20 Facts Every Woman Must Know About Her Vagina

While many people use “vagina” to refer to the whole below-the-belt area, inside and out, the term refers specifically to the muscular canal connecting the cervix (aka the lower part of the uterus) to the outside of the body. All the external parts of your reproductive system are properly called the vulva. The vulva includes:

Labia majora: The fleshy, hair-covered outer folds.

Labia minora: The inner lips, which cover the vaginal opening. These can be very small, or they can extend beyond the labia majora. It’s also common for one lip to be longer than the other.

Clitoris: The nerve-rich nub at the top of the vulva, crucial to orgasm and sexual pleasure.

“You should not need to put anything in the vagina to clean the actual inside,” says Dr. Dweck. That means no douching, no scrubbing inside, and definitely no scented products inserted into your vagina. And forget all the sprays, perfumes, and other products designed to cleanse the vulva: “Our culture is obsessed with the gazillion products out there for the vaginal area, but you really don’t need anything other than soap and water,” Dr. Dweck says.

One very important reason not to douche: “There’s a very delicate balance, a significant ecosystem of yeast and bacteria that are supposed to be there and stay in balance,” Dr. Dweck explains. Douching disturbs the balance of microbes in your vagina along with its natural acidity, potentially leading to the growth of harmful bacteria. In fact, douching has been linked to infections (such as bacterial vaginosis, yeast, and even pelvic inflammatory disease) as well as vaginal irritation.

From a vaginal steam (made famous by Gwyneth Paltrow) to a full-service “vajacial” (an in-depth treatment involving masks, exfoliation, tweezing, and creams applied to your vulva), specialized down-there spa treatments are, at best, unnecessary. At worst, they could lead to infections or even burns on your most sensitive parts. While your hair removal preferences are between you, your partner, and your favorite aesthetician (or dermatologist, if you choose laser hair removal), we advise saving your spa budget for a great facial or pedicure instead.

Some odor down there is perfectly normal. Your personal scent is unique and may vary according to your menstrual cycle, your diet, even how hydrated you are. That said, any foul odor or a smell that’s unusual for you is worth a visit to your ob/gyn to check for infection. And, says Dr. Dweck, “If you are having an odor you think can be noticed across the room, think long and hard about whether you may have left a tampon inside.”

A moist, warm environment can breed yeast and bacteria, so stick to underwear and clothing that provides your vulva with a little airflow. Dr. Dweck recommends cotton panties, or at least ones with a cotton crotch. Thongs are fine as long as they aren’t causing chafing or irritation. “Don’t wear panty liners or pads 24/7 if you don’t need them—they don’t allow breathable conditions,” Dr. Dweck adds. “I often recommend sleeping without anything on your bottom, to give you plenty of aeration.” (Exercising? Consider wicking workout underwear to avoid uncomfortable sweat-sopped panties.)

At the top of your vagina is your cervix, the lower end of your uterus. Secretions produced by the cervix (called cervical mucus) change in consistency throughout your cycle as your hormone levels rise and fall. “If you pay close attention to your cervical mucus, you can avoid or engage in sex at the right time to conceive,” Dr. Dweck says. (You can check by looking at the toilet paper after you wipe, or by inserting a clean finger into your vagina. You’re looking for what’s known as egg white cervical mucus, or EWCM, a stretchy, slippery consistency.) Along with taking your body temperature each day, checking your cervical mucus is one of the methods used in natural family planning.

“There are a lot of things that can cause an itch that aren’t a yeast infection,” says Hilda Hutcherson, MD, professor of ob/gyn at Columbia University Medical Center. That could include chafing from your clothing, irritation from shaving, or a product (like laundry detergent or soap) that the sensitive skin on your vulva is reacting to. And discharge and discomfort can be caused by other types of vaginal infections, including bacterial vaginosis (which typically comes with a foul-smelling discharge plus irritation and burning) and sexually transmitted infections like trichomoniasis. Check in with your doctor before you use an over-the-counter medication—the wrong treatment can actually make things worse.

Sorry, natural-medicine fans: Neither eating yogurt nor dabbing it on your nether parts have been proven to prevent or cure yeast infections. “However, some women do find that when they have that itching, putting yogurt on the area does feel quite soothing,” Dr. Dweck says. “It’s cool and calms down the itch. It’s not going to hurt. But remember, it’s not going to treat the yeast infection.” If you try it, make sure to stick to plain, unflavored, unsweetened yogurt; extra sugar can actually feed the growth of yeast.

The vagina is what experts call a “potential space,” which means it’s not open all the time. “The walls are collapsed on each other,” explains Dr. Hutcherson. “You’re not walking around with a gaping hole in your body.” Yet it can also stretch and widen during sex or childbirth to accommodate fingers, toys, a penis, or yes, even a 10-pound (or bigger!) baby.

As Dr. Hutcherson points out, “There’s an end to it.” That means tampons can’t escape your vagina and go wandering through your body, though they may get lodged high up against the back wall of the vagina where they’re more difficult to reach. If you have trouble retrieving a tampon, broken condom, or other object from your vagina, head to your ob/gyn for assistance fishing it out. (And don’t be embarrassed; doctors do this kind of thing all the time.)

Though it’s true you can’t permanently lose small objects in your vagina, that doesn’t mean anything goes. “Don’t put things in it that you can’t get out,” Dr. Hutcherson warns. That includes whipped cream, honey, sugar, or any other sticky or sugary food items. “It’s a setup for infection, because it’s totally going to change the environment of the vagina,” Dr. Hutcherson explains. “Yeast loves sugar, so you’re probably going to get an overgrowth of yeast, and it may change the pH as well.”

One of the main causes of vaginal dryness is low estrogen. “Whether you’re nursing or perimenopausal or menopausal, a lack of estrogen has a direct effect on your vaginal tissue,” explains Dr. Dweck. “The tissue becomes much less elastic, much thinner, more prone to injury. That can lead to uncomfortable sex and increase your chances of developing a UTI.” Luckily, there are plenty of options to treat dryness: Vaginal moisturizers, such as Replens, are used day-to-day to help ease and prevent dryness. Lubricants, whether water-based or silicone-based, can be used in the moment to help keep things more comfortable during sex. (Here are five types of lube to know about.) And for some women, doctors may prescribe vaginal estrogen, which eases symptoms without putting as much estrogen in your bloodstream as oral estrogen treatments.

Sure, getting busy burns calories, reduces stress, and boosts immunity, not to mention brings you closer to your partner. But here’s another health benefit of sex: “Sex keeps the vagina alive and lubricated, especially as women get older and estrogen goes down,” Dr. Hutcherson explains. “Sexual activity keeps blood flowing down there and decreases some of the changes that you get with menopause.” And in fact, all kinds of sexual activity can be helpful. “A lot of gynecologists right now are recommending vibrators to increase blood flow to the vagina,” Dr. Dweck notes.

If sex hurts, you don’t have to suffer (or abstain). “We have many remedies for painful sex,” Dr. Dweck emphasizes. Start with the basics: Experiment with different positions and with vaginal moisturizer or lube. Consider prescription remedies such as vaginal estrogen. “Then think about possible causes that are not due to dryness,” says Dr. Dweck, such as fibroids, ovarian cysts, or endometriosis. Your gynecologist can also help you rule out other potential culprits such as an infection or a skin condition.

When it comes to how your vulva looks, there’s a huge variation in what’s “normal.” That goes for everything from the size of your clitoris to the thickness and length of your labia (it’s totally normal to have asymmetrical labia, by the way). “As physicians, we don’t consider labia to be abnormal unless they’re causing trouble with chafing or infection, or if you’re having difficulty inserting a tampon or with intercourse,” says Dr. Dweck. (This hasn’t stopped thousands of women from getting cosmetic surgery down there, a procedure called labiaplasty.) As for color, a healthy vulva comes in all shades, and what’s normal for you can even change over time. “Pigment changes happen in the vulva frequently, particularly hormonal changes related to pregnancy and childbirth,” Dr. Dweck notes. (But see your doc if you notice unusual spots or discoloration.)

It’s true: Having a vagina makes you more susceptible to getting a sexually transmitted disease (STD) than a person with a penis. That’s because the thin lining of the vagina allows viruses and bacteria to pass through more easily than the tougher skin of the penis. It’s also more likely during heterosexual intercourse to suffer tiny abrasions, further increasing the possibility of infection, Dr. Dweck explains; and the use of spermicides can actually increase the chance of developing microabrasions. “Keep in mind a lot of STDs are not transmitted just by semen, but by skin to skin contact,” Dr. Dweck adds. We can’t say it enough: Use condoms!

“The vagina has the capacity to stretch beyond imagination,” says Dr. Hutcherson. “And it’s the only organ in the human body that has this capacity to stretch like that but then snap back into shape. So your vagina is not shot just because you have a large baby, or have sex with a large man, or use a large dildo.” Even if things are a bit looser down there post-delivery, it shouldn’t affect sexual satisfaction, according to a study published in the International Journal of Impotence Research.

Okay, technically you can’t exercise the vagina itself. But you can strengthen the muscles of the pelvic floor, which support the pelvic organs (including your bladder and uterus) and wrap around the vagina and rectum. Doing Kegel exercises to work your pelvic floor can increase blood flow to the vaginal area and help you have more powerful orgasms, as well as improve bladder control—crucial if you suffer from stress incontinence). If you’ve suffered damage to your pelvic floor due to pregnancy and/or childbirth, and Kegels alone aren’t cutting it, your ob/gyn may recommend pelvic floor physical therapy, which can include electrostimulation or biofeedback. In some cases surgery may be needed, Dr. Hutcherson says.

In 2014, the American College of Physicians caused a stir by recommending against routine pelvic exams for women who aren’t pregnant or having unusual symptoms. The American College of Obstetricians and Gynecologists disagreed, sticking to its own recommendation of annual pelvic exams for all women ages 21 and over. While you can discuss with your doctor whether or not you should have a pelvic exam, “It’s very important to come in for an annual visit no matter what,” Dr. Dweck emphasizes. “We get so much from the annual visit, including your family history, stress level, smoking and other risk-taking behaviors.”

credit: HealthMagazineOnline