External female genitalia: vulva

External female genitalia

The external female anatomy includes the mons pubis and vulva. Vulva is a single term used to describe all external female genitalia. Grouped around the vagina (an internal organ), these organs include the labia majora, labia minora, clitoris, vaginal vestibule, vestibular bulb, and Bartholin's glands. Together they form an oval shape around the vagina. The labia minora are smaller and surround the vagina. The labia majora are larger and, after puberty, the outer part of the labia majora is covered with pubic hair. At the point where the labia majora meet (near the pubic bone) is the clitoris. Next, we will briefly consider the main structural formations of this area.

Pubis

The Mons mons pubis, or mound of Venus, is the area at the front of the pelvic bone where women typically grow pubic hair. is a mass of fatty tissue surrounding the pubic bone. It contains sebum-secreting glands. Other glands secrete substances called pheromones, which are involved in sexual desire.

Labia

The large ones are the fleshy skin structures on the outside on either side of the vaginal opening. Each such “lip” has two surfaces: an outer, pigmented, covered with pubic hairs, and an inner, smooth surface filled with sebum-secreting follicles. The labia minora are internal, because they sit inward from the outer lips and can be of different sizes. They also serve a protective function by surrounding and enclosing the vaginal opening and the external urinary opening (urethra). In some women, they extend beyond the outer lips by several centimeters and are the reason for intimate plastic surgery.

Clitoris

The head of the clitoris is located at the top of the vulva, where the inner lips meet. It is usually about the size of a pea, although the size varies from woman to woman. From the outside, only the tip is visible - the head of the clitoris, but it has two trunks that extend into the body for as much as 10-12 cm. The clitoris contains many nerve endings that are very sensitive, especially during sexual stimulation. Outside it is surrounded by the so-called. The “clitoral hood” is a fold of skin that surrounds the glans and protects it from excessive friction.

Urethra

The opening of the urethra is located above the vaginal opening. The urethra connects to the bladder, and the opening is where urine exits the body to the outside.

Hymen

The hymen or hymen is a membrane of tissue that covers the external vaginal opening. However, not all women have a hymen. It may rupture as a result of pelvic trauma, sports, pelvic examination, masturbation, or not develop at birth. The absence of an intact hymen does not necessarily mean that the girl was sexually active.

Bartholin's and Skane's glands

Bartholin's glands are two pea-sized glands located near the vaginal opening whose role is to secrete mucus to lubricate the vagina during sex. Skene's glands perform the same function, but are located on the anterior wall of the vagina near the lower end of the urethra.

What should the labia of a healthy woman look like?

Both the labia majora and labia minora ideally have a pink color, which can darken during arousal due to the rush of blood to the tissues. The shade may change slightly due to hormonal changes, for example during puberty and pregnancy, as well as with age. In addition, the answer to the question of what color the labia should be, especially the labia majora, largely depends on what method the woman uses to get rid of hair in the intimate area. For example, shaving with a regular razor can cause darkening of the skin, and improper depilation can cause redness. However, all these conditions cannot be classified as pathological, especially since over time everything returns to normal.

With size and shape, everything is somewhat more complicated. Some women are frightened by the fact that the labia minora protrude under the labia majora. Others are confused by the asymmetry of the right and left lips. It should be understood that all of these are variants of the norm, as is the seemingly excessively elongated clitoris, although there are no official norms that clearly describe what the clitoris should be like in women.

The labia, like any other organ, can accumulate fat deposits, so if a woman has suddenly gained weight, it is logical that the intimate parts of the body have also increased in size. And if you lose weight too quickly, the skin does not have time to tone, which results in flabby, sagging labia.

The same applies to age-related changes: the lips and clitoris decrease in size with age, become less full and more flabby, and this is a completely physiological condition. Another thing is that such changes cause serious discomfort to a woman: she is embarrassed, avoids intimate relationships, all this negatively affects her psychological state in general and self-esteem in particular.

Is it possible to turn the situation around? Undoubtedly. Highly qualified and competent medical doctors in matters of intimate plastic surgery know how to do this competently and effectively.

Internal female genital organs

Internal female anatomy begins with the vagina, which is the canal leading from the vulva to the uterus. The cervix separates the vagina from the uterus, and the fallopian tubes connect the ovaries to the uterus. The following sections discuss these bodies in more detail.

Vagina

As mentioned above, the vagina is the canal that connects the vulva to the uterus. Its upper part connects to the cervix, while the lower part opens to the outside of the body. The opening to the vagina is part of the vulva. The vagina can vary in size, but the average length is about 6-10 cm. However, it increases in length during arousal.

It also contains special structures called Bartholin's glands. These are two pea-sized glands that are located on either side of the vaginal opening. These glands are responsible for secreting lubrication to keep the vaginal tissues from becoming too dry (see above). The vagina also serves as a conduit for cervical mucus, menstrual fluid, and other secretions. During childbirth, the baby is pushed out of the uterus into the light through the vaginal canal.

Neck

The cervix is the lower part of a woman's uterus. This is a cylindrical area of tissue that separates the vagina from the rest of the uterus. For most of the month, the external opening is covered with thick, sticky mucus that is inhospitable to bacteria. When pregnancy occurs, the mucus hardens and forms the cervical plug, which seals the cervical canal and protects the developing fetus until birth. During labor, the cervix dilates to allow the baby to move through the vagina.

Uterus

The uterus holds the fetus during pregnancy. It is located in the middle of the pelvic cavity. This muscle sac will shelter the fetus during pregnancy. During a woman's monthly menstrual cycle, the lining of the uterus thickens with blood in preparation for the release of an egg from one of the ovaries. This is done to prepare a nutrient medium for the fetus if pregnancy occurs. If pregnancy does not occur, the uterine lining sheds. This is called the menstrual period. It occurs every about 28 days, although the length of the cycle varies between women. The upper part of the uterus is connected to the ovaries by the fallopian tubes.

Ovaries

The ovaries are egg-shaped organs attached to the fallopian tubes on the left and right sides of the body. Each ovary is approximately the size of an almond. Most females in nature are born with two ovaries, which produce eggs. In a normal menstrual cycle, a woman's ovaries release an egg every 28 days or so, each of which has the potential for fertilization and pregnancy. The process by which an egg is released is called ovulation. In addition to producing eggs, the ovaries also produce the hormones estrogen and progesterone.

Fallopian tubes

The fallopian tubes connect the ovaries to the uterus. When the ovaries release an egg, it travels down the fallopian tube to the uterus for potential fertilization. If a fertilized egg implants in the tube wall, doctors call it an ectopic pregnancy. If this happens, it may be a medical emergency because the pipe may rupture.

Bulbs of the vestibule

Under the mucous membrane of the vaginal vestibule, on each side there are vestibule bulbs, almond-shaped, 3-4 cm long, 1-2 cm wide, and 0.5-1 cm thick and contain numerous venous plexuses. These structures are in close proximity to the ischiopubic rami and are partially covered by the ischiocavernosus muscles, as well as the muscles that compress the vaginal opening.

The lower edge of the vestibule bulbs is usually localized in the middle of the vaginal opening, and the upper edge reaches the clitoris. Embryologically, the bulbs of the vestibule are classified as analogues of the corpora spongiosum of the penis. In children, these structures usually extend into the pubic arch, and only their posterior end partially surrounds the vagina. But in the event of injury, rupture of these venous structures can lead to severe external bleeding or the formation of a vulvar hematoma.

The vaginal opening varies greatly in size and shape. In women who have not had sexual intercourse, the entrance to the vagina is surrounded by the labia minora and is almost completely covered by the hymen.

The hymen (KUTEP) is a thin, vascularized membrane that separates the vagina from its vestibule. There are significant variations in the shape, thickness of the hymen, as well as the shape of its opening:

ring-shaped,
membranous,
lattice, etc.

Typically, the opening of the hymen in women who have not had sexual intercourse can allow 1, or, less commonly, 2 fingers through. An imperforate hymen is a rare anomaly and leads to retention of menstrual blood, the formation of hematocolpos, hematometra, and cryptomenorrhea. The maiden membrane is formed by elastic and collagenous connective tissue with a small number of nerve fibers, does not contain glandular and muscle elements and is covered with stratified squamous epithelium.

In newborns, the hymen is highly vascularized; in pregnant women, its epithelium thickens and contains a lot of glycogen; after menopause, its epithelium becomes thin. During the first sexual intercourse, the hymen usually ruptures at the back, which is not always accompanied by bleeding, although profuse bleeding may sometimes develop. Sometimes the hymen is rigid and, if sexual intercourse is impossible, requires its opening (surgical defloration). After childbirth, only its remnants remain - the papillae of the hymen.

Changes in the hymen can have not only medical, but also legal significance in solving certain problems of forensic medicine (sexual violence, childbirth, etc.).

The blood supply to the vulva is carried out by numerous branches of the internal (from the internal iliac artery) and external (from the femoral artery) pudendal arteries, the lower rectal arteries. Veins accompany arteries of the same name. The vulva is innervated by the ilioaxillary, pudendal, femoral cutaneous and rectal nerves.

The area between the posterior frenulum of the labia and the external opening of the anus is called the gynecological (anterior) perineum.