Few people know exactly where the clitoris is located and how many openings the female genital area has. Gynecologist Mandy Mangler on male and female anatomy gaps, clitoral ghosting and the desire to please.
BRIGITTE WOMAN: Mrs. Dr. Mangler, in a recent British study, men and women were asked to name the different parts of the vulva on a diagram. What do you think: what percentage were unable to identify the clitoris?
Mandy Mangler: I assume very few people know the exact extent of the organ and what the overall structure inside the body looks like. If it’s all about the visible part at the top of the vulva known as the clitoris: maybe 40 percent?
Pretty good. It was 37 percent. And only nine percent were able to label all seven parts correctly. So the clitoris, the inner and outer labia, the vagina, the bladder outlet, the anus and the perineum.
Did women do better than men?
For the vagina and anus only. For the clitoris, for example, there was no difference.
In the case of the clitoris, there is certainly a reason why it has been downright ghosted by science for centuries. There are still textbooks in which it is not presented correctly. Many gynecologists also have difficulties with the complete assignment under the skin surface. On the other hand, if you consider how present the penis is, just in pornography.
And in art. in jokes. On toilet walls.
The penis clearly has the greater visibility. There are also thousands of studies on the penis and erection, because men find it extremely exciting to examine and measure and quantify everything about it.
And it is still men who sit on the money pots in research.
Yes, the gynecologists should actually be screaming and saying all the time: is it still okay? If it were the other way around, and if the penis were as disregarded as the clitoris for just one day—both anatomically and sexually—there would be something going on. I also find it bizarre that the vagina is still seen as the counterpart to the penis.
Instead of the clitoris.
Yes. During sexual arousal, the clitoris swells. There’s more blood flow, and this is where all the sensitive nerves are. She is responsible for the desire. Just like the penis. The vagina is just a boring tube of skin and muscle fiber with few nerves.
What do you experience in your practice? Do the women call their sex organs by their names?
It is rare for a woman to say the word vulva on her own. A small proportion of older and younger patients are well informed and use it, but that is maybe ten percent.
What are the patients saying instead?
They say “downstairs” or vagina. Or they say “externally” and then describe their symptoms. Many women also project their vulvar problems onto something else, such as the bladder or abdomen.
Why are we strangers to the word vulva?
Because it’s still rarely used. It is not present in kindergartens and schools and women have not learned it – the word is not yet sufficiently used in common parlance. While social media users may feel that there is more awareness of the vulva, it just can’t be said enough times for people to finally realize that this isn’t about the vagina, it’s about the vulva.
And instead of labia, we can better speak of vulval lips. The word shame is judgmental and inappropriate.
Apart from the correct term – how do you, as a doctor, notice that many women are not very familiar with the anatomy of their sex organs?
It starts with the appearance of the physiologically normal vulva – which varies extremely, but is often not accepted. The vulval lips are then too big, too small, too brown, not pink enough… I am asked if they could be cut off.
Vulval lip corrections are considered to be the fastest growing trend in cosmetic surgery.
Yes, and I see aesthetic surgeons who are very quick to say: Let’s cut something here and there too, bang, bang! Everything in me resists. I find that so pointless, even if I basically say that everyone is the boss of their own body and should do with it what they want. But such an intervention does not change the dissatisfaction with one’s own sexuality.
It also helps to know your own anatomy well.
This is crucial. For example, when women have orgasm problems, it often causes them to lose interest in sex. The men then say: women want less sex than we do. Not correct. We don’t want less sex, we just want sex differently. But if sex is all about penetration and ejaculation, why should a woman be interested in it? Sexuality is still thought of according to this pattern.
That’s why the idea of foreplay is so persistent: penetration is still considered the actual act.
We can eliminate the word foreplay from our vocabulary. There is a shared sexuality and it encompasses everything you do together.
What else needs to change?
Let’s start with the girls. I wish so much for them that they put themselves completely in the foreground and say: I only do things that aim to make me happy, I don’t do anything else. I will not do things I don’t like to please someone else.
A good intention for adult women, too.
It’s correct. And they should try what feels good. For example, many do not know that part of the clitoris lies under the outer vulval lips and that touch is very pleasant there. We were taught in anatomy studies that fat tissue is.
I know women who say: When, please, should I masturbate, I’m never at home alone.
Female, self-evident masturbation is also not desired at all. Because it leads to sexually enlightened women. If we dealt with our vulva and pleasured ourselves on a large scale, we’d have a better idea of what we wanted and didn’t want.
After all, men benefit when their partners have maximum fun…
Yes, it would be a win-win situation. But the men think they are giving up something, namely a nice situation in which they don’t have to worry about anything and then fall on the pillow satisfied. That too must be abolished urgently, this thinking that sex is over when the man ejaculates. Sadly enough, if the man had an orgasm in front of the woman, but then he can continue the lovemaking for a nice hour.
But that can put women under pressure to succeed.
You shouldn’t stress about it, sex is also a game. And some women find non-orgasmic sex exhilarating and satisfying. Especially at the beginning of a relationship you are often so euphoric that the sex is great at first, even if you don’t necessarily have orgasms.
But over time it gets annoying.
Yes, and then you have to say it, even if it’s easy to say and hard to do.
Do you have a practical text example?
Dude, I’ve been looking at this for two years now – or 20 – and honestly I don’t like it. We have never managed to implement sexuality in such a way that I reliably have orgasms. But it is a great challenge to explore this together now. And you can still thank me for researching it with you and not with the neighbor. So I cordially invite you to try out with me on my vulva tonight, everything that is beautiful for me. I’m not sure myself, we’ll find out.
Strong speech!
I just think men can still learn a lot about the vulva and women’s sexuality. As a man, that would be very important to me. That also increases the bond. If I have a sexually satisfied wife, then I can use it to compensate for other deficits: My wife has fun – not that bad that I have a little tummy.
Or also: no more stable erection.
Exactly, that’s what’s on top of that: that at some point the men can no longer perform as they wish and would rather not have sex at all. With that, the shared sexuality was done for us women as well. And the women often accept it without comment, that’s tragic.
Age-related changes in the vulva and vagina can also be a problem for women – keyword: vaginal dryness.
Yes, there are women who say: penetration feels like a knife in my vagina. These women should leave it alone. No penetration, that’s logical!
And if you want it?
The more regularly you have sex, the better the blood supply to the entire pelvis, and sex also means masturbation. Yoga and dancing and any form of pelvic floor training also lead to good blood circulation. This means that there is more moisture, no matter what age. And coconut oil helps a lot too.
For many years we have been experiencing greater sexual freedom and self-determination than ever before, while at the same time we see an image of women on Instagram & Co that propagates maximum conformity: shapely, perfectly styled, available. Where would you place us women today?
Today we have the opportunity to deal well with our femininity and our sexuality. But I still see this extreme desire in women to want to please. And I don’t think that’s ideal. My wish for us is that we find our own rules of the game. They are necessary for us to be a good, diverse society. Men have worked their way into a comfortable position over the centuries. And now we have to change it so thoroughly and creatively that in the end we are represented with our interests in the same way – also in terms of sex.
The study
How many orifices are there in the female vulva, and what are the seven parts of the female external genitalia called? Women and men in the waiting area of a British clinic were asked to answer this using a questionnaire. Only 46 percent of the 191 study participants knew that the vulva has three body openings. The vagina was mentioned most frequently (67 percent), followed by the anus (55 percent) and the bladder outlet (35 percent). Nine percent of those surveyed were able to correctly label a vulva image with all structures (clitoris, bladder outlet, vagina, inner and outer labia, anus and perineum), although “anus” did not have to be there, words like “butt hole” were also used accepted. Only for the vagina (41 or 15 percent) and the anus (39 or 15 percent) did the women perform better than the men.
Prof. Dr. Mandy Mangler
Prof. Dr. Mandy Mangler, 44, is chief physician at the clinic for obstetrics and gynecology at the Auguste-Viktoria-Klinikum in Berlin-Schoeneberg, and together with a colleague she heads the clinic for gynecology at the Klinikum Neukölln. Every two weeks, the doctor deals with questions about women’s health in the “Tagesspiegel” podcast “Gyncast”. She lives in partnership and has five children.