The Guide to The Vagina

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The purpose of this guide is to inform both women and men about the female genital anatomy and physiology (functioning). It contains information on the vulva (external genitals), vagina, hymen, pubic hair development, the internal organs of the pelvis (including the ovaries and uterus), and common diseases of the female reproductive tract. The resources page has links to other pertinent websites, and our list of recommended readings.

This guide is divided into a number of sections. To get the most from the guide, we recommend you begin with the Introduction section and continue down the list in order. You can move from section to section by clicking on the topics to the left frame. If you don’t see the chapter list, click on large title above.

The artwork above, L’Origine du Monde (The Origin of The World), was painted in 1866 by Gustave Courbet. Click on the picture for more information.

THE VAGINA

The Vulva and Internal Genitalia

A woman’s vulva is actually a grouping of most of the external sexual organs of the crotch. The vulva includes the vagina opening, the clitoris, the labia (majora and minora), the urinary opening (urethra), and the area over the pelvic bone that gets covered with pubic hair at puberty (called the mons veneris).

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1: Mons veneris
2: Hood of Clitoris
3: Clitoris
4: Labia minora
5: Labia majora
6: Anus
8: Perineum
10: Opening of Vagina
11: Opening of Urethra
The most obvious feature on an adult woman is the pubic hair. It grows from the soft tissue above the pubic bone and is called the mons veneris (1) (Latin for “mountain of venus”). In mature unshaven women, the pubic hair continues down and around the vulva to the anus (6). The anus is the opening of the rectum and colon. Click here for a detailed drawing of the external genitals. The hair covered area between the mons and the anus is also made of soft fatty tissue (like the mons). This is the outer lips of the vagina, or labia majora (5) (Latin for major lips). The labia majora are prominent in some women and minimal in others. For some, the skin of these outer lips is darker. The outer lips (labia majora) surround some soft flaps of skin which are hairless. These inner lips are called the labia minora (4) (Latin for minor lips). With sexual stimulation, they swell and turn darker as they get filled with blood. The space between the inner lips and the anus is called the perineum (8). If the inner lips are spread apart (as seen in the picture), one can see that they protect a delicate area between them. This area is called the vestibule. At the top of the vestibule, right below the mons area, the inner lips are joined to form a soft fold of skin, or hood (2), that covers the clitoris (3). The clitoris (pronounced KLIT-or-iss [no, it doesn't rhyme with Dolores]) is the most sensitive spot in the entire genital area. It is made up of erectile tissue that swells during sexual arousal. Below the clitoris is a small slit called the urethra (11) opening. The urethra is a thin tube about an inch and a half long that connects to the bladder. This is where urine comes out. Below the urethra opening is the larger opening of the vagina (10) (also called the introitus). The vagina is the birth canal, and connects the outside world of the vulva to the womb (or uterus).

THE VAGINA
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The vagina is a muscular tube-like structure that connects the exterior of the vulva to the internal organs of reproduction (i.e., the cervix and uterus, fallopian tubes, and ovaries). The vagina is tucked between the urinary bladder in the front and the rectum in the back. If nothing is in between the vaginal walls touch each other. When something is inside the vagina, (e.g., tampon, finger, penis, baby), the walls spread and “hug” the object .

The walls of the vagina are actually composed of 3 tissues. The inside wall is called mucosa and is similar to the inside of your mouth. Just below the mucosa is a layer of tissue that fills with blood. This is the erectile tissue and it swells when a woman is sexually aroused. The deepest layer is a coat of muscle, and this muscular coat is a wrap of tissue that can relax or constrict.

The vagina varies in length from woman to woman, but is generally 2.5 to 4 inches long (from vulva to cervix). In addition, the vagina has the ability to stretch quite a bit, thus allowing an erect penis in and a baby out (see our Male Genitalia Kit for details on average erection size and shape).

THE HYMEN

Girls are generally born with a thin membrane that covers the vagina opening. This is called a hymen. Intact hymens vary widely in shape from woman to woman. For most women, the hymen stretches easily, but even after being stretched, little folds of hymen tissue remain (below, right).

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Though it was long believed the absence of a hymen meant sexual intercourse had occurred (i.e., the woman was not a virgin), this is not necessarily true. The hymen is a delicate piece of skin that can stretch and break from sexual intercourse, the use of a tampon, or even vigorous exercise. The stretching and tearing of the hymen is what causes bleeding to sometimes occur after intercourse. “Popped her cherry” is slang describing the breaking of the hymen.

GENITAL DEVELOPMENT

During the pubertal years (usually between ages of 8 and 13, average age is 11), the vulva and internal genitals grow and change to their adult size. Just as breast development is staged, the medical way to gauge development is  Tanner s Sexual Naturity Rating. Tanner’s classification of sexual maturity looks at pubic hair growth to determine development level.

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Stage 1
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Stage 2
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Stage 3
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Stage 4
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Stage 5

The Stage 1 preadolescent has no pubic hair except for a fine “peach fuzz” body hair.

In Stage 2, there is sparse growth of long, slightly darkened, downy hair mostly along the labia. This hair is usually straight or only slightly curled.

In Stage 3, the pubic hair becomes darker, coarser, and curlier. It now grows sparsely over the mons veneris area.

In Stage 4, the hair grows in more densely. It becomes as coarse and curly as in the adult, but there is not as much of it.

The mature adult, Stage 5, has the classic coarse and curly pubic hair that extends onto the inner thighs.

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The final amount, color, and distribution of pubic hair surrounding the vagina is quite variable. About 90% of woman aged 18 and older have a “horizontal” pattern diagrammed below (far left). Other hair patterns are also depicted.

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PELVIC ORGANS

The internal organs that make up the female pelvis are the vagina, uterus (womb), fallopian tubes, and ovaries. (The vagina is considered one of the internal organs, as only the opening of the vagina is part of the external genitalia.)

The uterus in a non-pregnant woman is about the size of an orange. It has thick muscular wallsthat are needed during pregnancy to push the baby through the vagina and out into the world. (“Contractions” refer to the tightenning of the uterus during delivery.) Like the walls of the vagina, the inside walls of the uterus touch unless pushed apart by a fetus or abnormal growth. These inside walls grow thick and rich each month ; this growth peters off with menstruation (the period). The uterus is connected to the inside end of the vagina through the cervix. The cervix has the consistency of your nose, and is the tissue that is checked by a pap smear.

The ovaries are about the size and shape of unshelled almonds, and are held in place by ligaments that attach to the public bone. A layer of fat surrounds and protects these precious organs. Each ovary itself contains hundreds of eggs, one of which is released each month during ovulation. The egg travels down the four inch long fallopian tube where it is fertilized by a sperm (if a sperm happens to be present). A fertilized egg will become buried in the rich tissue of the uterus (endometrium) and develop into a fetus.

PELVIC DISEASE

Many different types of diseases affect the female genitals. Some of the most common diseases are caught from a partner during sexual contact (e.g., Chlamydia, Herpes, Vaginal Warts, AIDS, etc.). A detailed look at these diseases transcends the scope of this guide, and is available in our Sexually Transmitted Disease (STD) Online Guide. The guide shows photographs and gives detailed information on detecting, curing, and preventing the ten most common sexually transmitted diseases. In addition to the STDs, there are many other illnesses that can affect the female genitalia. These can be grouped depending on whether they affect the external genitalia (vulva) or the internal organs.

COMMON DISEASES OF THE VULVA
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Sexually Transmitted Diseases (STD) commonly cause infection and damage to the vulva area. Condyloma (vaginal warts) is a common STD caused by the Human Papilloma Virus (or HPV for short). The photo to the left shows a woman with vaginal warts (arrows) on her labia majora. (The patient is also on her period and has a tampon in the vagina.)

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Bartholin’s Cysts are infectious lumps that appear if the Bartholin’s glands get clogged up. The opening of these glands is located on either side of the vagina. Both sexually transmitted diseases and non-STDs can cause swelling that leads to this abscess. The photo shows yellow pus being expressed from a woman with an infected Bartholin’s gland. The swollen gland is very tender and warm to touch. Treatment is with antibiotics and often requires an incision to allow the infected gland to drain.

Vulvar Cancer usually affects woman in their 60s, and is often triggered by HPV (Human Papilloma Virus). Any non-healing area around the vagina or vulva must to be checked by a doctor to be sure it is not cancerous.

COMMON DISEASES OF THE INTERNAL ORGANS
Many of the STDs also cause infection and damage to the internal organs. These infections can sometimes lead to sterility (the inability to ever get pregnant) if  undiagnosed and treated. Much more information on this and other causes of pelvic inflammatory disease is in our STD online guide.

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The entrance to the uterus from the vagina is called the cervix, and is considered a part of the uterus. Cervicitis (inflammation and swelling of the cervix) can be caused by many things, including infections (e.g., chlamydia, HPV) and cancer. A pap smear should be done regularly in woman 18 and older or whenever sexual relations start because it has been proven that HPV can lead to cervical dysplasia (precancerous changes) and cervical cancer. Risk factors for cervical cancer thus include first intercourse at an early age and multiple sex partners. As expected, studies have shown that there is a much lower rate of cervical cancer in nuns and virgins. With the exception of sexual abstinence, the regular and correct use of condoms is the best way to avoid this and many other sexually transmitted diseases.

Ihe inner lining of the uterus (endometrium) can also get infections and cancers. Endometritis is the inflammation and disease of this tissue. Again, the most common culprits are often the STDs (Chlamydia and Gonorrhea) but other things can also cause this serious infection. Endometriosis (not to be confused with endometritis) is a disease where the endometrium inappropriately ends up on the ovaries, fallopian tubes, and other places in the pelvis. It is unclear how and why it ends up outside the uterus. This tissue thickens and experiences  significantpain and cramping during the hormonally-driven menstrual cycle. Certain medicines that affect hormone levels (like the birth control pill) can often be used to treat this problem.

CONDOMS

As far back as 1350 BC, there are records of Egyptian men wearing sheaths as decorative covers for their penises. In the eighteenth century, condom use became popular for protection against infections and unwanted pregnancies. The condom is usually made of latex rubber (another name for it is “a rubber”) and is meant to fit an erect penis. Many condoms come lubricated and/or premedicated with spermicide (a chemical that kills sperm cells on contact). Other condoms made of lamb intestines are more expensive and may not protect as well against sexually transmitted diseases. Condoms are designed to keep semen from getting into the woman’s vagina. To maximize the protective benefits of condoms, they must be used correctly.

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Condoms usually come rolled up in a package that will unroll to about 7 1/2 inches, though one should not unroll it until putting it on the erection. A 1 3/8 inch ring is found on the open end helps prevent the condom from slipping off during use. The closed end often has a nipple reservoir that catches semen and helps prevent the condom from breaking. A high-quality latex condom has a failure rate of 1% – 2%, meaning that one can expect their condom to break, burst, contain a minute hole, or slip off, once or twice every 100 times of use. Because of this, only abstinence is truly effective at preventing STDs.

To use a condom correctly, pinch the end (the nipple) to get the air out prior to placing it on the head of the penis. This pinched-off space will be where the ejaculate collects and minimizes the risk of bursting the condom. Roll the condom down the shaft of the erection, covering as much skin as possible (many STDs can spread from skin to skin contact even if there are no open sores or rashes present). The condom must be unrolled onto the erection before any intercourse occurs as it is common to leak a small amount of semen from the stimulated penis prior to ejaculation. If you are not using a lubricated condom, you should put K-Y Jelly or a spermicide onto the condom once it has been placed on the erection to lubricate and hence minimize the risk of tearing the condom during sexual relations. NEVER use Vaseline (petroleum jelly) on the condom as it can dissolve the latex. When withdrawing the condom-covered penis from the vagina or mouth, be sure to hold the rim to prevent it from slipping off and spilling sperm onto mucous membranes. In case of an accidental spill around or in the vagina, insert spermicide cream, jelly, or foam gently in and around the vagina. Do not douche.

Condoms can be bought at any drugstore, and usually come packaged in sets of 3 to 12. To order condoms-by-mail, discretely and inexpensively, check out our hardcopy male genitalia kit, or click on the condom picture.

RESOURCES

This online guide has answered some of the many questions afraidtoask.com has been asked about the genitals. Its purpose is to serve as an introduction and a basic guide to the anatomy and physiology of these organswhile helping you avoid disease. If you have questions or concerns about your health and body, we recommend asking your physician. Most doctors discuss these “personal” questions on a daily basis, so don’t be afraid to ask.

For more detailed information on this topics, please visit the following links. Much of the information in this guide is from an excellent book called Our Bodies, Ourselves: a book by and for women. In addition to basic anatomy and function, Our Bodies, Ourselves contains detailed information on sexuality, including masturbation, heterosexuality, homosexuality, pregnancy, and contraception.

Other recommended reading on this topic:

Our Bodies, Ourselves for the older woman. Gilda Radner, who died from ovarian cancer in 1989, wrote a terrific and moving autobiography called It’s Always Something. What’s Happening to My Body? A Book for Girls, A Growing Up Guide for Parents and Daughters. Changes in You and Me A Book About Puberty, Mostly for Boys.

CancerNet has detailed information on essentially all cancers, including breast, ovary, uterine, and more. The American Academy of Family Physicians has information as well as a list of qualified physicians in your area. And, of course, our Sexually Transmitted Disease Guide is an excellent resource for information and photographs.

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THE ORIGIN OF THE WORLD

L’Origine du Monde (The Origin of The World), was painted in 1866 by Gustave Courbet. Click here for more information on this artist and his artwork.

THE VULVA

M: Mons veneris
A: Hood of Clitoris
B: Clitoris
C: Opening of Urethra
D: Labia minora
E: Labia majora
F: Opening of Vagina
G: Vestibule (Bartholin’s Glands
H: Anus

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