The vulva is the collective term for female external genital organs, situated in the pubic region. It extends from the mons pubis at the front to the perineum at the back, and laterally to the genito-crural folds. The vulva includes several anatomical structures: the mons pubis, the labia majora, the labia minora, the clitoris, the vulvar vestibule, the urinary meatus and the vaginal opening. Each of these structures has a specific function in sexuality and the protection of internal genital organs.
The mons pubis is the triangular region above the pubic symphysis, covered with hair from puberty. The labia majora are two heavy skin folds that edge the vulvar slit and protect the internal structures. They are covered with hair on their external side and are rich in sebaceous and sweat glands. The labia minora are two thin cutaneous-mucosal folds, without hair, situated inside the labia majora. They join forward to form the clitoral hood and the frenulum of the clitoris.
The clitoris is a highly innervated erectile organ, the homologue of the male penis. It is made up of a glans, a shaft and two pillars that insert into the ischio-pubic branches. Only the clitoral glans is visible externally, the rest of the organ is encased within tissues. The clitoris is the main organ of female sexual pleasure, containing many sensory nerve endings. When sexually aroused, the clitoris engorges with blood and becomes turgid, increasing its sensitivity.
The vulvar vestibule is the area situated between the labia minora, housing the urinary meatus and the vaginal opening. The urinary meatus is the external opening of the urethra, through which urine is expelled. It is located above the vaginal opening and is surrounded by the para-urethral glands (Skene’s glands), which secrete a lubricating fluid during sexual arousal. The vaginal opening is the external opening of the vagina, partially closed by the hymen in virgins. The hymen is a connective tissue membrane which thins and gradually ruptures during life, particularly during first sexual encounters.
On either side of the vaginal opening are the major vestibular glands (Bartholin’s glands), which secrete a mucous lubricating fluid during sexual arousal. These glands can sometimes become infected and form an abscess, termed a Bartholin’s cyst, requiring antibiotic or surgical treatment.
The vulva is a highly sensitive erogenous zone, richly innervated and vascularised. The principle nerve branches that innervate the vulva are the pudendal nerves, which transmit sensations of pleasure and pain. The stimulation of the different parts of the vulva, particularly the clitoris, plays a central role in sexual arousal and female orgasm.
It is important to maintain good vulvar hygiene to prevent infections and irritation. Washing the vulva with water and using mild, fragrance-free soap, while avoiding vaginal douching and irritating products, is recommended. Wearing cotton underwear and avoiding tight clothes can also help prevent vulvar infections.
Certain pathologies can affect the vulva, such as vulvar dermatoses (lichen sclerosus, lichen planus), infections (vulvovaginitis, genital herpes), vulvar cysts or even vulvar cancers. Any persisting, painful or atypical vulvar lesion should provoke consultation with a doctor for a diagnosis and tailored treatment. Screening for vulvar cancer is based on regular clinical examination and biopsies of suspicious lesions.
In conclusion, the vulva is a complex and sensitive anatomical region, which plays an essential role in female sexuality and the protection of internal genital organs. A good understanding of vulvar anatomy and appropriate hygiene care is important for maintaining vulvo-vaginal health throughout life.
Key Points:
1. The vulva consists of female external genital organs, comprising the mons pubis, the labia majora, the labia minora, the clitoris, the vulvar vestibule, the urinary meatus and the vaginal opening.
2. The labia majora are two heavy skin folds that edge the vulvar slit and protect the internal structures.
3. Only the clitoral glans is visible externally; the rest of the organ is encased within tissues. The clitoris is the main organ of female sexual pleasure.
4. The urinary meatus is the external opening of the urethra through which urine is expelled. It is located above the vaginal opening.
5. The major vestibular glands (Bartholin’s glands) can sometimes become infected and form an abscess, termed a Bartholin’s cyst, requiring treatment.
6. Good vulvar hygiene is recommended, including washing the vulva with water and a mild, fragrance-free soap, and avoiding irritating products.
7. A good understanding of vulvar anatomy and appropriate hygiene care is important for maintaining vulvo-vaginal health throughout life.
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