VAGINA

The passage for the creation of life, for giving birth and for sexual pleasure-these are the functions of the vagina. Unfortunately the vagina is prone to minor disorders which require medical treatment.

The vagina is the channel which leads from the vulva to the uterus. During woman’s life the vagina undergoes several changes. The vagina of a child is obviously smaller than that of a mature woman. The lining of the wall of the vagina is thinner in a child or post menopausal woman than that of a woman in the reproductive years of her life. These changes are largely influenced by a group of hormones released by the ovary; these are called oestrogens.

The vagina plays an important role during intercourse and childbirth. The role during childbirth is relatively passive when the vagina forms the lower portion of the birth canal and is capable of opening sufficiently to allow the birth of the baby. We have only relatively recently begun to understand some of the changes which occur in the vagina during intercourse.

STRUCTURE

The vagina is a canal 7 cm (2 3/4 in) to 9 cm (3 1/2 in) long, surrounded by fibrous and muscular tissue, but lined with a layer of cells called squamous epithelium. The walls of the canal are normally collapsed onto one another and thrown into many folds. These properties make it easy for the vagina to be distended during intercourse or childbirth. The urethra lies on the front wall of the vagina and the rectum lies on the upper third of the back of the vagina. The anus is separated from the vagina by a fibro-muscular tissue called the perennial body. The ducts from two glands called Bartholin’s glands enter on either side of the outer end of the vagina, while the cervix protrudes into the top of the vagina.

During the reproductive years of a woman’s life the vaginal secretions are slightly acidic. This tends to inhibit the growth of harmful bacteria in the vagina, but during the pre-pubertal and post-menopausal years, the vagina becomes mildly alkaline. Under these circumstances the bacteria can thrive and occasionally make the vagina rather sore and uncomfortable - a condition called atrophic vaginitis.

The walls of the vagina are well lubricated with secretions from the cervical canal and Bartholin’s glands. During intercourse, secretions also seep through the vaginal epithelium into the vaginal canal. A certain amount of discharge from the vagina is normal in all women. The amount increases during ovulation and sexual arousal.

FUNCTION

During sexual arousal the genital organs, especially the labia minor and lower vagina, become engorged with blood and the amount of vaginal secretion increases. During an orgasm the muscles of the pelvis including those surrounding the vagina contract involuntarily.

If a women is particularly tense or anxious during intercourse, the muscles surrounding the vagina will go into spasm. This makes the vagina narrower and also makes sex painful. This condition is called vaginismus. It can be cured by help from a psycho-sexual counsellor, but it often takes many months before the woman can fully enjoy sex.

DISORDERS

Women sometimes find it very embarrassing to consult their family doctor about their gynecological problems. However, as most of the problems are relatively minor and respond to simple forms of treatment, it is well worth seeking medical advice early.

Probably one of the most common problems is an irritating vaginal discharge called thrush, which is caused by the candida albicans fungus. This can be easily treated with vaginal pessaries. Unfortunately it is easy to become re-infected with this by treating the woman's partner at the same time and warning her to be particularly careful about washing her towels and pants out very thoroughly a the spores of this fungus can lodge in these articles.

Another common problem is atrophic vaginitis. This condition affects women in their mid-sixties. It tends to make the vagina sore and uncomfortable. This occurs because these women no longer have high enough levels of oestrogen in their circulation to stimulate the growth of the vaginal epithelium. The vagina then loses its acidity which favours the growth of the bacteria. the condition can be easily treated with oestrogen creams or a slightly acidic jelly which is inserted into the vagina.