Posted in Genitals: A User's Guide

It’s What’s Inside that Counts?

My weakest area at med school was definitely anatomy. I enjoyed it though. Each week, we would go to the anatomy suite where the cadavers were kept and I would learn another thing I was previously mistaken about. The relationship between what we see and understand on the outside and what and where it is on the inside is often not straightforward.

The stomach, for example, is not the low down bit of the abdomen people hold when they have ‘bellyache’ – that’s more like bowels. This is part of the gut, but with has a distinct and different function. What a lot of people think of as the ‘vagina’ (the passage from the external body to the womb) would actually be better described as the ‘vulva’. In my experience, these misconceptions are rife in ideas about our reproductive organs. Let’s have a look at some of the internal xx anatomy…

Vagina: a passage leading from the outside to internal parts. It’s made up of muscular, stretchy tissue that can deform and accommodate various things (tampons, fingers, foreign objects, a baby…).

Cervix: the lower bit of the womb. Roughly tube shaped and typically around 2-3cm long. It has a hole (the cervical ‘os’) which leads from the vagina to the womb. It can change shape, size and consistency under hormonal control – e.g. getting smaller and opening during childbirth.

Uterus: Or ‘womb’. This is where a baby can grow. Sits just behind the bladder in non-pregnancy. The lining of this cavity is called the ‘endometrium’. It is the endometrium thickening and then shedding that is experienced as periods. The top bit of the uterus is called the ‘fundus’.

Fallopian tubes: connect the uterus to the ovaries. Also called the ‘salpinges’ or a ‘salpinx’. Each one ends in a ‘fimbria’. This is a little fringe of tissue that helps convey eggs in to the tubes from the ovaries.

Ovaries: whitish lumps of tissue where eggs are released from. They also produce hormones so have an important endocrine role.

All of these structures sit quite low down in the abdomen. Sometimes problems that feel like they are coming from this reproductive tract can be mistaken for problems with the bowel and vice versa. We’ll have a look at some of these problems another time…

Posted in Genitals: A User's Guide

A Hymn to the Hymen

The inspiration for this one came from a pub conversation.  It’s time for…

Firstly…

The hymen is a often described as a ‘membrane’.  It is membranous tissue, but this can lead to some confusion-

This is called an ‘imperforate hymen’.  The main reason it needs treatment (i.e. surgical removal) is that it means that menstral blood cannot drain during a period.

So, as with many aspects of genitals, individuals can be VERY different and this is completely normal.

 

References (a note): 

When I have an idea for something, I usually start by looking at some standard Gynae textbooks and then try to find reliable looking online sources (e.g. NHS, clinical guidelines).  They failed me somewhat on this topic.  I’ve found a teeny tiny amount of information from my textbooks (mainly on imperforate hymen).  This is basically a way of explaining why my main source is a wiki page (here)!