Women's Bodies, Women's Wisdom (58 page)

Given our collective history, then, it is little wonder that the entry points to the female body are associated with problems for so many women. Problems in the vulva, vagina, cervix, and lower urinary tract are primarily associated with a woman’s feelings of violation in her one-on-one relationship with another individual or in her job. Given the substantial number of immune cells at the mucosal surfaces, such as our vagina, urethra, cervix, and bladder, and given that the function of these cells is highly influenced by stress hormones such as cortisol, it is not difficult to see how a perception of violation and the subsequent biological cascade of hormones that results in response to this perception might well impair optimal function in this area of the body.

Indeed, it has now been well documented that psychosocial stress increases both the prevalence and incidence of bacterial vaginosis (BV), a type of vaginal infection caused by an imbalance in the normal vaginal bacterial environment. BV raises the risk of postoperative infections, HIV shedding and acquisition, and premature labor in pregnant women. BV is difficult to eradicate and often recurs. Though it is also associated with douching, oral sex, and multiple sexual partners, psy chosocial stress has now been found to be an independent risk factor for it, probably because of the adverse effect of stress hormones on the immune function of the vaginal mucosa.
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Energy Issues and the Lower Genital Tract

The inability to say no to a boundary violation can lead to in creased susceptibility to infection secondary to decreased levels of im munoglobulin type A or immunoglobulin type M. Think of it this way: Any perception of invasion in one’s emotional life can result in in creased permeability of one’s immune system boundary, both on the surface areas of the body and internally. This is especially true in those women with a history of psychosexual trauma in early life. A woman who has been in a sexually active love relationship and is rejected may perceive her rejection as a violation, and vulvar or vaginal problems can result. If she can’t feel and release her anger over this, she may develop recurrent urinary symptoms. Incest memories, sexual violation, and guilt feelings about sexuality can also result in repeated episodes of vaginitis.

A woman who has a health problem in the vagina, vulva, or cervix may be involved in a situation in which she is being used sexually or in a job without her complete conscious cooperation and consent. Or she may be feeling forced to do something against her consent or to act in a sexual way about which her emotions are divided. In such a situation her body is likely to respond with problems that we associate with sexual violation. These physical problems can appear if, for instance, she is using sex to obtain financial, physical, or emotional security or to manipulate another person, rather than to bring mutual pleasure. Feelings of being used or raped are associated with chronic vaginitis, chronic vulvar pain, recurrent venereal warts, recurrent herpes, cervical cancer, and associated abnormal Pap smears (cervical dysplasia).

Women with episodic urinary symptoms often find that the episodes are accompanied by anger or feeling “pissed off.” Getting a urinary tract infection (UTI) may be the body’s way of releasing anger. Women with recurrent UTIs should pay attention to what happened in their lives and relationships twenty-four to forty-eight hours before the onset of the symptoms. With practice, we can often become aware of the offending situation and take steps to change either the situation or our response to it. When the anger becomes more chronic and less available on a conscious level, the symptoms may take the form of continual urinary urgency and frequency.

Studies have shown that women with chronic bladder infections have more free-floating anxiety and more obsessive personality traits and tend to experience emotions only through their bodily symptoms (somatoform disorder) compared to women without this problem. In one study, in fact, women with chronic cystitis had scores comparable to those of psychiatric patients for levels of obsessionality. They were also prone to emotional states that were not balanced by their intellect.
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Several researchers have found that women who feel the need to urinate frequently but who don’t have infections are more anxious and neurotic than those without the problem. It has also been found that symptoms of anxiety correlate with urinary urgency (feeling as if she can’t make it to the bathroom in time), needing to get up at night to urinate, and frequent urination.
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Many women can relate to urinary frequency around exam time at school or when trying to get to sleep at night while worried about something.

Chronic vulvar problems such as pain and itching are associated with stress from anxiety and irritation related to being controlled either by a partner or by a situation that in energy terms is equivalent to a partner. An example would be a woman who feels so “married” to a job that totally controls her that, unconsciously, she is not free to experience her life on her own terms. Medical intuitive Caroline Myss suggests that we might think of this external control as a modern-day “chastity belt.” A woman’s mate may control her either by forcing her to have sex or by withholding sexual activity that she desires.

Ruth came to see me with a history of recurrent vaginitis and urinary tract infections that had not responded to the usual treatments, such as antifungal creams and antibiotics. Her husband wanted sex every night, and she believed that filling his sexual needs was part of her “job.” She did love him, but she was often too tired to make love in the evening and his desires irritated her. Nevertheless, she forced herself to do it, even as her unconscious resentment grew. Like many women, Ruth equated having a lot of sex with having a “satisfactory” sex life. At first she denied to me that her sex life had any problems. I pointed out to Ruth that when she had sex she didn’t want, the normal lubrication associated with female sexual desire was not present, and this, coupled with the friction of intercourse, set the scene for vaginal and urethral irritation and inflammation. (It is very clear that when women engage in any sex that is traumatic to their tissues, infection and inflammation can result.) When tissue trauma is combined with a lack of receptivity and a feeling of not being able to refuse, then the immune system will be affected adversely, making healing from the trauma that much more difficult. Eventually, as part of her treatment, Ruth sought help through therapy and learned how to express her needs in a positive way that enhanced her marriage.

The sexual imperative of our culture—that desirable women serve men sexually—is largely what gets women into trouble in the first place: in other words, into sexual situations that don’t serve their needs and that are in fact harmful. Many women are conflicted between needing to be loved and needing sexual pleasure, on the one hand, and wanting to say no to intercourse, on the other. Gynecological problems in the vulva, vagina, and cervix are often related to a woman’s inability to say no to entry into this area of her body when she wants to refuse but doesn’t believe she should. These prob lems are quite literally related to allowing herself to “get screwed.” One of my patients developed chronic vaginitis, for example, when her college (illegally) refused to award her credit for courses that she had completed. At first, she decided that she had no choice but to accept their mistreatment because she didn’t want to “make waves.” Despite many external remedies for vulvovaginitis, however, she did not get better until she appealed her college’s decision about her cred its and then refused to back down. She was eventually awarded the credits due her, and her vaginitis cleared up.

Besides frustration and anger, another emotion that generally tends to affect our health adversely is guilt. When our guilt is centered on our sexuality, it can become associated with problems specific to our entry points. The sexual revolution of the 1960s and 1970s broke down some of our culture’s puritanical views about sexuality, but a sexually repressed culture cannot be healed just by taking off its clothes. Now it is even more important for women to be clear about their sexuality and their choice of sexual partners. It is especially important that women consciously use their freedom to understand what their bodies really want and not be led by the blandishments of partners who equate free dom with irresponsible behavior.

Scientific research supports the premise that certain emotional factors are associated with chronic urinary, vaginal, vulvar, or cervical problems, including cervical cancer.
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One study showed that, compared with women with other types of cancer, women with cervical cancer are more likely to have sexual ambivalence, lower incidence of orgasm during sexual intercourse, and a dislike of sexual intercourse amounting to an actual aversion. They have more marital conflict, as evidenced by the increased incidence of divorce, desertion, or separation.
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Another study was done on women who had severely abnormal Pap smears that required further evaluation to assess whether the woman had progressed to actual cervical cancer. The authors found that they could predict which women had progressed to cervical cancer based on the women’s responses to their questions about recent stressful life events. If a husband or boyfriend had been unfaithful, was drinking, or was running around, for example, a woman with cervical cancer would always say something like, “I should have left him, but I couldn’t because of the kids” or “I thought he needed me.” When responding to the same situation in their own lives, the women without cervical cancer would say, “I can’t trust him—he wants more than he gives.” In this same study, if a family member got a major illness or died, the women with cervical cancer would say, “I should have worked harder and taken better care of him [or her].” The women without cervical cancer, on the other hand, were more realistic about the limits of their respon sibility to others and about their ability to change the natural course of events.
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One could argue that because these studies were done in the 1950s and 1960s, their conclusions are no longer valid. However, a 1988 study revealed the same thing—that cervical neoplasia and subsequent risk for invasive cancer were more likely to develop in those women who were passive in their relationships, avoided an active coping style, and were more socially conforming and appeasing when compared with a control group whose Pap smears were more benign.
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A 1986 study showed that women scoring high on scales of helplessness, pessimism, and social alienation had a higher incidence of disease involving the cervix. These personality characteristics were measured before the diagnosis of cervical cancer was made, thus minimizing the possibility that it was the diagnosis of the cancer that caused the personality characteristics.
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On the other hand, those women who were resilient, optimistic, and had active coping styles tended to have Pap smears that did not reflect abnormal and invasive cells.

Most women with chronic vaginal, urinary, or vulvar problems have had them for years. These problems are usually associated with unexpressed complaints about a situation in their lives that has been accumulating for an equally long period. Clinically, it is well known that treatment for chronic problems of this nature is often unsuccessful if the psychological and emotional aspects of the problem are ignored. Unfortunately, many such women have been to scores of doctors, looking in vain for the physical cure for their problem.

In energy terms, a woman sets the stage in her body for chronic vul var, vaginal, or urinary problems when she
lacks the courage to change
the negative aspects of an unhealthy relationship. Women with these problems have often had boundary violations early in their childhoods, and so they confuse violation with love. In adulthood, when a woman stays in a relationship with someone she doesn’t respect or even like because she is afraid to leave—for whatever reason, be it fears about financial or physical insecurity, about being single, or about her own dependence—she is participating in a prostitute archetype. If she continues to have sex with someone whom she doesn’t respect or love, she is participating in an energy pattern that is associated with chronic vaginal, cervical, or vulvar problems.

ANATOMY

The vulva is the outermost point of entry into the female genital system, leading to the vagina, which ends at the cervix and its opening, known as the cervical os (
os
is an anatomical word for “entrance” or “mouth”). The cervix forms the entryway into the uterus and inner pelvic organs—the tubes and ovaries. (see
figure 9
, page 165.) The vulva comprises the labia majora (outer lips) and labia minora (inner lips). The outer entrance from the vulva to the vagina is known as the
introitus
. The pubic hair on the vulva forms a protective barrier to the more delicate tissues of the vagina and the cervix. The vulvar skin contains apocrine sweat glands, identical to those under the arms. Apocrine sweat glands differ from regular sweat glands in that their secretions are triggered by emotional situations, not just by physical exertion. The vulva “sweats” more than any other part of the body.

The bladder is located just above the vagina, while the urethra, the structure that leads from the bladder to the outside, can be felt as the protruding tube-like ridge that runs down the top part of the vagina to just above the vaginal opening. The clitoris is just above the urethral opening. The anus lies just below and in back of the vagina.

The vagina constitutes a passageway to the cervix, which is actually the lowermost part of the uterus (and is sometimes called the uterine cervix). The cervix protrudes into the uppermost part of the vagina and is covered by the same type of cells as the vaginal lining.