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While reflecting on our anniversary, we were reminded of how many women have come before us, paving the way for straightforward conversations about women’s sexuality. This is the fifth in a series (read the firstsecond, third, and fourth) launching our sixth year with gratitude, and the last unless you nominate, in the comments below, a woman you’d like us to highlight!

Virginia Eshelman grew up as a Missouri farm girl. She sang country music for a radio station in her home town of Springfield. During World War II, she sang with a band, and later she married George Johnson, a bandleader. In 1956 they divorced, leaving her with two small children to bring up alone. She needed a job, so she went to the placement office at the university in St. Louis where she was studying sociology. The office sent her to William H. Masters, who was looking for a female assistant.

Masters, of the university’s department of obstetrics and gynecology, had undertaken secret research into sex. He was using prostitutes as research subjects, but he wanted to recruit a more typical population. Gini Johnson had no college degree, but she had a warm manner and an easy smile. She also turned out to have a formidable intelligence and bottomless determination. She went on to become a world-renowned authority on The Human Sexual Response, as their groundbreaking 1966 book was called.

She noted that neighbors, after their first book was published, “had a kind of Midwest mode of handling us.” They pretended nothing had happened.

Masters and Johnson studied hundreds of volunteers, men and women from the ages of 18 to 89, who were willing to have sex or masturbate in a laboratory setting, wired up and filmed. They measured heart rate, blood pressure, breath, brain activity, and metabolism. They even gave women a Plexiglas phallus with a tiny camera inside, to record what happened in the vagina during sexual arousal. Their fundamental discovery: that men and women have the same capacity for orgasm.

In 1970, Johnson said, “I still have a real thing against the fact that 95 per cent of the things written about female sexuality in the past were written by men—without ever thinking to consult women.”

In a 1994 dual interview, Masters told the New York Times, “I desperately needed a female, an intelligent woman who would have original thoughts.” Johnson put in, “In two things we have common ground—the drive to do something extraordinary and an appreciation of the subject matter.” Their mutual appreciation was such that they married in 1971. After their divorce in 1993, they remained research partners.

Lizzie Crocker wrote in The Daily Beast, “The fact that Masters gave Johnson equal billing on his life’s work—something most male doctors at the time would never dream of doing—was a reflection of how much he admired and adored her. Masters had the degree, but it was Gini who, by sheer dint of her energy, intellect, and charisma, was largely responsible for the success of their work.”

The two remain so well known that the Showtime series Masters of Sex, based on their story, has run for three seasons. It began to air shortly after Virginia Johnson died at the age of 88. She once said, accurately if immodestly, “We are [to sex] like Kleenex is to tissue.”

While reflecting on our anniversary, we were reminded of how many women have come before us, paving the way for straightforward conversations about women’s sexuality. This is the fourth in a series (read the firstsecond, and third) launching our sixth year with gratitude!

Helen Gurley grew up in the Ozarks, “ordinary, hillbilly, and poor,” but determined not to stay that way. When she was 10, her father died in an elevator accident. Her mother struggled for years to provide for her two daughters, then moved the family to Los Angeles in hopes of getting help from a relative. Helen Gurley, the valedictorian of her high school class, learned to type. She said she went through 17 secretarial jobs before a boss finally promoted her: to advertising copywriter. She never looked back.

She was a highly successful career woman but chafed at remaining unmarried well into her 30s, so she plotted to snare the movie producer David Brown (later known for The Sting, Jaws, and Driving Miss Daisy). Among her wiles: she put her phone in the fridge so she wouldn’t hear it ring, making her suitor think she was out with some other man. They stayed married for more than 50 years, until he died at the age of 93. She had told the New York Times, “I look after him like a geisha girl.”

When Helen Gurley Brown published Sex and the Single Girl in 1962, she was 40 years old and married; her husband had suggested the subject. She later recalled, “Before I wrote my book, the thought was that sex was for men and women only caved in to please men. But I wrote what I knew to be true—that sex is pleasurable for both women and men.”

The book’s notoriety led to her becoming the editor of Cosmopolitan. Her first cover, in the summer of 1965, featured ample cleavage, pouting pink lips, and heavily made-up eyes. She was aiming for the “grown-up girl, interested in whatever can give you a richer, more exciting, fun-filled, friend-filled, man-loved kind of life!” Her underlings were told, “no glums, no dour feminist anger and no motherhood.” She remained the editor of Cosmopolitan for 32 years. She claimed that her husband wrote the cover lines.

Helen Gurley Brown insisted that she was a feminist but others disagreed. One year after Sex and the Single Girl, Betty Friedan’s Feminine Mystique heralded a new wave of feminism. In 1970 Kate Millett led a sit-in in the Cosmopolitan office. Jennifer Pozner called Cosmopolitan “one of the most body-shaming, insecurity-provoking, long-lasting sexist media products of the last 100 years.”

Helen Gurley Brown died in 2012 at the age of 90. She had suggested that her epitaph say, “She worked very hard.” She claimed never to have taken a day off except for plastic surgery. As Margalit Fox’s obituary slyly put it, “She was 90, though parts of her were considerably younger.”

But Dr. Ruth had a gracious tribute. “What Helen Gurley Brown taught women was how to use their bodies not to give someone else pleasure but to give themselves pleasure, and that is a tremendous contribution for which I thank her on behalf of all the women who are now orgasmic and might never have been without her pioneering efforts.”

Whether in person in my office or by email from the MiddlesexMD website, I hear variations on this story more often than you might think: A woman who’s been without a partner for years—often as many as 10—has found someone new. While she’s happy to have found a partner with whom to be intimate, she finds that sex is uncomfortable or even painful.

I celebrate the new relationship with each woman! While it’s perfectly possible to be happy on our own, it’s also lovely when we find a “right person” with whom we can share our lives and experiences—and intimacy, too.

When we find that right person after menopause, sometimes physical changes take us by surprise. Pain with intercourse is typically associated with vulvovaginal atrophy, which is the effect of the loss of estrogen. Women notice that they have less natural lubrication, and vaginal dryness makes friction painful. And the vaginal tissues are less elastic; the vaginal actually can shrink.

Both dryness and loss of elasticity can be addressed most simply with a lubricant. Silicone lubricants (our most popular is Pink) provide the most glide and last longest. Vaginal dilators can be helpful if, after a period of sexual inactivity, tissues need some gentle stretching.

Providing estrogen to the tissues is another option. There are prescription products that supply estrogen only to the vaginal tissues: Estrace cream, Premarin vaginal cream, Estring, and Vagifem are all localized options. Osphena is a non-hormonal option for treatment of vaginal and vulvar pain.

Some women describe a burning sensation on penetration, which may be caused by vulvodynia. Estrogen is part of the solution then, too, and a thorough medical exam would be helpful to determine exactly what treatment is needed.

Women who are sexually active after a hiatus also sometimes report the first urinary tract infections of their lives! There’s a movement to replace the term “vulvovaginal atrophy” with “genitourinary syndrome of menopause.” Both terms are a little clumsy, but the latter more accurately represents the reality of the effects of menopause: that there is a urinary as well as a genital component. Again, anything that improves vaginal health is a plus for the urinary tract; adding localized estrogen may be necessary. If bladder infections are recurring, using an antibiotic each time you have sex can be helpful to preventing them.

And! If you’re not in a relationship right now, whether or not you’re looking for one, be mindful of your body’s changes. If you’d like to keep your options open for the future, create your own maintenance plan; with some ongoing care, you can avoid the need to undo the effects of time.

While reflecting on our anniversary, we were reminded of how many women have come before us, paving the way for straightforward conversations about women’s sexuality. This is the third in a series (read the first and second) launching our sixth year with gratitude to them!

Eve Ensler was an obscure New York playwright until she debuted her one-woman play, The Vagina Monologues. The very title was electrifying. Suddenly, audiences were being asked to say the word “vagina” out loud.

Ensler got the idea for the play when a woman she knew said “really hideous, demeaning things about her vagina.” That spurred her to interview more than 200 women. “It’s the easiest thing I’ve ever done in my life. People long to talk about their vaginas. It’s like a secret code between women.”

“Once they got going, you couldn’t stop them,” she said in a 2004 TED talk. “No one’s ever asked them before.”

She assembled some of their stories into a series of short monologues, ranging from humor (“Hurry, nurse, bring me the vagina”), to tragedy (gang rape as a weapon of war); from the birth of her own grandchild, to a fake orgasm more stupendous than the one in When Harry Met Sally.

In 1996, The Vagina Monologues won an Obie for best new play. There were other effects that Ensler had never anticipated. “Women would literally line up after the show because they wanted to tell me their story.” She had thought they would want to talk about sex. Instead, many told heart-rending tales of rape, incest, and violence. She found out that the UN estimates 1 in 3 women worldwide are beaten or raped. That number enraged her.

On Valentine’s Day of 1998, she began a new campaign: performances of The Vagina Monologues to raise money to stop the violence. The first year, she enlisted high-profile actresses like Whoopi Goldberg, Lily Tomlin, Glenn Close, and Susan Sarandon. Sony and ABC were corporate sponsors.

The V-Day movement has continued ever since. The money raised has gone to safe houses in Kenya for girls escaping genital mutilation; to the City of Joy in Congo for victims of rape; to Juarez, Mexico, where bones of murdered women were washing up on the beach. Money has gone to Haiti, Afghanistan, Egypt, and Iraq.

Women in the U.S. have also benefited. During the month of February, local productions pay nothing for the rights to the play, provided that all proceeds go to organizations working to stop violence against women.

Eve Ensler herself suffered abuse as a child. “I left my body at a very young age . . . I wasn’t informed by the intelligence of my body.” Living without connection to the body means “we are not living in our full creativity and intelligence.”

Her body received a shattering challenge in the form of stage 3 uterine cancer, but she never lost sight of the suffering of other women. In a 2010 Guardian article, she wrote with fury about the world’s indifference to the plight of women in the Congo, while she herself received excellent, curative care for her cancer. She remained, as the title of her 2013 memoir has it, In the Body of the World.

While reflecting on our anniversary, we were reminded of how many women have come before us, paving the way for straightforward conversations about women’s sexuality. This is the second in a series (read the first here) launching our sixth year with gratitude to them!

The name of the world-renowned sex expert Dr. Ruth immediately brings to mind her warm, German-accented voice. Dr. Ruth Westheimer, 88 years old, has her own YouTube channel, where you can find clips of her answers to important questions such as I’m over 65—can I still have sex?, her frisky report on a kiss from President Obama, and even her thoughts on Fifty Shades of Grey.

Though only four foot seven in her prime, she’s been a huge figure in sex education since the early ’80s, when she started a fifteen-minute radio show,“Sexually Speaking,” on a local New York station. At first, the station was so wary of the subject that her show aired Sundays at midnight, and Dr. Ruth answered written questions only. Soon that evolved to an hour-long live call-in show with a seven-second delay. Live TV was next. She made several appearances on the David Letterman show, her radio and TV shows were syndicated, and she was on the cover of TV Guide and People magazine. She taught the nation that sex can be talked about, and on live TV!

She was reassuring and compassionate on-air with nervous people, especially the young—asking questions, putting them at ease. Even in her younger days, she exuded a grandmotherly air. It’s hard to imagine that, tiny as she was, she’d been trained as a sniper in Palestine.

She had a narrow escape from the Nazi horror. When she was 10 years old, her mother and grandmother sent her to safety in Switzerland. She spent the war in an orphanage with many other Jewish children, refugees from Germany. After learning in 1945 that her parents had been murdered in the Holocaust, she went to Palestine and trained in the army. She relates, “When I was in my routine training for the Israeli army as a teenager, they discovered completely by chance that I was a lethal sniper. I could hit the target smack in the center further away than anyone could believe.” But, she says, she never killed anyone. “Even today I can load a Sten automatic rifle in a single minute, blindfolded.”

She went on to study psychology in Paris, then immigrated to the United States, where she made her home in Manhattan. She earned advanced degrees from the New School and Teachers College, Columbia University, then did post-graduate work in sexuality with Helen Singer Kaplan from Vienna, a psychiatrist who pioneered scientific research about sex.

She retains a close association with Israel and Judaism. “For years, I wondered why I could talk about the things I talk about so openly. Now I know. For us Jews, sex was never a sin.” In her book Heavenly Sex: Sexuality in the Jewish Tradition, she writes, “The great rabbi Simeon ben-Halafta called the penis the great peacemaker of the home.”

In addition to her many books and recorded programs, Dr. Ruth’s Family Encyclopedia of Sex & Sexuality is available on-line. Those who helped her escape from Nazi Germany made possible a well-lived life, with a great legacy.

We saw the obituary for Dell Williams while we were gearing up for our MiddlesexMD anniversary. Realizing how many women have come before us, paving the way for straightforward conversations about women’s sexuality, we decided to start our sixth year with a series on those women pioneers. This is the first in that series.

The courageous pioneer Dell Williams died in March at the age of 92. She spent the second half of her life on a crusade to help women “define, explore, and celebrate” their sexuality. Back in 1974, she founded Eve’s Garden, the first store in America where women could buy vibrators and other sexual aids in a safe, private environment. All these years later, it’s still going strong.

Dell Williams grew up in the Bronx. After thriving as a WAC, in show business, and as a New York advertising executive, she made an unexpected career move, precipitated by a march. As she put it, “I stepped into the Women’s March for Equality in 1970 like a lamb and I walked out like a lion.” She joined the New York chapter of NOW, and “another chapter in [her] life began.” It was an intoxicating time, when women were giving each other the strength to redefine what their lives could be.

In 1972 she helped to organize the Women’s Sexuality Congress, which set her on the path of her life’s work. More than a thousand women gathered at a New York high school to talk about sex in a brand-new way. About the sex educator Betty Dodson, Williams said, “Her forthright talk transformed women from body-shy to body-proud.” Dodson recommended the Hitachi Magic Wand, which was supposedly for muscle massage but was highly functional as a vibrator. Inspired, Dell Williams went to Macy’s to buy one. The male sales clerk asked what she was going to use it for. The embarrassing encounter led her to think, “Somebody really ought to open up a store where a woman can buy one of these things without some kid asking her what she’s going to do with it.”

So she founded Eve’s Garden, first as a mail-order business in her kitchen, then as a store nearby on West 57th Street, discreetly upstairs. She wanted it to be a place where women could “celebrate the joy of their own sexuality” in comfort, at first with no men allowed. The mission was “to encourage women to take responsibility for their own sexuality, honor the sacredness of sex, and clearly understand that bodily pleasure and spiritual joy are one, and an inalienable right.” Kim Ibricevic, the current manager of Eve’s Garden, said that Williams “wanted to focus on the spiritual side of sex and felt that if every woman had an orgasm, there would be peace in this world.”

In a video made when she was well into her 80s, she is as warm and enthusiastic as ever. Flanked by two doctors, women whom she was introducing as sex counselors, she exclaims that “Eve’s Garden is just a garden of delights.” She describes how empowering it was for her to learn that she could take responsibility for her own pleasure, and how she had spent decades fighting for “women’s awareness that they had a right to enjoy themselves.”

As she put it, after so many years of studying the subject, “Sexuality is the biggest mystery of them all.”

Birthdays are a useful thing—although it’s increasingly easier to celebrate them for our children (or grandchildren) than for ourselves. Here at MiddlesexMD, we’re celebrating a milestone: It was five years ago this month that we launched our website. While I’ve been practicing medicine for much longer (did I say it’s not easy to celebrate every milestone?), this marks five years of encouraging women to learn about and take charge of their sexual health throughout their lives.

Celebrating Five YearsThere are a number of ways to measure how far we’ve come, like marking our children’s height on a chart. The first that comes to mind is the number of women who’ve been in touch. We’ve been in contact with hundreds of thousands of women (and men who love them) from 209 countries. Many have thanked us for solving a specific problem, or for simply providing some hope and a path to follow. We’ve talked to hundreds of women in person, too, at medical conferences. Nurse practitioners and other health care providers have said how grateful they are to have a resource for patients and, because many of them are women, have shared personal stories, too. As a physician, I have more options available to me than I did five years ago. Osphena comes to mind as a treatment for vaginal and vulvar pain. And while localized estrogen products have been on the market for a while, I’ve noticed more advertisements for them. While too much advertising—especially of pharmaceuticals—can sometimes just be noise, I see the ads as an increase in conversation about women’s sexual health. And that’s a good thing. I’m hopeful about increased conversation at the FDA, too. Last fall I attended meetings to discuss how the agency reviewed and set priorities for drugs to treat women’s sexual health challenges. It’s been rewarding to join with colleagues in Even the Score, a campaign for women’s sexual health equity. In March, eleven members of Congress signed a letter to the commissioner of the FDA, expressing the firm belief that “equitable access to health care should be a fundamental right” and noting the disparity between the number of FDA-approved drugs for male sexual dysfunction (26) and female sexual dysfunction (0). It will take some time for new treatments to make their way through development, testing, and FDA approval. In the meantime, I’m also happy to note more books (including my own) and websites offering information, encouragement, and community to women as they navigate midlife and beyond. I hope you’re talking, too—to your partner, your friends, your sisters, and your health care provider. When we share our experiences, we feel less alone. And we can also learn from each other about what’s happening and what works to keep us vital and engaged. Because we know that even at—especially at—midlife and beyond, we’ve still got it! (Through the end of April, celebrate with us by using the code PARTYFIVE to take 20 percent off your purchase from our website.)

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