The V Book: A Doctor's Guide to Complete Vulvovaginal Health Care. By Stewart, Elizabeth G. M.D. New York: Bantam Books, 455 pages, resources, journal abbreviations, notes, index, illustrations. Paperback: ISBN: 0553381148, $13.95
Reviewed by Andrea Adams-Miller, BA, Sexuality Educator, and Psychophysiologist, www.SexualityTutor.com, Findlay, OH.
The first words that come to mind are "Finally, a book that addresses women's genital health." As a long time sexuality educator for women with vulvovaginal disorders, this book is a longtime desired and welcome attribute for helping women understand their physiological functions regarding sexual and reproductive healthcare. The V Book: A Doctor's Guide to Complete Vulvovaginal Health Care is refreshingly geared towards the average female reader. Therefore, the information is a bit more in-depth then the basic rather uninformative outlines of sexual and reproductive healthcare found in many texts, yet, not so involved or medically technical that the common layperson can understand the information and be able to relate it to themselves.
The word "complete" used in the title is most accurate, as The V Book covers a wide variety of vulvovaginal concerns including: physiological anatomy and functioning, changes in sexual and reproductive organs with age and hormonal affects, hygiene, sexual relationships, gynecological examinations, infections, disorders, and disease. In addition, almost every page has corresponding charts, diagrams, drawings, photos, cartoons, and other supplemental information to add to the reader's personal knowledge bank. Included with this supplemental information are "V notes" that are text boxes filled with short quips of information that highlight historical facts, definition of terms, journal article quotes, advice or suggestions, cultural differences, do and don'ts, and medical tidbits all concerning gynecological aspects. That is not all the book has to offer, it also includes text boxes called "Voices" that included quotes from authors, playwrights, patients, and other women. All these quotes are from women with something to say that deserved a platform for relaying their concerns, opinions, experiences, and observations.
Following along those lines, another helpful aspect of the text dialogue is the integration of women's personal stories. This information is so valuable to the women I have corresponded with through the last several years. The value stems from the fact that the women feel validated, connected, and normal. There is much power for women knowing that they are not alone in their vulvar disorders, that someone believes that they have vulvar problems even though they may not be immediately visible, and that they can read that there is help and information.
The V Book starts out with an introduction quiz that lets the reader know where their informational level is at regarding vulvovaginal health care then informs them that their questions will be answered in the following pages. Stewart then informs the readers of her interest and background in this area including her medical training. This helps women to know that there really is a doctor who care and understand the particular needs of women with vulvovaginal health concerns. Additionally, by offering her credibility upfront, a reader can proceed with confidence knowing that the information they read is validated by peer reviewed journal articles, medical training, and professional experience.
Within her introduction, she outlines the book's structure that is designed for ease of reading. The V Book design is divided into three parts: "An Owners Manual," "When You Need Help," and the "Problem and Answer Guide." Then each of these sections are further separated into chapters that seem to progress naturally from basic information then expand into more in-depth details and considerations of that specific topic before transitioning to the proceeding section.
In part one, "An Owners Manual," Stewart starts by talking about the historical aspects of vulvar health then segues into discussion of various feelings, that are dependent on their personal upbringing, experiences, and fears, that women may feel regarding their most intimate parts. The author then steps the women through the vulvar anatomy, telling them what is what, and what it does. Then tells them how to conduct a vulvar examination for themselves to keep on their own physical health, and to allow them to claim their genitals as their own, free them of dirty thoughts, and leads them to self-exploration and self acceptance of their bodies as a whole. Included in the first chapters, a reader will find information on what is normal vulvar health, how the bodies changes through puberty, childbirth, and menopause. Then, the author addresses the issue of vulvar hygiene. In the reviewer's experiences, this area is often overlooked in the office examination; yet, women's complaints often include itching, burning, infection, and odor that may be caused by improper or overzealous hygiene practices. To the reviewer, it seems that informing women how to take care of their genitals before a problem exists might create avoidance of these medical concerns in the first place. This first section ends with Stewart disarming the secrecy surrounding sexual desire, arousal, orgasm, masturbation, sexually transmitted disease, and birth control.
Part two carries on the discussion of vulvar hygiene further by exploring what might bring on such disorders and what to avoid now that you have itching, burning, and unusual discharge. Then after a short discussion on symptom identification and possible causes, Stewart shares with the women how to proceed once the symptoms have turned unmanageable. This section is a set up for the author to relate how important it is to get medical care and to call the correct type of doctor for a medical evaluation. This section concludes with a thorough informational chapter discussing the ideal protocol for a gynecological examination starting with the importance of your doctor knowing your honest medical, sexual, and lifestyle history. Then Stewart discusses in detail the protocols of the pelvic examination itself, and details surrounding appropriate testing and evaluation of tests. Additionally, this section stresses foremost how important it is to get help while the problem is apparent, and for patient honesty in sharing information that assists the doctor making make an appropriate evaluation.
The book then delves into further particulars of the common disorders such as yeast infections, and sexually transmitted diseases mentioned in the previous chapters. However, Stewart expands this section to include other disorders like lichens sclerosis or vulvodynia, disorders deemed uncommon according to the grand scheme of medical disorders, however, they are disorders that may affect hundreds or thousands of women. For these women, it is a fortunate situation that Stewart includes these less common disorders, as there is little information accessible for women suffering from these disorders. Although vulvovaginal health information is attracting more attention and is slowly expanding with the efforts of women's sexual health advocates, the lack of information and lack of vulvovaginal health specialists available are few. Therefore, it appears this author, a vulvovaginal specialist herself, certainly understands this dilemma and has offered one solution to the problem of insufficient educational material by including the disorders. This section certainly reflects a feel of importance as the author has chosen that the book engulf over two hundred pages of the book's entirety. To the reviewer, this goes to show how much careful detail that Stewart has offered her readers so that they have a good grasp on the disorders, the symptoms, the treatment options, and management styles of the different vulvovaginal disorders.
Stewart concludes The V Book with the chapter title, "V is for Voice." This title alone creates a feeling of pride and admiration within the reviewer. It is the reviewer's ideal that women need a place and a platform for discussing their gynecological health. Women need a chance to have research conducted to search for treatments and cures for their particular disorders, and have a right to have this information displayed prominently for their easy access. Finally, women deserve the right to take ownership of their sexual and reproductive health in the manner that they find suitable for themselves. In reading Stewart's last chapter, it appears that Stewart, too, wants to educate, enrich, and empower women to complete sexual and reproductive health.
This book should be a staple in every woman's personal bookshelf. It is a valuable resource tool for women of any age, and certainly would be a most appropriate gift for the adolescent transforming into a young women to a women past her child birthing years well into menopause. As a sexuality educator, this book will be highly recommended to facilitate the teaching experience to colleagues requiring information in women's sexual health, and be recommended to clients to support their learning experience with me.
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