By Melanie Sutton
Ever noticed how the things we don’t talk about are the things that people often feel shame around? And sometimes if mentioned at all, these things are in hushed whispers? The secrecy can lead to anxiety, fear, myths and misconceptions around what should be a topic we talk about freely and comfortably. Case in point: our V-parts (as I like to affectionately call them); technically named the Vulva and Vagina, are the outside and inside genitals (respectively) of female bodied people. These parts are particularly vulnerable to misrepresentation due to the cultural influences on sexuality and shame, and the secrecy can be a fertile breeding ground for misinformation and negative feelings. By bringing awareness to the forefront, we can become more comfortable with our V-parts and enjoy our bodies rather than worry about them.
I am a Pelvic Physical Therapist (or Physiotherapist, in countries outside the US). I have seen and worked with literally THOUSANDS of vulva and vagina owners over the past almost 15 years of my career. The most common recurrent theme I see is that people are worried about how they look and smell, what that says about them, and whether or not they are “normal”. It is less common for me to see people who know all about their V parts and are at peace with them. I am on a mission to raise awareness and comfort talking about these amazing parts of our bodies, and to help people to get medically sound information they can trust.
I can (and do!) talk all day, every day, about the Vulva and Vagina, what they are and how they function as well as things to try when they aren’t at their best, so narrowing me down to a single topic is a challenge, but I’d like to tackle a couple of the most common concerns I hear.
First: appearance. Ever heard the phrase “fingerprints are like snowflakes”? Each one unique and individual? Well, so are our Vulvas. So many variations! Unique, individual, and beautiful - just like snowflakes, and we get to enjoy them all year long! The outer lips, or labia majora, are the ones with hair on them, and the inner lips or labia minora are inside and hairless. The inner lips are often asymmetrical. The size of the inner lips as well as their color is highly variable and can change with age and stage (puberty, pregnancy/postpartum, peri/postmenopause, and with arousal). Sometimes the labia minora are totally hidden from view, other times one or both of them may be visibly seen hanging between and/or lower than the labia majora. Any of those things are perfectly normal and there is nothing wrong. There has been an upward trend toward young females seeking labiaplasty procedures to make theirs look “a certain way” which is unfortunate, given that there is NO “one look” and that’s part of being a human female! Our vulvas--like our faces--are unique to us and deserve to be loved and appreciated as they are.
The outer demarcation between the vulva and vagina is called the vestibule, and is observed by a change in color called “Hart’s line” (isn’t that sweet?) that surrounds the introitus, or entryway. The vagina is the “vault” made up of smooth muscle that is inside the body. The hymen is an internal tissue at the entryway of the vagina, and has long been associated with virginity and purity, such that in some cultures, blood on the wedding night sheets was the supposed indicator of the purity of the bride.
Here’s where things get tricky. There is actually no way to “prove” virginity or promiscuity anatomically (well, outside of the de facto line of reasoning of pregnancy and childbirth, that is). There’s a wide variation in the presence and degree of hymenal tissue, and there may be no visible hymen or bleeding for some females. Hymenal tissue could be disrupted with exercise, activity, injury or use of menstrual products. The bottom line is: hymenal tissue and/or bleeding is NOT an indicator of experience or lack thereof, and you can’t tell by “looking” whether a female has been active (or how active). This could have resulted in some drastic and unwarranted consequences for women for whom virginity was disproved by lack of blood evidence in the past.
Some of you may be thinking that if not by looking, surely one could tell by “feeling”. Well, I’m here to tell you that, no - that line of reasoning does not hold up well either. The common myth is that the vagina would be “stretched out” or “cavernous” with more activity, however the vaginal tissue is very elastic. The rugae (or ridges) of the vaginal canal, along with the pelvic floor muscles, expand with sexual activity and childbirth and return to position following those activities. This flexibility and accommodation helps to explain how the female body is able to accomplish such a momentous task of building and birthing a baby (or multiples!). One more reason to love our V parts! There are variances in muscle tension between individuals that are not dependent on sexual activity, and more tension is not necessarily “better”, particularly if there is pain involved in the activity. Because muscles throughout our bodies normally through various stages of tension with rest and activity, the presence or lack of muscle tension is not an indicator of previous activity. If an activity is painful (which is NOT normal, and IS treatable), there is likely to be associated muscle tension which can cause problems with function and should be addressed. The presence of pain does not necessarily related to activity level, but may limit functional activity.
One thing that can be seen from the outside that would give a clue to previous activity in the area is the presence of any scars. These can be seen after tearing or episiotomies in childbirth and also with female genital mutilation (which is still practiced in some cultures) or potential other localized trauma or surgery. The appearance of the tissue, and sometimes the function, may be altered after these types of events. If function is an issue, people can work with their physician and a pelvic physical therapist such as myself to help things to function properly.
So while there is no “normal” look, what you can and should expect from your vulva and vagina is that they function without pain or difficulty. That means bedroom and bathroom activities should be without pain, including voiding and penetration, and if not, you should speak with your doctor and seek out care from a pelvic physical therapist to help you get the best function possible.
If you have any questions, get in touch via www.pelvichealthmentor.com