I want to chat about the vagina, it is a complex part of our body that has its very own what I like to call “microclimate”.
The vagina is made up of three layers of tissue. The first layer is the layer that you can touch, this is called the mucosa. It is similar to the lining of the mouth, except that it has folds or wrinkles. The second layer is made up muscle and the innermost third layer is made up of fibrous tissue that connects to other parts of your body.
The vagina is shaped like a flattened tube, which is in a collapsed state most of the time. It what is termed as a “potential space” – a space that has the ability to get bigger and smaller. For example, it can allow a baby to pass through it, can fit snugly around a menstrual cup or tampon, finger or any size penis. The vagina also provides a passageway for menstrual flow from the uterus, via the cervix to leave the body during menstruation.
LAYER ONE: MUCOUS MEMBRANE
This mucous membrane produces vaginal secretions. These secretions are perfectly normal and important for “self-cleaning” and act as an important part of the reproductive system. The secretions have an acidic pH to help prevent the growth of bad bacteria and yeast. The vagina is inhabited by healthy bacteria known as the normal “flora” which affect the pH of the vaginal secretions by keeping it acidic. The bacteria colonise the vagina, the mucous membrane does not produce the bacteria. Good bacteria found in the vagina include Lactobacillus species.
While some women won’t have much moisture from these secretions, others will have quite a bit, and, this will vary depending on where they are in their menstrual cycle, or whether they are pregnant or breastfeeding.
These mucous membranes also mean that your vaginal walls are highly absorbent (permeable). Therefore, your vagina is an important link to the inside of your body, like a big open door. This gives it the ability to absorb anything it encounters directly into the bloodstream. Interestingly some medications are given vaginally due this absorption quality.
Because of the vaginas amazing way to absorb it may also expose women to higher levels of chemicals from products used inside the body. Unlike the rest of our body the vagina does not breakdown (metabolize) anything that it absorbs so it is important to be mindful of what you put inside your vagina and how long it is left there.
LAYER TWO & THREE: MUSCULAR LAYER & FIBROUS LAYER
This is made up of two layers of smooth muscle: an inner circular layer and outer longitudinal layer.
The Vaginal Muscles and Pelvic Floor. This is a network of muscles, ligaments and skin in and around the vagina which also provides support to the bladder, intestines and uterus. These smooth muscles are supported on a fibrous network containing collagen and elastin. These elastic muscles can not only accommodate a penis during intercourse but help facilitate birth by being able to expand and contract. These muscles also assist with healthy abdominal pressure. Other muscles (skeletal muscles) that support the vagina and attach it to the pelvis and other structures.
What are the most common vaginal problems?
Conditions that might affect your vagina include:
A vaginal prolapse is a condition in which structures (like the uterus, bladder and bowel) fall out of their normal positions due to this muscle structure failing. Sometimes these structures can prolapse to the point where they require surgery. Surgery may be required when the prolapse affects urination, defecation, sexual function and significant pelvic pressure discomfort.
Vaginitis is an inflammation of the vagina that can result in discharge, itching and pain. The cause is usually a change in the normal balance of vaginal bacteria or an infection. Reduced oestrogen levels after menopause and some skin disorders can also cause vaginitis.
The most common types of vaginitis are:
- Bacterial vaginosis, or BV is caused by an imbalance in the bacteria found in your vagina, with an overgrowth of certain less favourable bacteria. This causes you to have a smelly discharge.
- Yeast infections, commonly called thrush, are caused by a naturally occurring fungus (Candida) that live in your vagina. Certain conditions cause an imbalance of this fungus and it grows out of control, causing extreme itchiness, redness, swelling and a white discharge.
- Trichomoniasis, is caused by a parasite and is commonly spread by sexual intercourse. This can cause an offensive discharge and pain.
Sexually transmitted infections can affect the healthy flora of the vagina, these include: gonorrhoea, chlamydia, genital warts, syphilis and genital herpes. Signs and symptoms can include genital sores, a vaginal discharge and pelvic pain
Vaginismus is an involuntary spasm of the muscles of the vaginal wall. This occurs when a something is put inside the vagina (penis, menstrual cup, tampon or sex toy). This can cause pain, pelvic floor spasm and difficulties with using tampons, menstrual cups or intercourse.
Vaginal Cysts can cause pain during sex or make it tricky to insert a Menstrual Cup or Tampon.
TSS or Toxic Shock Syndrome is a bacterial infection that has entered the bloodstream via a cut or abrasion in the vagina. These bacteria travel directly to the internal organs and can be fatal.
TSS and Menstrual Cups Research has shown that after 8 hours a bio-film can form on the surface of a menstrual cup. If a bio-film has the opportunity to form then it is possible that the bacteria associated with TSS (Staphillococcus Aureus) can adhere to the cup surface. Once this bacteria adheres to the biofilm it multiplies quickly. If you have an internal abrasion, this bacteria can now enter the bloodstream and cause TSS. It is our strict advice to ensure that you empty your menstrual cup every 4-8 hours to prevent this happening. Also NEVER use a menstrual cup if you have an internal abrasion.
What can I do to keep my vagina healthy?
You can take steps to protect your vaginal health and overall health. For example:
- Be sexually responsible. Use condoms to prevent bacterial infections or STD’s. If you use sex toys, clean them after every use.
- Avoid douching as this can remove the good bacteria responsible for keeping your vagina healthy.
- Do pelvic floor exercise to exercise your muscles, keeping the structure supporting your vagina in good shape.
- Know your medications. Discuss medication use and possible vaginal side effects with your doctor.
- Limit the amount of alcohol you drink and don’t smoke. Too much alcohol can cause sexual dysfunction and nicotine might inhibit sexual arousal.
- Change your tampon every 4-8 hours, washing your hands before and after insertion.
- Empty your Menstrual Cup every 4-8 hours, washing your hands before and after insertion. Sterilize your cup between cycles.
While not all vaginal problems can be prevented, regular check-ups can help ensure that problems affecting your vagina are diagnosed as soon as possible. Don’t let embarrassment prevent you from talking to your doctor about any concerns you might have about your vaginal health. Vaginas are just a normal part of your body and need just as much care!
Written by: Kimberli Schuitman
- A Question for Women’s Health: Chemicals in Feminine Hygiene Products and Personal Lubricants: https://ehp.niehs.nih.gov/122-a70/
- Female Reproductive System http://faculty.etsu.edu/forsman/femalelecture.htm
- Vagina https://health.howstuffworks.com/sexual-health/female-reproductive-system/vagina-definition1.htm
- Teach Me Anatomy: The Vagina http://teachmeanatomy.info/pelvis/female-reproductive-tract/vagina/
- Inner Body – Vagina: http://www.innerbody.com/image_repfov/repo12-new.html
- WebMed Vaginal Infections: https://www.webmd.com/women/guide/sexual-health-vaginal-infections#1