Last year, there was an online series that got a lot of attention because an episode focused on women learning about their lady parts. The women on the show admitted that they didn’t really know much about their female organs, what they look like, what was normal/abnormal with them, or even how many orifices (holes) they have down there! (Spoiler alert: there are three)
Now I know our patients are much more well-informed, but I thought we’d just have a basic anatomy and female pathology conversation, because knowledge is powerful. Also, sometimes this topic can be embarrassing or difficult to discuss, and misconceptions or misunderstandings of our anatomy can follow us late into life and we may be too afraid to try to resolve them. So here we go.
It’s essential to know exactly how your parts all work so that you can take great care of them and identify if they’re not working properly and contact your provider as needed. It’s also valuable to know exactly what it is we’re examining in your annual exam. An external exam includes a review for any irregularities of the vulva, and the internal examination includes using a speculum so that we might visualize the cervix (and take a cervical cell sample, a Pap Smear), and a bimanual exam (two hands- one in the vaginal opening, one on the abdomen) to assess the uterus and ovaries. Sometimes a rectal exam is necessary, also. There will also always be a breast exam to identify any abnormalities in the breast tissue. When you see how your anatomy all relates, you will understand why these exams are helpful in assessing the health of your female organs.
This is just a very basic explanation of everything. Everyone’s anatomy is different. You may experience variants on normal or abnormalities of your female organs that need to be addressed by your provider. Please, if you would like general clarification on anything, privately message us here. If you have any questions/concerns regarding your own anatomy, please contact your Oakland Macomb provider directly.
In this post, we will address the external anatomy and in a later post this week, we will move on to the internal organs.
The vulva includes all the outside female anatomy- the labia, the clitoris, and the urethral, vaginal, and anal openings and hymen (before it’s perforated). There is a small mound of fat above the vulva to protect all these precious parts, called the mons pubis.
Labia. the lips/flaps that cover the delicate clitoris, urethral opening and vagina. The outside layer (labia majora) is covered in pubic hair and is mostly made of protective fat. The inside layer (labia minora) is a fold of skin covering the vaginal opening.
Clitoris– the top most organ underneath the labia, this is no bigger than the size of a pencil eraser or the tip of your finger, but it houses a LOT of nerves. It is very sensitive to stimulation and pain.
Urethral opening– the top most opening (hole) is the opening for the urethra, which is a tube that attaches to the bladder inside the body (which attaches to the ureters, which attach to the kidneys). This hole is where urine comes out. Female urethras are very short, and as you can see, the urethral opening is very close to the anus, where feces comes out. This is why women are at increased risk of getting infections in their urine, because it is easy for bacteria from the feces to get into the urethral opening. This is why we recommend vigilance in keeping the urethral opening clean, by doing things like after using the bathroom always wiping front to back, always emptying the bladder after intercourse, and always wearing clean, loose-fitting undergarments. We do NOT recommend douching.
Vaginal opening– the second opening from the top. The vagina goes from this opening into the body, into the body up to the cervix, and is an average of 3-6” deep. It is a highly versatile organ, and facilitates sexual intercourse and childbirth and is a channel for menstrual blood during menses. It is made of multiple layers of tissue, from the mucosa that you can see, that provides a self-cleaning and self-lubricating mechanism to deeper layers of connective tissue and smooth muscle that allow for expansion and retraction. It is normal to have some vaginal discharge regularly, which will change with your cycle. Of course, if you find any new lumps or bumps or abnormal or foul-smelling discharge, itching, burning, or pain you should notify your provider. Vulvar and vaginal tissue changes after menopause, with the reduced estrogen your body is making. If you are experiencing excessive dryness or pain, please notify your provider. (Also, a reminder: after you have completed menopause- meaning NO vaginal bleeding for 1 full year, if you do then have any vaginal bleeding, it is considered abnormal and should be immediately addressed by your provider. It should really be called MenoSTOP, not MenoPAUSE, as we do NOT expect to see bleeding again once you’re done).
Hymen- a thin membrane of tissue that partially covers the vaginal opening early in life.
Anus– the third opening, farthest from the top. There is a little area of skin between the vaginal opening and the anal opening called the perineum. The anus is what delivers feces from the rectum and bowel. It contains a sphincter to help control evacuation. Again, it is important to try to keep the bacteria in the anus away from the vaginal and urethral openings to prevent infection.
Breasts– although, clearly, breasts are not located with all the other parts we are discussing, let’s take a moment to mention that female breast tissue is unique and variable and requires regular exams, with the other female organs. Breast exams are part of your exam by your provider annually, and over age 40 (possibly younger) annual mammograms (radiological imaging of the breast tissue, checking for any abnormalities, to rule out cancers) are recommended. We also recommend self breast exams monthly, because if there are any new lumps or bumps we want them found early. Anything new or unusual with your breast tissue (reminder: it extends up to your clavicles along your bra strap area!) you should contact your provider immediately.
So, those are the basics of external female anatomy. Again, if you have any concerns about any of your own parts, please contact your Oakland Macomb provider immediately.
We will discuss the internal female anatomy later in the week. Until then, be well!