We Probe Dr. Lissa Rankin, Author of What’s Up Down There? On Vaginas, Sex, and Aging

If you don’t already have a copy of Dr. Lissa Rankin’s new book, What’s Up Down There? Questions You’d Only Ask Your Gynecologist If She Was Your Best Friend, you should. Rankin, a practicing gynecologist and founder of The Owning Pink Center in Mill Valley, California, sifted through thousands of questions from her friends, patients, blog readers, and Twitter followers to create a book filled with real questions about our ladyparts — including stuff like: “What’s the most common labia size, and please don’t say that all vaginas are different and special. Seriously, what’s the most common?” Her answers are hilarious, candid, personal, racy (she confesses everything from what her vagina tastes like to her STD history, something we’ve never heard from our doctors), and full of the real answers we spend all night looking for on Google.

We recently sat down with Lissa to do what everyone else wants to do with her: Ask questions.

What inspired you to write “What’s Up Down There”?

Basically, five years ago I thought I was all done with vaginas. I had been working full-time as an OB/GYN, was expected to see 40 patients a day, and was really miserable. So I ended up leaving my job; a huge leap of faith because my husband was a stay-at-home dad and we didn’t have money in savings. I thought I was going to be a full-time artist and writer, but I realized nine months later that you can quit your job but you can’t quit your calling. I realized that I was supposed to be in service to women in some way.

I ended up taking a writing workshop at Esalen Institute in Big Sur, this “woo-woo”, New Age, hippie retreat center. The last night of the workshop, everyone was drinking wine and someone started telling the story of their first orgasm. We went around the circle telling our stories, and one by one, women started pulling me aside and asking me: “Lissa, can we ask you a question… like, over in the corner?” I ended up spending the evening in the corner with women lined up to ask me questions, and I realized that’s what I really loved doing: Being the girlfriend gynecologist, spending one-on-one time with women, and answering their questions, but outside of the sterile “white coat” environment.

Long story short, an editor approached me with the idea for the book, and it was perfectly timed with my realization of wanting to serve women. I had started the community at OwningPink.com, so I basically gave them the anonymous opportunity to ask the questions they would ask their gynecologist if she were their best friend. These are all real questions, I couldn’t have made them up.

Is it difficult getting women to talk about their vaginas with you?

It’s much harder than I thought it would be, because there’s so much resistance, but I just have to trust that I’ve done my part, I’ve put it out there, and I hope it ends up being a conversation starter, and where it goes from there is out of my hands. When I give talks, women are so reticent, but by the end of the hour-long talk, they’re all talking to each other. That’s when I feel like I’ve accomplished my mission: When they come in not talking about it and they leave talking about it.

Getting on TV is also difficult, because producers don’t know what to do with me. They would know what to do with me if wore my white coat. Society has this image of doctors as disembodied brains walking around without body parts, kind of like pastors or kindergarten teachers — you know they have body parts but you don’t really want to think about it. So they don’t know what to do with me when I talk about my own experience. Doctors are trained to be very clinical about it, but I’ve gone out of my way to not be that way, and people aren’t quite sure what to make of that. It makes people uncomfortable.

Between the ages of 30 and 50, a lot changes about women’s bodies, but we don’t hear much about what happens “down there.” Do women really “dry up” and lose interest in sex when they get older?

I was just having a conversation with a group of menopausal women about this who said that menopause opened them up to their inner sexpot. So much of women’s sexuality and sensuality is mental. Women in their 20s and 30s, while their physiology and hormones are at their optimum, mentally they’re just not ready for the level of sexual awakening that the 50- and 60-year-olds are. They’ve learned to live in their bodies, they’ve accepted the skin that they’re in, and because of that emotional and mental processing, they can more easily inhabit their bodies, even though their bodies have shifted and changed and they have more physical challenges.

I think that as women get older, their sex lives just keep getting better – that’s my experience with my patients and my friends and people that I’ve talked to. I know that I felt the sexiest looking in the mirror when I was 28, but the older I get the more I feel sexy in other ways. It’s not that I have the world’s greatest pair of legs anymore, but there are other things that have changed, and I’m open to things in a new way.

Your book has a few chapters about pregnancy, childbirth, and fertility. Do women who don’t have kids get alienated from conversations about our bodies?

Certainly, being pregnant is a really interesting journey for a woman. Pregnancy is a time when you’re forced to be in your body. You can’t ignore it anymore because everything is different: Your vagina is different; sex is different; there’s this thing moving inside of you. You can’t ignore it, and then you go through the experience of childbirth, where all of a sudden you’ve got ten people in a room looking at your coochie, and there’s an openness that often comes with that. You might have your husband and your doctor and your dad and your best friend and the nurse and a flipcam looking at you, and I think women who go through that experience become more comfortable with their bodies, but that doesn’t mean that women who haven’t had children need to be left out of that experience. If you’re not going to have children, then you have to come at it in other ways, learning to live in your body, be open in your own skin, and not feel shame.

The other thing that happens when you have a child is that you develop a reverence for your body. Seeing what your body has been able to do really make you love your girl parts. Those who don’t have biological children miss that, but they can experience it in other ways, like going to workshops and reading books like this, but it does take self-education as opposed to it being done to you.

A recent study came out saying that baby boomers are having more sex, but they’re not being as safe as younger generations. Do you think that’s true?

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    • Susan

      I’d have to agree that the childbirth experience really changes you for the better.
      Yep, lookin’ at the coochie changes you. And I have friends who can also
      vouch for that too. BTW, changing 2000 diapers also changes you. That’s
      a different topic. :)