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Q- How much do you know about vulvovaginal health?
A- Probably not enough.

Being comfortable with your body is not a matter of modesty- it’s a matter of good health. For the first time, women have all the vulvovaginal information they need in The V Book. This is not a gynecological sourcebook. There’s nothing about your periods or pregnancy. That information is plentiful elsewhere. The V Book focuses specifically on vulvovaginal matters: the latest research translated into understandable explanations, combined with my experience, the insight of my colleagues, and a framework that aims to make this knowledge both accessible and interesting.

The V Book is divided into three parts: what to know and do when you’re well, what to know and do when you develop a problem, and an in-depth guide to specific problems and their treatments.

Part One: Owner’s Manual starts far away from the V zone—in your head. In order to feel more comfortable reading about the vulva and vagina—let alone talk about them with your clinician or anyone else—it’s useful to understand why this is such a difficult topic for most women. Chapter 1 (The Mind) walks you through this short history of the vulva and vagina—from celebration to confusion to a whole lot of blushing.

Chapters 2 (The Vulva) and 3 (The Vagina) are perhaps the most important of all; they take you on an eye-opening walk through V anatomy. Because the Vs are anything but static organs, Chapter 4 (At Different Ages) explores how this anatomy changes, from before birth to the menopause. Once you understand what’s what, you’re ready to learn how to keep everything healthy (Chapter 5: V Smarts). That includes everything that comes into contact with the area, from tampons and pads to underclothes, soaps, feminine-hygiene products, even hot wax and razor blades for hair removal. Finally, because sexual function is the primary feature of these organs, I’ve given it a separate chapter (6: Sex Matters).

Part Two: When You Need Help is a handy reference for the inevitable times when things don’t feel “right.” (Though it’s a good idea to read it over when you’re feeling perfectly fine!) Chapter 7 (The Most Bothersome Symptoms) maps out exactly what its title implies: what causes odor, itching, unusual discharge, and dryness, and what you should know about these oh-so-common conditions. Chapter 8 (Now What?) is designed to help you decide how to proceed with self-care or a medical appointment when symptoms develop. I explain why you can’t get a good diagnosis over the phone and how to find a good V clinician.

You’ll notice throughout the book that I use the word “clinician” instead of doctor. That’s because physician’s assistants (PA) or certified nurse-practitioners (CNP) do an amazing job caring for women. A woman often sees a PA or NP instead of or in addition to a physician for vulvovaginal care. “Clinician” is therefore a more accurate, all-inclusive term than “doctor.” A complete run-through of what you should expect from your clinician during an office visit appears in Chapter 9: The Ideal V Exam. Not only do I explain you what’s happening on the other side of the stirrups, but I’ll tell what tests you want to be sure you get to diagnose a V problem, what your Pap is all about, and how to make pelvic exams less miserable.

Finally, Part Three: Problem and Answer Guide, covers all the V-disorders. You don’t need to know about all of them in such depth. But if you do develop one of these conditions, I can assure you that you can’t possibly read enough on it. I start with all the most common problem, the various sorts of vaginitis (vaginal irritation usually caused by an infection): yeast infections (Chapter 10), bacterial vaginosis (Chapter 11), trichomonas (Chapter 12), and then a roundup of other types, such as atrophic vagnitis and strep vaginitis (Chapter 13).

Next come all kinds of skin disorders, many of which are familiar elsewhere in the body but can affect the vulva, too. These include allergies to semen, latex, yeast, and other sources (Chapter 14); the diseases eczema, psoriasis, lichen sclerosus, and lichen planus (Chapter 15); and assorted other V bumps and color changes (Chapter 16).

In addition to vaginitis and skin disorders, there’s a third major V problem that is of great interest to me-- pain. Vulvodynia (vulvar pain) and vestibulodynia (pain in the vestibule) are just beginning to be recognized by doctors, but they have plagued many women for years. Fortunately, there are some exciting advances in their treatment. Chapter 17 (It Hurts) provides a run-down on V pain never before available to women. Chapter 18 (Sexual Healing) also contains previously unavailable material on maintaining sexuality when intercourse is painful. Though not part of your genitalia, the urinary tract can have two pain problems —bladder infections and interstitial cystitis—that produce V symptoms; they are highlighted in Chapter 19 (Bladder Pain).

Next come two viruses that have become epidemic, with serious impact on V health: genital herpes (Chapter 20 : The Lifetime Virus) and Human papilloma virus or HPV (Chapter 21:The Crafty Virus). The herpes chapter is so named because it is a permanent infection, which those who have it need to learn to live alongside (which yes, can be done). The HPV chapter uses the word “crafty” because this can cause annoying genital warts, produce worrisome Pap test results, or remain present with no symptoms at all. HPV is what causes cervical cancer. Chapter 22 covers vaginal and vulvar cancer. These are rare, but a book of this sort would not be complete without including them. The final chapter (Chapter 23: V is for Voice) sums it all up.

I’ve included complete medical references so that your clinician can reference any topic I’ve covered that you wish to discuss with him or her.

Let me be clear that The V Book is not out to change modesty. Private parts are meant to stay private. But The V Book is designed to help you realize that the vulva and vagina should not be private to you.

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