VaginaL De-mystifying tour

Vagina Anatomy 101

​The names for all of the vagina parts! Because if those are your parts, you should know their names... (and also, even if they're not your parts they might be parts of the person you like to have sex with, and you should know about them).

A Retrospective Note Re: Intended Audience

I admittedly wrote this post originally with cisgendered women in mind as the audience. Accurate education in vaginal anatomy is sorely lacking in our society and there is lots of misinformation that gets circulated out in the world (I'm looking at you, hymen). This post was intended to educate and empower people with a vagina to look at and learn about theirs. In retrospect, vagina-having-people are not the only people who should be familiar with the anatomy of vaginas, so I have made edits to be more inclusive.

For people whose anatomy doesn't match their gender, however, looking at and talking about genitals like this can be a major source of psychological distress. If that applies to you and medical terms for female-associated sex organs trigger dysphoria, you should just skip this post.

My number one goal is to make intimate conversations and exams as comfortable as possible for people. In clinic, I use whatever anatomy terms my clients use and prefer. I believe there is value and power in learning about our own bodies and anatomy, regardless of the names we use. This particular post provides a tour of vaginal anatomy using medical terms. If that's something you'd like to learn more about, take the jump.

External Anatomy
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We’ll start with the most obvious parts that people are generally most familiar with: the labia. Labia is latin for, literally, “lips,” and there are two sets which appear as folds of skin around the opening to the vagina. The external (“outside”) labia are generally a bit thicker and have smoother skin than the internal (“inside”) labia. Some people have external labia that cover their internal labia, and some people have internal labia that stick out from behind their external labia. Both situations are normal. Also, it’s not uncommon for right and left lips to look somewhat lopsided; no one is perfectly symmetrical.

Above the labia/vulva is a pad of flesh known as the mons pubis (“pubic mound”). This is mostly a fat pad that lays over the top of the pubic symphysis or pubic arch - the bones at the very front of your pelvis. During pregnancy when a growing belly is getting measured, the pubic arch is the lowest point where we measure from.

Introitus is the official medical term for the opening of the vagina. The labia are the folds of skin around the introitus. This is the hole babies come out of; it is very stretchy.

Just above the introitus is where you can find the clitoris (it’s really not that difficult to locate). It’s a round “bump” or sensitive knob of tissue where the internal labia come together. Fun fact: the external part of the clitoris that you can see and feel is only a small part of the whole structure. Clitoral tissue extends along the walls of the vagina, wrapping around the introitus and also reaching back inside along the top of the vagina. This tissue has LOTS of nerves and blood vessels, and when you’re aroused it expands in size, becomes extra sensitive, and contributes to vaginal secretions to make penetration easier and more pleasurable.

Between the top of the introitus and the clitoris, sometimes positioned a little bit back inside the edge of the introitus, is where you can locate the urethra, the hole where urine comes out. For the record: people do not pee from their vaginas.

Finally, in the opposite direction at the bottom of the introitus is an area of anatomy known as the perineum. This is the skin that lies between the bottom edge of the vagina and the rectum. In common slang it is sometimes called the “taint.” Everyone’s perineum is a different length; some are quite long with a few inches of space between the vagina and anus, and some are shorter with only an inch or less of skin.

We should mention, for a moment, the third hole down here: the anus or rectum. This is the hole stool comes out of and is further back, about where your buttocks start. For the record: people do not poop from their vaginas either, and babies do not come out of your butt.

Also: the bacterial organisms that happily live in the anus and rectum can cause uncomfortable infections if they get into the vagina. If you're having anal intercourse, follow a vagina first, anus last order of operations during sex. Other options include using a new condom for each location, and/or a sexy shower or bath with your partner between locations. Basically, be mindful to avoid moving organisms from the rectum to the vagina.

Internal Anatomy
When you come to see a health provider for a vaginal exam we are thorough, looking at all of the external structures described above. We also take a look internally, using a speculum to check on internal structures.

The vagina is actually the specific term for the tunnel of tissue that extends inward from the introitus to the base of the uterus. Vagina is another latin term which translates to “sheath,” and when you think of the visuals of penetration during penis-in-vagina intercourse, the name makes quite a bit of sense. The walls of the vagina are super stretchy and self-lubricating. When not aroused or in the act of childbirth, the walls have sort of a ribbed or grooved appearance. These ridges are called rugae (pronounced “rue-gay”) and are part of what makes the vagina so elastic. At times when estrogen levels decline (menopause, early breastfeeding) the rugae disappear and the walls of the vagina look more smooth. This is a sign that there may be low estrogen levels, and the smooth walls can lead to discomfort during penetrative intercourse.

A short distance into the vagina from the introitus is an anatomical structure frequently misunderstood. The hymen, or hymenal ring, is often imagined to be a thin membrane of skin stretching across the opening of the vagina. This is generally not the case; a more accurate description is a ring of tissue, or fringe of tissue, encircling the introitus that marks the beginning of the internal vaginal skin. It is incredibly rare that a hymen is a completely solid sheet of tissue, and if it is there are usually issues when that person starts to menstruate because it blocks period blood flow. Most hymens have some amount of opening from birth, and it’s more common for there to be a larger passage and less hymenal tissue than the other way round.

The hymen is stretchy just like the rest of the vagina, and although popular culture and mythology would have us believe that there is a “rupture” or “popping” that occurs with initial penetration, this is not always the case. Hymenal tissue can be disrupted from everyday activities and exercises that don’t involve any penetration, and many people do not have any significant discomfort or bleeding with their first penetrative sexual encounter. Now you know.

Another common misconception about internal vaginal anatomy is that “stuff can get lost up there.” This is a fear people express about using tampons and the nuva ring. While it is possible to forget that you have a tampon in, the back of the vagina is essentially a dead end. You won’t permanently lose anything up there.

What is in the back of the vagina is the cervix, which is the opening to the uterus, although most of the time it is closed. During ovulation or a period it opens a little bit to either let sperm swim in, or menstrual blood flow out. Even when it does open for these processes, the hole (called the cervical os) doesn’t get much bigger than a pencil eraser (so you’re still not going to lose anything up there). The cervix can open much larger, and does just that during labor and childbirth to let a baby through. Fun fact: the cervical os changes shape after it has opened up for a baby. Before giving birth for the first time the os is almost a perfectly round circle. After fully dilating it will look a little more elongated, like a slit, when it goes back to its usual size.

Although it’s tricky to see one's own cervix, it’s not impossible; a speculum, mirror, and flashlight will allow you to take a look. Check out beautifulcervix.com for info on self-cervical exam. Most folx can feel their own cervix by inserting 1-2 fingers into the vagina. Vaginal walls feel soft and stretchy, and the cervix feels like a firmer smooth bump; similar to the difference between the feel of your cheek and the tip of your nose.

The cervix also changes position during the menstrual cycle. During ovulation it softens just a little bit, opens slightly, and moves forward to make it easier for sperm to swim up. It can be easier to feel it right around mid-cycle when ovulation occurs. Conversely, it moves further back in the vagina and closes after ovulation, so it can be a little trickier to feel later in the cycle.

In addition to looking at external genitalia and looking at the internal vaginal walls and cervix during an exam, sexual health professionals also feel for anatomy that cannot be seen: the uterus and ovaries. The cervix is the very bottom portion of the uterus and is the only part that pokes out into the vagina. By placing a couple of fingers inside the vagina beneath the cervix, and putting a second hand on the outside of the lower pelvis, it’s possible to feel the general size and shape of the uterus and in which direction it’s situated. Some uteri tip forward towards the belly and are called “anteverted” and some uteri tip backward towards the low back and are called “retroverted.” Most uteri have some amount of tip to them, but a uterus that is neither tipped forward nor backward is said to be in “midposition.” The direction a uterus is tipped has about as much impact on a person as being either right or left handed; we don't have control over it, all variations are normal, and most of the time it doesn't matter.

Ovaries are much harder to feel because, under normal circumstances, they are so darn small! About the size of an almond on either side of the uterus. We use a similar technique to feel for ovaries as we do for the uterus; we try to “catch” them between an internal finger and external hand. It’s not uncommon to not be able to feel the ovaries during a normal exam, and this is not a concern. In fact, if we feel a sizeable lump where an ovary should be, we get more concerned about potential cysts or other abnormal structures.

Glossary

Anus - The opening to the rectum where you pass stool from. Located back behind the vagina approximately where the buttocks start.
Cervix - The very bottom and opening of the uterus that sits at the back of the vagina
Clitoris - Sensitive knob of tissue at the very top of the vagina where labia come together
External Labia (aka Labia Majora) - The outer vaginal lips/folds of skin surrounding the opening to the vagina
Hymen - Stretchy skin at the inside edge of the opening of the vagina; marks the beginning of internal vaginal walls. Does not reliably indicate virginity.
Internal Labia (aka Labia Minora) - The internal vaginal lips/folds of skin surrounding the opening to the vagina
Introitus - The opening to the vagina. (The hole babies come out of.)
Mons Pubis - The pad of tissue above the vagina covering the bones at the very front of the pelvis; also, the very lowest point of the pelvis.
Os - The opening of the cervix; the hole that dilates in labor
Ovaries - Small internal organs on either side of the uterus that produce eggs for reproduction. About the size of an almond.
Perineum - The skin between the vagina and the anus. aka "the taint".
Pubic Arch - Where the bones of the pelvis connect at the front of the body; the very top of the vagina
Rugae - The ridges on the walls of the vagina that help make the tissue super stretchy
Speculum - A medical device used to look inside the vagina
Urethra - The hole where urine comes out, located between the introitus and the clitoris
Uterus - Also called the womb; this is the internal muscular organ that holds a growing baby in pregnancy
Vagina - The sheath, or tunnel, of tissue that extends from the introitus to the base of the uterus

Your Own Anatomy
I encourage all folx to learn about their individual anatomy, to learn the names of specific structures, and to learn where all of their parts are. You can generally do this on your own with the help of a mirror, but having a health professional who specializes in genital anatomy orient you to your body can be an empowering educational experience. We can also help you find trickier parts to locate or see, such as a cervix. Any time a health care professional is conducting an intimate exam for you, they should let you know exactly what they are doing and tell you what they are seeing. If you are wondering what’s going on down there, ask them to show you with a mirror, or guide you to feel what they are feeling.

What to check in with an anatomy expert? That’s totally my job! Come see me, I’m really good at having conversations about genitals in a non-awkward way, and I’m happy to help you take a personalized tour of your anatomy.

©2019 Chelsea Gould