The Vagina

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This elicits different thoughts from different audiences.  I am talking about it as a doctor, a gynecologist.  I truely believe , the vagina is an amazing organ.  And it is complicated. As a surgeon I am aware that it is 3 dimensional and there is a compartment under the bladder which also contains the elusive G shot.  There is a compartment over the rectum and the wall between these two structures is the recto-vaginal septum.  The upper most part of the vagina is the cervix which is the portal of the uterus.  There are ligaments that extend from the back wall and the sacrum called the uterosacral ligaments and ligaments lateral that are more like a fan of collagen-like tissue called cardinal ligaments. It is surrounded by a complex arrangement of muscles, nerves and the urogenital diaphram.  The skin is designed like an accordian, that is dependent on  adequate blood supply, AND hormonal stimulation to the receptors to keep it, accomodating.  This means it will stretch to allow that which wants to enter such as a baby, a person or a thing.  The vagina will recoil due to its fibroelastic tissue but if the fascial structures are weakened under the skin, hernias can develop such as a cystocele, rectocele or enterocele.  Glands produce mucous and normal discharge and there is a delicate balance of bacteria of many different varieties to allow an environment that is permissable to the passage of sperm upward in search of the elusive egg.   It is warm and soft and the subject of much romantic thought, discussion and fantasy.   If the accordian is not recoiling properly or if the folds are lost due  to the  loss of hormones , surgery or radiation,  the VAGINA can either be too tight, too loose or does not feel right. Patients are trying to get it feeling better, back in balance or more physico-aesthetically pleasing.   It is the  source of many appointments, discussions, medications or surgeries.  It can be the source of great pleasure or great anxiety.  There can be infections, trauma, pain or confusion about it.  It is very complex and not to be minimized.  It commands respect.  Dr N