual capability does not depend on a huge penis.' As well as proclaiming genital size, or status, the shape of an individual's nose was said to convey a sense of their virility. Yet not all physiognomists agreed on which shapes said what. Some subscribed to the notion that the more elephantine the nasal appendage, the stronger the supposed sexual vigour. But according to others, it was a snub nose that was the true hallmark of a lustful man.

It's not just men, though, who had their noses sized up, sexually speaking. Women did too. Moreover, correlations between the nose and the genitals were not confined to the west. SiangMien, the Chinese art of reading faces, describes how the nose of a woman or a man can be used as a measure of a person's vitality and sexual powers, of a person's ability to love. The nose, it says is 'the centre of life'. Fascinatingly, it was also believed that the state of a woman's nose could be read as a sign of sexual arousal. According to the ancient Chinese sex manual, Secret Instructions Concerning the Jade Chamber, the second of five signs of sexual desire in women is said to be 'breasts hard and nose perspiring'. The manual helpfully adds that a woman's dilated nose and mouth 'means that she wants you to insert your penis'.

The ancient Chinese science of reflexology also teaches that the genitals correspond to the nose and a person's upper lip. And this, it is said, explains why kissing and sniffing are a natural part of sexual foreplay and pleasure. More explanation of this connection is given in Tantric texts, which state that a woman's upper lip is one of her most erogenous zones because of a subtle nerve channel connecting it with the clitoris. This nerve, called the 'Wisdom Conch-like Nerve', is said to be curved like a shell as it anchors to the clitoris, channelling orgasmic energy. This is why sucking and kissing a woman's upper lip is often enough to bring her to orgasm.

Western ideas about the perceived female naso-genital alliance also held that evidence of sexual activity in women was written on their nose.

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However, while Chinese sex manuals saw this system as a way of making sure that a woman was fully aroused, western men touted the condition of the female nose as a test for virginity. Alarmingly, the thirteenth-century writer on physiognomy, Michael Scotus, claimed to be able to tell the sexual status of a woman suspected of moral turpitude by fingering her nasal cartilage. Surprisingly, some doctors today claim to be able to tell from changes in the shape of a woman's nose whether she is pregnant or not.

The idea that the nose and the genitals are connected is also expressed in ancient western theories about the development of the embryo in the womb. By this reckoning, solar system planets held sway over the development of an individual's features, with each planet ascribed a function in the foetus' formation. Mars ruled the third month of development in the womb, and the formation of the head, while the sun influenced the fourth month and the creation of the heart. Not surprisingly, perhaps, the planet Venus, traditionally viewed as the purveyor of venery, pleasure and sexual delight, was thought to bestow concupiscence and desire on the developing infant during its fifth month in the womb. The popular late Middle Age treatise Women s Secrets relates how, 'In the fifth month Venus by its perfect power perfects certain of the exterior members and forms certain others: the ears, the nose, the mouth, the penis in males, and the pudenda, that is the vulva, breasts and other members in females. It also causes the separation of the hands and feet and fingers.' Following Venus was Mercury, reigning over the voice, eyebrows and eyes, and making hair and nails grow.

Not surprisingly, perhaps, literature and language does not escape the yoking of nose with genitals. Resemblances between the phallus and the nose were often alluded to in Roman literature. What's more, similarities between a woman's genitalia and her nasal attributes were expressed remarkably succinctly in Latin sexual vocabulary. Nasus, the Latin for nose, was also used as a term for the clitoris - the sexual slang of its day. Curiously, as images in the book Femalia, by Joani Blank, show, the crown of a woman's clitoris does sometimes look a little like a nose - a snub nose, that is. The linguistic pairing of the nose and the clitoris is found in other cultures. The Mehinaku tribe of Brazil refer to a woman's clitoris as the nose of her vagina (itsi kiri). A woman's clitoris, or vaginal nose, say the Mehinaku, moves about 'searching for its food' - a man's penis - in the manner of a predator sniffing out its prey. Other parts of female genitalia are also equated with facial features, such as the forehead and lips, and the entire vagina is symbolically identified as a mouth.

For the Mehinaku, sex itself is seen as a kind of eating, an idea that is also reflected in their language, whereby the verb to eat also means to have sex. Hence the genitals of one sex are the food of another. Mehinaku

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myth and ritual also suggest an equivalence between the penis and the nose. Other cultures' rituals underline such associations. For example, an archaic way of mocking a man who is unable to become erect enough for sexual intercourse - who has lost his male sexual power - is for a woman to make a hole in the impotent man's nose and place a cowrie shell there (a symbol of the vagina and female sexual power).

As above, so below

Why the multiple associations between a person's nose and their sexual organs? Can looking at the nose actually be a viable avenue to viewing the vagina? Well, the idea that the nose and the genitalia may be connected in some way has an illustrious history in medicine. Hippocratic doctrine taught that the nose could be used as a diagnostic tool for ailments occurring elsewhere in the body, especially the reproductive organs. The nostrils, in particular, were viewed as important indicators of health. For men, naturally damp nostrils and watery, plentiful sperm were read as revealing a healthy constitution. Nasal discharge, it was reported, could be dried up with a dose of sexual intercourse. Elsewhere, though, religious scribe Celsus (150 ce) advised men to 'abstain from warmth and women' at the first sign of a cold or catarrh, as acts of venery would only inflame and irritate the nose.

Interestingly, Hippocratic medicine held that the affinities between the nose and the genitals were more pronounced in women than they were in men. This enhanced female naso-genital alliance stemmed, it is thought, from the Hippocratic belief that a sexually mature woman's body contained a tube or route (a hodos, the Greek for 'way') which linked the nostrils and mouth (orifices of the head) with the genital orifice, the vagina. As the Hippocratic men of medicine saw it, both ends of this tube, or uninterrupted vagina, had a mouth (stoma), and so the two were analogous. Remnants of their anatomical reasoning remain in medical terminology and language today. Both the head and the genitals have a neck (cervix), mouth (the mouth of the womb or uterus) and lips (labiae). This idea of the vagina as a second mouth is found in other cultures, such as the Mehinaku, as we've seen. It's also pertinent to recall that reflexology states there is a connection between the mouth and the genitals, and, surprisingly, western medicine seems to suggest there is too, as women are advised to relax their mouths at the final moment of giving birth, because this helps the vagina release the baby. This idea of the vagina as woman's second mouth also helps to explain the saying 'Ella habla por en medio en las piernas - 'She speaks from between her legs'.

But back to Hippocrates' ideas. Using his hodos reasoning, the orifices at either end of the tube (nose, mouth and genitals) were used in various

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ways. One end could be used to detect problems at the opposite end, or either end could be read as a sign of the condition of the internal tube itself. And either end could also be used as the site for the administration of suitable therapy- be it 'from the top' (and) or 'from the bottom' (koto) of the tube. Many naso-genital diagnoses and associations were made. 'Dry and blocked, not upright' nostrils were an indication that the mouth of the womb was closed and tilted. Naturally damp nostrils were linked with watery, plentiful sperma muliebris (female sperm), and were seen as a sign of a healthy constitution.

Menstruation was one of the most important conditions read by the hodos theory. For example, a pain in the throat pointed to the start of the menstrual period. Nosebleeds too were linked to the onset of puberty and menstruation, or could be connected to childbirth. And with a direct route envisaged from vagina to nostrils, nasal blood flow was viewed as evidence of diverted menstruation in those women whose menstrual bleeding was deemed not heavy or frequent enough. According to the medical maxims of the Hippocratic Aphorisms: 'If the menses are deficient, it is a good thing when blood flows from the nostrils.'

Hippocrates' ideas of a connection between female genitalia and a woman's nose were enduring. More than a thousand years after their conception they still formed the basis of treatments for female conditions. This is illustrated clearly in the Trotula, the most influential compendium on women's medicine in medieval Europe. For instance, the Trotulas advice 'On the Regimen for a Woman Giving Birth' suggests: 'when the time of birth arrives ... let sneezing be induced with the nose and mouth constricted, so that the greatest part of her strength and spirit tends towards the womb ... Likewise, let troches (lozenges) be made from galbanum with asafoetida and myrrh or rue, and let a fumigation be made to the nose. Above all, let her be aware of the cold, and let there not be any aromatic fumigation to the nose. But this can be applied more safely to the orifice of the womb ...'

Rather alarmingly, vaginal or uterine fumigation was common in medieval times. This consisted of a woman sitting on a perforated seat above scented, smoking fumigation pots and stools (see Figure 6.1). Paucity or lack of menstrual blood is one of the conditions that was treated in this way, with the Trotula prescribing:

Take ginger, laurel leaves and savin. Pound them and place them together in a plain pot on live coals, and let the woman sit on a perforated seat, and let her receive the smoke through the lower members, and thus the menses will return. Let this be done three or four times or even more often. But for the woman who frequently takes applications of this kind, it is necessary that she anoint her vagina inside with cold unguents lest she become excessively heated.

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Figure 6.1 Renaissance instruments for vaginal fumigation: The patient sat over a small burner and received either attractive or repellent aromas into her vagina. The perforated instrument on the right is designed to hold the vagina open -the better to receive the healing vapours.

The hodos theory is perhaps responsible for many of the notions surrounding women's health. Take the 'wandering womb' idea. A woman's womb was seen as capable of wandering along her hodos, be it up or down. However, this womb-wandering was seen as causing medical problems, such as womb suffocation, or, as it was later known, hysteria. Womb suffocation, it was understood, was a disorder that occurred when the womb moved upwards towards the stomach, chest, heart or throat. Symptoms of womb suffocation, the Trotula says, include 'loss of appetite from an overwhelming frigidity of the heart ... Sometimes ... she loses the function of the voice, the nose is distorted, the lips are contracted and she grits her teeth ...'

Remedies for wombs that had wandered too far upwards typically involved applying aromatic potions, which would coax the womb to return to its correct position. According to the Trotula, 'the womb follows sweet-smelling substances and flees foul-smelling ones'. Hence the treatments for a raised womb (uterine suffocation) could involve anointing the vagina inside and out with oils with pleasantly scented odours, such as iris, chamomile, musk or nard oil, or smelling the rank aromas of 'castoreum, pitch, burnt wool, burnt linen cloth and burnt leather'. Cupping glasses could also be applied to the groin and pubic areas, or sternatives (substances that induce sneezing) were sniffed.

According to Hippocratic thinking, a woman's genitals-to-head hodos also seemed to allow for the free flow of semen backwards and forwards

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from vagina to brain. This belief may explain why one ancient test for whether a marriage had been consummated or not was for the bride's neck to be measured before and after the wedding night. An increase in size showed a successful union. A similar neck test was also used to trap adulterers. This semen theory probably underpins the belief that indulgence in venery - the pursuit of sexual gratification - can affect an individual's voice. Indeed, Greek and Roman writers believed that it was also possible to tell when a girl had lost her virginity because her voice became deeper. Medieval and Renaissance writers gleefully retold the story of how Diogenes Laertius of Democritus recognises that Hippocrates' daughter has been deflowered during the night from a change in the girl's voice. Perhaps they were having a dig at Hippocrates.

The connection between voice and venery was also thought to affect men. For instance, seventeenth-century authors recorded how voice trainers infibulated a man's penis - enclosing it in bands and fetters - in a bid to protect the singer's glory. Meanwhile, this idea of the voice being affected by sexual activity has persisted into the twentieth century. In 1913, the New York Medical Journal published the paper 'Connections of the sexual apparatus with the ear, nose and throat'. In it, the author writes: 'After a night consecrated to Venus, patients which have had any nasal, aural or laryngological abnormality invariably find this condition exaggerated.' On a more serious note, a recent study highlighted the fact that 30 per cent of women with vocal cord dysfunction suffered sexual abuse during childhood.

Scents and sensuality

Significantly for this view of the vagina, it is not just physical similarities and supposed physiology that have pulled the nose and genitalia together. It's the function of the nose too - the sense of smell. Smell has consistently been perceived as the sexual sense, the most intimate sense, the animal sense. It is, according to Rousseau, 'the sense of memory and desire'. The recognition of smell as a powerful sexual stimulus is reflected throughout history - celebrated as an aphrodisiac in perfumes and poetry, yet often maligned as a bad influence by philosophers and governments. Civet, the honey-like marking sexual secretion of the urogenital sacs of the African civet cat, was one of the most sought after aphrodisiac scents. According to the medieval writer Petrus Castellus: 'Civet will cause a woman so much desire for coitus that she will almost continually wish to make love with her husband. And in particular, if a man wishes to go with a woman, if he shall place on his penis this same civet and unexpectedly use it, he will arouse in her the greatest of pleasure.'

Musk too has been viewed as a potent 'provoker of venery' throughout

THE STORY OF V

history. In the nineteenth century, French novelist Emile Zola writes this of musk and women: 'With the aid of a piece of musk she abandons herself to forbidden delights. She is in the habit of surreptitiously sniffing it. She drugs herself with it until orgiastic convulsions overwhelm her.' However, one seventeenth-century writer warns of the dangers of using musk too liberally, writing of a couple who doused their genitalia in musk only to find that, like dogs, they could not disengage from each other after.

Poetry frequently and beautifully twins scents and sensuality. Within poetry's verses, naso-genital associations and allusions, which perhaps could not be spoken of straightforwardly, were free to be eulogised. Such poems read as spellbinding and mesmerising evocations of desire, steeped as they are in smells redolent of lust, love and genitalia. For example, the soon-to-be married couple in 'The Song of Solomon' detail their delight in the power and richness of the odours of each other, writing of mountains of myrrh and hills of incense. Aroused by her bridegroom's passionate portrayal of the bountiful scents of her still-locked 'garden' (vagina), the bride calls on the north and south wind: