Q1. What is the role of the vagina in female anatomy?
The female reproductive system is designed to carry out several functions. It produces the female eggs necessary for reproduction, called the ova or oocytes. The system is designed to transport the ova to the fallopian tubes, where fertilization of the egg by the sperm takes place leading to a conception. The next step for the fertilized egg (embryo) is to implant into the walls of the uterus, thus initiating pregnancy. The vagina serves to receive the semen from the male partner. In the vagina, the viscous semen ejaculated by the male partner liquefies due of the internal body temperature, which allows the sperms to get free and swim further into the uterus via the cervix.
Q2. If its function is reproductive why has it been turned into an object that needs beautification?
The vagina does not need any beautification because it cannot be visualized externally! As a matter of fact, it is a potential space within the female body. The space opens up only when an object e.g., the male penis, a vaginal tampon, or an object used for masturbation is inserted inside. The only person who can visualize the vagina is the gynecologist, who uses instrumentation to look inside the vagina to assess its health.
Q3. The pH balance of the vagina is naturally acidic. What function does it play in maintaining the health and functioning of the vagina? What do doctors mean by healthy bacteria in the vagina? What are they? What role do they play?
The normal pH of the vagina is 4.5 or less, which is on the low or acidic, side of the pH spectrum, the neutral being 7. This low pH helps to maintain a healthy balance of the yeast and bacteria that normally live in the vagina. Lactobacillus, a group of lactic acid producing bacteria, dominates in the vagina. These beneficial bacteria keep the vaginal pH acidic and prevent harmful bacteria from invading the reproductive system. If vaginal pH is raised i.e. if it goes towards the basic or alkaline side of the pH spectrum, the normal balance of organisms can be upset, resulting in inflammation known as vaginitis.
Q4. What are the tips to maintain the pH balance? Do douching or feminine washes work?
To maintain the pH balance correctly, clean the vulva with plain, warm water. If you use soap, choose a mild soap, like perfume-free glycerin soap. Douching can disrupt the normal vaginal pH and lead to vaginitis, hence douching is not recommended on a regular basis. Douching regularly washes away the good bacteria, which normally help to maintain the acidic pH in the vagina, leading to an alkaline pH, thus encouraging vaginitis. Vaginitis can be due to the presence of sexually transmitted diseases, estrogen deficiency at menopause or even due to pregnancy. Please consult your gynecologist for any symptoms of vaginitis, which usually include burning, itching or unusual discharge or odor.
Q5. What are some tips to maintain feminine hygiene?
Wear cotton panties to keep away heat and moisture both of which nurture bad bacteria. Use condoms during sexual activity. If possible, avoid sexual activity during menstruation, as pH of menstrual blood is 7.4, which is much higher than the pH of the vagina, and is therefore alkaline. This reduces the acidity in the vagina and can promote infection. Exposing the vagina to prolonged use of tampons and pads can lead to vaginitis. Change tampons and sanitary napkins every 4 – 6 hours, even if not soiled.
Q6. What are the stages of change a vagina goes through in the lifetime of a woman? As a woman attains puberty, her ovaries start secreting estrogen, the female hormone, which is responsible for all the physical changes seen in a woman such as a curved figure, breast enlargement, getting taller, etc. While these external changes occur, there are internal changes in her reproductive system too. The uterus gets larger, its lining gets thicker, and the vaginal tissue gets thicker and more elastic. These hormonal changes help a women start with her periods, and allow the vagina to expand without being injured. Young girls before puberty and post-menopausal women lack the estrogen hormone; hence the vagina remains thin and is susceptible to tearing easily, followed by vaginitis and bleeding.
Q7. Why does the vagina become loose after a natural delivery?
The vaginal muscles which surround the vagina are externally stretched during a vaginal delivery and are prone to tear, especially if the baby is large. It is important to exercise these muscles following delivery, so that the vagina maintains its tone and does not become loose or lax. A very lax vagina may affect the sexual pleasure of both the partners and also can promote urinary incontinence in a woman. Hence exercising the pelvic muscles usually achieved through Kegel’s exercises is very important. It is only vaginal surgery to tighten the vagina which has been found to be scientifically helpful in increasing sexual pleasure.
Q8. Why is there such a big issue over a small tissue – the hymen – in India?The hymen is a small membrane at the entrance of the vagina which is normally torn due to penetration during sexual activity, or could get relaxed with constant use of vaginal tampons or masturbation with objects. The presence of the hymen at marriage has been used as a test of virginity by certain cultures and a torn hymen has been used as evidence of rape. In modern times, both these signs are considered irrelevant and obsolete.
Q10. How to maintain vaginal health through a body’s aging? Are lubricants efficacious and healthy to use if the vagina becomes dry, and if sex is painful?
Aging causes the vagina to get dry, thin and narrow leading to painful sex and is vulnerable to infections. Lubricants are helpful and healthy to use, but need to be used during sexual intercourse, which can be messy. Most effective are vaginal estrogen creams which help to improve the vaginal status to a healthy state and need not be used at the time of intercourse. The estrogen in the cream helps to improve vaginal health and does not merely lubricate as other lubricants do.
Q11. Why do many doctors warn against use of panty liners or talcum powder new research shows that it can raise ovarian cancer risk by 30%?
There is a theory that when one uses talcum in the genital area the particles may travel up through the vagina to the ovaries and cause ovarian cancer. But, since the 1970s, talcum powder which is used by consumers does not contain asbestos which is a known cancer agent. There is no scientific evidence that they cause or increase the risk of cancer. Panty liners on the other hand can cause irritation of the genital skin if not changed when soiled. But panty liners are definitely not known to increase the risk of cancer.
Q12. Is the vagina more susceptible to infections than other organs? What are the kinds of vaginal infections?
The vagina is more susceptible to infections only if an infection is introduced into it when it is most susceptible, as mentioned in situations earlier. There are several kinds of vaginal infections. Yeast infection causes severe itching, curd-like discharge and foul odor. It is treated with anti-fungals both orally and locally. It is commonly seen in women on OC pills, antibiotics, and in diabetics. Trichomoniasis Is commonly seen in sexually active women. It causes copious greenish or yellowish discharge, vaginal irritation and foul odor. It is treated with anti-bacterials. Bacterial Vaginosis is one of the commonest infections which is usually mild and may not cause any other symptoms except some vaginal discharge, or fishy odour after sex, hence it is usually neglected. Bacterial Vaginosis can occur due to multiple sexual partners and douching. It can also lead to preterm delivery if pregnant.
Q13. How important is it to visiting the Gynecologist, and when? How important is a pap smear?
It is extremely important to visit your gynecologist for an annual checkup and pap smear, even if there are no complaints. But if there are any symptoms such as excessive vaginal discharge, which is causing burning, irritation, itching and foul odor you must see the Gynecologist at the earliest.
Q14. What are the effects of feminine washes, whitening creams, tightening creams, tampons and Brazilian wax on vaginal health?
Feminine washes are to be used external to remove odor to make a woman feel clean and hygienic. If they are used internally as douches, then they can harm her.
Whitening creams: All vaginas, whether they belong to the white-skinned or dark-skinned women, are pink in colour, just as the inside of a mouth is.
Tightening creams: They contain chemicals which do not really tighten the vagina, but can cause harm by irritating the vagina. Some tightening creams contain alum, which has been claimed to tighten the vagina, but honestly do nothing to the vagina.
Tampons: They are preferred by women wearing bikini or wearing tight trousers, to prevent an embarrassing bulge of a sanitary napkin. But women tend not to change it frequently especially on days when bleeding is not heavy, which can then lead to infection. It is important to change the tampons every 4 to 6 hours, whether soiled or not.
Brazilian wax: Today, many women get a Brazilian wax done in the pubic area which includes waxing all hair in the pubic region, over the labia and extending backwards into the anal region. Such waxing has been known to cause complications such as burns of the genital skin, chemical reactions and skin infections, which may be severe in diabetic women.
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