Janelle McAlpine MMRes BA (Human Bioscience) BMid
Registered Midwife
Am I normal?
One question many women ask themselves is whether they are normal down below. A rise in plastic surgery rates on female genitalia suggests that some women, at least, are not happy with how they are put together down there and are perhaps modelling themselves on the close ups available for viewing thanks to the internet.
However, many women are simply unaware of what is normal, what is not, the basic anatomy of the female genitalia and reproductive system. Here is a basic overview of how women are put together down below, written in plain language. Please keep in mind that while women are all made up with the same bits and pieces there are always slight variations between each of us. We are all individuals, after all.
Basic Anatomy – Vulva
Clitoris
The clitoris is the female equivalent of the head of the penis. It is made up of bundles of nerve cells and rather than being a button or a knob is actually a shaft which extends back into the woman’s body. The nerves in the clitoris make it extremely sensitive, and when a woman is aroused sexually it becomes erect much in the same way a man gets an erection under the same circumstances. Stimulation of the clitoris is important for sexual satisfaction.
Labia Minora and Majora
The labia minora (or ‘little’ or ‘inner’ lips) are found either side of the clitoris, urethral and vaginal openings are are an extension of the clitoral hood. The size of labia differ between women. Sometimes the labia minora are tucked away and completely enclosed by the labia majora. Sometimes they may hang out a little bit. The labia majora are the ‘outer’ or ‘big lips’ that are what are seen on the outside. These labia acts to protect the sensitive areas and opeinings in the the vulval region. In most women the two sides of both sets of labia are different, and one sits a little lower than the other. As long as they are clean and healthy it is all within the range of normal.
Urethral Opening
This is the hole where your wee comes out. It is the exit end of the tube that comes from your bladder, where your wee is stored until you need to go to the toilet. It is usually found below the clitoris and above the vaginal opening but there is variation in exactly what position it sits from woman to woman.
Vaginal Opening
The vaginal opening is the outside end of the muscular tube that is your vagina. This is the hole than a penis goes in during sex and where you bleed from when you have your period. This is also where your baby comes out in a vaginal birth. The other end of your vagina ends in a tightly closed circular structure called the cervix (more about that later).
Perineum
The perineum is the name for the area between the genitalia and the anus. It is made up of several layers of muscle as well as the skin that covers them.
Anus
This is where your poo comes out. It is the exit end of the rectum, the final part of your intestines.
Basic Anatomy – Reproductive system
Cervix
Your cervix (or the neck of the womb) is the structure that is found at the inside end of your vagina. Most of the time it stays tightly closed and in reality should only open up in order to you to give birth. The cervix also has some nerves in it and can play a pleasurable role during sex. However, it can also be painful if treated too roughly so if you have pain during sex at full penetration this is probably whats happening. More information can be found about the role of the cervix here.
Uterus
The uterus has a few different components. The body of the uterus is the part in which a baby will grow. It consists of a few layers with different functions. the endometrium is the layer that builds up during your cycle and then is shed during your period (the blood of your period is actually discarded endometrium). The myometrium is the muscular component and is responsible for rhythmic contraction – when your aren’t pregnant this assists in shedding the endometrium, when you are pregnant it is the muscle layer responsible for your contractions. The fundus of the uterus is the very top part. If you are pregnant your care provider will measure the fundus to keep an eye on how your baby is growing.
Fallopian Tubes
These are the tubes that the egg (and the embryo after fertilisation) travel down on the way to your uterus.
Ovaries
Your ovaries have a couple of functions, being the production and release of eggs during each cycle, and the production and release of the hormones that control these cycles and sustain a pregnancy of necessary.
Pap Smears
A Pap test is the test of a sample of cells taken from a woman’s cervix or vagina. The test is used to look for changes in these cells that show cancer or conditions that may develop into cancer. If detected early, cervical cancer can be cured. A pap smear is recommended every 3 years from the time you become sexually active.
The Pap test is done during a pelvic exam. A doctor uses a device called a speculum (see below) to widen the opening of the vagina so that the cervix and vagina can be examined. A plastic spatula and small brush are used to collect cells from the cervix. After the cells are taken, they are placed into a solution. The solution is sent to a lab for testing. A Pap test should not be painful but will be uncomfortable. Pap smear result take about a week to come back to your doctor. If you haven’t heard from them in a few weeks, give them a call and chase them up. However, no news is good new in this situation as abnormal results will usually prompt a phone call from your nurse or doctor.
What do my results mean?
A normal Pap smear means the cells from the cervix look normal and are not showing any signs of unusual changes. An abnormal Pap smear means the cells do not look normal. This may prompt a repeat pap smear or some follow up tests to perform an accurate diagnosis or determine what treatment you may need. An abnormal smear does not always mean that cancer or pre-cancerous cells were found during the examination. There are many causes for abnormal Pap test results, including infection, inflammation related to using a diaphragm or sex, and changes related to your menstrual cycle. Your doctor will evaluate the results to determine if further testing is necessary.
A repeat Pap test may also be necessary if enough cells weren’t collected during your initial test to allow proper evaluation.
Women with certain risk factors, such as a history of abnormal Pap smears, should be screened more frequently. Please speak to your doctor about what frequency of Pap smears is most beneficial to you.
Hygiene
Your vagina has a self-cleaning mechanism which makes it really quite easy to look after. However there are a few maintenance issues that will help with your vaginal health and keep bacteria balanced and under control.
- Shower at least once a day. If you have two or more showers daily try to limit how much soap or body wash you use as it dries out your skin and can create an imbalance in the normal bacteria that live there.
- Keep your vulva area clean. Use mild, unscented soap and water. Do not attempt to wash the inside. Rinse well.
- After using the toilet, wipe from front to back. Wiping the other way can introduce gut bacteria into your reproductive system and cause infection.
- Wear cotton underwear. Cotton lets air flow and keeps you dry.
- Minimise how often you wear tight-fitting clothing, such as panty hose, and tight-fitting jeans.
- Change out of wet swimsuits as soon as possible. All of these clothes may increase body heat and moisture in your genital area, promoting bacterial overgrowth.
- Change pads or tampons often.
- Don’t douche or use deodorant tampons or feminine sprays, powders, or perfumes. These items can change the normal balance of organisms in your vagina.
A quick note:
Examinations down below are uncomfortable for a number of reasons. You are in a vulnerable position with an unfamiliar person pointing a spotlight at your genitalia. Sometimes a speculum may be inserted into your vagina. Please wash yourself if there is a possibility of an exam down below. Good hygiene makes this experience less unpleasant for all involved.