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  • Dr. Lady Doctor

Health Class Redux: Your Vagina

This is the vulva - only the opening to the vagina can be seen!

Of all the lady parts, the vagina may be the most mysterious and least understood by most people, including those who have one of their own! Even otherwise educated women will refer to their external genitals as their "vaginas". Here's a basic rundown of the important parts of women's anatomy that aren't often taught in health class:

  • External genitalia - aka the vulva. Includes mons pubis, labia majora (outer lips) and labia minora (inner lips). This is what is visible from the outside.

  • Vagina - closed tube that extends from the vaginal opening and ends at the cervix (the opening to the uterus). Key fact: only the opening to the vagina is visible from the outside between the labia minora (and only from certain angles)!

  • Urethra - hole where urine comes out - above the vaginal opening. Key fact: women don't pee from their vagina!

  • Clitoris - just above the urethra - small nub of very sensitive tissue - pleasure center for many women

And its too bad the vagina is so misunderstood because it is really awesome! The vagina is essentially self-cleaning and has built-in defense mechanisms to protect against foreign invaders (including infection causing bacteria, viruses AND sperm!). These defense mechanisms start with the vagina's microbiome - a delicate balance of bacteria that are dominated by the "good" bacteria called lactobacillus. Lactobacillus uses fuel from the cells of the vagina to keep the vaginal pH in the acidic range. A healthy vaginal pH level – between 3.8 and 4.5 - in addition to secretion of fluids, allows the vagina to clean itself and encourages the growth of good bacteria.

Most harmful bacteria have a hard time surviving in an acidic environment. Keeping those harmful bacteria under control is important for general hygiene and comfort and to help avoid infection and diseases. A vaginal pH level above 4.5 can make you more susceptible to inflammation of the vaginal tissue (vaginitis), which can be caused by yeast, bacterial vaginosis (BV) or irritation from feminine products. More about the symptoms of vaginitis (and thorough discussion of vaginal discharge) here.

Some vaginal infections can make you more susceptible to other STIs like chlamydia and gonorrhea. When harmful bacteria overwhelm the normal vaginal bacteria, such as in BV, the vagina's natural defenses are decreased which results in an increased likelihood of acquiring STIs when exposed from an infected partner.

There are many things that can alter your vaginal pH. Here are a few of the most common:

  • Sex: Semen has a pH range of 7.1 – 8 and can trigger a change in your balance. Try using condoms if you have irritation after sex.

  • Menstruation: Blood has a pH of 7.4, so levels will be elevated during your period. Most women’s bodies can handle the difference, but if you notice unusual discharge, odor or other symptoms, call your doctor.

  • Tampons: Tampons absorb menstrual fluid and with it, the good and bad bacteria present.

  • Breastfeeding or Menopause: Hormones, especially estrogen, play a large part in keeping our vagina’s pH level healthy. When women breastfeed or start menopause estrogen levels are low and pH levels can rise.

In addition, many products that we think may help to “clean” the vagina (such as scented soaps, douches, etc) can actually harm the natural balance of good bacteria and defeat the vagina’s self-cleaning mechanism. So, rather than taking things into your own hands if you notice a change in your vagina, seek advise from a healthcare provider. #dontdouche

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