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More intimate geography
In Part VI of this series, we looked at Natalie Angiers Women: An Intimate Geography, an entertaining, very thorough examination/celebration of our bodies. We probed the intimate details of our eggs, our chromosomes, and our vaginas, ending with an intense look at the clitoris. In part VII, we continue in this vein with more about the clitoris, followed by the uterus, the breast, the ovary, and estrogen.
Having concluded that the clitoris was at the core of female sexuality, Angier states that we should reject any attempts, Freudian or otherwise, to downgrade it. She then describes the depth and variety of the clitoral-derived orgasm, including those who say that they climax best with the application of deep pressure within the vagina, a claim that led to gynecologist Ernst Grafenbergs proposal of the existence of a Grafenberg or G spot, a sort of second, internalized clitoris. Many contested this notion, still others have questioned the G-spots existence altogether. Angier feels, The roots of the clitoris run deep, after all, and very likely can be tickled through posterior agitation. In other words, the G spot may be nothing more than the back of the clitoris.
Angier looks at a study at the University of Sheffield where 28 women had small heated oxygen electrodes inserted in their vaginas. (Who is participating in these studies?) They were asked to masturbate to orgasm, to indicate when it began and ended, and to grade the intensity on a scale of one to five. The average orgasm turned out to be surprisingly long, lasting an average of 20 seconds. Yet the intensity rate had nothing to do with duration nor did the relative blood flow.
So this tells us .?
Next Angier goes into the issue of clitoridectomies saying, there are no official guidelines for what constitutes clitorimegaly, but anything projecting beyond the mollifying lips of the vulva is a candidate for clitoridectomy. When a baby is born with equivocal genitals, surgery was, and is, the norm. Why, she asks, is the clitoris so vulnerable to the hatchet? According to proponents, genital cutting serves several purposes. It supposedly tames a woman, abridging her innate wantonness and discouraging her from any thoughts of cuckoldry. Less familiar to westerners is the cosmetic objective of pruning, the desire to accentuate the visual discrepancy between female and male.
Angier confesses to feeling depressed by the persistence of the rite, and states, while we should be sensitive to cultural traditions, still she considers genital cutting as an extreme abuse of human rights.
Chapter five is about the prodigal uterus, the part of the body that is unique to women, that doesnt have an anatomical equivalent in the male It is in this chapter, particularly, that we are reminded of why women have had to go into such intimate anatomical detail in the process of liberating ourselves. Its in part because of this Galen character and his followers for the next 2,000 years who basically conceived of the female body as a males body turned inside out. That is, they saw the vagina as an inverted penis, the labia as a foreskin equivalent, the uterus as internal scrotum, and the ovaries as testicle equivalents.
Angier counters by telling us that, yes, the adult genitals are homologous, but in her version the ovaries correspond to the testes, the clitoris is the analog of the penis, the labia is equivalent to the scrotum, and both sexes have responsive breast tissue. The homology also breaks down with respect to the uterus. The uterus, she says, offers a clear case of presence vs. absence.
Angier reviews the medical men: Hippocrates believed that the uterus wandered untethered through a womans body, giving rise to womens failings, hence the word hysteria from the Greek word for womb. He also believed that the uterus had seven chambers lined with tentacles or suckers. This nonsense persisted until Leonardo Da Vinci drew an opened uterus fairly accurately but he illustrated a milk vein that went from the uterus to the breast, transforming blood from the pregnant uterus into milk.
Some physicians in the 19th century argued that the uterus competed with the brain for blood, thus a womans effort to improve her mind came at the expense of her fertility.
The war of the womb continues, Angier writes, as the abortion debate distills to who owns the uterus. Also, although one-half the population has one, the uterus is the site of two of the most common surgical procedures performed in the U.S: cesarean and hysterectomy. Angier argues that the uterus was and is a magnificent invention, a revolution in physiology. While it may have nothing to do with a womans brain it has everything to do with the brain of the fetus it bears.
She then takes up menstruationNot all women breed, but nearly all women bleed or have bled. She goes into the innumerable myths and taboos around menstruation, many attributable to medical men mentioned earlier: Hippocrates, Aristotle, and Galenor HAG as she calls them. Hippocrates argued that fermentation in the blood precipitated menstruation because women lacked the ability to dissipate the impurities in the blood through sweat. Galen believed it came from residual blood in food that women were unable to digest. Aristotle assumed that it represented the excess blood not incorporated into the fetus.
Angier writes that the notion of menstrual blood as toxic has pervaded our thinking for years, even though no studies have ever borne out the conviction that men can smell when a woman has her period or that menstruating women attract bears (so dont go camping). She quotes Camille Paglia on the subject: Menstrual blood is the stain, the birthmark of original sin, the filth that transcendental religion must wash from man
Angier points out that, rather than women being less competent during menses, the opposite is true. Research suggests, she says, that heightened activity, well being, and sexual desire often accompany the premenstrual phase of the cycle. Also, in the last few years, researchers have learned more about the endometrias productive capabilities. The uterus expresses hormones and releases them into the body, it makes proteins, sugars, and fats that prompt smooth muscle tissue to contract and expel decidua during menstruation. The womb also synthesizes and secretes beta endorphins and dymorphins (cousins to morphine and heroine). It makes anandamide, a molecule identical to the active ingredient in marijuana.
Angier feels that while we dont know how important this is to womens overall health or whether it continues after menopause, but such research indicates that we should be very cautious about removing the uterus. Yet every year 560,000 women in the U.S. are hysterectomized. (She refers to it as womb-shucking.)
This is kind of a mild response, isnt it? Shouldnt we be a little more than cautious?
Chapter seven deals with the breast. A womans breasts, argues Angier, are pretty, theyre flamboyant, theyre irresistible. But they are arbitrary, and they signify much less than we think.
Only the human breast inflates at puberty and remains engorged through life. No other organ except the uterus changes so dramatically. (By the way, the average bra size is 36 B and has been since the modern bra was introduced 90 years ago.)
Breasts weigh a few ounces in fact and a few tons in metaphor, writes Angier. They have been described as communal kiosk; they have been portrayed with snakes wrapped around them, dispensing poison as well as love; witches and devils have withered breasts; goddesses have many breasts; Amazons have mastectomies to improve their archery skills; women accused of witchcraft often had their breasts hacked off.
Linnaeus, an early scientist, introduced the term mammalia (of the breast); he also gave us our species nameHomo sapiens or men of wisdom. Thus, in Linneaen terms a female character (the lactating mama) ties humans to brutes, while the male character (reason) makes us separate. This was used as an argument to deny women rights (to vote, divorce, own property). Some 19th century scientists used breasts to demarcate various human races. European breasts was small and civilized; the African breast was flabby and pendulous like the udder of a goat.
Desmond Morris presented them as buttock mimicsthat is, pair bonding to raise children meant intercourse face-to-face rather than doggy-style, therefore the clitoris migrated forward, the breast arose to mimic the buttocks.
Angier says this is all fine but probably nonsense since women like a nice butt as well, and it could only indicate that we prefer the curved to the straight and narrow. (What?!) She is also skeptical about breasts as encouragement for sex as Several other primates, including bonobos and orangutans, also copulate face to face, and the females wear no sexual badges on their chests, no clever replicas of their narrow rumps or swollen vulvas. Nevertheless, they are sought afterin the case of bonobos, many times a day. What is P. paniscuss secret, and does she have a catalogue?
Because breasts play a part in reproduction, many theorists assume they developed to advertise fecundity. Others suggest that breasts evolved to deceive about a womans ovulatory status and mask issues of paternity. Others claim the breast is for fat storage needed during years of lactation. Still others (Helen Fisher of The First Sex, mentioned earlier in this series) speculate that breasts are womens pleasure chests. Elaine Morgan believes that humans spent part of the time in water and sees breasts as flotation devices for infants to cling to.
Angier says that breasts are a poor signal of a womans maternal worth; that there is no evidence for the aquatic theory. She thinks they are the bodys way of paying homage to the circle and that our mistake is attributing a grander meaning them. If breasts had something important to say, they would be much less variable and whimsical than they are. They would be like mere mammary glands, a teaspoon per breast per woman. If breasts could talk, they would probably tell jokesevery light bulb joke in the book.
Chapter eight, Holy Water, is about breast milk. Angier writes: As a sacred fluid, the milk of the Virgin ranks just below the blood that flowed from Christs wounds. But she says, The Madonnas was not the first latte to be exalted, not the last. She then tells the story of the Greek god Zeus who sought divinity for his son Hercules, born of an affair with the mortal Alcmene. Zeus sneaks into the bedroom where his wife Hera is sleeping and puts Hercules to her breast for a taste of infinity. Hercules suckles so hard that Hera awakens and shakes him off in outrage, spurting milk across the skieshence the Milky Way.
While menstrual blood is considered polluted, a womans breast milk is considered pure. Yet throughout history breastfeeding has occasioned spleen and hectoring . Lactation has not been allowed to be what it is, the business of the body. Few know much about it.
Angier points out that the breast can be thought of as a modified sweat gland, but also as a modified placenta as they are both specialists, temporary workers designed to nourish a baby. And regardless of a womans nutrition, her milk is nutritious. It is a product of the mammary gland, Angier writes, some components taken from the mothers bloodstream, others are made in the alveolar cells. milk is often billed as natures perfect food, and in this case the ad copy is accurate. It is all that a newborn mammal needs to survive.
Yet, 40 percent of infants in the U.S. are bottle fed, and of the babies that are breast fed to start, only half receive breast milk at the age of six months. By a year 10 percent are still breastfed. Angier then gives some interesting historical information on breastfeeding:
- Wet nursing was used mostly by the wealthy until the 17th century when half or more of all women were sending their babies to wet nurses. Only 10 percent of Parisian babies in 1780 were nursed in their own homes.
- Some suggest that cows and goats were domesticated to feed babies.
Neither wives nor wet nurses were supposed to have intercourse while breastfeeding, for it was thought that breast milk was formed in the uterus from menstrual blood. Intercourse was thought to cause menstruation, which would taint the flow of milk. So if a woman didnt breastfeed she became pregnant sooner. Wet nurses freed women to spend more time pregnant.
- In 1694, Mary Astell wrote A Serious Proposal to the Ladies, arguing that breastfeeding acted as a check on excessive pride.
- Jean Jacques Rousseau attacked women who would not suckle and Linnaeus condemned wet nursing.
- William Cadogan wrote in Advice to Mothers in 1769 that mothers needed the advice of medical men when it came to breastfeeding: In my opinion, this Business has been too long fatally left to the Management of women who cannot be supposed to have proper knowledge to fit them for such a task.
- Mary Wollstonecraft in A Vindication of the Rights of Women urged women to breastfeed, claiming that a husband would feel more delight seeing his child suckled by its mother, than the most artful wanton tricks could ever raise
- In 1793, the French government decreed that if a mother didnt breastfeed her child she wouldnt be eligible for welfare payments.
- In 1794, the German government required all women to nurse their young.
- After the 18th century, wet nursing became less popular and by the 20th century infant formula had replaced it. Before 1930, most U.S. women breastfed. By 1972, only 22 percent did and then for only the first few weeks of life.
Currently, breastfeeding advocates have made some progress, particularly among educated women who now breastfeed at a rate of 75 to 80 percent. Breastfeeding is back in style.
Angier concludes the chapter: This stylishness is decidedly to the good, for infants thrive on breast milk . Still the tone of some of the La Leche-style sounds suspiciously similar to the tracts by Cadogan and Rousseaujudgmental and absolutist. (Not quite the same, surelythey were patriarchal nits, after all.)
Angier writes, Can we forgo the polemics and exercise a little more maternal compassion here? In the real world of the two-career family, most women will breastfeed for the first few weeks or months . Like women throughout history they will do the best they can under the constraints of work, duty, and desire . Whatever they do they will feel guilty for not doing enough, and they will wish that they too could drink from the breast of Mary or Hera, thus becoming immortal mothers whose children will never die.
Chapter nine, A Gray and Yellow Basket, is about the ovary, which Angier says is dull and gray, the size of an almond in the shell, but lumpy. It is the eggs basket.
Here we learn that until girls and boys are three or four a hormone pulse secretes tiny bursts of reproductive hormones. A girls ovaries respond and she is likely to be slightly waggish and slightly erotic and her body, all bodies, fascinate her. At the end of toddlerhood the pulse generator shuts down and she is likely to turn prudish. At around the age of ten, the adrenal glands, the blood-rich structures that sit atop the kidneys like porkpie hats, secrete adrenaline, the fire-under the butt hormone, and they also release small doses of sex hormones. Says, Angier: It is possible that the brain adjudges reproductive readiness by fat content, as a rule of thumb is that when a girl reaches 100 pounds she pubesces regardless of her height and age. Whatever the trigger, the ovaries are ready to roll. They are the primary source of sex hormones that sexualize the bodywhich cause pubic hair to grow and eventually for menstrual blood to flow.
Angier tells that the cycle is not dull but dynamic and athletic. Even Victorian anatomists were astounded by the ovarian cyclesome fascinated, many disgusted. For instance, Rudolf Virchow, the father of modern pathology, compared it to teething, causing pain and the liveliest disturbance of nutrition and nerve force. Historian Jules Michelet wrote of it as a woman being wounded each monthwhich is at the center of a physiological and psychological phantasmagoria dominating her life. Havelock Ellis saw the monthly release of an egg as a worm that gnaws periodically at the roots of life.
Angier sums up these patriarchs: The ovary may be almond in size, but to the voyeurs among Victorian physicians, it certainly was no almond of joy.
She goes on to describe the ovulatory cycle in detail concluding that the ovulatory cycle is a matter of physiology, and it occurs more or less on its own. But it is not entirely deaf to the cyclist.
Studies of the cycles of roommates have shown menstrual synchronicity, particularly in a 1971 study by Martha McClintock that was published in Nature magazine. Subsequent studies have either confirmed or refuted the synchronicity theory. Studies of rats show females strive to ovulate and conceive within a week or two of each other, possibly because pooling puppies seems beneficial. Also, if a female rat falls out of sync, she ends up giving birth to a litter composed largely of daughters. Rather than the standard half male/half female brood the theory being that if only one or two pups are going to make it, its best that they be females. Says Angier: Among rats (and many other species), daughters are the safe sex, sons are the high-risk sex. Daughters are government bonds; sons are junk bonds.
In 1998, McClintock published a major report in Nature confirming that we have some rat in us: that ovaries are susceptible to the sway of the group. Swabs from the armpits of women at different points in their ovulatory cycle were applied to the upper lips of other women. The secretions either hastened or prolonged the cycles of many, though not all, of the women exposed to them.
Angier tells us that a lot of this research about synchronicity is still in dispute. Women who live with men, for instance tend to cycle more predictably than women who live alone, and regular cycling augments the chance of conception. A woman might be responding to pheromones from the mans armpit or groin. Or it could be that pleasure, like the presence of other females, can have congress with the ovaries and sway the timing of ovulation. Or maybe a follicle, on feeling the tremblor [as a result of orgasm] will quicken the pace of maturation and tell the brain, Hurry up, please, its time, and the brain will respond with an LH surge, the ovums hymn of freedom.
In chapters ten and eleven, Angier takes up the history of hormones, focusing mostly on estrogen. Lately, she says, there has been a hormone renaissance. (Hormone comes from the Greek horman, which means to arouse, to excite, to urge). It is fashionable, she writes, to ascribe such supposedly male traits as the tendency to swagger, posture, interrupt, and belch in public to testosterone. And gals on a shopping trip become estrogen sinks or waft billows of estrogen.
There has been an explosion of hormone research as hormones seem to be a quantifiable way to distinguish men from women, competitor from cooperator, domesticated from feral. The key hormones for women are estrogen, progesterone, testosterone, oxytocin, and serotin. Yet scientists truest love, says Angier, is estrogen. They have created a pharmacopoeia of synthetic estrogens, etc. Women are exposed to constant contradictions: we have too much estrogen, we have too little, it keeps our hearts strong, our wits sharpestrogen has become a Marvel comic superheroine.
She then tries to separate what we know and what we dont know from the parables. Here are some of the things we now know:
- From age 12 to 50, women have 3 to 10 times more estrogen circulating through the bloodstream than men, but after 50 a mans gradually rises as a womans declines.
- A given organ is sensitive to estrogen if the cells of that organ contain estrogen receptors. In that case it takes very little to get a big response, as women are very sensitive to estrogen
- From a recorded case of a man without estrogen receptors, scientists have concluded that estrogen is essential for the maturation and preservation of bones in men as well as women.
- Estrogen affects the onset of diabetes
- It is important in maintaining the body in later life, but is not essential to fetal survival
- There is no association between rates of intercourse and where a woman is in her ovulatory cycle (we do not have sex more often during ovulation, the only statistical high point is the weekend).
- There is no correlation between estrogen levels and physical arousability
- A number of researchers have suggested that it is testosterone not estrogen that is the true hormone of the libido in men and women alike. But the evidence suggests that for women, testosterone is the hand- maiden to estrogen
- Estrogen is a promoter, not an initiator
Angier looks at teen girls: Who can forget adolescence? And who has ever recovered from it? At puberty, there is an often-overlooked correspondence between this period of crisis and frailty for girls and the hormonal squall in her head (as well as the mixed cultural messages she is getting). She suggests that girls learn from other girls and women and defy the magazines. Glue rubber insects and Monopoly hotels on top of a bathroom scale Sports help . Sticking by your girlfriend helps . Learn to play the drums. The world needs more girl drummers. The world needs your wild, pounding, dreaming heart.
- Hormone therapy works: it reduces mortality by an impressive margin. According to a 1997 report from a Nurses Health Study, women on hormones has a 40 percent lower risk of dying than women who had never taken themmostly as a result of a decline in heart disease. However
- Hormone therapy helped those who needed it mostsmokers, those with high blood pressure and cholesterol levels; for women in good shape there was no statistical benefit.
- Survival benefits declined with duration of usethe rate of death from breast cancer cancelled the reduction in coronary disease.
- Other studies on long-term (ten years or more) hormone replacement therapy (HRT) showed that it is associated with a 50 percent hike in the risk of breast cancer.
- Some studies show HRT may reduce the risk of Alzheimers by 50 percent.
- Many say that it makes them feel smart again, but estrogen doesnt improve a womans IQ.
Hmm, gluing rubber insects, and other individual solutionsthat seems a pretty pathetic way to confront the thousands of pages of media messages and patriarchal/sexist attitudes about teenage girls.
Chapter 12 deals with menopause or can we live without estrogen? Angier asks, what is it about womens health issues that turns people malign? Hysterectomies, cesarean sections, abortions, mammograms, hormone therapy: our bodies, our hells . Here we are saddled with another gynecrisis, another source of anguish over the cantankerous merchandise the female body, this crisis perhaps the biggest one ever. By the year 2000 there will be about 50 million women in the United States over the age of fifty, all of them potential candidates for hormone therapy. If every one of them were to take hormone pills for the next thirty years that amounts to 1.5 billion woman-years of drug consumption.
Naturally, most gynecologists and internists think hormones are the right choice for menopausal women. Angier gives us a few salient facts:
In the U.S. 46 percent of post-menopausal women take or have taken hormone therapy. But it turns out one of the biggest reasons women reject HRT is that they have positive feelings about menopausethey dont think of it as an illness, so whats to treat?
Comparing a group of 45-year-old women who expressed an intention to use hormone therapy after menopause with a group who planned not to, researchers in London found that there was little significant difference in the womens health or socioeconomic status, but that HRT intenders reported significantly lower self-esteem, higher levels of depressed mood, anxiety, and negative attitudes to the menopause. They also expressed stronger beliefs in their doctors abilityas opposed to their ownto control their menopause experience.
Angier notes that doctors have not responded well to talk about menopause as natural (would she be referring to efforts by the womens movement?). To get women to take HRT, they must raise issues of infirmity, weakening heart, crumbling frame, and enfeebled mind. If a woman asks her doctor why women lapse into this precarious state of hormone deficit in midlife and why nature has not better equipped them for their sovereign years, a doctor will reply, if it were up to nature, we wouldnt be having this conversation and I wouldnt be writing this prescription if it were up to nature, you, my postreproductive doyenne, would already be dead.
Or would you? Lets ask that old woman out there in the field, the one with the shovel in her hands. Shes digging up something, and it sure doesnt look like her grave.
As readers can see, this book is fun to read, and its liberating get inside Angiers mind and sense of humor. She combines science with common sense and an irreverence for the established views and studies. But a fair amount of the relevant information has been made available through Our Bodies Ourselves, which she references twice, briefly. There are no indexed references to the womens movement, a few brief, partly negative, references to feminism, no referenes to any more radical womens health writers, and mostly individual solutions to what are clearly systemic problems and continued patriarchy and sexism in the health and science fields. Everyone should read it, yes, absolutely. Especially for one of the issues we will cover in Part VIIIher take on evolutionary psychology. Z