This is going to be an anatomy lesson of female genitalia, so if you are not interested (which you damn should be!) then read no further.
People often mistakenly refer to female genitalia as vagina, but when we do that we are really just speaking to the part of a woman’s body that has 2 main purposes: for male pleasure and for conception and delivery of a baby. The vagina is an important part of female genitalia, but it does not accurately depict the entire picture. Let’s get into it!
Words matter. It is so correct to know and use the correct terminology, because that serves many purposes. We need and deserve body autonomy. If we understand the correct words we can use the correct words to describe if something hurts, feels uncomfortable, or when it feels good or pleasurable. We need to be able to discuss our concerns with healthcare providers instead of just saying “it hurts down there”, “something is wrong with my lady parts”, or “my vagina hurts”. It’s important for children to understand these terms so they can accurately describe if someone violates their privacy or boundaries. Using the right words can be life saving!
Vagina: Let’s start with the vagina since so many of us know that and use that to describe our own or other peoples genitalia. The vagina is a hollow tube. Unless there is something in the vagina, the vagina closes in on itself and is a dark and moist place. The walls are ruggated, or bumpy kind of like an accordion, and this is important for stretching during intercourse or during childbirth. Without the presence of estrogen, these ruggations will go away. During intercourse, the vagina stretches about an inch! The vagina doesn’t have a lot of areas of pleasure or pain, but intercourse can be pleasure or painful! Parts of the clitoris sit on top of (the G-zone) and beside the vagina like a straddle. Internal pressure of the vaginal walls can be pleasurable. Vaginal penetration can be painful if there is a pelvic floor dysfunction, endometriosis, bowel or bladder issues, or irritation at the vestibule. Which leads me to the next V….
Vestibule: The vestibule is the most under-recognized, under-appreciated, under-examined part of female anatomy. A vestibule is a doorway or entry. That’s exactly true for the vagina, it’s at the entry point into the vagina. The vestibule is derived from the same tissue that the bladder is derived from, which is why a problem with the vestibule must be ruled out if you have bladder issues. A lot of times vestibular pain feels like bladder pain leading to the over-diagnosis of interstitial cystitis and UTIs (when not proven by a culture). The vestibule has a lot of hormone receptors, and actually has more androgen (DHEA and testosterone) receptors than it does estrogen receptors. So androgesn are impearative for vestibular health! There is lots to consider if someone has vestibular pain – it could be hormonal, inflammatory, infectious or neuroproliferative. You need a skilled clinician to help discover the cause. You can find one by searching ISSWSH.
Vulva: And last but certainly not least, the vulva. The vulva is the whole thing! The mons (top portion), the clitoris, the labia minora and majora or inner lips and outer lips, the infralabial sulcus. This is what we should use to refer to our genitalia, not vagina. The vulva includes the vestibule and vagina, but it also includes the areas of our anatomy that are most pleasures – labia, mons, and clitoris.
Here’s a diagram by Pelvic Guru that helps highlight some anatomy:
