Posted in Genitals: A User's Guide

The Egg and Sperm Race…

A message we all seem to consistently pick up in Sex Ed and elsewhere is “you have unprotected sex, you get pregnant”.  However, if we think about this, we know that it isn’t quite the whole truth.   An often quoted statistic is that around 84% of couples trying to get conceive and having sex twice or more a week will get pregnant in a year (e.g. NHS, 2019).  If you do the sums, you can see that that’s an awful lot of sex not resulting in a pregnancy!

So, why not?  Well, pregnancy relies on four conditions that need to be met (Impey and Child, 2012):

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Firstly, an egg must be produced.  An egg is produced by the ovaries once every cycle and is only viable (capable of being fertilised) for a few days.   Sex outside of this time is less likely to result in pregnancy – remember though that sperm can live inside the vagina for up to seven days.  This means that penis-in-vagina sex that happens up to seven days before this ‘fertile window’ can still result in pregnancy!

Secondly, adequate sperm must be released.  ‘Adequate’ means that the number and quality of the sperm in ejaculate must be sufficient to fertilise an egg.

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Thirdly, sperm must reach the egg.  Lots of contraceptive methods work on this part of the process – for example from preventing sperm from entering the vagina and the womb (condoms) or by preventing the egg from travelling from where it is produced in the ovaries to the womb, via the fallopian tubes (tubal ligation, sometimes called ‘female sterilisation’).

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And lastly, the embryo (i.e. an egg fertilised by a sperm) must implant in to the lining of the womb.  This allows the embryo to survive and develop.  Again, some contraceptive methods work partly by altering this process (e.g. the copper coil or the ‘morning after’ pill).

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So, all of these four factors need to align to result in pregnancy!

 

 

References

Impey., and T. Child., (2012) Obstetrics and Gynaecology. Fourth Edition. Wiley-Blackwell: Electronic Copy.

NHS online, Overview Infertility, (Accessed online 2nd April 2019).

 

 

Posted in Genitals: A User's Guide

Hidden Depths

The clitoris used to be  represented and thought of as a small ‘pea’ like structure, sitting above the urethra (Enright, 2019).  It wasn’t until relatively recently when Professor Helen O’Connell fully investigated and modelled the full extent of the clitoris in 1998 (Fyfe, 2018).  O’Connell is a Urologist (a type of doctor, who specialises in surgery in areas of the body including the bladder and urethra).  She used cadavers to map fully map out the clitoris, demonstrating that it was a much bigger structure.  Like this:

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The structure of the clitoris, showing its relation to the urethra and vaginal opening (After Drake  et al., 2010).

It includes structures that are hidden deep to other tissue, such as the corpus cavernosum and the bulbs of the clitoris.  As you can see from the diagram the bulbs of the clitoris are very close to the vagina – even more so when a person is aroused, as they become swollen and more erect by blood being diverted to them, just as the penis does (Drake et al. 2010).

There is an excellent and short French cartoon about the structure, function and history of ‘Le Clitoris’- the only organ that is just for pleasure – here.

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3D printed, scale-sized model of the clitoris

 

References:

Drake, R. L., Vogl, A. W. & Mitchell, A. W. M. (2010) Gray’s Anatomy for Students. Second Edition. Canada: Churchill Livingstone Elsevier.

Enright, L. (2019) Vagina a Re-Education. Croydon: Allen & Unwin.

Fyfe, M. (October 2018) Get Clitorate: how a Melbourne doctor is redefining sexuality. The Sunday Morning Herald.  Accessed online on 21.03.2019 at [https://www.smh.com.au/lifestyle/health-and-wellness/get-cliterate-how-a-melbourne-doctor-is-redefining-female-sexuality-20181203-p50jvv.html}

 

Posted in Genitals: A User's Guide, Uncategorized

By Design

Ever heard the term ‘designer vagina’?  This generally refers to a certain type of cosmetic surgery, not to the vagina itself but to the ‘inner lips’ (or labia minora) of the vulva.  Surgery here involves removing tissue from and reshaping the appearance of the labia minora- in other words to ‘trim’ it.   Many people with vulvas have a labia minora that protrudes so that it appears visible – therefore however large this is it is likely to be ‘normal’.  Additionally, in young people biological changes occur during puberty that can change the appearance of the inner labia.  For this reason it is often recommended by the NHS that those under 18 do  not get this type of surgery.  However, there seem to cases of children having labiaplasties.  According to one report over 200 people received labiaplasty procedures funded by the NHS in 2015-2016.  We know that people with visible labia are more likely to think that their genitals look ‘abnormal’ than those without, even though both are equally common (Lykkebo et al, 2017). Some accounts have blamed this on the prevalence of seeing only vulva with neat and invisible labia minora.  Whatever the cause, the desire to have this type of surgery seems increasingly common with a 45% rise seen in labiaplasty numbers worldwide between 2015 and 2016.

 

 

 

Posted in Genitals: A User's Guide

Dare to Hair

Pubic hair and body positivity can be a tricky issue. On the one hand, people absolutely have the right to cut, shape, dye, remove or in any other way sculpt their own personal body space! I get how it can be liberating and a way of taking control of your own body and quite literally shaping your intimate identity.

On the other hand, there seems to be a growing repulsion for body hair that isn’t manicured. A dislike for ‘natural’ hair, particularly (but not exclusively) when it comes to vulvas. Some people specifically find it ‘unhygienic‘. This despite the fact that pubic hair, like the hair on your head, has specifically protective functions.

So trim and go as bare as you dare around your nether regions if you want to. But maybe think about why your doing it!

Posted in Genitals: A User's Guide

Luscious Lips

‘Labia Minora’ is latin for ‘smaller lips’.  It’s the word used to describe the flaps of tissue that sit inside the larger labia majora (‘large lips’) and surround the innermost structures of the vulva – like the clitoris and the vagina.

Exactly what an individual’s labia minora look like in terms of shape and size vary hugely.  Some have fairly minimal tissue, which doesn’t tend to be visible unless the labia majora are spread (i.e. legs akimbo!).  Some people have much larger amounts of tissue.  When people talk about having cosmetic surgery to the vulva, they often call it a ‘designer vagina’.  However, it is surgery to the labia minora (a ‘labiaplasty’ or ‘vulval surgery’) that they are in fact referring to, not surgery to the vagina itself.   Some people feel that this type of surgery is almost always unnecessary and related to unfounded fears that people have about larger labia minoras being ‘abnormal’.

Posted in Genitals: A User's Guide

Getting Technical

This week, artist Laura Dodsworth’s latest piece hit the news. This is a collection of photographs of 100 vulvas. One of the reasons this is great is that it taps into and challenges taboos around vulval genitalia. One of the misconceptions very publicly elicited was the language and terms use- Dodsworth correctly uses ‘vulva’ to refer to the externally visible parts of this type of genitalia:

That ignorance around this exists became very evident, very quickly. One twitterer tried to ‘correct’ it. I’m doing so, he used the term ‘vagina’ which, although a common mistake, refers to the passage between the cervix (entrance of the womb) and outside of the body. These bits can be photographed, but it’s rather tricky and involves specialist equipment!

Professional and amateur vulva and vagina owners alike were swift to correct him. I really recommend reading this link, with popcorn.

Posted in Genitals: A User's Guide

A Cock and Bull Story…

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Rounding off the year, let’s have a look at penises!  We (the societal ‘we’) tend to be a bit more familiar with the constituent parts than we are with vulvas…

Glans: This is the tip or ‘head’ of the penis.

Foreskin: This is a fold of skin that covers the glans of the penis.  It can be removed, either at birth or later in life, for either medical or cultural reasons in a process called circumcision.  Rates of this practice vary across the world and it isn’t as common in the UK as in other parts of the world.

Urethra: The opening of the penis.  Semen, urine and discharge can leave the body here.  As with discharge from the vagina, this can be normal.  Changes in the discharge (e.g. smell or colour), especially when accompanied by other symptoms (pain, itchiness) can however indicate something’s not quite right and might need checking out.

Shaft: This is the main bit of the penis.  Internally are found the tubes that carry urine and semen out of the body, as well as blood vessels supplying the penis – this is part of the mechanism that causes the penis to become hard and bigger during an erection.

The average penis size is 9 cm when not erect, although there is a fairly large and health variation in this.

Posted in Genitals: A User's Guide

But, Am I Normal?

We seem to sometimes fall in to the habit of talking about ‘discharge’ from the vagina as if it’s always bad thing- for example as a sign of an infection.  It can be easy for forget that it’s also a healthy part of how this bit of your vulva works.  The vagina produces a mucousy discharge that helps keep it clean and protects from infection.  But what is it ‘meant’ to look like?!  Healthy discharge should be:

  1. SMELL – not strong and/or unpleasant.
  2. COLOUR – clear or white.
  3. CONSISTENCY – thick and sticky or slippery and wet.

It’s perfectly normal for it to vary a bit with age and during different bits of the menstral cycle, but as long as it’s within these parameters, it’s all perfectly normal… so now you know!

 

Posted in Genitals: A User's Guide

Unwelcome Visitors: Thrush

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Thrush is one of the causes of unusual vaginal discharge. Usually not ‘offensive’ smelling, it is often described as ‘cottage cheese’ – it has that kind of lumpy and white quality.  Or like the chest of the bird thrush, which is speckled and light compared to the rest of its body!

Unlike other causes of abnormal discharge, it is not a sexually transmitted infection.  STIs are spread from person to person, through direct contact such as skin-to-skin or bodily fluids (saliva, mucous, semen, blood, etc).  Thrush however, is an overgrowth of a type of fungal yeast (candida albicans) that ordinarily lives in other parts of the body, without causing an infection.

As well as the discharge, it is usually accompanied by an itching feeling.  Thrush proliferates in damp parts of the body.  As well as being able to cause infection in the vagina, in can therefore cultivate under the foreskin of the penis, or in skin folds around the rest of the body.

Vaginal thrush is treated with a cream, a pessary (i.e. a ‘tablet’ that comes with a device to be put straight in to the vagina), an oral tablet or combinations of these.  In the UK, this treatment is available ‘over the counter’ – you can go to a pharmacy and get it without a prescription.  However, it’s a good idea to go to your GP if it’s the first time you’ve had thrush.  They can then check that this is what it is.  It’s important to get further medical help if you’ve had regular infections or tried the treatment before and it isn’t working.  You may also need to see your doctor if you have other medical complications as well.

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References:

NHS, ‘Thrush in Men and Women’, accessed 14.11.2018.

Wikipedia, ‘Candida Albicans’, accessed online 14.11.2018.

Centre for Disease Control and Protection, ‘Candidiasis’, accessed 15.11.2018.

EMC, ‘Canestan Duo Patient Information Leaflet’, accessed online 15.11.2018.