In mammals, the vulva (pl. vulvas or vulvae) comprises mostly external, visible structures of the female genitalia leading into the interior of the female reproductive tract. For humans, it includes the mons pubis, labia majora, labia minora, clitoris, vestibule, urinary meatus, vaginal introitus, hymen, and openings of the vestibular glands (Bartholin's and Skene's). The folds of the outer and inner labia provide a double layer of protection for the vagina (which leads to the uterus). While the vagina is a separate part of the anatomy, colloquially the term has often been used synonymously with vulva. Pelvic floor muscles support the structures of the vulva. Other muscles of the urogenital triangle also give support. Blood supply to the vulva comes from the three pudendal arteries. The internal pudendal veins give drainage. Afferent lymph vessels carry lymph away from the vulva to the inguinal lymph nodes. The nerves that supply the vulva are the pudendal nerve, perineal nerve, ilioinguinal nerve and their branches. Blood and nerve supply to the vulva contribute to the stages of sexual arousal that are helpful in the reproduction process. Following the development of the vulva, changes take place at birth, childhood, puberty, menopause and post-menopause. There is a great deal of variation in the appearance of the vulva, particularly in relation to the labia minora. The vulva can be affected by many disorders, which may often result in irritation. Vulvovaginal health measures can prevent many of these. Other disorders include a number of infections and cancers. There are several vulval restorative surgeries known as genitoplasties, and some of these are also used as cosmetic surgery procedures. Different cultures have held different views of the vulva. Some ancient religions and societies have worshipped the vulva and revered the female as a goddess. Major traditions in Hinduism continue this. In Western societies, there has been a largely negative attitude, typified by the Latinate medical terminology pudenda membra, meaning 'parts to be ashamed of'. There has been an artistic reaction to this in various attempts to bring about a more positive and natural outlook.
Structure
The human vulva is made up of the following:
Mons pubis The mons pubis is a soft mound of fatty tissue in the pubic region covering the pubic bone. Mons pubis is Latin for "pubic mound" and is present in both sexes to act as a cushion during sexual intercourse, and is more pronounced in the female. The variant term mons veneris ('mound of Venus') is used specifically for females.
Labia The large outer pair of folds are the labia majora, which contain and protect the labia minora and other structures of the vulva. The labia majora meet at the front of the mons pubis, and meet posteriorly at the urogenital triangle (the anterior part of the perineum) below the anus. The labia minora are the small inner pair of skin folds that protect the openings. The labia minora are often pink or brownish black, relevant to the person's skin color. The grooves between the labia majora and minora are called the interlabial sulci, or interlabial folds. The labia minora meet posteriorly as the frenulum (fourchette).
Clitoris Located at the anterior junction of the labia minora is the clitoris, a highly erogenous sexual organ. The visible portions of the clitoris are the glans and frenulum. Typically, the glans is roughly the size and shape of a pea, and can vary in size from about 6 mm to 25 mm (less than an inch). The size can also vary when the clitoris is erect, which happens when two regions of erectile tissue known as the corpora cavernosa (along with the bulbs and crura, which both constitute the root of the clitoris) fill with blood, making the shaft engorged. The glans contains many nerve endings, which makes it highly sensitive. The only known function of the clitoris is to focus on sexual feelings. The clitoral hood is a protective fold of skin and it may partially or completely cover the shaft and glans. The hood may be partially or completely hidden within the pudendal cleft.
Vestibule The vestibule is the area between the labia minora, where the vaginal introitus and the urinary meatus - the openings of the vagina and urethra respectively - are located. The meatus is below the clitoris and atop the introitus. The introitus is sometimes partly covered by a membrane called the hymen. The hymen will usually rupture during the first episode of vigorous sex, and the blood produced by this rupture has been seen to signify virginity. However, the hymen may also rupture spontaneously during exercise or be stretched by normal activities such as the use of tampons and menstrual cups, or be so minor as to be unnoticeable, or be absent. In some rare cases, the hymen may completely cover the introitus, requiring a surgical procedure called a hymenotomy. Two greater vestibular glands known as Bartholin's glands open into either side of the introitus and secrete a mucous vaginal lubricant. The openings of the lesser vestibular glands, known as Skene's glands, are found on either side of the urethral meatus.
Muscles
Pelvic floor muscles help to support the vulvar structures. The voluntary, pubococcygeus muscle, part of the levator ani muscle partially constricts the vaginal opening. Other muscles of the urogenital triangle support the vulvar area and they include the transverse perineal muscles, the bulbospongiosus, and the ischiocavernosus muscles. The bulbospongiosus muscle decreases the vaginal opening. They play a role in the vaginal contractions of orgasm by causing the vestibular bulbs to contract.
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