Vulva Vagina
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Vulva Vagina
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Mark Gurarie is a freelance writer, editor, and adjunct lecturer of writing composition at George Washington University.
Rochelle Collins, DO, is a board-certified family medicine doctor currently practicing in Bloomfield, Connecticut.
The external portion of female genital anatomy , the vulva—also known as the pudendum—protects a woman’s sexual organs, urethra, vestibule and vagina. The epicenter of sexual response, its inner and outer flaps are known as the labia majora and labia minora. 1 As such, this organ can be subject to a range of health issues, including vulvar cancer, bacterial infections, as well as a number of sexually-transmitted diseases. It’s important to understand how this part of the body works, and how it’s connected to aspects of overall health.
Anatomically speaking, the vulva is a blanket term for all of the structures of the external female genitals. Here’s a quick breakdown of these structures: 1
Female external genitalia—particularly the sizes and colors of the mon pubis, clitoris, labia majora and minora, as well as the vaginal opening—can vary a great deal from person to person. 1 Basically, these variations are associated with the amount of estrogen activity during puberty, with larger, thicker features associated with increased presence of this hormone during this time. The greatest differences are seen in the size, color, and structure of the labia majora and minora, with some women displaying more prominent folds. In other cases, the clitoris and clitoral hood are larger and more prominent. Largely, though, functionality is unaffected by these differences.
In addition, there are rarer cases of congenital variations of the vulva, involving the physiology of the uterus and vagina. There are four classes of this: 2
The vulva is primarily associated with sexual function—in addition to being directly involved during sexual intercourse, itself, it provides hormone production and protection of reproductive pathways—though it also is involved in the excretion of urine. In terms of the latter and as noted above, the vulva houses the urethra, which delivers urine from the bladder out of the body. 3
During sexual activity, the vulva is particularly involved. During arousal, several parts become flushed with blood, including both the labia minora and majora, the clitoris, and the vestibular bulbs; this changes the shape of the vagina, stimulates sexual pleasure, and works to bolster lubrication for sexual intercourse. 4 These physiological changes also work to promote chances of conception, secreting female hormones to mix with male semen deposited in the vagina to allow an opportunity to fertilize the egg.
Among the many diseases or conditions that can impact the vulva, very many issues are due to sexually transmitted infections (STIs). These include: 1
In addition, a range of other conditions can affect this part of the body, including: 1
Screening and examination of parts of the vulva are an essential aspect of female health. Prompt detection of health problems here, especially of cancer but certainly of STIs that may affect this part of the body will greatly improve outcomes. That said, testing and examination of this part of the body can be challenging, especially in absence of symptoms. Here's a quick breakdown:
Munarriz R, Kim N, Goldstein I, Traish A. Biology of female sexual function .
American Cancer Society. Tests for vulvar cancer .
University of Michigan Medicine. Syphilis tests .
American Cancer Society. HPV and HPV testing .
US Department of Health and Human Services, Office on Women's Health. Genital herpes .
By Mark Gurarie
Mark Gurarie is a freelance writer, editor, and adjunct lecturer of writing composition at George Washington University.
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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.
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Published on 12/14/2021 at 12:44 PM
Do you know the difference between the vagina and the vulva?
Research shows that many people don’t know the right words for this important reproductive anatomy, so to learn more, we talked to “Come As You Are” author Emily Nagoski about all the basics.
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