Anatomy and Function of the Vagina and Pelvic Muscles

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Jump to Blood Supply of Vagina
Jump to Developmental Anomalies
Jump to The Protective Vaginal Environment
Jump to Vaginal and Vulvar Fluids
Jump to Normal Vaginal and Vulvar Fluids (Photographs)
Jump to Sensitivity to Sexual Stimulation
Go to How to Sexually Stimulate the Vagina

Anatomy Index

Introduction

This article primarily addresses the internal female reproductive organs, if you want to learn more about the external female genital organs please see the articles about the vulva and locating the vagina. Care of the vagina is addressed in the article about hygiene, and vaginal infections are addressed in the article about vaginitis.

It is important to note that when you read through medical references and journals you quickly become aware of the fact that there is still a lot we don't know about normal female sexual and reproductive anatomy and function, and there is some degree of debate within the medical community concerning these subjects. Very little is written in stone, and the enormous amount of normal diversity may prevent any concise conclusions. Most women probably need to know what is normal for them, and go from there, rather than looking to their peers for examples of normalcy. If you start out not knowing what is normal for you, it becomes more difficult to know what is abnormal, and potential causes for it.

Starting in childhood, girls should be encouraged to explore their body so they know what is normal for them. As they near and progress through puberty they need to be fully aware of the changes that occur, and also that their peers are experiencing the same or similar changes. As they begin exploring partnered sex and experiencing the changes associated with reproduction and aging they may then know more clearly when things have changed, and when things are no longer normal. Girls and women should be encouraged to "play doctor" on a regular basis. Women at least 18 years of age may want to start a photographic record of what their healthy vulva and vagina look like, for future reference.(6) Then if concerns should arise, they can show their doctor how things were in the past compared to the present.

Functions of the Vagina

The vagina is an extremely elastic multipurpose muscular passage that extends between the vestibule, which is part of the vulva, and the cervix, which forms the lower portion of the uterus. The normal functions of the vagina include:

Conducting normal vaginal and cervical fluids out of the body during the entire menstrual cycle, beginning at puberty and extending to menopause.

Creating an environment that helps protect the internal reproductive organs from disease.

Acting as a conduit through which menses passes out of the body during a woman's menstrual period.

Producing vaginal lubrication during sexual arousal, despite not having any type of glands.

Motivating women by means of a vaginal ache to seek out vaginal penetration during sexual arousal; combined with sexual desire this potentially motivates women to reproduce, to engage in partnered sex.

Serving as a passage out of the body for a baby during vaginal delivery.

Providing a doctor with access to the cervix and internal reproductive organs during a gynecological exam, so they may perform a PAP test and bimanual examination.

Producing varying degrees of pleasure for women during their sexual activities, alone and with a partner; potentially providing reward for engaging in a reproductive activity.

If a woman has male sexual partners, acting as a potential receptacle for fingers, dildos, other sex toys, a penis, and possibly male ejaculate during vaginal intercourse.

If a woman has female sexual partners, acting as a potential receptacle for fingers, dildos, other sex toys, and a dildo in a harness during vaginal intercourse.

Anatomy of Vagina

The normal appearance of the vagina and pelvic muscles are most often misrepresented in illustrations in anatomy and sexuality publications, as the images are based on examinations of the body conducted after death, and medical artists usually have to distort their appearance for reasons of visual clarity. The resulting images most often portray the vagina as an open cavity within the body, which is definitely not the case. This false presentation is sometimes a source of confusion for young women trying to explore and discover their body, and couples exploring partnered sex. The following photographs reveal how the vulva and vaginal orifice normally look for one woman. More examples are available in the article about locating the vagina.

The vagina's external orifice is located within the vestibule of the vulva, which is the area situated between the inner labia. The vestibule, highlighted in the following illustration, is also the location of the urethral orifice, Bartholin's and vestibular glands, and hymen. As indicated in the photographs shown above, the vestibule and vaginal and urethral orifices aren't always as clearly evident and defined as indicated in this illustration. The color of the mucosal tissue of the vestibule changes during puberty, from reddish to a dull pink, while also becoming softer in appearance, and the tissues more flexible; estrogen deficiency and menopause may reverse these changes.(4)

From the book "Atlas of Human Sex Anatomy"
By Robert Latou Dickinson M.D., F.A.C.S.
Copyright 1949 The Williams & Wilkins Company.

The vestibule and vulva are not flat, nor do they all appear the same when examined. In the following illustration, the vulva on the right depicts what Dr. Dickinson believed represented an "average" vestibule; orientated with a woman lying on her back with legs straight. Observe how the urethral orifices, labeled "meatus," are each in a different location in relation to the vaginal orifice. The urethral orifice on the left appears to be located within the vaginal orifice, whereas the one on the right is clearly separated from it. This will influence not only the urine stream, but also where a woman will find her urethral orifice when she desires to locate it. This may explain why some women believe they urinate and ejaculate through their vaginal orifice rather than their urethra. Urine may flow out of the vaginal orifice if there is a vaginal fistula, which is an abnormal passage between the vagina and urethra, bladder, or rectum.

Color Code: Clitoral Glans - Blue, Pubic Bone - Yellow, Hymen - Green, Vagina - Red
From the book "Atlas of Human Sex Anatomy"
By Robert Latou Dickinson M.D., F.A.C.S.
Copyright 1949 The Williams & Wilkins Company.

Something that is very important to note is, when a woman is standing or sitting upright her vulva and vestibule are parallel to the ground. When she is on her hands and knees her vulva is vertical, and while lying on her back the angle depends on the inclination of her hips. The following illustrations provide some indication of the various angles at which the vagina is positioned within the pelvis when a woman is laying her back with her legs and hips elevated at different heights. The resulting inclination of the vagina will determine at what angle and direction fingers, tampons, penises, and other objects must be positioned to be successfully inserted. Incorrect placement of the object can cause injury to the vulva and hymen. These four illustrations also demonstrate how the depth of the vestibule and vulva varies from woman to woman, which influences the apparent depth of the vagina when objects are inserted.

Color Code: Clitoral Glans - Blue, Pubic Bone - Yellow, Hymen - Green, Vagina - Red
From the book "Atlas of Human Sex Anatomy"
By Robert Latou Dickinson M.D., F.A.C.S.
Copyright 1949 The Williams & Wilkins Company.

Below, I have rotated one of the illustrations shown above to provide an indication of the angle of the vagina when a woman is on her hands and knees, as some couples have experienced difficulty with rear entry sexual positions, even if they have been successful in the missionary position. This illustration demonstrates why the penis must be angled up towards the small of a woman's back, and enter from below, when a woman is entered from behind.

Color Code: Pubic Bone - Yellow, Hymen - Green, Vagina - Red
From the book "Atlas of Human Sex Anatomy"
By Robert Latou Dickinson M.D., F.A.C.S.
Copyright 1949 The Williams & Wilkins Company.

This illustration demonstrates the angle of the vagina when a woman is standing, which is a position sometimes recommended when inserting a tampon; if you raise one leg then your vulva will tilt upward, changing the angle of your vagina.

Color Code: Pubic Bone - Yellow, Hymen - Green, Vagina - Red
From the book "Atlas of Human Sex Anatomy"
By Robert Latou Dickinson M.D., F.A.C.S.
Copyright 1949 The Williams & Wilkins Company.

The vaginal orifice is maintained in a normally closed position by the pelvic muscles, which are highlighted in the following illustration. Unlike the urethral orifice and anus, the vaginal orifice does not form a watertight seal, which results in body fluids flowing freely from the vagina, if they are of sufficient quantity. The urethra and anus each have a sphincter, the vagina does not. This means women don't have voluntary control over the release of their vaginal fluids, which can be a cause for emotional distress when they are in large quantities or occur at seemingly inappropriate times.

Copyright 1981, The Federation of Feminist Women's Health Centers
Illustrated By: Suzann Gage, L Ac, RNC, NP

The following MRI image and illustration demonstrate how the superficial female sexual and reproductive organs are normally located in very close proximity to one another, without any open cavities or voids. When an object enters the vagina it will most likely place pressure on the surrounding structures, including the urethra and erectile bulbs of the clitoris.

The Journal of Urology, Vol. 159, 1892-1897, June 1998
Helen E. O'Connel, John M. Hutson, Colin R. Anderson, and Robert J. Plenter

The following illustrations demonstrate how the mid-vagina is normally in the shape of an H. Observe how close the organs are together, anytime something enters the vagina, regardless of size, the body must make room for it. If the adjacent bladder or rectum are storing waste liquid and material this may influence a woman's ability to insert objects into her vagina, and the physical sensations experienced while doing so.

From the book "Eve's Secrets" Page 110.
Author: Josephine Lowndes Sevely.

This is an internal view looking down toward the vulva and anus. The pubic
bones are at the top of the image, the tailbone (coccyx) is at the bottom.
Clinically Oriented Anatomy: Fifth Edition
Copyright 2006 Lippincott Williams & Wilkins.

The following illustration reveals the deep pelvic muscles, but also incorrectly shows the vagina as an open cavity within the body, partly as a result of being based on human dissections.(3) During life, the pelvic muscles are always under a slight amount of tension, which is necessary to hold the contents of the pelvis in place, as otherwise they would be forced out by gravity. This normal tension, called resting or basal tone, holds the vagina closed except when something is inserted. If these muscles are too tight, inserting objects into the vagina may be painful or impossible. If they are injured or weak, then incontinence or prolapse (photographs of prolapse) are a possibility. This is why it is very important for the pelvic muscles to be strong yet flexible. Contrary to common folklore, a tight vagina, requiring the presence of tense pelvic muscles, isn't normal or healthy.

From the book A New View of a Woman's Body
Copyright 1981, The Federation of Feminist Women's Health Centers
Illustrated By: Suzann Gage, L Ac, RNC, NP

The following illustrations reveal the typical placement and alignment of the vagina and uterus within the body, and what happens to their alignment when the pelvic muscles become weak; the pelvic muscles have been highlighted in red.(3) Also note how the vagina normally doesn't follow a straight line into the body, which is something important to be aware of when inserting rigid objects. MRI images shown farther down on the page also reveal this internal alignment. In 20% of women the uterus is normally tilted to the rear rather than the front or straight up, which you can learn more about by clicking here and here.

Female Pelvic Floor Anatomy: The Pelvic Floor, Supporting Structures, and Pelvic Organs,
Sender Herschorn, MD, FRCSC
Please See Note (3)

Beyond the pelvic muscles, the vagina, uterus, and other pelvic organs are held in place by several supporting structures. These features are commonly left out of anatomy illustrations for reasons of visual clarity, but give the false impression the organs simply float within the pelvis. The following illustration provides an indication of how complex and extensive these supporting structures are. The orientation of this illustration may be a bit confusing: picture a woman standing, the vulva is at the bottom, the tail bone is to the left, and the pubic bone is to the right. While the presented shape of the vagina, at three different locations, aren't completely accurate, they do demonstrate how the supporting structures influence the shape of the vagina at these locations.

Contemporary Views on Female Pelvic Anatomy. By Matthew D. Barber MD
To see image more clearly, click on above link to download PDF file.

Inside the pelvic cavity, the vagina merges with the cervix. Since the cervix is made up of a different type of tissue than the uterus it is considered an entirely separate organ.[1] In a way, the cervix forms the external orifice for some of the internal female reproductive organs (the uterus, fallopian tubes, and ovaries). The cervix must act as a barrier to the outside world because objects and microscopic organisms can enter into the vagina relatively easily, which would place the uterus and a developing fetus at risk of infection if it did not. This is also why the vagina has an elaborate system of defenses that help protect against unwanted invasions, while still allowing one extremely important invasion; more on that later. It is the cervix that must create a physical barrier that will keep harmful organisms out of the internal pelvic organs, or a pelvic infection (PID) is a possibility. Menstruation serves to help protect the uterus and internal reproductive organs from infection by periodically shedding its lining, because if sperm can at times enter the uterus through the cervix so might other organisms.(1)

The vagina increases in size a bit at its junction with the cervix, but is still a collapsed potential space. The cervix projects down into the vagina; envision a tennis ball inserted into a sock. The area between the cervix and vaginal wall is called a fornix. There are the anterior (front), posterior (back), and lateral (side) fornices, with the posterior fornix being the largest potential space. The following illustration shows the anterior and posterior fornices, and demonstrates how this causes the front wall of the vagina to be slightly shorter than the rear wall, by about 1/2 inch (1.23 cm) on average.[2]

Clinically Oriented Anatomy: Fifth Edition
Copyright 2006 Lippincott Williams & Wilkins.

When not sexually aroused, the front wall of the vagina is about 3 inches (7.6 cm) on average in length, with a range of 2.3 to 3.7 inches (5.8 to 9.3 cm), and the rear wall is about 3.5 inches (8.8 cm) in length on average, with a range of 2.8 to 4.2 inches (7.1 to 10.6 cm). The width of the vagina is 1.4 inches (3.4 cm) on average, with a range of 0.8 to 2.0 inches (2.1 to 5.0 cm).[2] This length does not take into account the depth of the vulva, which is the distance between the outer labia and vaginal orifice, commonly called the introitus or vestibule, and depicted in the illustrations shown above. The depth of the introitus is about 1 inch (2.6 cm) on average, ranging from 5/8 to 1 3/4 inches (1.5 to 4.6 cm).[3]

This means on average, the vulva and vagina can receive objects 4 to 4.5 inches in length, depending on whether the object enters the anterior or posterior vaginal fornix. It also means the average penis, having a length of 5.1 to 5.9 inches (12.9 to 14.9 cm), is sufficiently long to fill the length of the vagina.[4] During sexual arousal, the vagina is reported to lengthen by up to about 50%(2), resulting in a length of perhaps 4 1/2 inches (11.4 cm). This last observation is debatable, as a study performed in 1991 using MRI found only the front wall of the vagina increased in length, and then only by 1 cm (0.4 inches). The uterus' position "hardly changed." indicating it is unlikely the vagina increases much in length during sexual arousal.[5] The vagina may stretch under pressure, when an object is inserted, but it doesn't appear to do much of this on its own.

The following MRI images demonstrate the potential space created by the vaginal fornices. The top image shows the normal resting position of the vagina, cervix, uterus, and bladder. In the bottom image, a liquid gel has been injected into the vagina to aid in creating a medical diagnosis, but in the process demonstrates the shape and elasticity of the upper vagina and the area surrounding the cervix. This is important to note, as it helps illustrate where a tampon or a penis should be positioned if they are to fit comfortably and fully within the vagina. If objects are angled incorrectly when inserted they may hit against the cervix rather then entering into the vagina fully.

Color Code: Bladder - Blue, Pubic Bone - Yellow, Uterus - Purple, Cervix - Teal, Vagina - Red/Pink.
MRI of the Female Pelvis Using Vaginal Gel,
Michéle A. Brown1, Robert F. Mattrey, Stephan Stamato and Claude B. Sirlin

In the following MRI images observe how large the bladder, highlighted in blue, has become in the image on the right, and how this has altered the position of the uterus and vagina. This change in size is the result of increased urine being stored within the bladder, as the bladder is much like a balloon that requires internal outward pressure for it to expand. This pressure and resulting movement of the internal organs may in part explain why a full bladder alters a woman's sexual experiences, and may even trigger physical sexual arousal. (The original reference does not comment on the significance of the increased size of the bladder.)

Color Code: Bladder - Blue, Pubic Bone - Yellow, Uterus - Purple, Vagina - Green
Magnetic resonance imaging of male and female genitals during coitus and female sexual arousal,
Willibrord Weijmar Schultz, Pek van Andel, Ida Sabelis, Eduard Mooyaart

The following images reveal the position of the erect penis during vaginal intercourse, when couples are in the missionary position. The tip of the penis is positioned in the posterior fornix. Some women find it pleasurable when the penis and other objects press or bump into the cervix during sexual activities, others find it uncomfortable or painful. The cause of these different experiences is unknown, but one potential cause of pain is endometriosis.

Midsagittal image of the anatomy of sexual intercourse (experiment 12). P=penis, Ur=urethra,
Pe=perineum, U=uterus, S=symphysis, B=bladder, I=intestine, L5=lumbar 5, Sc=scrotum
Magnetic resonance imaging of male and female genitals during coitus and female sexual arousal,
Willibrord Weijmar Schultz, Pek van Andel, Ida Sabelis, Eduard Mooyaart

The following photographs reveal what the inside of the vagina looks like when viewed through a speculum. As you can see, there are many bumps and ridges, which are called rugae. This irregular surface may cause concern when women explore their vagina for the first time, as the vagina is often portrayed as a perfectly smooth tube. From the time a girl is a few week old infant until she experiences the onset of puberty her vagina looks and functions much differently than shown here. (4)

From the book A New View of a Woman's Body
Copyright 1981, The Federation of Feminist Women's Health Centers

The following photograph reveals what the vaginal wall looks like when viewed straight on, which isn't normally possible. This accordion like appearance is the result of the vagina's ability to stretch sufficiently to allow an erect penis and full term infant to enter.

http://library.med.utah.edu/WebPath/FEMHTML/FEM084.html

The wall of the vagina is comprised of three layers of tissue:

The inner most mucosal or mucus layer is made up of the same tissue as the inside of your mouth, nonkeratinized stratified squamous epithelium. These skin cells are sensitive to the hormonal changes of the menstrual cycle, namely the hormone estrogen.[6] Despite being a mucus membrane there are no glands inside the vagina that produce mucus secretions. Normal vaginal moisture "percolates" through the epithelium from the abundant blood vessels present in the underlying tissue (lamina propria). During the reproductive years, the normal vaginal environment is "just moist" rather than producing a steady volume of fluid. There is a slight amount of fluid that seeps from the vagina in varying amounts throughout the menstrual cycle; this topic is addressed in the article about hygiene.[6] The vagina also reabsorbs some of the moisture present.[6] The normal or basal level of moisture present in the vagina isn't commonly sufficient to facilitate sexual intercourse. During sexual arousal, transudate and cervical mucus form tiny "bead-like droplets" that slowly, or not so slowly, pool together coating the vaginal canal, and most often the vestibule and beyond.[6] "The smooth, slippery quality of the formed fluid is probably due to its pick up of sialoproteins coating the vaginal epithelium from the cervical secretion."[6]

Click on Image to See Full Size
http://www.siumed.edu/~dking2/erg/RE053b.htm

The middle, muscular or muscularis layer, of the vagina is comprised of two separate layers of smooth muscle, an outer longitudinal (lengthwise) and an inner circular (donut shaped) layer. Women don't have voluntary control over these muscles. They are normally under a small amount of tension, and active throughout the menstrual cycle, but especially during the onset of menstruation, though women generally aren't aware of this, except when it becomes painful (dysmenorrheic pain).[6] At this time, I don't believe we know how these involuntary muscles function during intercourse and other sexual activities. Involuntary contraction of these muscles may cause pain and prevent vaginal penetration, resulting in a condition called vaginismus.

The outer elastic layer of the vagina provides structural support.[6]

The following photograph illustrates how the female prostate gland, commonly called the G-Spot, may project into the vaginal canal; this may not be a "typical" example. It isn't unusual for there to be a raised ridge or area of firmness along the front or top wall of the vagina that may produce pleasure and female ejaculation when stimulated during sexual activity. This feature is more pronounced in some women than others. It is possible for this swelling to be indicative of infection, if associated with additional signs of infection. In this example, you can see evidence of the underlying individual ducts that make up the prostate gland, though they empty into the urethra and possibly the vulva rather than the vagina.

The following illustration demonstrates how the urethra may project noticeably into the vaginal canal. It isn't known if this illustration is based on an actual woman, or meant to graphically illustrate how the urethra lies within the vaginal wall of all women, even though the two organs are usually shown as completely separate and isolated.(5) This illustration could show what the inside of the vagina looked like in the example discussed and illustrated above, where the urethral orifice appears to be within the vaginal orifice. Stimulation of the top or front wall of the vagina will most likely stimulate the female urethra and prostate gland, and this is likely why the majority of women have said vaginal stimulation results in an urge or desire to urinate, at varying degrees of frequency and intensity during their sexual activities.

Clinically Oriented Anatomy: Fifth Edition
Copyright 2006 Lippincott Williams & Wilkins.

The following illustration gives you an idea of how much the vulva and vagina can dilate to allow the passage of an infant during childbirth. The black outline indicates the location of the pelvic bones that form the birth canal. If the birth canal is found to be too small for vaginal delivery, necessitating a Caesarian section, it is because the pelvic bones are positioned too close together for the size of the baby's head, not because the vagina is too small.[1] This illustration, and one shown above, allow us to see how the vagina must stretch in the direction of the anus when objects are inserted, or pass through it. Stretching or pressing the vagina in the direction of the pubic bones is likely to crush the urethra, prostate gland, and other soft tissues in the area, causing pain and possible injury.

From the book "Atlas of Human Sex Anatomy"
By Robert Latou Dickinson M.D., F.A.C.S.
Copyright 1949 The Williams & Wilkins Company.

Continued - Part 2

Anatomy Index

Notes:

1) Oral Contraceptives (OC) can be used to inhibit menstruation. At this time, this is believed to decrease the risk of pelvic infections, perhaps because OC's alter the cervical mucus. The cervical mucous likely acts as a barrier to harmful organisms. Reference 1, Reference 2, Reference 3, Reference 4

2) When writing this article I couldn't find the reference from which I came about my prior claim of a 50% increase in the length of the vagina during sexual arousal. Some references say the vagina lengthens, but they don't usually state by how much. Reference 4 states: "So the exceptional man whose erect penis is eight inches long can still make love to any woman, providing he excites her properly and introduces his organ very slowly. If he does this, her vagina will lengthen by 150 or 200 per cent [1 1/2 to 2 times its normal length] to accommodate him." The vagina may stretch when an object is inserted, but sexual arousal alone doesn't appear to lengthen it by all that much. Reference 1, Reference 2, Reference 3, Reference 4

3) MRI images of living subjects have indicated the pelvic muscles are normally not "bowl" shaped, rather "In a woman with normal pelvic floor function, the levator ani muscle complex in its tonically [normal] contracted state has an intricate three-dimensional structure in which its anterior [front] portion (pubococcygeus and puborectalis) is oriented vertically as a sling around the mid-urethra, vagina, and anorectum and its posterior [rear] portion (the pubococcygeus) has a horizontal upwardly biconvex shape resembling a butterfly wing (Figure 3)." [7] Below, I have enlarged and enhanced the image provided in the cited reference.

4) "At birth, the vagina is 4 cm [1.6 inches] long, lengthens approximately 1 cm [0.4 inches] during early childhood and 8 cm [3.1 inches] during late childhood, and reaches mature length of 10 to 12 cm [4 to 4 3/4 inches] by menarche. The vagina at birth resembles the mature vagina with its deep cryptic rugae and folds secondary to [as a result of the] maternal estrogenic effect [raised estrogen level]. As maternal estrogen levels fall in the infant within the first few weeks after birth, the vaginal wall becomes dry, thin, nonelastic, and nonrugated. The vagina remains in this quiescent state until the onset of puberty. During early puberty, increased estrogen levels affect the vaginal epithelia [exposed skin surface]. Such pubertal changes can be noted on examination by identification of the more mature dull pink color of the vaginal mucosa [mucus tissue], increased vaginal secretions, and increased vaginal wall flexibility compared with the prepubertal findings of the red translucent mucosa, sparse secretions, and a relatively rigid vaginal wall." From Rudolph's Pediatrics: Edition 21, by Colin D Rudolph, Abraham M Rudolph, Margaret K Hostetter, George Lister, and Norman J Siegel, editors

5) "The close physical proximity of the urethra and the clitoris to the anterior vaginal wall suggests an association between these anatomical structures and sexual function. In fact, the anterior vaginal wall is an active organ, transmitting during intercourse, the effect of penile thrusting in the vagina to the clitoris, by stretching the two ligaments that insert around its base." Measurement of the Thickness of the Urethrovaginal Space in Women with or without Vaginal Orgasm, Journal of Sexual Medicine Volume 5 Issue 3, Pages 610 - 618

"The distal vagina is a structure that is so interrelated with the clitoris that it is a matter of some debate whether the two are are truly separate structures. The same relationship applies to the female urethra. Though in anatomical terms it is possible to dissect one structure fully from the other, the three structures (distal [outer] vagina, clitoris, and urethra) share blood supply and innervation." The Anatomy of the Distal Vagina: Towards Unity, Journal of Sexual Medicine Volume 5 Issue 8, Pages 1883 - 1891

6) In the U.S. it is illegal for anyone to take a photograph of the vulva or vagina of anyone under the age of 18, and this includes the woman herself. Unfortunately, electronic images are easy to distribute, which means they are potentially a matter of public record once created, especially if a computer or cell phone is lost or stolen, or the images are voluntarily shared with a friend or sexual partner who later shares them with third-parties, which is a common occurrence. At present, our legal system does not make a distinction between appropriate and inappropriate use of technology by those not yet considered an adult by the legal system, hence everything is considered illegal. For women 18 and older, they may want to password protect these images by using encryption software, some of which is available for free. Obviously, the password should be known only to the woman herself, as sharing the password defeats the purpose of having one, and easy to remember ten or more years later.

7) I do not want to appear as though I support male circumcision without reservation, as men were around for thousands of years prior to the invention of circumcision, yet we still survived and evolved as a species; other mammals appear to exist quite well with intact foreskins. Circumcision DOES reduce the rate of HIV transmission, but the primary risk factor isn't associated with a penis having an intact foreskin, but rather with having multiple sexual partners, as well as other risk factors. If a man with an intact foreskin never engages in penile-vaginal or penile-anal intercourse, and other risky activities, then he will more than likely never acquire HIV. The greater the number of sexual partners he has, and the poorer his personal hygiene habits, the greater his risk for acquiring HIV and other STDs, and spreading it to his sexual partners. Circumcision reduces but DOES NOT eliminate the risk of contracting and spreading HIV and other STDs. My concern is that men who are circumcised may believe they are immune to HIV, which is absolutely not true. The same principle applies to young women, and eventually young men, who get the HPV vaccine; getting vaccinated does not eliminate all the other risks factors, only potentially blinds us too them. Strictly and ideally, from a medical perspective, men and women should limit the number of sexual partners they exchange body fluids with to those the plan to conceive a baby with, or at least as few as possible, to protect their overall health and quality of living. This is because harmful organisms are constantly evolving, and the speed at which they spread around the world has reduced from years to hours. This however does not rule out the possibility for engaging in partnered sex with more than one person during your lifetime.

General References:

The V Book: A Doctor's Guide to Complete Vulvovaginal Health, Elizabeth G. Stewart, M.D..

Contemporary Views on Female Pelvic Anatomy, Matthew D. Barber MD

Female Pelvic Floor Anatomy: The Pelvic Floor, Supporting Structures, and Pelvic Organs, Sender Herschorn, MD, FRCSC

Female Genital Anatomy, Center for Sexual Medicine at Boston University School of Medicine

Atlas of Human Sex Anatomy, Robert Latou Dickinson M.D., F.A.C.S.,Copyright 1949 The Williams & Wilkins Company.

A New View of a Woman's Body, The Federation of Feminist Women's Health Centers, Illustrated By: Suzann Gage, L Ac, RNC, NP

Clinically Oriented Anatomy: Fifth Edition, Lippincott Williams & Wilkins.

Eve's Secrets, Josephine Lowndes Sevely.

Cited References:

1. The V Book: A Doctor's Guide to Complete Vulvovaginal Health by Elizabeth G. Stewart, M.D. Copyright 2002.
2. Vaginal Anatomy and Physiology, Siddique, Sohail A. MD, Journal of Pelvic Medicine and Surgery: November/December 2003 - Volume 9 - Issue 6 - pp 263-272
3. Atlas of Human Sex Anatomy, Robert Latou Dickinson M.D., F.A.C.S., Copyright 1949 The Williams & Wilkins Company.
4. Human penis size, Wikipedia.com
5. Magnetic resonance imaging of male and female genitals during coitus and female sexual arousal, Willibrord Weijmar Schultz, Pek van Andel, Ida Sabelis, Eduard Mooyaart
6. Female Genital Anatomy, Center for Sexual Medicine at Boston University School of Medicine
7. Contemporary Views on Female Pelvic Anatomy, Matthew D. Barber MD