<h3>Excerpt</h3> <div><div> <h2>CHAPTER 1</h2> <p>Meet Your Incredible Pelvic Nerve</p> <p>The poetic, the scientific, the erotic - why should the imagination care which master it served?</p> <p>- Ian McEwan, "Solar"</p> <p>Spring 2009 was beautiful. I was emotionally and sexually happy, intellectually excited, and newly in love. But it was a spring in which I also, slowly, started to realize that something was becoming terribly wrong with me.</p> <p>I was forty-six. I was in a relationship with a man who was extremely well suited to me in various ways. For two years, he had given me great emotional and physical happiness. I have never had difficulty with sexual responsiveness, and all had been well in that regard. But almost imperceptibly, I began to notice a change.</p> <p>I had always been able to have clitoral orgasms; and in my thirties, I had also learned to have what would probably be called "blended" or clitoral/vaginal orgasms, which added what seemed to be another psychological dimension to the experience. I had always experienced a post-coital rush of good emotional and physical feelings.</p> <p>After lovemaking, as I grew older, usually, after orgasm, I would see colors as if they were brighter; and the details of the beauty of the natural world would seem sharper and more compelling. I would feel the connections between things more distinctly for a few hours afterward; my mood would lift, and I would become chattier and more energized.</p> <p>But gradually, I became aware that this was changing. I was slowly but steadily losing sensation inside my body. That was not the worst of it. To my astonishment and dismay, while my clitoral orgasms were as strong and pleasurable as ever, something very different than usual was happening, after sex, to my mind.</p> <p>I realized one day, as I gazed out on the treetops outside the bedroom of our little cottage upstate, that the usual post-coital rush of a sense of vitality infusing the world, of delight with myself and with all around me, and of creative energy rushing through everything alive, was no longer following the physical pleasure I had certainly experienced. I started to notice that sex was increasingly just about that physical pleasure. It still felt really good, but I increasingly did not experience sex as being incredibly emotionally meaningful. I wanted it physically - it was a hunger and a repletion - but I no longer experienced it in a poetic dimension; I no longer felt it as being vitally connected to everything else in my life. I had lost the rush of seeing the connections between things; instead, things seemed discrete and unrelated to me in a way that was atypical for me; and colors were just colors - they did not seem heightened after lovemaking any longer. I wondered: What is happening to me? Although nothing else in my life was going wrong - and though my relationship continued to be wonderful - I began to feel a sense of depression; then, underneath everything, a sense of despair. It was like a horror movie, as the light and sparkle of the world dialed downward and downward - now, not just after lovemaking, but in everyday existence. The internal numbness was progressing. I could not pretend I was imagining it. An emotional numbness progressed inexorably alongside it. I felt I was losing, somehow, what made me a woman, and that I could not face living in this condition for the rest of my life.</p> <p>I could not figure out, from anything I had researched, what could possibly be causing this incredible, traumatic loss. One late night, sitting by the cold iron wood stove, alone, frantic with questions, and feeling hopeless, I began literally bargaining with the universe, as one does in times of great crisis. I actually prayed, proposing a deal: if God (or whoever was listening; I would go with anyone who was willing to take the call) would somehow heal me - somehow restore what I had lost - and if I learned anything worth knowing in the process, I would write about it - if there was the least chance that what I had learned could possibly help anyone else.</p> <p>With a heavy heart - afraid to hear that nothing could be done for me - I made an appointment with my gynecologist, Dr. Deborah Coady. In this I was extremely fortunate, since she is one of the very few physicians who specialize in the aspects of the female body that, it would turn out, I was being affected by: problems with the pelvic nerve.</p> <p>Dr. Coady is a lovely woman in her forties, with soft light brown hair that falls to her shoulders, and a face that has a certain expression of gentle fatigue and receptivity to others' pain. Because of her specialty in female pelvic nerve disorders, and, in particular, in one of its painful variants, which thankfully I did not have, called "vulvodynia," she often sees women who are experiencing a broad range of suffering. This has made her unusually careful and compassionate.</p> <p>Dr. Coady examined me, asked questions in a quiet voice, and finally told me she believed I was suffering numbness from nerve compression. I was so panicked at this point about what I was losing in terms of the emotional dimensions of my life and my sexuality - and so terrified of losing any more - that she took me into her private office.</p> <p>There, in an effort to reassure me, she showed me two "Netter images" - beautifully drawn full color anatomical illustrations. Frank Netter was a gifted medical illustrator, whose images of various parts of the human body are visual classics, collected by some neurologists, gynecologists, and other specialists, to help them explain abstract medical realities, in a vivid way, to their patients. The first image depicted the way that the pelvic nerves in women branch out to the base of the spinal cord. Another showed how a branch, which originates in the clitoris and dorsal and clitoral nerve, arches elegantly to branch to the spinal cord, while other branches curve sinuously, originating in the vagina and also in the cervix. The nerve branches from the clitoris and vagina go to the larger pudendal nerve, whereas the nerve branch originating from the cervix goes to the larger pelvic nerve. All of this complexity, I would learn later, gives women several different areas in their pelvises from which orgasms can be produced, and all of these connect to the spinal cord and then up to the brain.</p> <p>Dr. Coady suspected that my problem was a spinal compression of one of the latter branches.</p> <p>But she wanted to assure me that because of the way women were wired, no matter how bad the spinal compression that she suspected I had might prove to be, I would never lose the ability to have an orgasm, from the clitoris. Minimally comforted, I left her office, with an appointment for an MRI, and a referral to Dr. Jeffrey Cole, New York's pelvic nerve man.</p> <p>I met with Dr. Cole at the Kessler Institute for Rehabilitation, which he helps to lead, in Orange, New Jersey. A calm, quietly amusing man, with an old-fashioned, reassuring manner, he had looked at my initial x-rays, had examined my posture as I stood before him, and then had urgently written me a prescription for a hideous black back brace.</p> <p>Two weeks later, I went back for a follow-up visit with Dr. Cole. Azaleas were now in bloom - it was still the loveliest part of the spring - but I felt almost faint as I sped into the suburbs in the back seat of a battered taxi. I was also very uncomfortable, since, for the past two weeks, I had been wearing the prescribed back brace. It extended from above my hips to below my rib cage, and it made me sit up perfectly straight.</p> <p>I was really scared to hear what Dr. Cole had to say, since I knew he now had my MRI results. The MRI, Dr. Cole informed me, showed that I had lower back degenerative spinal disease: my vertebrae were crumbling and compressed against each other. I was very surprised, having never had any pain, or any problem with my back at all.</p> <p>He startled me by showing me the additional x-rays he had taken during the last appointment; there was no way to miss or misread it: on "L6 and S1," my lower back, my spinal column was like a child's tower of blocks that had slid, at a certain point, exactly halfway off central alignment - so that half of each stack of vertebrae was in contact with the other, but half of each ended in space.</p> <p>I dressed and sat in Dr. Cole's consultation office. He put me through an unexpectedly tough and direct interview: "Did you ever have a blow to your lower back?" "Did anything ever strike your lower back?" He said it was a serious injury and that I must have some memory of having sustained it. I repeated that I had no memory of any such trauma. When I finally realized what he might also be asking, I confirmed that no one had ever hit me.</p> <p>But after about five minutes of this back and forth, I realized that yes, I had indeed once suffered a blow. In my early twenties, I had lost my footing in a department store, fallen down a flight of stairs, and landed on my back. I hadn't felt much pain, but I had felt shaken. An ambulance had arrived; I had been taken to St. Vincent's Hospital and x-rayed. But nothing had been found to be the matter, and I had been released.</p> <p>Dr. Cole took in the information and ordered another series of images - this time a more detailed x-ray. He also performed an uncomfortable test in which he shot electrical impulses through needles into my neural network, to see what was "lighting up," and what had gone dark. In our third meeting, also at the suburban facility, I was back on the exam table. Dr. Cole explained that the new set of x-rays had revealed exactly what the matter with me was. I had been born, he explained, with a mild version of spina bifida, the condition in which the spinal vertebrae never develop completely. The blow from twenty years before had cracked the already fragile and incompletely formed vertebrae. Time had drawn my spinal column far out of alignment around the injury, which was now compressing one branch of the pelvic nerve, one of the branches Dr. Coady had shown me in the Netter image - the one that terminated in the vaginal canal.</p> <p>I had been unbelievably lucky never to have had any symptoms until then, he said. Given the severity of my injury, it was fortunate that, though I had increasing numbness, I had had no pain. Much though I disliked working out, it seemed that a lifetime of grudging exercise had strengthened my back and abdomen enough to have kept any worse symptoms from manifesting until then. But time had done its work: where the two sections of spine were misaligned, the pelvic nerve was entrapped and compressed, and the signals from one of its several branches were blocked from moving up my spinal cord to my brain. The neural impulses from that part of my body had "gone dark." I wondered if this had something to do with how I felt - or was not feeling - after sex, though I was too shy to ask. He explained that I would need to consider surgery to fuse the vertebrae and to relieve the pressure on the nerve.</p> <p>After I had walked for him so he could check my gait to make sure my legs had not been affected, and after he had measured my shoulders to be sure they were level, I mentioned to him - perhaps partly for a second opinion, for reassurance - that Dr. Coady had assured me that my clitoral orgasms would not be affected, even if the branch of the pelvic nerve that was injured did not ever get better. He agreed that that was correct; if the clitoral branch of the network were to be affected, it would have been so by then. The fact that that branch was unaffected was an accident of my wiring. And then he explained casually, "Every woman is wired differently. Some women's nerves branch more in the vagina; other women's nerves branch more in the clitoris. Some branch a great deal in the perineum, or at the mouth of the cervix. That accounts for some of the differences in female sexual response."</p> <p>I almost fell off the edge of the exam table in my astonishment. That's what explained vaginal versus clitoral orgasms? Neural wiring? Not culture, not upbringing, not patriarchy, not feminism, not Freud? Even in women's magazines, variation in women's sexual response was often described as if it were predicated mostly upon emotions, or access to the "right" fantasies or role playing, or upon one's upbringing, or upon one's "guilt," or "liberation," or upon a lover's skill. I had never read that the way you best reached orgasm, as a woman, was largely due to basic neural wiring This was a much less mysterious and value-laden message about female sexuality: it presented the obvious suggestion that anyone could learn about her own, or his or her partner's, particular neural variant as such, and simply master the patterns of the special way it worked.</p> <p>"Do you realize," I stammered, not self-possessed enough in my astonishment to consider that the debate I was about to describe might not have been as momentous to him as it was to me, "you've just given the answer to a question that Freudians and feminists and sexologists have been arguing about for decades? All these people have assumed the differences in vaginal versus clitoral orgasms had to do with how women were raised ... or what social role was expected of them ... or whether they were free to explore their own bodies or not ... or free or not to adapt their lovemaking to external expectations - and you are saying that the reason is simply that all women's wiring is different? That some are neurally wired more for vaginal orgasms, some more for clitoral, and so on? That some are wired to feel a G-spot more, others won't feel it so much - that it's mostly physical?" </div></div><br/> <i>(Continues...)</i> <!-- Copyright Notice --> <div><blockquote><hr noshade size="1"><font size="-2">Excerpted from <b>Vagina</b> by <b>Naomi Wolf</b>. Copyright © 2012 by Naomi Wolf. Excerpted by permission of HarperCollins Publishers.<br/>All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.<br/>Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.</font><hr noshade size="1"></blockquote></div>