What Is the Vulva?

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Genital tubercle of female at fourteen weeks Development of genitals showing homologues from indifferent at A to both sexes – female on right Development of genitals showing homologues from indifferent to both sexes In week three of the development of the embryomesenchyme cells from the primitive streak migrate around the cloacal membrane. This division creates two areas one surrounded by the urethral folds and the other by the anal folds.

At this time the sexes still cannot be distinguished. The lower part of the canal is blocked off by a plate of tissue, the vaginal plate. This tissue develops and lengthens during the third to fifth months and the lower part of the vaginal canal is formed by a process of desquamation or cell shedding. The end of the vaginal canal is blocked off by an endodermal membrane which separates the opening from the vestibule.

In the fifth month the membrane degenerates but leaves a remnant called the hymen. This condition is known as labial fusion and is rarely found after puberty when oestrogen production has increased.

Pubic hair is much coarser than other body hair, and is considered a secondary sex characteristic. Premature pubarche may sometimes indicate a later metabolic – endocrine disorder seen at adolescence. The disorder sometimes known as a polyendocrine disorder is marked by elevated levels of androgeninsulinand lipidsand may originate in the fetus. Instead of being seen as a normal variant it is proposed that premature pubarche may be seen as a marker for these later endocrine disorders.

This is broken down by bacteria on the skin and produces an odor, [46] which some consider to act as an attractant sex pheromone. This contributes to the maturation of the vulva with increases in the size of the mons pubis, and the labia majora and the enlargement of the labia minora.

This appears between the eighth and twelfth week and continues to darken as the pregnancy continues. The vaginal opening and the vagina are also enlarged. This condition has been renamed by some bodies as the genitourinary syndrome of menopause as a more comprehensive term.

It provides entry to, and protection for the uterus, and the right conditions in terms of warmth and moisture that aids in its sexual and reproductive functions. The external organs of the vulva are richly innervated and provide pleasure when properly stimulated. The mons pubis provides cushioning against the pubic bone during intercourse. It can cause discomfort during sexual activity as it can cause the clitoral glans to stick to the hood, and is easily removed by bathing.

Their fatty acid composition, and consequently their odor changes in relation to the stages of the menstrual cycle. Local stimulation can involve the clitoris, vagina and other perineal regions. The clitoris is the human female’s most sensitive erogenous zone and generally the primary anatomical source of human female sexual pleasure. Stimulation to orgasm is optimally achieved by a massaging sensation.

During arousal vaginal lubrication increases. Vulva tissue is highly vascularised ; arterioles dilate in response to sexual arousal and the smaller veins will compress after arousal, [30] [56] so that the clitoris and labia minora increase in size. The clitoris becomes increasingly erectand the glans moves towards the pubic bonebecoming concealed by the hood. The labia minora increase considerably in thickness. The labia minora sometimes change considerably in color, going from pink to red in lighter skinned women who have not borne a child, or red to dark red in those that have.

Immediately prior to an orgasmthe clitoris becomes exceptionally engorged, causing the glans to appear to retract into the clitoral hood. Rhythmic muscle contractions occur in the outer third of the vagina, as well as the uterus and anus. Contractions become less intense and more randomly spaced as the orgasm continues. The number of contractions that accompany an orgasm vary depending on its intensity. An orgasm may be accompanied by female ejaculationcausing liquid from either the Skene’s gland or bladder to be expelled through the urethra.

The pooled blood begins to dissipate, although at a much slower rate if an orgasm has not occurred. The vagina and vaginal opening return to their normal relaxed state, and the rest of the vulva returns to its normal size, position and color.

In the s, Marie Bonaparte conducted surveys among women to find out whether they get an orgasm during coitus. The causes of lack of sexual arousal were known to be aversion or psychological inhibitions. Among the test subjects, there were women who, with a man they loved and desired, “felt the greatest pleasure at certain tender touches”, but were nevertheless not sufficiently aroused during coitus.

Bonaparte examined the distance between the clitoris and the vagina in women. All the women with a large gap stated that they did not experience satisfying pleasure from penile penetration, although some were very sensitive to “precise stroking by the man”.

Bonaparte concluded from this an anatomical causal connection between a large CUMD and “vaginal frigidity” explaining why only women with the clitoral glans close to the vagina so that it is continuously touched by the penis were able to experience “the highest sexual pleasure” during coitus. This can be a symptom of many disorders, some of which may la vulva determined by a patch test.

The most common cause of irritation is thrusha fungal infection. Vulvovaginal health measures can help to prevent many disorders including thrush. A severe variant of this is vulvovaginal-gingival syndrome which can lead to narrowing of the vagina, [75] or vulva destruction. Over thirty types of pathogen can be sexually transmittedand many of these affect the genitals. Trichomoniasis is transmitted by a parasitic protozoan and is the most common non-viral STI.

Studies have shown that vulvar melanomas appear to have a different tumor biology and mutational characteristics compared to skin melanomaswhich has a direct impact on the medical treatment of vulvar melanomas. Pelvic pain might also occur especially during urinating and sex. Typically, a wide-local excision is performed, in which the tumor is excised including a safety-margin of healthy tissue to ensure its entire removal, which is confirmed by a pathologist.

This affects a number of young girls and is not considered unduly problematic. The condition can usually be treated using creamsor it may right itself with the release of hormones at the onset of puberty. There is no single identifiable cause. Crohn’s disease of the vulva is an uncommon form of metastatic Crohn’s disease which manifests as a skin condition showing as hypertrophic lesions or vulvar abscesses. Another more complex ulcerative condition is hidradenitis suppurativa which is characterised by painful cysts that can ulcerate, and recur, and can become chronic lasting for many years.

Dermatoscopy can distinguish this condition from genital warts. This can result in tears known as perineal tears in the vaginal opening, and other structures within the perineum.

A tear takes longer to heal than an incision. These procedures include vaginoplasty which can also be performed as a cosmetic surgery. Other cosmetic surgeries to change the appearance of external structures include labiaplasties. They refer to the lack of data relevant to their safety and effectiveness and to the potential associated risks such as infectionaltered sensation, dyspareuniaadhesionsand scarring.

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