Sunday 24 March 2019

It's self-cleaning... the G-spot might exist (or it might not): 10 facts about the vagina

The vulva has been continually let down by science - and by doctors and anatomists, who argue over the full extent of the clitoris or existence of the G-spot. There are some unassailable facts, however, and learning them is key to understanding female health and sexuality, writes Lynn Enright, author of a new book on the subject

Some women will derive pleasure from the so-called G-spot; some won't
Some women will derive pleasure from the so-called G-spot; some won't

Did you know that the vagina changes: during sex, throughout the menstrual cycle, and with age and different life stages? We need to talk about women's sexual and reproductive health, about our experiences of sex and pregnancy, and about pain and pleasure; read on for some fascinating insights.

1 The vagina is inside your body and the vulva is outside...

The vagina is the muscular tube that leads from the vulva to the uterus. It's generally about 7 to 10 centimetres in length and most of the time the walls of the vagina are squeezed against each other. The vagina can expand to fit a tampon or a finger or a penis, or whatever, but it is not a hole - when I sit in the bath, water does not enter my vagina. The vagina expands during arousal, both lengthways and widthways; it also expands dramatically during childbirth. The vagina is enclosed; it would be impossible to lose anything in the vagina, impossible for anything to make its way further into the body, beyond the vagina, past the cervix.

2 The cervix is the part of the uterus that extends into the vagina...

The cervix can change position, colour and shape at different stages of the menstrual cycle or when there are hormonal changes in puberty and menopause.

The opening of the cervix is just a tiny hole, through which menstrual blood or seminal fluid can pass. A finger, penis, menstrual cup or tampon could not fit through it - but, during labour and childbirth, the opening of the cervix dilates to accommodate a baby. There are glands in the cervix that produce cervical fluid, which changes consistency during the menstrual cycle, responding to hormonal changes. Cervical screening tests (also called smear tests) check the health of the cells in the cervix - changes and abnormalities in the cells of the cervix are nearly always caused by the human papillomavirus (HPV) and, if left untreated, these abnormal cells can become cancerous.

3 People often say 'vagina' when they mean 'vulva'...

The vulva covers a lot. It is the mons pubis (sometimes called the mons Venus or Mound of Venus) - the fatty flesh that covers the pubic bone. It is the clitoral hood and the clitoris underneath that. It is the labia - the outer labia and the inner labia (sometimes called the labia majora and labia minora). It is the vestibule, which is the space between the inner labia. It is the urethral opening, which is small and often hard to see. And it is the opening to the vagina, which is also called the vaginal introitus.

Those are the components that make up a vulva. What a vulva looks like, however, differs from person to person. Some people will have much more hair than others. There will be variation in colour, depending on skin tone, sexual arousal, age and other factors. Some people will have smaller or larger labia, smaller or larger clitorises.

4 The vagina is self-cleaning...

The vagina is self-cleaning - the vaginal flora (bacteria that live in the vagina) keep the vagina healthy by prohibiting the growth of yeast and other organisms. Discharge from the vagina has a slightly acidic taste and smell; this acidity is what prohibits harmful bacteria from developing. The smell and quantity of discharge can vary depending on the stage of the menstrual cycle - and sex or heat or exercise can affect the smell, too. If there is a significant change in the texture or smell of discharge an infection is likely, and a visit to the doctor is required.

5 The hymen is not a cling-film like covering of the vaginal opening...

The hymen has been misunderstood and misrepresented for centuries, taking on a cultural meaning that does not reflect the biological reality. The hymen is a mucous membrane along the vaginal opening. It is usually shaped like a ring or a crescent, although some people will have strands stretching across the vagina. In very rare cases, which might require medical intervention, it will appear like a covering. There are significant variations in the hymen from girl to girl and woman to woman, and some people are born without a hymen. Some women's hymens become less noticeable in early adulthood, as hormones change; others will see changes in their hymen after giving birth or reaching menopause. The hymen performs no biological function. It is untrue to say that the hymen is 'broken' the first time a girl or woman has penetrative sex.

6 Labiplasty is the fastest growing type of surgery in the world...

Sometimes, the inner labia sit inside the outer labia but usually they do not; in most people, the inner labia will protrude beyond the outer labia. Often they are unsymmetrical with one side longer than another. The labia change during puberty - getting longer or changing colour, or both - but this is rarely discussed. There is great variation in labia from person to person: a 2018 Swiss study examined 657 white women aged between 15 and 84 years old and found that measurements vary significantly. Some labia measured 4cm in length, while others were 10cm.

7 The clitoris extends inside the body...

Beneath the clitoral hood, at the uppermost part of the vulva, is the clitoris. Or, more accurately, is some of the clitoris. This visible part, called the glans, varies in size from person to person, ranging from around 0.5 to 3.5cm. The clitoris and the penis have similarities; they have developed from the same embryonic tissue. The glans of the clitoris is, like the glans of the penis, the most sensitive part with thousands of sensory nerve endings. Beyond the glans is the shaft of the clitoris, which then divides into two 'legs', which are known as crura. These crura are inside the body and so are not visible. There are also two clitoral bulbs inside the tissue of the vulva. When a person is aroused, the entire clitoris becomes engorged with blood.

8 Most women orgasm most intensely via clitoral stimulation...

Thanks to Sigmund Freud, female orgasms have been unhelpfully divided into categories - vaginal and clitoral - with vaginal orgasms being deemed more "mature" than clitoral ones. Actually, as the clitoris extends inside the body, most so-called vaginal orgasms actually derive from the clitoris. Recent research also shows that as many as two out of three women require stimulation to the glans of the clitoris to orgasm, or find that clitoral stimulation makes their orgasms more intense.

9 The G-spot might exist... or it might not...

Some women find that stimulating an area on the front wall of their vagina - called the G-spot - induces orgasm or makes orgasm more intense. Some women can find no such area. And most scientists agree that there is no actual anatomical structure that can be reliably called a G-spot. The conclusion? People's vaginas are different and the blood vessels and nerves in one will be different to another - some women will derive pleasure from the so-called G-spot; some won't.

10 The vulva changes as we age...

After menopause, the body produces less oestrogen. This means that skin becomes drier and, for many, that affects the vagina and urethra, too. Genitourinary syndrome of menopause (GSM) is a fairly new term. Previously called vulvovaginal atrophy, atrophic vaginitis or simply persistent vaginal dryness, it is a common symptom of the menopause, estimated to affect up to 50pc of women. Sex can often be painful as a result. Many women find that symptoms are passed off as unimportant or as an inevitability of ageing but hormone replacement therapy (HRT) and pelvic-floor exercises can help.

Vagina: A Re-Education by Lynn Enright, published by Allen & Unwin, is out on Thursday

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