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[Editor’s Note: While THC and CBD steal most of the limelight, they represent just two of the hundred-plus compounds in the cannabis plant—each with unique properties just waiting to be studied, and with them, potential medical and therapeutic benefits. This series shines a spotlight on these little-known, less studied, and therefore less understood wonders in waiting.]

The Germans have a word for it—Kummerspeck, literally “bacon guilt,” the regret one feels after a rash overindulgence of food. It’s a general term yet is apropos in describing an at times unsavory (at others, very savory) aftereffect of what we call the munchies, meaning chomp chomp.

This is partly why another compound produced by the cannabis plant, tetrahydrocannabivarin, or THCV (delta9-THCV to be precise), although first isolated in the 1970s, has been getting more and more attention in recent years. Nearly identical in chemical composition to THC, THCV has two fewer carbon atoms in its hydrocarbon “tail.” This seemingly small change makes THCV a different puzzle piece with which the body interacts. THCV can produce effects similar to those produced by THC but with lower potency. In low doses, THCV actually antagonizes some of the effects of THC, while at higher doses it can encourage them, but it’s definitely not “THC-lite.” Unlike THC, THCV has been shown to suppress appetite, which could be beneficial to those with overeating disorders, and shows signs for some other potential avenues for use farther down the road. Let’s dive into what those are.

But first, let’s back up to how cannabinoids interact with the body. A full description is beyond the scope of the blog entry and it’s worth remembering that many cannabinoids have diverse and dose-dependent pharmacology, THCV very much included. With that said, once cannabinoids are consumed, the compounds come into contact with endocannabinoid receptors, part of the endocannabinoid system, which helps to regulate many biological functions, such as appetite, anxiety, learning and memory, emotional response, reproduction, metabolism, growth and development. The endocannabinoid receptors are CB1, which are located mostly in the brain, and CB2, which are found throughout the body. Because of this, the endocannabinoid system is often thought of as the bridge between the body and the mind.

The brain’s CB1 receptors have been determined to play a role in reward signals related to appetite and the consumption of food, among other signaling pathways. THC tends to activate these receptors, resulting in those hedonistic dives into the fridge. At low doses, THCV opposes this activation of the CB1 receptor. In other words, THCV blocks the CB1 receptors from activating in presence of THC, which, presumably, is how THCV can attenuate some THC effects. Relatedly, in rodent tests, THCV has been variously shown to decrease weight gain and interest in food, as well as increase weight loss and energy expenditure. Other studies show that this reward-blocking trait may have some potential in combating nicotine addiction and relapse.

“While I’m not so sure about its pharmaceutical value, in terms of the diet market, there’s definitely potential,” says Jon Wani, Director of Client Relations at MCR Labs, a Massachusetts cannabis testing firm.

The compound is found only in trace amounts in most cannabis plants (half of 1%). Slightly more potent strains, such as Durban Poison or Doug’s Varin, usually descend from a subset of monstrous sativas—sometimes growing 30 feet high—in parts of Africa and Australia, as they thrive in hot, arid climes. Wani says that while most, if not all, indicas and sativas in the U.S. are actually bastardized hybrids, sativas from places like these are genetically more pure, meaning they’re also more likely to produce the high that sativa is commonly bandied about.

“From anecdotal reports, there’s a tremendous amount of energy—like an I-wanna-go-clean-my-house-right-now sort of thing,” he says. “You’ll get stoned in your head but you won’t feel lethargic. Imagine the appeal of that for a second: getting stoned and then being motivated to go take a hike or go play some tennis.”

Of course, confounding factors such as individual physiology, mood, and diet make any promise of desired effect somewhat suspect, he still sees value in THCV. “If someone had a sativa and it got them really ‘up,’ I would venture to guess it’s not only the terpene profile in that specific plant, but it’s the THCV that’s causing that effect.”

Barriers
Suffice it to say, these varietals grow best outside, Wani says, while the majority of U.S. cannabis growing is done indoors, making it another barrier to research and development aside from the industry’s nascency and a thicket of laws that tie the hands of researchers.

Another factor, he says, is grow time. Higher THCV strains take about twice as long to flower as common strains’ period of seven to ten weeks, making it unattractive to most growers and producers, many of whom have never heard of the compound or are understandably skeptical about its effects and their marketability thus far.

Given the runaway success of CBD and an industry full of undiscovered territory, sheer novelty still has outsized currency in the market. “If someone had 100 pounds of it, they would sell out in a couple of days, even if people didn’t even know what it was going to do to them,” Wani says.

Other potential
In some lab studies, THCV has lowered blood sugar and stimulated insulin production, prompting some speculation that the compound could have potential benefits for those with diabetes. To this end, England-based GW Pharmaceuticals is reportedly working on a drug that couples it with CBD. Other possible applications include the treatment of osteoporosis, as it may help stimulate the growth of bone, and its anticonvulsant attributes may one day lend themselves to treating neurodegenerative disorders and various types of seizures.

THCV interacts not just with the endocannabinoid system but with constituents of other signaling and regulatory systems, and it may be possible to exploit these properties. For example, the compound has shown signs of decreasing inflammation and pain in mice and could one day be useful in lessening the symptoms of schizophrenia.

For now, THCV will always come with other cannabinoids, such as THC, and the extent to which it can offset or augment some of the effects of THC remains to be seen. If seeking it out for yourself, of course, ask for the test results.

So, does THCV have a future in the diet world and beyond? Until we find out, we certainly have something to chew on.

In the 1975 cult classic Rollerball, premised on a fictional sport that could be described as a spiky, no-holds-barred roller derby, the rules, in toto, are simple: “No timeouts, no substitutions.”

Replayed countless times growing up, the line is seared into the brain of Rachel Braun Scherl, becoming a mantra that’s emblematic of the grit that’s long put the multipronged marketer, author, and frequent keynote speaker at the intersection of all things #femtech, #sextech and #orgasmicleadership.

“We’d always been in the business of building brands and businesses, and you’re always looking for a category that’s emotionally engaging,” she says. “It turns out, there’s very little that’s as emotionally engaging as people’s sex lives.”

As co-founder and managing partner of SPARK Solutions for Growth, a strategic consultancy now 20 years strong, she’s been in the game long enough to see that in women’s sexual health, a new playing field is emerging—and with it, perhaps, new rules. One thing is clear: There’s no stopping now.

We caught up with the self-described Vagipreneur to talk about the whirlwind moment in women’s health and what makes her tick.

Women’s sexual health can be a wild biz. How does it differ from other industries? 

There is so much societal discomfort with the complex reality—the complex beauty—of women’s health. Last I saw, fewer than 25 states in the country require sex ed, and a subset of those don’t require it to be medically or factually accurate. So we don’t have the education the way we used to, which means we don’t have the language. At the same time, we have ubiquitous access to porn, which is becoming the de facto sex education, and we have people from many cultural backgrounds have different feelings about the role of intimacy and sexuality, so we’ve created this environment where it’s very difficult to have a conversation. Add to that, we’re becoming more and more knowledgeable about the spectrum of sexual identity, so what we’re working with is a little bit antiquated.

What makes the space especially challenging?

One of the big issues has been access. It’s still quite difficult getting advertisements on the content channels you want. When I started in this space, we went to 100 outlets—network, cable, website, radio—and 95% of the time, people essentially said, “No, we don’t want your money to advertise this product.” So here we’re saying it’s fine having every kid on the planet know what it is to have a four-hour erection, but we can’t say anything about a vagina or sexuality or orgasm or lubrication. For example, back in the day we couldn’t even get ads on Lifetime, yet somehow we’re totally comfortable watching the Superbowl on CBS and seeing those ads. So there’s a huge disparity between men’s and women’s advertising.

Similarly, so many female health companies cannot get their products approved on Facebook, and especially the ones targeted to women 35-plus, where it is a primary source of where they get their information. And when you look at the way Facebook classifies its advertising, erectile dysfunction is placed under family planning. So while the algorithms are perhaps applied with discipline, the underlying thought process behind the algorithm shows a disparate attitude.

You’ve seen tons of sex products for women. Where does Vella fit in? 

Let’s start with the fact that it’s a clinically proven product, which is something very few products can say. It has CBD that was designed by a brilliant scientist who’s as well renowned in sexual health as anybody on the planet, so it’s not just someone slapping some more CBD into another product. It’s an extension of the personality and gestalt of the company, whose DNA is based on creating incredibly well-designed, scientifically proven products.

The work of an entrepreneur in a burgeoning industry never stops. What keeps you sane?

I spend a lot of my weekends watching my kids play college squash. I also love cross training and watching classic comedies, movies, and Broadway shows. I’ve seen Chorus Line 11 times, and I could see Wicked every day.  I don’t sing or dance, so I’m always amazed at the level of talent, and the production behind telling a story on stage—it’s an incredibly complex business I’m always blown away by. And with a lot of the things I like to do, I like to be taken away and focus on something else.

The other thing is, my mother always said when I was growing up, if you need to recharge, go outside yourself and do something for somebody else. So I also like to volunteer or help somebody out who needs help. But I don’t do all of those every day obviously. I don’t want to pretend that I wake up, save the world, exercise, and then run businesses. But laughter and exercise are the two primary things I do to keep myself on track.

What do you wish you knew? 

I wish I had a magic wand.

Over the course of my career, I’ve seen hundreds of businesses, and sometimes I see things and say, I wish I understood what was motivating about that. Right now we’re in a market where every day, people are being inundated with new products, and not all rise to the top. And sometimes it’s better marketing, and sometimes it’s a better product, and sometimes it’s better management, and sometimes it’s a combination. But sometimes there are these products where I just say, I don’t get it. What did those people know? So I guess I wish I could predict what’s going to happen many years from now. It would’ve been amazing to have been a part of the team that said the internet is going to change the world, or to be Steve Jobs when he predicted we’d be in a world where devices were all connected. He had a vision into the future that, in my experience, very few people have. So to be hyper prescient, to be able to see things not years in advance, but decades in advance.

Magic wand pending, what would you say about the future of this industry? 

I think there will be a lot of shakeups, as with any industry that’s growing, and I think it’s the same with CBD. Not all the businesses are going to survive. What I think is the most important, and what is really relevant, is you really do want to know products that work. CBD is in everything, which may be good, it may be terrible. But what really differentiates Vella is it has science behind it. People know CBD works for a lot of things, but it hasn’t been proven for all those things.

One of the great things about being in this space is that it attracts interesting, dynamic, hard-working people. It’s incredibly collaborative. Competitors work together to get important messages out about access or about the right language, or about advertising. It’s an exciting space to be in.

Two pairs of pliers, dozens of baggied-up metal hoops, and—it made so much sense now—printed-out Google results for making a chainmail. After all that fidgeting, the burly, seven-foot enigma, swaddled in a slanket and lurching well past the armchair property line, was owning his space in the world, and then some. And I, forcibly snuggled against him as he began his medieval crochet, was a little bit jealous.

The flight from Tulsa to Las Vegas is three hours. I was the cowboy-hatless passenger going for MJBizCon, an annual cannabis conference hosted by Marijuana Business Daily that blossoms ever bigger each year, flooded with folks lured by the billion-dollar biz taking shape and who’re ready to gamble in green.

Well, I was and wasn’t going. We were aiming for the parties that surround it, which is a relief, because in the photos and things I’d read from prior sleuthing, the exhaustion of the event seemed to jump off the page.

Hunter S. Thompson once said, “A little bit of this town goes a very long way”—something anyone who’s been to Vegas once automatically knows. And on the way there, weathering the degrading constant graze of dingle-berried fleece streaked with strays from my neighbor’s long mane, I was already starting to see where Mr. Thompson was coming from.

***

Rocketing through the Strip in an Uber, I arrived at the Cosmopolitan, a flirty hotel and the de rigueur lodging choice for the conference. A bunch of wide-brimmed ball caps and gauged ears in the elevator assured me that I had the right place. And given the only other tidbit I had—that we had a penthouse suite on the 61st floor—those parties would likely often be coming to us.

After dropping my bags, the Manna team and I whisked off to an American joint downstairs for dinner. The hotel had morphed into a mall, and I would later find out that most of Vegas is one big dizzy interconnected mall, full of replica statues and landmarks from other cultures and, because it was December, overtaken with poinsettias, which also looked fake even, even though they were probably real.

While waiting for the jumbo surf and turf that would turn me into Daryll Hannah from the restaurant scene in Splash, I finally got to meet the team that until now were disembodied voices I’d quizzed over the phone in my few months since I began blogging for the company.

There was Nial DeMena, our affable CEO; Chief Medical Officer Harin Padma-Nathan, a wine connoisseur who navigated our bottle selection; our CFO, Frank Manganella, who seemed to know every single cannabis figure in town, their pedigree, and what they were weighing on their internal scales; and Chief Scientific Officer Michael Frid, who took off his glasses and rubbed his eyes to complain about the latest bogus black hole studies and the importance of revitalizing the optic nerves of rats as he cycled his phone and the WSJ inches from his nose. Right then I knew that this was an unusual team, our conversation different from what any other cannabis cohort in town was probably talking about during their first night of MJBizCon. That I was pretty sure of. It was the first bet I was willing to make in Vegas.

Amid a parade of bros stopping by the suite the next day, I snuck away for a coffee downstairs, which became an unexplored area of the mall, rife with a whole world of delights that almost made going outside irrelevant. Plunking down $8 for a latte at Starbucks, I glanced over to a couple engaged in PDA, doing nasty nuzzles over a Venti and a mimosa flute. His and hers. Booze hath no boundaries here, which 23-year-old me would’ve really been into. Nauseated, I stepped outside for a small walk on the Strip for some fresh air. In the sky was the surreal Caesar’s Palace, a Pantheon on stilts, where Jupiter might shoot craps, or oddly futuristic ruins of a world ravaged by rising ocean water—an absurd building design that seems frighteningly more practical by the day.

Eye level was a tad less inspiring. A four-mile zoo parade of warbling Midwestern women sipping souvenir cups, plastered and bouncing off the partitions lining the road, which do double duty saving the lives of tipsy tourists and making it harder to exit the strip. Maybe they were actually sober; anyone would feel drunk from the sensory overload of just walking through the crossfade of Top 40 hits as lights and sights flash into your skull. It’s disorienting by design—and for a nongambling, at the moment sober chap like me, each attraction only tempted insofar as it offered respite from the rest of them.

Early that evening, the drinks started flowing as the suite swelled with all sorts of people, now diverse and young movers-and-shakers from places like Rolling Stone and Penske Media. I did my very best to play it cool and pretend I knew some things, not all things, but a few.

Suddenly it was time to leave for an infused dinner by 99th Floor, held in the Flamingo’s Stirling Room. Not on the list, I lingered around the table of nametags until it began, choosing, at the all-knowing Frank’s discretion, to be the stand-in for a “Joe.” With a renewed sense of purpose in Joe’s identity, I went forth.

The multicourse meal ensued, each plate and drink noted with the milligrams of THC you’re signing up for. It was all tantalizing, but despite being quite hungry, I was afraid to have much of anything. So was the blonde lady next to me, and we kept ordering non-infused rolls, each time lamenting having to specially request the carbs we typically take great pains to avoid. Girlfriend, we are so off.

“Y’know Joe, it’s so funny how at these things people have a tunnel vision of what they’re after,” she said as everybody mingled between courses. Totally! I squealed out, and 15 seconds later, a lady appeared out of nowhere and asked me what I did in cannabis. Not long after I replied, she deadened her gaze, began mumbling and twirled away again into the networking waltz. Joe wouldn’t have taken it personally; he, I presumed, was a seasoned professional at the top of his game. So I wasn’t going to either. I needed to be strong for Joe, whoever he was.

Several hours and three warm, smudgy glasses of chardonnay later, with our party itinerary for the night all but shot, we piled into a SUV for the end of the Acres Field dispensary party. I got a wristband from a girl who was leaving, and we snaked past the abandoned step-and-repeats to find Astroturf and a dance floor out back.

The beats there were slappy—the gyrating trolls and circles of mad chiefers, getting happy stupid in a dense fog of smoke, would definitely back me up on this. Finally, here, I saw a slice of the joy of cannabis culture, away from the straight-laced business types that have stormed the field. Cannabis is growing as a medicine, but it will also always be a silly, social way to let your hair down and get weird. The enduring virtue of getting high is that no one quite has all their bearings on reality, so in slightly mistrusting our perception, we give other people the benefit of the doubt—a kind of tonic to the anxiety-fueled seriousness and pretense that, these days, we need just as much. Ok, you can put your tissue away, I’m done now.

***

The next morning, we waited for what must’ve been nine months for breakfast to be delivered. Michael Frid was sitting at the bar, in good, well-rested spirits, firing off jokes at a fast clip:

“Rene Descartes walks into a bar. ‘Having coffee?’ says the waiter. Descartes says ‘I think not’ and disappears.”

Silence. The exhausting night some of us had before made for a tough crowd. While others prepared for flights home, Michael and I went to do some reconnaissance work at Planet 13—the turnstiled crowds and video projected onto the ceiling made felt a bit like museum on free admission day.

I found Michael talking to a cute budtender and self-described “sweaty sleeper” named Amanda, who said she loved the Manna Patch, it helped her with her anxiety and pain, and that she could start feeling it within 10 minutes of putting it on. That’s how it is for me too, although we technically say 30 minutes. I had one on my lower back for a hangover, and considered flashing her when she said it, but I did not want to move that much.

Another night, another bar, then I woke up to a text from Nial, saying he’d checked out of the hotel. I frantically jumped up and called to see when checkout time was, ordered an egg sandwich from room service, and boxed up the remaining products we brought and went down to the FedEx. I got back to the suite to find a note under the door from room service. Room service arrived again, 5 minutes before official checkout time, and because I had no change or sense of customary tip, and they had no card reader, I paid $50 for an egg sandwich I had five minutes to eat. Woof.

***

One morning, as I was leaving the pyramid that is the Luxor Hotel, my phone died in the lobby, forcing me to camp next to the fake tombs and the fake ‘50s carhop, hungover and decomposing in the recycled air, drinking a coffee with fake pumpkin flavor as slot bells screamed like a firehouse in the distance. Someone won again. Or fake won; they were far too frequent to be real. I sat in a stupor. Was my life on fire? Is 2019 on fire? Is this whole planet on fire? Maybe, mostly, yes.

It was funny and oddly relaxing, the way things going up in flames sometimes can be funny and relaxing. In a world combusting with deep fakes, fake news, fake users, and fake songs by fake artists on Spotify, Vegas held a brand of fake I was more sure of, an innocent fake that made me feel realer by contrast. It was a phony relief—a fake that isn’t trying to be something else. It’s claims to authenticity these days that makes me uneasy.

The flight back was 2.5 hours, not three, as one man, seen boarding between a herd of cowboy hats, loudly pointed out, accounting for the earth’s spin to move Tulsa closer from the other side, like burning something at both ends.* Is time actually faster when the world moves against you? I thought, leaving a city the way probably many do: listless and ever so briefly touched by thrill. Perhaps, in Vegas, time flies when you’re having anything. If you play your cards right, each moment is a total crapshoot.

*Disclaimer: Manna is well aware of the Coriolis effect, and therefore does not support this belief.

After months of testing the pharmacologic effects of CBD on the vaginal smooth muscle in rats and humans, Vella, Manna’s cannabinoid-based sexual serum, was born. Now it was time to translate the science the formula hinges on.

In the arena of anatomy and physiology, words alone have always fallen short. So to best show the science behind it, Manna commissioned board-certified Medical Illustration Studios to show how the smooth muscle is pivotal to arousal in women.

But when the team set about to have them made, they quickly confronted an issue at least as old as the field itself.

“I myself didn’t know at the time how difficult it would be to find source material for the kind of anatomical story we were trying to tell,” says Manna’s Chief Design Officer Carolyn Wheeler. “Which is to say, we couldn’t find an existing representation—medical illustration or otherwise—that scientifically explained the physiological process of female arousal. This was both sad and exciting.”

Dr. Harin Padma-Nathan, Manna’s chief medical officer, is quick to point out that the science in these drawings isn’t anything new, but that they are unique in their focus on the role that the smooth muscle plays in arousal and orgasm.

About the illustrations

Unlike more well known muscles, such as the calf or bicep, smooth muscles are involuntary and not tied to tendons and bone. The reproductive smooth muscles in men and women consummate physical arousal: relaxing them lets blood flow in, which causes engorgement. In men, that means an erection. In women, this gives the vulva rigidity to support penetration and also helps produce lubrication. By nano-encapsulating cannabinoids to be water-friendly, Vella is able to deliver them to the smooth muscle, which relaxes it.

Smooth muscle relaxes during arousal. (Image copyright Manna Molecular)

A closer look at the illustrations accounts for the twofold effect: Blood fills lacunar spaces in the corpus cavernosum of the clitoris when the smooth muscle lining the spaces relax. This reduces the resistance to capillary filling of the spaces and these then balloon into pockets that, when filled, produce engorgement. Around the vaginal wall, the penetrative hallway, the influx of blood produced by smooth muscle relaxation results in a process called transudation, whereby a serum like watery lubricant is produced and released into the vaginal vault—another evolutionary upgrade to facilitate more comfortable, “successful” sex (if reproduction is your thing). Whatever the goal, it’s safe to say that comfortable and more pleasurable sex is something most people can get behind.

Relaxed smooth muscle allows blood to fill lacunar spaces in the clitoris, resulting in engorgement and subsequently lubrication. (Image copyright Manna Molecular)

Physiology aside, a mix of cultural and psychological factors often makes sexual health—and health in general—a hairier matter. Writing for Design Bias, a Vice series examining the often unintentional ways hegemony replicates itself in various fields, Rose Eveleth draws a line from medical illustrations to real-world implications.

In a 2014 study of more than 6,000 images from 17 anatomy textbooks, researcher Rhiannon Parker found that just 36% of images with an identifiable sex were female (and of those, 86% were white), relatively unchanged from similar studies in the early ’90s. The disparity raised scores on implicit, but not explicit, bias among medical students.

Though it’s not often distinguished, coronary heart disease, as Eveleth notes, presents itself differently in women than in men, which could be a factor in women being misdiagnosed at higher rates than men. Black women are three times more likely to die in childbirth than white women, which many experts say is mostly due to doctor bias.

“There are severe disparities in health literacy based on race and socioeconomic factors that we need to tackle by creating effective and widely accessible visuals that resonate with the increasingly dynamic makeup of our modern society,” says Jennifer Hollis, diversity committee chair of the Association of Medical Illustrators.

In the area of sex disparity, Dr. Nicole Prause, founder of Liberos, a sexual biotechnology firm, can attest. As a longtime researcher and educator of the odds and ends of sexual health, she’s familiar with the confusing messages women receive about orgasm.

“I think people have no idea what that’s supposed to look like or that that’s even supposed to happen. And I think a large part is because there’s no representation of it,” Prause says. “I have looked for the images, and I look everywhere—no holds barred, safety search off.”

One reason for the sex disparity is that female sexual organs, largely internal and unseen, are simply harder to access. “If you’re gonna cut it out of a cadaver, where do you make your cut?” Prause says. “How do you pull it out of the pelvis, and what is that gonna sever? And there, you’re definitely not gonna see it functional. So it’s a hard problem to solve.”

The other factor—and to which other disparities, such as race, gender, and age, can largely be ascribed—is the long legacy of white androcentrism that has for centuries pervaded nearly every facet of Western medicine, often exacerbating the misguided science of the times with a once-removed knowledge of the female experience. (Freud, for example, theorized that orgasm from clitoral arousal signaled an immature, psychologically underdeveloped female, whereas vaginally inspired orgasms indicated the opposite.)

Add to this that physiological signs of arousal are often harder to recognize for women themselves, rendering it a more subjective experience than it is for men.

In her book Bonk: The Curious Coupling of Science and Sex, researcher Mary Roach describes how in some studies examining female arousal, in which the participants’ feedback was compared with their physiological data during the time of arousal and orgasm, the correlations have sometimes been so low that researchers sometimes wonder whether physical changes should be taken to mean anything at all in terms of arousal. This is in line with a similar study Prause herself conducted at the University of Iowa, in which 20 masturbating women were asked to press a button at the onset of arousal and again at orgasm, where only about half the women’s responses matched up with the diagnostic indicators they were hooked up to.

This is not to say that the body doesn’t know what it wants. More than 70% of women say that clitoral stimulation was necessary or helpful in achieving orgasm, while just under a fifth report orgasming from intercourse alone. But if the mind plays a larger role in women’s arousal, it stands to reason that education—or lack thereof—could have more of an impact in its realization.

Extending this logic, I just had to ask Dr. Prause: So is it possible that some women may never orgasm simply because they don’t know what it’s supposed to look and feel like? Her answer may shock some men: Absolutely, yes.

“Even if you look to sex films and adult films, they’ll often use [artificial] lubricant to show something that appears to be wet, but you can still look at the vulva and plainly tell she’s not aroused,” Prause says. “To me, that’s one of the biggest oversights of sex education today—that is, vasocongestion is a more important sign of arousal than lubrication, because lubrication is affected by all kinds of things,” such as antihistamines and menopause.

With this dearth of representation, what, then, is left? Other images rush to fill in the gap, and with them, a ready sociosexual script. Without adequate knowledge of their bodies and needs, women, it seems, are often left to simply simulate what they see projected across the funhouse mirrors of culture.

“I’m reminded here of the expression ‘the map is not the territory,’” Wheeler says. “When you map or draw something, you gain the ability over others to speak to it with power and authority. You are determining the contents of its story.

“We think of Manna as guided by the exercise of figuring out what from the Western medical system to bring with us into this new industry, and what to leave behind,” she says. “Ultimately I see these medical illustrations as a way to talk more easily and openly about women’s sexual health, which still feels like a bit of a radical act.”

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