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The vulva is a portal for a variety of functions (reproductive and excretory) and has a unique role in sexual feelings and function.
Because it is covered with both dry, squamous skin and moist mucous membrane, it is subject to diseases affecting both. Because of the close proximity of the rectum, intestinal bacteria (anaerobes and coliforms) are more or less constantly present to some degree. These may influence the type and course of infections in this area.
The vulva may develop conditions both benign and malignant, symptomless, annoying, or even disabling.
The larger lips, labia majora, extend from the mons pubis to the rectum. These are large, fleshy pads that cover the bony pubic rami. They each contain a Bartholin gland, which is usually not noticed but occasionally causes some problems.
Just inside the labia majora are the smaller lips, the labia minora. In women who have not had a baby, they are very thin and are usually hidden, to some extent, by the labia majora. After a pregnancy, they are thicker and more prominent. They are rich in nerve endings and are usually very sensitive to touch. During sexual arousal, they swell and moisten with extracellular fluid. During urination, the labia minora function to direct the urine stream in a more or less single direction by forming a curtain on either side of the urethra.
The labia minora come together at the top of the vulva to form the clitoral hood. This tissue covers the clitoris, which lies just beneath the hood. The clitoris is characteristically firmer than the surrounding tissues, with a rubbery consistency. It has a high concentration of nerve endings and is extremely sensitive to touch and vibration. It is usually, but not always, the area of greatest sexual sensitivity. During the early stages of sexual arousal, it swells and protrudes just beyond the clitoral hood. In the latter phases of arousal, it generally flattens and retracts back beneath the clitoral hood.
The urethra lies between the clitoris and the vagina. It conducts urine from the bladder to the outside. It is normally non-tender to light or moderate touch. On each side of the urethra are the pin-point Skene’s ducts.
When the labia are spread open, the hymen or remnants of the hymen are visualized. This ring-like structure is usually torn at first intercourse, leading to a small amount of bleeding. For some women, insertion of tampons or other objects will lead to hymeneal rupture. After healing, only small bumps or flaps of skin remain.
Anatomic variation with hymens is considerable. Some are thin, stretchy, and so small as to be largely unnoticed. Others are thick and nearly impenetrable. Rarely, the hymen completely covers the vaginal opening, disallowing the passage of menstrual products.
Just inside the hymen is the beginning of the vagina. In contrast to the smooth vulvar skin, the vaginal skin has circumferential ridges (rugae). The vagina is not cylindrical in shape, but more like a flattened cone, narrow at the vaginal opening, and widening as the vagina approaches the cervix. Normally, the anterior and posterior vaginal walls are in contact with each other, but during intercourse or an examination, they separate. During sexual arousal, the vaginal skin “sweats” small droplets of extracellular fluid, which is the primary source of lubrication during intercourse.
The posterior fourchette is the area of mucous membrane between the rectum and the hymeneal ring.
Some women do not seem to have any noticeable discharge, while others normally have a more or less constant slight discharge that is odorless, clear to white and mucoid in nature.
The material collected here is intended for use by medical and nursing professionals, and those in training for those professions.
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In the Philippines, sex trafficking of young girls moves online
Mar 23, 2016 7:42 PM EDT
https://www.pbs.org/newshour/show/in-the-philippines-sex-trafficking-of-young-girls-moves-online
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Sex tourism has long been a scourge in the Philippines. But now there's a disturbing new trend in the trafficking of mostly young women and children: vulnerable victims are being lured online and tricked into the trade. Special correspondent Fred de Sam Lazaro reports.
Next: a disturbing new trend in the trafficking of mostly young women and children into the sex trade.
Special correspondent Fred de Sam Lazaro reports from the Philippines on what police call cyber-trafficking.
It's part of his ongoing series Agents for Change.
Sex tourism has long been a scourge in the Philippines, an industry that thrives on trafficked human beings and deep poverty in this nation of 100 million.
Recent studies have shown that anywhere from 100 to more than 300 thousand Filipinos are trafficked each year; 80 percent, four out of five, are under the age of 18.
The government, under international pressure, has stepped up enforcement. Stings like this one to rescue young women are more common, as are arrests and convictions. But the sex trafficking industry, as always, seems a step ahead in the game.
IVY CASTILLO, Officer, Manila Police Cybercrime Center:
That's only one but there are a lot.
At the police cyber-crime center, officer Ivy Castillo explained one of the many ways that vulnerable young women are tricked into the trade.
So, they're pretending that this is a real modeling agency to entrap the young girls?
It has all the trappings of a glamorous fashion model agency, especially to a young rural Filipina girl.
At first, they are requested to send this image.
They're asked to submit pictures that seem innocuous, facial shots, ostensibly part of the selection process.
The next requirement is with a two-piece.
The next steps call for more revealing images, just the torso, not the face, they're assured, giving the false impression that it's unidentifiable. The young woman won't make the connection that computer software will, until it's too late.
They have got her face from her previous, more innocent images, and have Photoshopped them with the nude ones.
In no time, they are shamed and blackmailed into working for the opaque criminal networks behind the trade.
Lila Shahani is on a government task force on human trafficking.
LILA SHAHANI, Human Trafficking Task Force:
Cyber-pornography is easily one of our biggest problems. It's proliferated very quickly. and it's an expensive thing to police, and we're a Third World country.
But it's an industry fueled by First World demand, from pedophiles mostly in Europe, North America, and Australia, says officer Castillo.
These foreign perpetrators, they have contacts here in the Philippines, wherein these contacts are looking for children.
And perhaps the most frustrating challenge with this cyber-sex industry is a social one. Cecilia Oebanda, who founded the Philippines' largest anti-trafficking group, says many people don't believe or don't want to believe it's that harmful.
CECILIA FLORES-OEBANDA, Director, Visayan Forum Foundation:
Because they think that they're — the girls are just actually performing in the computer, and there's no contact, there is no touch. For them, it's OK. There's no harm actually put to the child.
At a shelter her agency runs is living proof that it's not just emotionally abusive, but also frequently escalates. The children are invariably inducted into traditional prostitution and its daily physical abuse.
These two 15-year-olds were rescued in a police sting from a cyber-porn racket. Their alleged pimp, a man named Jerrie Arraz began as a good samaritan neighbor.
There was a time when my mother need money because my stepfather was in jail. So she asked Jerrie for help.
He was really kind. When we didn't have food, he gave us food. Jerrie offered to send Gina to school.
This young woman is the 11th of 12 children in a family from one of the many rural Philippine islands beset by poverty and often natural disasters.
Opportunities are scarce, so, at 12, the offer of a scholarship from a kindly stranger, a man visiting to her village, was hard to resist.
He said that he's from Manila. So, I would say my dream is to study in Manila and to know the people, to — like, to wear nice clothes.
She accompanied the man to Manila, and was placed with Arraz, with whom he was apparently associated. She was in fact placed in school, but, gradually, there were demands, and they escalated, to display herself before strangers online, then to perform sexually and with Arraz in front of the camera.
He would wake me up to say there was a customer online and he wanted us to perform while the customer was watching. Each time, it happened, I just cried.
In time, the cyber-sex had escalated to plain old prostitution.
In a month, about four to five times, we met with foreign customers in a hotel, plus daily online.
It was when both girls were in a hotel one day that Arraz was nabbed as he negotiated with two undercover detectives posing as customers.
There were Caucasian — Caucasian undercover agents.
Prosecutor Jonathan Lledo was on the sting team, one of whose members hid in waiting.
He was inside the closet for four hours.
And the phone call rung that signaled that money exchanged hands. And we opened the door and announced. There was bewilderment. There was: What is happening here?
The young women, in terror, ran to their trafficker and to his defense.
We always felt like Jerrie was our father, so that's what we told rescuers. He is our father. We were really scared.
It's been called the Stockholm syndrome, Lledo says, one more complication in rescuing hostages who become sympathetic to their captor, and any change to what has become normal in their lives is unsettling.
The trafficker is providing them with food, clothing, shelter and a place to stay, and law enforcement will disrupt all this.
As it turns out, six children were removed from the home of Jerrie Arraz and placed with Oebanda's agency, including a 1-year-old infant abandoned by its mother.
The more immediate task is to try to restore childhoods through counseling and eventually adoption into homes, education and skills training for those older.
Most of our cases are referred from our foreign counterparts.
Philippine police officials say most of the enforcement comes from the consumer end. Tracking down providers is fraught with difficulty. They can be anywhere, evidence against them, if it exists, hidden in the cloud instead of a hard drive.
A lot of bad guys are not being caught, right?
Another big challenge is that police must rely on tips from the public, says task force member Shahani.
There is a real fear of — among informants of retaliation from big syndicates.
But Oebanda, who has long campaigned against trafficking, sees progress.
Our conviction rate has more than double. So, for me, that progress is indications of the political will.
Attention is now on Jerrie Arraz's trial, now under way in Manila. These images are from his Facebook page. It's the first so-called cyber-trafficking case to be brought, in hopes that it will mark a turning point.
For the "PBS NewsHour," this is Fred de Sam Lazaro in Manila.
Fred's reporting is a partnership with the Under-Told Stories Project at the University of St. Thomas in Minnesota.
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