Posts Tagged ‘vulva’

How High Is Your V.I.Q. (Vaginal Intelligence Quotient)?

June 17, 2017

Andrew Siegel MD  6/17/2017

You may know your I.Q., but do you know your V.I.Q.?  Let’s begin with a test of your knowledge of lady parts and determine your “Vaginal Intelligence Quotient” or V.I.Q.  See how many of 8 female genital structures you can properly identify. Answers are at end of this blog entry.  Note that there is one anatomical part that virtually no one gets right.  (Thank you Michael Ferig, Wikipedia Commons).

vulva_hymen_miguelferig

 

The Female Nether Parts

The female nether parts are a mystery zone to a surprising number of women, who often have limited knowledge of the inner workings of their own genital anatomy. Many falsely believe that the “pee hole” and “vagina hole” are one and the same. The truth is that the terrain between a female’s thighs is more complicated than one would think…. three openings, two sets of lips, mounds, swellings, glands, erectile tissues and very specialized muscles. While female anatomy may be mysterious to many women, many men are downright clueless and would be well served to learn some basic anatomy. Learn lady parts…knowledge is power!

“The vagina is a place of procreative darkness, a sinister place from which blood periodically seeps as if from a wound.”

“Even when made safe, men feared the vagina, already attributed mysterious sexual power – did it not conjure up a man’s organ, absorb it, milk it, spit it out limp?”

–Tom Hickman from “God’s Doodle”

The names of several lady parts begin with the letter “V”—vulva, vagina and vestibule. What could be a better choice since the area (the vulva) is V-shaped?

pixabay-v

Thank you Pixabay for image above

The Vulva 

The vulva is the outside part of the female genitals. It consists of the mons pubis, labia majora, labia minora, vestibule, vaginal opening, urethral opening and clitoris.

The mons is the triangular mound that covers the pubic bone, consisting of hair-bearing skin and underlying fatty tissue. It extends down on each side to form the labia majora, folds of hair-bearing skin and underlying fatty tissue that surround the entrance to the vagina. Within the labia majora are two soft, hairless skin folds known as labia minora, which safeguard the entrance to the vagina. The upper part of each labia minora unites to form the clitoral hood (prepuce or foreskin) at the upper part of the clitoris and the frenulum (a small band of tissue that secures the clitoral head to the hood) at the underside of the clitoris.

Figure_28_02_02

(Anatomy of the vulva and the clitoris by OpenStax College – Anatomy & Physiology, Connexions Web site. http://cnx.org/content/col11496/1.6/, Jun 19, 2013., CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=30148635, no changes made to original)

The Vestibule

The vestibule is the “entryway,” an area located between the inner lips that contains the entrances to the vagina and the urethra. Urine exits from the urethral opening on the vestibule and not from the vaginal opening. There is a small amount of vestibule tissue that separates the urethral opening from the vaginal opening.

 The Vagina

The word “vagina” intelligently derives from the Latin word for “sheath,” a cover for the blade of a knife or sword. Most women (and men) falsely think of the vagina as the external female genitals. The external lady parts are the VULVA as opposed to the VAGINA, which is internal.

 The Clitoris

The word clitoris derives from the Greek “kleitoris,” meaning “little hill.” The clitoris is uniquely an erectile organ that has as its express purpose sexual function, as opposed to the penis, which is a “multi-tasking” sexual, urinary and reproductive organ. The clitoris is the center of female sensual focus and is the most sensitive erogenous zone of the body, playing a vital role in sensation and orgasm. If an orgasm can be thought of as an “earthquake,” the clitoris can be thought of as the “epicenter.” The head of the clitoris, typically only the size of a pea, is a dense bundle of sensory nerve fibers thought to have greater nerve density than any other body part.

Like the penis, the clitoris is composed of an external visible part and an internal, deeper, invisible part. The inner part is known as the crura (legs), which are shaped like a wishbone with each side attached to the pubic arch as it descends and diverges. The visible part is located above the opening of the urethra, near the junction point of the inner lips. Similar to the penis, the clitoris has a glans (head), a shaft (body) and is covered by a hood of tissue that is the female equivalent of the prepuce (foreskin).  The glans is extremely sensitive to direct stimulation.

The shaft and crura contain erectile tissue, consisting of spongy sinuses that become engorged with blood at the time of sexual stimulation, resulting in clitoral engorgement and erection. The clitoral bulbs are additional erectile tissues that are sac-shaped and are situated between the crura. With sexual stimulation, they become full, plumping and tightening the vaginal opening. The crura and bulbs can be thought of as the roots of a tree, hidden from view and extending deeply below the surface, yet fundamental to the support and function of the clitoral shaft and clitoral glans above, which can be thought of as the trunk of a tree.

When the clitoris is stimulated, the shaft expands with accompanying swelling of the glans. With increasing stimulation, clitoral retraction occurs, in which the clitoral shaft and glans withdraw from their overhanging position, pulling inwards against the pubic bone.

The clitoris is a subtle and mysterious organ, a curiosity to many women and men alike. It is similar to the penis in that it becomes engorged when stimulated and because of its concentration of nerve fibers, is the site where most orgasms are triggered. Clitorises, like penises, come in all different sizes and shapes. In fact, a large clitoris does not appear much different from a small penis. The average length of the clitoral shaft including the glans is 0.8 inches (range of 0.2-1.4 inches). The average width of the clitoral glans is 0.2 inches (range of 0.1-0.4 inches).

The clitoris becomes engorged and erect during sexual stimulation. Two of the pelvic floor muscles—the bulbocavernosus (BC) and ischiocavernosus (IC)—engage and contract and compress the deep internal portions of the clitoris, maintaining blood pressures within the clitoral erection chambers to levels that are significantly higher than systemic blood pressures.

The bulbocavernosus reflex is a contraction of the BC and IC muscles (and other pelvic floor muscles including the anal sphincter) that occurs when the clitoris is stimulated. This reflex is important for maintaining clitoral rigidity, since with each contraction of the BC and IC muscles there is a surge of blood flow to the clitoris, perpetuating clitoral engorgement and erection.

 

vulva_hymen_miguelferig

Thank you Michael Ferig, Wikipedia Commons, for illustration above

Answers to Anatomy Quiz:

LM: labia majora (outer lips); VV: vaginal vestibule; Lm: labia minora (inner lips);  C: clitoris; U: urethra (urinary channel); V: vagina; H: hymenal ring (remnant of membrane that partially covered vaginal opening); A: anus (butthole)

Your V.I.Q.:

0 correct:  Vaginally feeble

1-2 correct: Vaginally deficient

3-4 correct: Vaginally average

5-6 correct: Vaginally superior

7 correct: Vaginally gifted

8 correct: Vaginal Genius…as sharp as a seasoned gynecologist!

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”:  www.HealthDoc13.WordPress.com

Dr. Andrew Siegel is a practicing physician and urological surgeon board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  Dr. Siegel serves as Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community that is in such dire need of bridging.

Author of MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health http://www.MalePelvicFitness.com

Author of THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health  http://www.TheKegelFix.com (much of the content from today’s entry was excerpted from The Kegel Fix)

Men Are From Mars, Women From Venus, But There’s Not Much Difference Between A Vagina And A Penis

December 10, 2016

Andrew Siegel MD 12/10/2016

What is it that most distinguishes a male from a female? The obvious answer is the genitals, with the penis/scrotum having a vastly different appearance from a vagina/vulva.  Despite the male and female genitals being the feature that most characterizes the difference between a male and female, there are striking similarities. The genitals of both sexes are biologically homologous– similar in structure and having a common embryological origin–with development into male versus female based simply on the hormonal environment at the time of development.  Today’s entry discusses the similarities (as opposed to the differences) between the genitals and the “homologues,” the specific anatomical structures that are of common embryological origin and are more alike than are commonly recognized. 

Whether one develops a penis or a vagina is determined at the moment the sperm penetrates the egg. The egg contains an X chromosome and the sperm either an X or Y chromosome. When the coupling results in an XX, the blueprint for female development is established; when the coupling results in an XY, the blueprint for male development is established. The bottom line is that the father determines the sex of the child.

Several weeks later, when the fertilized egg has turned into an embryo, the external genitals are identical. Female genitals are the “default” model, which will remain female, absent the presence of the male hormone testosterone (T). T is activated to dihydrotestosterone (DHT) that causes conversion of what would be a vulva and vagina into a penis and scrotum. Biochemical magic! The bottom line is that the developing embryo will remain female unless T/DHT are available to masculinize the external genitals.

In the young embryo there are three key genital structures: the “tubercle,” the “folds” and the “swellings.” In the absence of T/DHT, the genital tubercle (a midline swelling) develops into a clitoris. The urogenital folds (two vertically-oriented folds of tissue below the genital tubercle) become labia minora (inner lips). The labio-scrotal swellings (two vertically-oriented bulges outside the urogenital folds) fuse to become labia majora (outer lips). In the presence of T/DHT the genital tubercle morphs into a penis, the urogenital folds become the urethra and part of the penile shaft and the labio-scrotal swellings fuse to become a scrotum.

Genital Homologues

The penis is the homologue of the clitoris. Both structures are highly sensitive organs with a tremendous concentration of nerve fibers and contain erectile tissue (corpora) that enables them to expand in size and rigidity with stimulation. Both the penis and clitoris have a head (glans) and shaft and deep internal roots. Both are covered with a layer of skin that can be pulled back to expose the underlying anatomy. In the male this is referred to as the foreskin, which is the homologue of the female clitoral hood.

penile-clitoral_structure

Comparison of penis (left) and clitoris (right)–note similar shape and internal structure, Attribution: Esseh, Wikipedia Commons

The male scrotal sac is the homologue of the female labia majora. The raphe (the seam that runs vertically up the perineum, scrotum and penis) is the homologue of the pudendal cleft (the slit between the labia) in the female.

vulva_vs_scrotum

 

Comparison of vulva (left) and scrotum (right); note similarity of outer labia to scrotum and female pudendal cleft to male raphe,  by Richiex (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)%5D, via Wikimedia Commons

The male prostate gland is the homologue of the female Skene’s glands. Both produce fluid that is released at the time of sexual climax. The male Cowper’s glands are the homologue of the female Bartholin’s glands, both of which secrete fluid at the time of sexual stimulation, pre-ejaculate fluid in the male and vaginal lubrication fluid in the female.

 

male_anatomy_en-svg

Male anatomy, note prostate gland and Cowper’s glands, by Male_anatomy.png: alt.sex FAQ derivative work: Tsaitgaist (Male_anatomy.png) [GFDL (http://www.gnu.org/copyleft/fdl.html) or CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0/)%5D, via Wikimedia Commons

skenes_gland-svenska

Note Skene’s gland and Bartholin’s glands openings below and to side of urethra and vagina respectively, by Nicholasolan (Skenes gland.jpg) [GFDL (http://www.gnu.org/copyleft/fdl.html), CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0/) or CC BY-SA 2.5-2.0-1.0 (http://creativecommons.org/licenses/by-sa/2.5-2.0-1.0)%5D, via Wikimedia Commons

Bottom Line: As different as female and male anatomy are, so they are similar.  The study of comparative genital anatomy and embryological origin is fascinating.  Next week’s entry addresses when this process of differentiation into male versus female goes awry, leading to “ambiguous” genitalia, and how the study of one such particular genetic defect led to the creation of a billion dollar blockbuster drug in common use for purposes of shrinking enlarged prostates and growing hair in men with male pattern baldness.   

Wishing you the best of health,

2014-04-23 20:16:29

www.AndrewSiegelMD.com

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”:  www.HealthDoc13.WordPress.com

Andrew Siegel MD practices in Maywood, NJ.  He is board-certified in both urology and female pelvic medicine/reconstructive surgery and is Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and attending urologist at Hackensack University Medical Center. He is a Castle Connolly Top Doctor New York Metro area and Top Doctor New Jersey.

Dr. Siegel is the author ofTHE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health (www.TheKegelFix.com) and MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health (www.MalePelvicFitness.com). 

The Clitoris: What’s Under The Hood?

May 7, 2016

Andrew Siegel MD 5/7/16

The clitoris is a complex and mysterious organ possessed by all female mammals. Many men (as well as a fair share of women) are clueless (“uncliterate”) about this curious, unique and fascinating structure. The intent of this entry is to provide a primer of useful knowledge so that you can understand what is under the (clitoral) hood, literally and figuratively.  Advances in imaging—especially magnetic resonance (MR)—have provided a much clearer understanding of clitoral anatomy. Whether you are a female or a male, a greater knowledge and appreciation of the anatomy, function and nuances of this special female body part will most certainly prove useful and beneficial. 

Female External Genital Anatomy

The clitoris is part of the vulva, the outer part of the female genitals. The vulva consists of the mons, outer lips, inner lips, vestibule, vaginal opening, urethral opening and the star of the show–the clitoris.

5. vulva 

(Female external genital anatomy, from The Kegel Fix, credit to illustrator Ashley Halsey)

Clitoral Geography: Mountains, Hills and Earthquakes

The vulva is home to some hilly and bumpy terrain that is well worth gaining familiarity with so it can be traversed with finesse. The word mons derives from Latin meaning “mountain” because it is the rounded and prominent fatty tissue overlying the pubic bone. The word clitoris derives from the Greek “kleitoris” meaning “little hill.”

An earthquake is the shaking of the Earth’s surface caused by the sudden release of energy resulting from movements within the earth’s crust that creates seismic waves. If a female orgasm is thought of as an “earthquake,” the clitoris is the “epicenter.” The head of the clitoris—typically only the size of a pea—is an extraordinarily dense bundle of sensory nerve fibers.

 Pleasure (and Reproduction)

The clitoris is central to the female sexual response and sexual climax, the only human organ that exists solely for pleasure, although nature has secondary motives. The clitoris is a vital part of the anatomical design used for nature’s clever “bait and switch” trick, in which the pursuit of a pleasurable activity drives reproduction of the human species and the perpetuation of life. In the mammalian kingdom, if reproduction was not associated with sexual pleasure, how much sexual activity do you think would actually occur?

Male and Female Comparative Genital Anatomy

It might surprise you how remarkably similar the female and male external genitals are. In fact, in the first few weeks of embryonic existence, the external genitals are identical. The female embryo’s external genitals are the “default” model that will remain female in the absence of masculinizing hormones. The female clitoris and the male penis are essentially the same structure, as are the female outer lips and the male scrotum. In fact, there is not much difference in appearance between a very large clitoris and a very small penis.

Although the clitoris is the female equivalent of the penis, it is exclusively a sexual organ, whereas the penis is a urinary, sexual and reproductive organ. Like the penis, the clitoris is largely composed of erectile tissue that upon arousal and stimulation engorges with blood and with increasing stimulation becomes erect. After sexual climax, the clitoris returns to its normal relaxed state.

Interesting trivia: The female spotted hyena, squirrel monkey, lemur, and bearcat all have in common a very large clitoris. When erect, it appears very similar to the male’s penis and is used to demonstrate dominance over other members of their clans. It is referred to as a “pseudo-penis.”

The Tip of the Iceberg, But Far From Frigid

 Most of the clitoris is hidden and internal. Commonly misrepresented as a “bean” or “button,” the external nub is the clitoral head, merely the “tip of the iceberg.” The iceberg metaphor is an apt one in terms of anatomy, but is off target with respect to what a clitoris is—the seat of female genital passion—with its head having a greater concentration of nerve endings than any other body part, a far cry from “ice.”

Clitoral Anatomy

The glans (head) is the external and visible part of the clitoris. It is located just above the opening of the urethra. The remainder of the clitoris is internal and consists of the clitoral shaft (body) and its extensions, known as crura (legs). The prepuce (foreskin), a hood of skin formed by the inner vaginal lips, covers the clitoral shaft.

clitoris

(Anatomy of the vulva and the clitoris by OpenStax College – Anatomy & Physiology, Connexions Web site. http://cnx.org/content/col11496/1.6/, Jun 19, 2013., CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=30148635, no changes made to original)

The crura are wishbone-shaped and are attached to the pubic arch as it diverges on each side. The shaft and crura contain erectile tissue, consisting of spongy sinuses that become engorged with blood at the time of sexual stimulation, resulting in clitoral engorgement and erection. Beneath the crura on either side of the vaginal opening are the clitoral bulbs, sac-shaped erectile tissues that lie beneath the outer vaginal lips. With sexual stimulation, they become full, plumping and tightening the vaginal opening.

One can think of the crura and bulbs as similar to the roots of a tree, hidden from view and extending deeply below the surface, yet fundamental to the support and function of the clitoral shaft and head above, comparable to the tree’s trunk and branches.

Pelvic Floor Muscles

These important muscles are critical to sexual function in general and clitoral function in particular. They control the voluntary tightening and relaxing of the vagina, increase genital blood flow, support clitoral erection and contract rhythmically at the time of orgasm. Two of the pelvic floor muscles are especially vital to clitoral function: the ischiocavernosus and bulbocavernosus muscles that surround the crura and the bulbs, respectively. They stabilize the deep roots of the clitoris and compress the roots when engaged, increasing genital blood flow and maintaining clitoral erection, since their compressions push blood from the roots back towards the shaft and glans.

3. superficial and deep PFM

(Female pelvic floor muscles, from The Kegel Fix, credit to illustrator Ashley Halsey)

The pelvic floor muscles strongly contribute to the transformation of the clitoris from flaccid to softly swollen to rigid. By compressing the roots of the clitoris, they elevate blood pressure within the clitoris to maintain clitoral swelling and erectile rigidity. At the time of climax, these muscles contract rhythmically, and an orgasm would not be an orgasm without the contribution of these muscles working together with the clitoris.

Interesting trivia: The blood pressure within the clitoris at the time of a clitoral erection is hypertensive (high blood pressure) range, accounting for the rigidity. This is largely on the basis of the contractions of the aforementioned pelvic floor muscles. The only regions of the body where hypertension is desirable are the penis and clitoris.

Sexual Function And The Clitoris

With arousal and sexual stimulation, the clitoral erectile tissue engorges, resulting in clitoral shaft thickening and swelling of the glans. With increasing clitoral stimulation, clitoral retraction occurs, in which the clitoral shaft and glans withdraw from their overhanging position, pulling inwards against the pubic bone.

When a sufficient threshold of sexual stimulation is reached, climax occurs with contraction of the pelvic floor muscles, vagina, urethra, uterus and anus.

The clitoris plays a central role in orgasm for the majority of women and for most, clitoral stimulation is necessary to achieve orgasm. Some women require direct clitoral stimulation, while for others indirect stimulation is sufficient; about 25% are capable of achieving orgasm via vaginal intercourse alone. Vaginal intercourse often results in indirect clitoral stimulation since the crura and bulbs flank the vaginal opening and these inner parts of the clitoris are stimulated with penetrative thrusting.

Interesting trivia: Magnetic resonance studies have shown that a larger clitoral head size and shorter distance from the clitoris to the vagina are correlated with an easier ability to achieve a vaginal orgasm.

There is a clitoral literacy movement that is gaining momentum. Please visit:

http://projects.huffingtonpost.com/cliteracy for more information on the clitoris and this campaign to foster awareness of this curious organ.

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”:  www.HealthDoc13.WordPress.com

Author of THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health– newly available on Amazon Kindle, Apple iBooks, B&N Nook and Kobo (paperback edition will be available soon).

Author page on Amazon: http://www.amazon.com/Andrew-Siegel/e/B004W7IM48

Apple iBook: https://itunes.apple.com/us/book/the-kegel-fix/id1105198755?mt=11

Trailer for The Kegel Fix: https://www.youtube.com/watch?v=uHZxoiQb1Cc

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health and Promiscuous Eating: Understanding Our Self-Destructive Relationship With Food   

Co-creator of Private Gym and PelvicRx: comprehensive, interactive, FDA-registered follow-along male pelvic floor muscle training programs. Built upon the foundational work of Dr. Kegel, these programs empower men to increase pelvic floor muscle strength, tone, power, and endurance: www.PrivateGym.com or Amazon.  In the works is the female PelvicRx pelvic floor muscle training DVD. 

Pelvic Rx can be obtained at http://www.UrologyHealthStore.com, an online store home to quality urology products for men and women. Use promo code “UROLOGY10” at checkout for 10% discount.