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OBSTETRICS
Female Anatomy
Menstruation
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The female external genital organs, also called the ‘VULVA’, are those genital organs that are present on the surface of the female body and can be easily examined. From front to back, the female external genital organs which are easily visible are the mons pubis which extend into the two labia majora. The other organs are enclosed between the labia majora. They are the two thin labia minora, the clitoris, the vestibule, the external urethral meatus, the vaginal opening covered with a hymen in virgins, the perineum and a number of glands like the Bartholin's glands and the vestibular glands.
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Mons Pubis : The mons (also called mons venereum or mount of Venus) is the rounded fatty mass over the pubic bone covered with hair and coarse skin. It acts as a buffer during sexual intercourse, preventing injury to the underlying bone. It also contains sebaceous and sweat glands. Some of the latter form a specialized type of gland called the apocrine glands. These glands release a secretion with a characteristic smell that increases sexual attraction. Before menstruation starts in a young girl, the mons pubis contains less fat and is considerably flattened and hairless. At the time of puberty, the release of estrogen and progesterone from the developing graafian follicles in the ovaries causes the laying down of fat in this area. Hormones from the adrenal cortex stimulates the growth of pubic hair on the mons pubis, as well as in the external surface of the labia major as well as the perineum. After menopause, the pubic hair becomes thinner, coarser and starts to grey. The mons loses the pad of fat. In a very elderly woman, even the labia majora and minor may become thin and flattened. Labia Majora : The labia majora are bilateral folds of skin with underlying fat extending backwards from the mons pubis. They are homologous to the scrotum in males. Posteriorly they merge into the perineum in front of the anus. Their outer surface becomes covered with hair at puberty. But the inner surface remains smooth, moistened by the secretions from the sebaceous and other glands deep inside. The labia majora also contain apocrine glands. In a young girl, before the onset of menstruation, the labia major are thinner with less fat and a fine smooth skin. Hair growth over the labia is one of the first signs of maturity of the ovaries with the growth of graafian follicles. In women in menopause, the labia becomes thinner with less fat and considerable hair loss.
Labia Minora : The labia minora are delicate flaps of soft skin which lie within the labia majora. They may be of different sizes in different women and if large enough, may protrude from between the labia majora. Their inner surfaces remain in contact with each other. Anteriorly, they unite to enclose the clitoris between them, forming the prepuce and frenulum from before backwards. The labia minora contains no fat but are so vascular that they become turgid during sexual stimulation. Since the labia are very thin and delicate, they can get torn during labor and childbirth causing heavy bleeding. Bleeding can continue even in the postpartum period and postpartum infections are a common occurance. Vestibule : The vestibule is the part of the vulva lying between the two labia minora. It has two important openings – (a) the external urethral opening which is a small slit-like opening just behind the clitoris (b) the vaginal opening which is a larger opening behind the urethral opening. In virgins, the opening of the vagina is covered by a thin incomplete membrane, called the ‘hymen’. Injuries during labor occurs commonly in the vestibular region, especially the paraurethral region.
Clitoris : The clitoris is present in the upper part of the vestibule at the point where the two labia minor meet.It is a small cylindrical structure homologous to the penis in males. Like the male penis, it also has a glans, a prepuce and two corpora cavernosa which are attached to the pubic bones. The clitoris is made up of erectile tissue and is richly supplied with nerves, making it the most erotically sensitive part of the body. Bartholin’s glands : These are small pea-sized glands situated inside the vestibule on either side of the vaginal opening. They produce a mucoid secretion at times of sexual excitement that help to lubricate the vagina and vulva. Vestibular bulbs : They are embedded in the mucous membrane of the vestibule and are composed of erectile tissue. Perineum : The perineum is the less hairy cutaneous area lying between the vaginal orifice in front and the anus behind. |
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