Women's outdoor floors. Anatomy of a woman's vagina

Some 15 years ago, the word "vagina" caused bewilderment and even indignation among mankind. Many girls, still wanting to know how the vagina works, were embarrassed to raise this issue so as not to seem ignorant. There has always been interest in the body of a woman, and at the moment this topic is relevant and is discussed quite often.

It's no secret that in educational institutions today the female vagina is taught in the classroom, including.

Female How is the vagina arranged?

The reproductive system of women is divided into two types:

• external organs;
• internal.

What goes to the external organs

To study how a woman's vagina works, you need to consider the structure of the entire reproductive system.

The organs of the external system are represented by:

• pubis;
• large and small labia;
• clitoris;
• vestibule of the vagina;
• bartholin's glands.

Pubis

The pubis of a girl is called the lower region of the anterior abdominal wall, which rises due to the subcutaneous fat layer. This area is characterized by the presence of a pronounced hairline, the color is darker than the hair on other parts of the body. Outwardly, it resembles a triangle, in which the upper border is outlined and the top is directed downward. In the pubic area are the labia, which have skin folds on both sides, in the middle there is a genital gap with the vestibule of the vagina.

Small and large labia - what are these organs?

The labia majora can be described as skin folds where fatty tissue is located. The skin of this organ is endowed with many sweat and sebaceous glands, and during puberty, hair appears on it. In the lower part of the large lips there are Bartholin's glands. During the period when there is no sexual stimulation, the lips are in a closed position, creating protection from damage to the urethra and the entrance to the vagina.

The small lips are located between the large ones, outwardly these are two skin folds of a pinkish tint. You can also find another name - the organ of the sexual senses, since they contain many vessels, nerve endings and sebaceous glands. Small lips are connected over the clitoris, and a fold of skin is formed - the foreskin. During arousal, the organ becomes elastic due to saturation with blood, as a result of which the entrance to the vagina narrows, which improves the sensations during intercourse.

Clitoris

The clitoris is considered the most unique system of a woman, it is located at the upper base of the small lips. The appearance and size of the organ may vary depending on the individual characteristics of the woman. Basically, the length varies within 4 mm, less often 10 mm or more. The function of the organ is to concentrate and accumulate sexual feelings; in an excited state, its length increases.

Vaginal vestibule

This organ is a slit-like region, which is bounded in front by the clitoris, on the sides - by small lips, behind - by the posterior commissure of the labia, and is covered from above by the hymen. Between the clitoris and the entrance to the vagina is the external opening of the urinary canal, which opens in the vestibule. This organ fills with blood during sexual arousal and forms a "cuff" that develops and opens the entrance to the vagina.

bartholin glands

The location of the glands - at the base and in the depths of the large lips, have a size of the order of 15-20 mm. In an excited state and during sexual contact, they contribute to the release of lubricant - a viscous grayish liquid rich in protein.

internal reproductive organ system

To understand how the female vagina works, you need to consider the internal genital organs as a whole and individually, this will give a clear picture of the structure of the organs.

Internal organs include:

• vagina;
• ovaries;
• fallopian tubes;
• uterus
• cervix;
• virgin hymen.

The vagina is an important organ

The vagina is an organ that takes part in sexual contact, and also plays an important role in the birth of a child, since it is a component of the birth canal. On average, the size of the female vagina is 8 cm, but it can be smaller (up to 6 cm) and more - up to 10-12 cm. The vagina has a mucous membrane inside with folds that allow it to stretch.

The device of the female vagina is made in such a way as to protect the body from all sorts of harmful effects. The walls of the vagina consist of three soft layers, the total thickness of which is about 4 mm, and each of them performs its own functions.

• The inner layer is the mucous membrane.

It consists of a huge number of folds, thanks to which the vagina can change its size.

• The middle layer is smooth muscle.

Muscular longitudinal and transverse bundles are present in both the upper and lower parts of the vagina, but the latter are more durable. The lower bundles are included in the muscles that regulate the work of the perineum.

• The outer layer is adventitia.

This is a connective tissue, which is represented by elastic fibers and muscles. The function of adventitia is the union of the vagina and other organs that are not part of the reproductive system.

Functions of the vagina:

• Sexual.

This is the main function of the vagina, since it is directly involved in the conception of children. During unprotected intercourse, a man's sperm enters the cervix through the vagina. This allows the sperm to reach the tube and fertilize the egg.

• generic

The walls of the vagina, when connected to the cervix, form the birth canal, since during contractions the fetus passes through it. During pregnancy, under the action of hormones, the tissues of the walls become more elastic, which allows you to change the size of the female vagina and stretch it to such a size that the fetus can come out freely.

• Protective.

This is a very important function for the female body, since the vagina acts as a barrier due to its structure. With the help of the walls of the vagina, the body self-purifies, preventing the ingress of microorganisms.

• Output.

With the help of the vagina, discharge is removed as a result of the working capacity of the woman's body. As a rule, these are menstruation and clear or whitish discharge.

In order for the microflora of the vagina to be healthy, it must be constantly moist. This is ensured by the internal walls, in which there are glands that secrete mucus. Allocations not only protect the body from the development of diseases, but also contribute to the painless course of sexual intercourse.

However, it is worth paying attention to the abundance of mucus secretions, it should not be excessive. Otherwise, you need to see a doctor.

Every girl should know how the vagina works, because this organ performs important functions.

ovaries

It contains about a million eggs, where the formation of the hormones estrogen and progesterone takes place. In this organ, there is a change in the level of hormones and their release by the pituitary gland, due to which the eggs mature and exit the glands. This process is called ovulation and repeats again after about 28 days. Close to each ovary is the fallopian tube.

What are fallopian tubes?

This organ is represented by two hollow tubes with holes that go from the ovaries to the uterus. At the ends of the tubes are villi, which, as the egg is released from the ovaries, help to capture it and direct it into the tube so that it enters the uterus.

Uterus

It is represented by a hollow pear-shaped organ located in the pelvic cavity. The uterine walls are layers of muscles, due to which, during pregnancy, the uterus changes size along with the fetus. During labor pains, the muscles begin to contract, and the cervix stretches and opens, and then the fetal egg passes into the birth canal.

This is a rather interesting question, how the vagina is arranged, because knowing the structure and functions of a woman, one can clearly understand how the conception of a child begins, how it grows and is born.

Cervix

This organ is the lower part of the uterus with a passage that directly connects the uterus itself and the vagina. When the moment of childbirth comes, the walls of the cervix become thinner, the pharynx increases and becomes an opening with a diameter of 10 cm, during this period the fetus is possible to exit.

Hymen

Another name is hymen. The hymen is represented by a thin fold of mucous, which is located at the entrance to the vagina. Each girl has her own individual characteristics of the hymen. It has several holes through which blood is released during menstruation.

It breaks at the first sexual contact, this process is called defloration. This may cause pain and bleeding. At a young age, the gap is less painful, this is due to the fact that after 22 years the hymen loses its elasticity. In some cases, the hymen remains intact if it is too elastic, then the first sexual experience does not bring any discomfort. Hymen collapses completely only after childbirth.

The structure of the vagina of a virgin and a woman from the inside is not much different. As a rule, the differences are just in the presence or absence of the hymen.

It is generally accepted that the absence of a hymen indicates the presence of a sexual life in a girl, but this is not direct evidence. The film can be damaged as a result of heavy physical exercise, as well as during masturbation.

The structure of the entire human body is a whole science that captivates more and more people every year. Mankind is interested not only in information about how the vagina is arranged, but also in other organs, because there are a lot of them in our body, and each of them is vital.

The external female genital organs are vulva. It includes anatomical structures that are placed outside from the pubis in front to the posterior opening in the back. They are presented:

Pubis- a rounded increase formed by adipose connective tissue, which is located above the pubic symphysis. The amount of adipose tissue in the pubic area increases during puberty and gradually decreases after menopause. The skin of the pubis during puberty is covered with curly pubic hair, which thins after menopause. The upper border of the hairline in women usually forms a horizontal line, but may vary; down, the hair grows along the outer surface of the labia majora, and forms a triangle with a base at the upper edge - a shield. The pubic skin contains sweat and sebaceous glands.

Largelabia- These are two rounded folds of skin that extend from the pubis to the perineum on both sides of the pudendal fissure. Embryologically, the labia majora are homologous to the male scrotum. In front, they form the anterior commissure of the labia, behind - a transverse bridge slightly elevated above the surface of the skin - the posterior commissure of the labia. The labia majora are 7-8 cm long, 2-3 cm wide and 1-1.5 cm thick; contain adipose and fibrous tissue, sweat and sebaceous glands.

Venous plexuses in the thickness of the labia majora, when they rupture during trauma, contribute to the development of a hematoma. In the upper part of the labia majora, the round ligament of the uterus ends and the obliterated vaginal process of the peritoneum, the Nuka canal, is located. Vulvar cysts can form in this canal.

By the period, the outer surface of the labia majora does not differ from the surrounding skin. During puberty, the outer labia are covered with hair. In children and women who have not given birth, the labia majora are usually in a closed position and completely cover the pudendal fissure; their inner surface is smooth, thinned and resembles a mucous membrane. After childbirth, the labia majora do not close completely, their inner surface becomes more skin-like (although not covered with hair), which is more noticeable in women who have had many births. After menopause, the labia majora are subject to atrophy, the secretion of the glands decreases.

Smalllabia- two small, thin, reddish folds of skin that are located medially from the large labia and obscure the entrance to the vagina and the external opening of the urethra. The labia minora is very variable in shape and size. In women who have not given birth, they are usually covered by large shameful lips, and in those who have had many births, they protrude beyond the large labia.

The labia minora is covered with stratified squamous epithelium, does not contain hair follicles, but has numerous sebaceous glands and several sweat glands. The sebaceous glands enlarge during puberty and atrophy after menopause. The thickness of the labia minora contains connective tissue with numerous vessels and some muscle fibers, as in typical erectile structures. The presence of numerous nerve endings in small shameful lips contributes to their extreme sensitivity. From above, the labia minora converge (the anterior frenulum of the labia) and each of them is divided into two smaller folds, the lateral part of which forms the foreskin, and the medial part forms the frenulum of the clitoris.

In the lower part, the labia minora gradually become thinner and form the posterior frenulum of the labia, which is noticeable in nulliparous women. In women who have given birth, the labia minora below gradually merge with the inner surface of the labia majora.

Clitoris- This is a small, cylindrical organ, usually no more than 2 cm long, which is located in the upper part of the vaginal vestibule between the upper ends of the labia minora. The clitoris consists of a head, body and two legs and is homologous to the male penis. The long, narrow clitoral peduncles originate from the inferior surface of the ischio-pubic rami and join under the middle of the pubic arch to form the body of the clitoris. The latter contains two cavernous bodies, in the wall of which smooth muscle fibers pass.

The head of the clitoris usually does not exceed 0.5 cm in diameter or 1/3 of the length of the clitoris. It is formed by spindle cells and is covered with a stratified squamous cell, which contains numerous sensory nerve endings. When the clitoris is erect, its vessels are combined with the bulbs of the vestibule - cavernous tissue, which is localized on both sides of the vagina, between the skin and the bulbospongius muscle. The clitoris is the main erogenous zone of a woman.

thresholdvagina- an almond-shaped space between the clitoris from above and the posterior frenulum of the labia minora below, laterally limited by the shameful lips. The vestibule of the vagina is a structure similar to the embryonic urogenital sinus. On the eve of the vagina, 6 openings open: the urethra, the vagina, the Bartholin ducts (large vestibular) and, often, the Skene (small vestibular, paraurethral) glands. The back of the vaginal vestibule between the entrance to the vagina and the posterior frenulum of the labia forms a navicular fossa, or fossa of the vestibule of the vagina, usually noticeable in women who have not given birth.

Bartholin'sglands, or greater vestibules of the gland, - paired small complex structures with a diameter of 0.5 to 1 cm, which are located at the bottom of the vestibule on both sides of the entrance to the vagina and are analogues of the Cooper glands in men. They are located under the muscles surrounding the entrance to the vagina and are sometimes partially covered by the bulbs of the vestibule.

The ducts of the Bartholin glands are 1.5-2 cm long and open on the eve of the vagina from the outside of the lateral edge of the entrance to the vagina, between the maiden membrane and the small shameful lips. During sexual arousal, the Bartholin glands secrete a mucous secretion. Closure of the gland duct infection in the case (by gonococci or other bacteria) can lead to the development of an abscess of the Bartholin's gland.

outer holeurethra located in the middle of the vaginal vestibule, 2 cm below the clitoris on a slightly raised surface (papillary elevation), usually has the form of an inverted letter B and can stretch up to 4-5 mm in diameter. The length of the urethra in women is 3.5-5 cm. The lower 2/3 of the urethra are located directly above the anterior wall of the vagina and are covered with transitional epithelium, the distal 1/3 - with stratified squamous epithelium. Under the external opening of the urethra are the openings of the small vestibular (skene, paraurethral) glands, which are analogues of the male prostate gland. Sometimes their duct (about 0.5 mm in diameter) opens in the posterior wall, inside its opening.

bulbs of vestibule

Under the mucous membrane of the vestibule of the vagina, on each side, bulbs of the vestibule are placed, having an almond-shaped shape 3-4 cm long, 1-2 cm wide, and 0.5-1 cm thick and contain numerous venous plexuses. These structures are in close proximity to the ischiopubic rami and are partly covered by the ischiocavernosus muscles, as well as muscles that compress the vaginal opening.

The lower edge of the bulbs of the vestibule is usually located in the middle of the entrance to the vagina, and the upper edge reaches the clitoris. Embryologically, the bulbs of the vestibule are referred to as analogues of the spongy bodies of the penis. In children, these structures usually extend beyond the pubic arch, with only their posterior end partially surrounding the vagina. But in the event of an injury, rupture of these venous structures can lead to severe external bleeding or the formation of a vulvar hematoma.

The entrance to the vagina is very variable in size and shape. In women who have not had sexual intercourse, the entrance to the vagina is surrounded by small pudendal lips and is almost completely covered by the hymen.

Maidenhymen(KUTEP) - a thin, vascularized membrane that separates the vagina from its vestibule. There are significant variations in the shape, thickness of the hymen, as well as the shape of its opening:

• annular,
• membranous,
• lattice, etc.

Usually, the hole in women who have not had sexual intercourse can pass 1, or, less often, 2 fingers. The imperforated hymen is a rare anomaly and leads to a delay in menstrual blood, the formation of hematocolpos, hematometers, cryptomenorrhea. The girl's membrane is formed by elastic and collagenous connective tissue with a small amount of nerve fibers, does not contain glandular and muscle elements and is covered with stratified squamous epithelium.

In newborns, the hymen is highly vascularized; in pregnant women, its epithelium thickens and contains a lot of glycogen; after menopause, her epithelium becomes thin. During the first intercourse, the hymen usually ruptures at the back, which is not always accompanied by bloody discharge, although profuse bleeding may sometimes occur. Sometimes the hymen is rigid and in case of impossibility of sexual intercourse requires its opening (surgical defloration). After childbirth, only its remnants remain - the papillae of the hymen.

Changes in the maiden's hymen can have not only medical, but also legal significance in solving some problems of forensic medicine (sexual violence, childbirth, etc.).

The blood supply to the vulva is carried out by numerous branches of the internal (from the internal iliac artery) and external (from the femoral artery) pudendal arteries, the lower rectal arteries. The veins accompany the arteries of the same name. The innervation of the vulva is carried out by the iliac-axillary, pudendal, femoral cutaneous and rectal nerves.

The area between the posterior frenulum of the labia and the external opening of the anus is called the gynecological (anterior) perineum.

Clinical correlations

The skin of the vulva can be affected by local and general skin diseases. In the moist area of ​​the vulva, diaper rash often occurs, in obese women this area is especially susceptible to chronic infection. The skin of the vulva in postmenopausal women is sensitive to topical administration of corticosteroids and testosterone and insensitive to estrogens. A common cystic structure of the vulva is the Bartholin gland cyst, which becomes painful as it develops. Chronic infections of the paraurethral glands can lead to the formation of urethral diverticula, which have clinical symptoms similar to other lower urinary tract infections: frequent, uncontrolled and painful urination (dysuria).

Trauma to the vulva may result in significant hematoma or profuse external bleeding due to the rich vascularity and lack of valves in the veins of this area. On the other hand, increased vascularization of the vulva promotes rapid wound healing. Therefore, wound infection in the area of ​​episiotomy or in obstetric injuries of the vulva rarely develops.

Adolescents get a general idea of ​​\u200b\u200bthe genitals of men and women even in high school. Practice shows that, without encountering problems in this area, broader knowledge is not required. But in some cases, there is a need for extended information. For example, when studying the problem of infertility, it is important to know what role follicle-stimulating and luteinizing hormones play, what are the genetic characteristics of germ cells, and much more.

For a better understanding of the reasons for the impossibility of fertilization, you first need to understand the structural features and functions of the organs of the reproductive system in women and men.

There is much in common in male and female bodies - a head with hairline, limbs, chest, stomach, pelvis. But there are also differences for each gender. Women are smaller (on average) than men, and women also weigh less (on average). A woman has more rounded and smooth body lines due to thinner bones and the presence of more fatty tissue in the mammary glands, pelvis, hips and shoulders. The pelvis of a woman is wider, the bones are thinner, the pelvic cavity is more voluminous than the cavity of the male pelvis. Such a correct development of the woman's body favors the fulfillment of her role - bearing and giving birth to children.

The structure of the external genital organs of a woman

The structure of the external genital organs of a woman is as follows: they are rollers, or folds, going from front to back, from the pubis to the external opening of the anus. The labia majora, like the pubis, are covered with hair, the labia minora are covered with skin on the outside, and a mucous membrane lines them from the inside. Anteriorly - anterior labial junction - anterior commissure. Just below it is an analogue of the male penis - the clitoris, which is no less sensitive, has the same cavities inside, overflowing with blood during sexual arousal. In the region of the posterior commissure of the labia, in their thickness, on both sides there are small glands, the size of a pea, which secrete a mucous secretion. The functions of the glands of the external genital organs are to moisten the entrance to the vagina of a woman when she is close to a man.

The structure of the genital organs of a woman: a description of the vagina

Further, speaking about the structure and functions of the genital organs of a woman, the vagina is considered - an elastic muco-muscular canal 10-13 cm long, the mucous membrane is assembled into a large number of folds, providing vaginal extensibility, which is important for the birth of a child and the adaptation of partners to the size of the genital organs of each other. friend. Lactic acid bacteria normally exist in the vagina, producing lactic acid, which, despite its low acidity, still prevents the penetration of other types of microbes into the vagina.

In sexually transmitted diseases, lactic acid bacteria are absent or their number is sharply reduced, they are replaced by other types of microorganisms, vaginal dysbacteriosis occurs, called bacterial vaginosis.

The structure of the genital organs of a woman and the functions of the female gonads (with video)

Further, speaking about the structure and functions of the genital organs of a woman, the muscular cervix is ​​considered, which is located at the end of the vagina and is curved slightly backwards. Its length is 3-4 cm, and the muscular wall is a whole centimeter thick! Inside the cervix there is a channel connecting the uterus with the vagina and the external environment. The channel has an external opening, consisting of muscle and connective tissue, and an internal opening leading into the uterus. The canal almost entirely consists of muscles, top covered with one, invisible to the eye, layer of mucosal cells. As part of this mucous membrane of the cervical canal, there are glands that secrete mucus, which flows down into the vagina, taking the infection with it. In this layer of the mucous membrane of the cervical canal, there are also female sex glands, the functions of which are to secrete cervical fluid, which actually resembles a gel.

First of all, the function of this organ of the reproductive system is to create a barrier to infection. The cervix protects the uterus from pathogens. But it is also a selective filter for spermatozoa, which allows mobile and normally formed spermatozoa to pass through and detains defective ones. But even for active and normal sperm, cervical fluid is an obstacle. This barrier becomes permeable during the period of readiness and release of the egg from the ovary - ovulation.

Active spermatozoa make "channels" in the cervical fluid and in a chain, like ants, penetrate higher and reach the area of ​​​​the fallopian tubes, where they can meet with the egg about 30 minutes after ejaculation (splashing of seminal fluid). At other times, the cervical fluid becomes thicker, it is much more difficult for spermatozoa to pass through or not at all! The functions of this organ and the gonads are to ensure the throughput of spermatozoa into the uterus and tubes. This happens within 5-7 days after ejaculation - the release of sperm.

The video "The structure of the genital organs of a woman" will help you better understand the anatomy of the reproductive system:

The structure and functions of the female genital organs: the uterus

This section of the article discusses the structure and functions of such a female genital organ as the uterus. This muscular organ begins just behind the internal os of the cervix. It has a pear shape. The length and width of the uterus are approximately equal, 4-6 cm each, the anteroposterior size is 3-4.5 cm. The structure of this internal female genital organ includes three layers of muscles - longitudinal, transverse, or circular, and oblique, directed along the axis of the uterus top down. The outer layer is covered by the peritoneum, it is located above the muscular layer of the uterus.

Inside from the muscle layer is the inner lining of the triangular cavity of the uterus. This inner lining is called the endometrium. This is a functional layer, the thickness of which depends on the level of sex hormones in the ovaries. The thickness of the endometrium is an indicator of the usefulness of ovarian function. The uterine cavity is narrow - 1.5-2.5 cm. But it is here that the fetal egg is attached and is inside until it grows from a size of 3 mm to a full-fledged full-term fetus after 275-285 days of pregnancy. During pregnancy, the uterus increases significantly in size, gradually squeezing all other organs of the abdominal cavity. And during childbirth, all three muscular layers of the uterus are actively working, pushing the fetus out, helping it to be born into the world, where it will become a newborn baby from the fetus.

Speaking about the structure and function of the genital organs of a woman, it should be noted that in the upper part of the uterus on both sides there are small holes - the entrance to the fallopian tubes, going from the uterus to the walls of the small pelvis. The length of the fallopian tubes is 10-15 cm, the lumen of the tube is 1.5-7 mm. The outer ends of the fallopian tubes hang over the ovaries and are covered with fringes - fimbria, swaying towards the uterus. And inside the lumen of the fallopian tubes, special cilia also sway towards the uterus. The fallopian tubes also have a muscular layer that helps the germ cells - the egg and sperm - move towards each other.

Where are female sex hormones produced: ovaries

Where are sex hormones produced in the female body? Paired ovaries form eggs and produce sex hormones.

In the outer layer of the ovaries, vesicles with eggs - follicles - mature. As they grow and develop, they fill with follicular fluid and move towards the surface of the ovary. Follicles grow up to 2 cm - final maturity. The follicular fluid contains the maximum level of the main ovarian hormone - estrogen. The large size of the mature follicle thins the wall of the ovary, it ruptures, and the egg is released into the abdominal cavity. This process is called ovulation.

During the reproductive period of a woman's life, when there is a possibility of pregnancy, approximately 400,000 eggs mature and are released in the ovaries. The functions of these female genital organs are most active at a young age, when the maximum number of full-fledged eggs matures.

At ovulation, the fimbriae (fringes) and cilia of the fallopian tube just begin to actively act, which, like the tentacles of an octopus, scoop up the egg and capture it into the funnel of the fallopian tube. The process of capturing the egg and sucking it into the fallopian tube lasts only 15-20 seconds.

And inside the tube, cilia swaying at high speed create a conveyor effect, helping the egg move along the fallopian tube towards the uterus. The egg moves from the funnel to the narrow part of the fallopian tube, the isthmus, where it is met by spermatozoa, which turned out to be faster than all the others. When one of them manages to pass through the shiny, denser shell of the egg, fertilization occurs. After that, the fertilized egg, which had time to start dividing into 2-4-8 cells, continues to move along the ampoule of the tube until the moment of implantation comes - entering the uterine cavity and immersing in the thickness of the endometrium.

This happens after 3-4 days, when the isthmus opens and the no longer fertilized egg, but the fetal egg enters the uterine cavity.

If a fertilized egg enters the uterus before the implantation period, then it cannot attach to the endometrium, dies and is thrown out of the uterus.

This happens with an enlarged uterine cavity, into which an intrauterine device (IUD) is inserted. If the transport of a fertilized egg to the uterus is delayed, then it is implanted in the fallopian tube, an ectopic (tubal) pregnancy occurs, the outcome of which is a foregone conclusion. It can also most often come from the IUD. Due to the movement of the fallopian tubes in the opposite direction, the frequency of ectopic pregnancy increases four times, since such an incorrect movement throws the embryo from the uterus back into the fallopian tube. Therefore, the IUD is not recommended as a contraceptive, it is an obsolete and harmful remedy.

If the fertilization of the egg does not occur 12-24 hours after ovulation (the spermatozoa were not frisky enough or turned out to be of poor quality, or maybe they simply were not enough in quantity or there was simply no sexual contact), then it is covered with a dense protein membrane, the spermatozoa that arrived in time late, do not penetrate, the ability to fertilize is lost.

What are sex follicle-stimulating (FSH) and luteinizing (LH) hormones in women, their functions

The next aspect of the topic of the structure of the reproductive system is the function of sex hormones, the monthly ovarian cycle and ovulation, hormonal changes in the body, and which hormones regulate ovulation.

As mentioned above, female sex hormones are produced in the ovaries. When a girl is born, there are about two million potential follicles in her rudimentary ovaries. But about 10-11 thousand of them die every month, even before the onset of puberty. By the time puberty begins, a teenage girl has 200-400 thousand eggs left. This supply, it turns out, is by no means infinite. During the reproductive period, which lasts from the first menstruation to menopause, these eggs are only wasted, and no new eggs can be formed. The most offensive thing is that they are thoughtlessly wasted on fruitless cycles. No one gives information to young girls that their biological clock is ticking inexorably and eggs are inevitably wasted. Waste of eggs does not depend on the state of health, on the production of hormones, on the intake of biological additives.

In the 19th and early 20th centuries, eggs were used very economically: numerous pregnancies and childbirth followed by prolonged breastfeeding - all this time there were no cycles, and there were enough eggs for up to 50-60 years! And now, when menstruation begins at 12-14 years old, and they get married and become pregnant at 25-35 years old, all this time the eggs are wasted, for infertile cycles. And for each ovulation, not one single, but up to 1000 eggs are spent! Yes, even abortions that cause mass death of eggs! Therefore, more and more often there are cases of early menopause, which comes not from the "fatigue" of the ovaries, as it was before, but from the depletion of the supply of eggs in the ovaries, and it occurs at 36-42 years! The only thing that can stop the ticking of the biological clock, return a long non-cycling - taking hormonal contraceptives. The constant intake of an ideally matched dose of artificial hormones into the body stops the production of its own hormones, which means it inhibits both the development and expenditure of eggs. But they will not prescribe contraception to non-sexually active teenage girls!

From the moment of puberty, the primary oocytes, or eggs that were previously in a long rest, begin to develop. The process of initial development of eggs is long. And as soon as the egg begins to mature, there is no turning back, it will not return to a state of rest.

The egg either leads in the development race and grows to about 2 cm, and ovulates, leaves the ovary, and if the leader is different or something interferes with ovulation, then all the eggs that have grown by this time in both ovaries undergo reverse development and resorption. The most characteristic sign of the development of an egg is its transformation into a follicle, since follicular fluid accumulates in its capsule, and such eggs become visible during ultrasound - ultrasound. This growth of follicles is stimulated by follicle-stimulating hormone, from the beginning of development to a mature follicle, 8-14 days pass.

What is follicle-stimulating hormone in women and what is its role? FSH is a gonadotropic hormone from the anterior pituitary gland. Despite the fact that FSH stimulates all eggs to form follicles, only one leading or dominant follicle is ahead of everyone. The rest are gradually fading away. Egg growth stimulation uses high doses of artificial FSH, and therefore two or even three follicles may lead. It is more common for twins or multiple pregnancies to occur.

Two to three days before ovulation, a mature follicle produces a large amount of estrogen. This contributes to an increase in the amount of cervical fluid. And estrogens stimulate the pituitary gland to secrete another hormone that regulates the ovaries - LH, luteinizing hormone. LH causes the egg to be released from the ruptured follicle.

An increase in LH causes thinning of the ovarian wall above the mature follicle, the wall breaks, releasing the egg into the abdominal cavity, the follicular fluid with hormone concentrate also spills into the abdominal cavity (which causes a drop in the level of basal temperature, since the hormone content in the blood decreases sharply).

When ovulating, some women feel instant stabbing pains from the ovary where it occurred. Others feel only slight discomfort in the lower abdomen, pulling pains for one and a half to two hours.

Women who take hormones that cause artificial ovulation, sometimes due to the ovulation of several follicles at the same time, experience a more pronounced pain component, they may have a decrease in blood pressure, begin, weakness, etc. Sometimes even hospitalization is required for two or three days.

Ovulation, depending on the phase of the menstrual cycle

In an empty follicle, from where the egg jumped out, the walls are lined with cells that multiply rapidly and change color, become fat, yellow, so the former follicle becomes a corpus luteum, a structure of the second phase of the menstrual cycle, releasing lutein hormone (buttercup - yellow flower), progesterone. The influence of progesterone is such that the cervical fluid becomes thick, viscous, practically plugs the cervical canal, sperm cannot pass. But at the same time, the layer of the endometrium (the inner lining of the uterus) is loosened, ready to accept the fetal egg. If pregnancy does not occur, then the corpus luteum does not live longer than 8-14 days. The amount of progesterone gradually decreases, the corpus luteum resolves, which leads to a gradual detachment of the loose and heavy endometrium from the uterine wall. When the endometrium is completely exfoliated, menstruation occurs.

A decrease in ovarian hormones potentiates the release of FSH, a follicle-stimulating hormone, from the pituitary gland, which will cause a new follicle to grow, and everything repeats until the ovarian follicular reserve is depleted.

The entire cycle of follicle growth, ovulation and the second phase of the cycle, the phases of the menstrual cycle occur depending on FSH and LH.

With the growth of the follicle before ovulation, a maximum of estrogen is released, therefore, FSH decreases by a feedback mechanism and LH rises to cause ovulation and take care of rapid luteinization, the transformation of an empty follicle into a corpus luteum. Then the production of gonadotropic hormones decreases, both estrogens and progesterone decrease, and menstruation occurs. Signals from the hypothalamus in the form of GnRH arrive approximately every 90 minutes, providing stimulation to the ovaries in women and the testes in men.

With a decrease in the function of the sex glands in women and men, when the follicular reserve is depleted in the ovaries, and in men the level of the male hormone testosterone decreases with age, sperm production decreases, the pituitary gland begins to intensively produce gonadotropins (FSH and LH) in an increased amount, also by the reverse mechanism. connections.

In each cycle, with an increase in FSH, significant genetic changes occur in the growing egg, which becomes the follicle. Also, the rise in LH not only causes ovulation, but also genetically prepares the egg for fertilization.

The structure and function of the male reproductive organs and glands

As in women, the male genital organs are divided into internal and external, each of them performs its own function.

The external male organs are the scrotum and the penis. Inside the scrotum are the sex glands - the testicles, or testicles. From the name it becomes clear that the function of this male genital organ is the formation of a seed - spermatozoa. At the posterior edge of each testis are the epididymis, from which the vas deferens begin. The structure of these internal genital organs of a man is such that from the inside the testes are divided into lobules, in which numerous seminiferous tubules pass. Spermatozoa are produced in the walls of these tubules.

In the process of maturation, spermatozoa move to the epididymis, and from there - further, to the vas deferens, due to the contraction of their walls. Due to the special structure of the male genital organs, the vas deferens enter the pelvic cavity and are connected by lateral branches to the seminal vesicles located behind the bladder. After passing through the thickness of the prostate gland, located between the bladder and rectum (like the uterus in women), the ducts open into the urethra, located inside the penis.

How are male sex hormones produced?

This section of the article is devoted to the functions of such male gonads as the testes.

Male sex hormones are produced by the testes, and they are endocrine glands that secrete hormones into the bloodstream that cause changes in the body that are characteristic of a man. The formation of male hormones, as well as female ones, is regulated by the pituitary gland, and the pituitary gland itself controls the central nervous system. The spermatozoa pass through the vas deferens and attach what the seminal vesicles and prostate secrete, as a result of which they acquire active mobility. Millions of sperm are produced every week. In men, there is no cyclicality, spermatozoa are produced constantly.

In each case of intimacy during ejaculation of sperm, in a volume of 3 to 8 cc. cm, in 1 cu. cm should be from 60 to 200 thousand sperm. The entire volume of the ejaculate (a portion of semen during one sexual intercourse) should contain 200-500 million spermatozoa. The largest amount of spermatozoa is contained in the first portions of the seed, which splashes out of the penis (penis) into the vagina.

In the first moment from the onset of ejaculation, the cervix is ​​washed by a highly concentrated shaft of sperm, there are approximately 200 million spermatozoa. And the sperm must enter the cervical fluid in the cervical canal. They must penetrate the channel due to their mobility. Nothing else helps sperm get into the cervical fluid, only their concentration and motility. Sudden ejaculation is favorable for spermatozoa, as they can immediately enter the cervical canal, otherwise the acidic environment of the vagina can quickly immobilize and kill them. For sperm, even their own seminal fluid is dangerous, which can destroy them if they are in it for more than two hours. Spermatozoa that have not entered the cervical fluid will remain in the vagina for half an hour after orgasm, will be immobilized by the acidic environment and eaten by vaginal leukocytes, destroyed by antisperm antibodies. Only 100,000 sperm cells enter the uterus through the cervical fluid and can reach the egg.

Watch the video "The structure of the genital organs of a man" below:

Follicle stimulating hormone (FSH) in men

Speaking about the structure and functions of the gonads in men, it should be noted that there is no cyclicality in the representatives of the stronger sex. Follicle-stimulating hormone (FSH) in men has a more or less constant level, male sex hormones and sperm are produced constantly.

Gonadotropic hormones secreted by the pituitary gland (gonads - gonads, ovaries or testes, and tropism - the direction of action) are combined by FSH and LH, which, in turn, are controlled by hypothalamic releases (release - release). Regarding gonadotropins, gonadotropic releasing hormone - GnRH is secreted. So, the hypothalamus allows the pituitary gland to secrete FSH, stimulate the growth and development of eggs into follicles. The hypothalamus is located above the pituitary gland, this is one hormonal-regulatory system.

A set of genetic material and features of the germ cell

Each human germ cell contains 46 chromosomes, "built" in 23 pairs. The set of genetic material of the germ cell contains all the genetic, hereditary information about the structure and functions of our body. But in the egg and in the sperm, which must merge with each other, there is only half of the genetic information, one chromosome from each pair, and when two germ cells merge, 23 pairs are again formed, but this will be a combination of information about the structure and functions of two organisms , of which the information of their embryo - fetus - child will consist.

The sperm precursors in the testes also have 46 chromosomes, like all body cells. But with the gradual maturation of spermatozoa, the number of chromosomes is halved, all spermatozoa carry 23 single chromosomes.

A growing follicle contains an egg with 46 chromosomes, and an ovulating egg still contains a complete set of chromosomes, which will last until the sperm enters the egg. In the process of fertilization of a pair of chromosomes, the eggs will disperse, leaving only half of the set of chromosomes. At this moment, fertilization occurs - the fusion of the nuclei of the egg and sperm, and then pairs of chromosomes are again formed from two half sets, which will determine the appearance and characteristics of the unborn child. This is how the main miracle happens - the creation of a new life containing the genetic information of both parents, grandparents on both sides and other relatives in endlessly changing combinations!

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Many men are well aware of the length and thickness of their own penis. It would never even occur to a woman to measure her charms with a ruler in her hands.

Meanwhile, the question of how “it” looks from the outside equally worries both the strong and the weak half of humanity, says Polish sexologist Jerzy Kowalczyk. In his new book, Intimacy Full Face and Profile, he shares his observations on this issue.
main member of the proposal

In his erotic fantasies, a man imagines himself with a very large penis. It is customary to think that any woman dreams of copulating with such a superman. But life shows that it's not just about the scale...

One day a 23 year old man came to see me. Good-looking, a slanting sazhen in the shoulders and a dumb question in his eyes. He complained that his beloved girlfriend for a year, as soon as he took off his trousers, began to smile, saying that she had never seen such a thing. And to the counter question “What is it?” kept silent. I had to ask the guy to undress ... Examination of the genitals did not show anything special. But when an erection appeared, the unexpected happened - the organ almost tripled, reaching 27 centimeters in length and, which is really funny, acquired a curved, as if wavy shape. The guy looked at me like he was waiting for the verdict. I reassured him: "You only have very large veins." And he himself thought: “What just doesn’t happen!”
There are no two absolutely identical penises in the world!

But any of them consists of a body, a head and a bridle connecting them. By the way, the frenulum is equipped with the largest number of nerve endings and therefore has a particularly acute sexual sensitivity. If a man has not been circumcised, then his head is covered by the foreskin. Color, size, shape, hairiness give an infinite number of variations on the main theme. Despite this, I will try to classify manhood. Three main types predominate in form. The first is cylindrical, when the base and tip of the penis are approximately the same diameter. The second type is pointed, when the base is clearly wider than the head. If the opposite is true, then this is the third type - mushroom-shaped, with a wide head and a narrow base.

The length of the male organs also differ significantly from each other. All those that are longer than 24 centimeters during an erection are included in the giant group. The commonwealth standard includes penises from 16 to 22 centimeters. Fortified bodies are called organs with a length of 8 to 16 centimeters. There are, of course, unique ones - huge, more than 25 centimeters, and very small ones - shorter than 2.5 centimeters. I combined all of them into an extreme group, which is of interest to surgeons, endocrinologists and sexologists.

There is also a fairly large variation in the thickness of the male organ - from 10 to 2.5 centimeters in girth! Respectively classification It is conducted in three simple types: thick, medium and thin.

There are no restrictions on color either, I have seen almost the entire range of colors of penises - from blue-black to pale pink. The only exception is the yellow-green gamut.

But the testicles do not shine with a special variety. As a rule, the left hangs a little lower than the right. A normally developed testicle has a length of 4-4.5 cm and a width of 2-2.8 cm. The weight of one is from 15 to 25 grams. And yet it happens that the testicles suddenly begin to increase sharply. This happens in some diseases - for example, in elephantiasis. Thus, there are only two classifications of testicles - healthy and diseased.

flower in bed

I noticed such a strange thing: women often know very well how the husband's genitals are arranged, but in themselves they cannot distinguish the clitoris from the urethra. It is these patients who often complain about the lack of sexual satisfaction, irritability. It gives me great aesthetic pleasure to describe the female device, because, firstly, it is beautiful, and secondly, women should know themselves!

A 24-year-old woman came to the appointment with a whole bunch of complaints: her husband is not satisfied, she cannot get pregnant, she is worried about pain during coition and incessant itching in the vagina. Examination and analyzes showed that the woman is practically healthy. I recommended her douches and suppositories to relieve vaginal irritation. But nothing has changed in a week. When asked if all my recommendations were fulfilled, the woman admitted that no, she supposedly was disgusted to do this. I had to spend several sessions of psychotherapy. Because
the woman who does not love her
be and their genitals, can never become happy and healthy ...

The external genital organs of a woman (vulva) consist of the pubis, large and small genital lips, clitoris and vaginal opening. The pubis forms fatty tissue over the pubic bone. Due to the large number of nerve endings, it is often a source of acute sexual arousal. The labia majora are two folds of skin that also contain a lot of adipose tissue. In nulliparous women, they are closely pressed against each other, and in those who have given birth, they are slightly ajar. The labia majora is the main gate of the female womb, protecting it from damage and infections. Small labia, in which there are no fat cells, look like thin flower petals. They have a lot of blood vessels and nerve endings, so when excited, they change color and appear swollen. Small lips converge over the clitoris.

This is an absolutely unique organ, the only task of which is to bring sexual pleasure to a woman.

On average, its diameter is about 0.5 centimeters. When excited, filling with blood, he, like the penis of a man, can increase several times. And finally, an amazing organ - the vagina. Its walls are compressed, and the length is from 8 to 12 centimeters, but as needed, the vagina can double in size, and during childbirth - several times!

In general, we can say: the female genital organs are absolutely individual. Their size, color, location, shapes create unique combinations. But here, too, there is classification. For example, by the location of the vulva. The one closest to the navel is called the "English lady". If it is closer to the anus, then this is a “minx” group, and those who have taken a strictly middle position are called “queens”. Many nations have their names for different sizes of the vagina. So, in tantric sexology there are three main types. The first is a deer (no deeper than 12.5 centimeters). The female fallow deer has a tender, girlish body, firm breasts and hips, is well built, eats in moderation, and loves to have sex. The second is a mare (no deeper than 17.5 centimeters). The female mare has a slender body, lush breasts and hips, and a noticeable belly. This is a very flexible, graceful and loving woman. The third type is the elephant (up to 25 centimeters deep). She has large breasts, a broad face, short arms and legs, and a deep, rough voice.

Known poetic comparisons of the vulva in appearance genital lips, which can also be considered a kind of classification: rosebud, lily, dahlia, aster and tea rose ...

Occasionally there is an underdeveloped vagina. Today, this congenital pathology is correctable: plastic surgery will allow a woman to lead a full sexual life.

What is needed for complete happiness?

Sex is such an intimate topic that sometimes a person does not have the courage to speak frankly about his experiences. Many of my patients preferred to endure, tried to figure it out on their own or waited for it to “resolve itself”. And they came when they were already completely desperate or confused. And it happens that a couple of words are enough: “Everything is in order!” So, I am writing for those who are still afraid to come to me - let them read and calm down. The following questions were repeated so often that I remember them by heart ...

Does circumcision affect a woman's sexual experience?

There is no solid evidence that circumcised men are better or worse as lovers than uncircumcised men. The benefits of circumcision relate mainly to penile hygiene.

Is it possible to create the effect of penis enlargement with the help of a “hairstyle”?

Nature itself took care of some men, extending the hairline to the navel in the form of a thin path. If you do not have such a path, I will not recommend hair extensions in this place. A tattoo in the form of a snake or a dragon's tail can have the same optical effect as the notorious path. But I wouldn't recommend this either. I'll try to please you with the fact that your penis is bigger than you think!

It goes deep into the body almost to the anus. Under the prostate it bifurcates like a compass, forming two legs that are attached to the pubic bone. During the next erection, you can check this by pressing your finger on the place between the anus and the scrotum.

How to find your soul mate by external signs?

Folk art in the spirit of “chubby large lips speak of a large penis” or “by the shape of the fingers, nose and something else you can guess the shape of his“ friend ”did not find any serious confirmation. But the most important thing is not this. Need to look for a person
century, not a sexual apparatus! And
only the heart will help you here. All my experience as a sexologist testifies: where there is love, there is harmony, and where it ends, problems begin.

Medical Encyclopedia

Priapism is a prolonged (more than six hours) painful erection of the penis. The syndrome got its name from the name of the ancient Greek god of fertility, Priapus, who had a huge penis. Ancient physicians treated priapism with leeches. By sucking on the naked head of the penis, they sucked out excess blood. In the history of medicine, cases of mass priapism due to nerves are known. So, during the devastating earthquake in Chile in 1960, more than six hundred patients with this problem were registered. At the time of the cataclysm, all the affected men were making love, and their psyche simply could not stand the rough interference of nature in intimate life. A similar picture was observed during the eruption of Vesuvius in 1944.

Strong remedy

If the husband has a too small penis, there are two possible solutions to the problem of sexual disharmony. First: the operation of lengthening and thickening of the penis. Second: try to shrink the vagina. Almost all women who have given birth have overstretched pelvic floor muscles. Special gymnastics will help reduce them: you need to squeeze the pelvic muscles, as if drawing the anus into yourself. It is even more effective to do this with dildos. And the popular device "Persist" allows not only to train the strength of the grip, but also to see the results of training on a special sensor. As a rule, within a few months it is possible to significantly improve orgasmic sensations. Finally, you can solve the problem radically by reducing the vagina with plastic surgery.

orange thickets

Not a single traveler managed to see the genitals of the Pygmies of the Nua Nua tribe from Central Africa. Not because the loincloths masked the causal places of the natives. These chaste coverings were replaced by ... unnaturally dense and long vegetation. Some pygmies had hair hanging down to their knees, and had an orange tint. Against the background of the black body of the Africans, they looked more than immodest. It turned out that the Nuai people used a hair growth stimulant, which was extracted from the juice of the leaves of a rare variety of tea tree. This juice is also a strong natural dye.

Idols without makeup

The list of "Hollywood's longest penises" walks through the pages of the yellow American press. It was compiled with the informational support of anonymous lucky women who, by the will of fate, ended up in the same bed with a star. For example, this list includes Warren Beatty, whose "penis hangs like a donkey", Sean Connery, who worked as a sitter before his film career and remained in the memory of one artist as "the owner of a surprisingly large organ", and Anthony Quinn, about whom the mistress wrote: "Tony's penis is at least 30 cm, terribly thick, but ugly." Charlie Chaplin, who was proud of his 30-centimeter penis as "the eighth wonder of the world", also got into the obscene list. Here they are, idols!

Casanovas are not born

A survey of men on the topic "Are you satisfied with the size of your own genitals? was recently conducted by the British National Academy of Health. 30 percent of the young men answered that they were satisfied, and 68 percent that they were very satisfied, because "more than a friend's and generally huge." Men over forty were much more restrained: 70 percent reported that there are larger penises; 27 percent are completely dissatisfied; and only 3 percent did not complain about nature. Many added that compared to their experience, skill and ingenuity, the size of the penis itself means nothing. Scholars are divided. Some thought that the acceleration continues and the young men have become larger, others are sure that young people are simply wishful thinking. And still others stated: Casanovas are not born - they become them.

external genitalia (genitalia externa, s.vulva), which have the collective name "vulva", or "pudendum", are located below the pubic symphysis. These include pubis, labia majora, labia minora, clitoris and vaginal vestibule . On the eve of the vagina, the external opening of the urethra (urethra) and the ducts of the large glands of the vestibule (Bartholin's glands) open.

Pubic - the border area of ​​the abdominal wall is a rounded median eminence lying in front of the pubic symphysis and pubic bones. After puberty, it becomes covered with hair, and its subcutaneous base, as a result of intensive development, takes on the appearance of a fatty pad.

Large labia - wide longitudinal skin folds containing a large amount of fatty tissue and fibrous endings of the round uterine ligaments. In front, the subcutaneous fatty tissue of the labia majora passes into the fatty pad on the pubis, and behind it is connected to the ischiorectal fatty tissue. After reaching puberty, the skin of the outer surface of the labia majora is pigmented and covered with hair. The skin of the labia majora contains sweat and sebaceous glands. Their inner surface is smooth, not covered with hair and saturated with sebaceous glands. The connection of the labia majora in front is called the anterior commissure, in the back - the commissure of the labia, or the posterior commissure. The narrow space in front of the posterior commissure of the labia is called the navicular fossa.

Small labia - thick folds of skin of smaller sizes, called the labia minora, are located medially from the labia majora. Unlike the labia majora, they are not covered with hair and do not contain subcutaneous fatty tissue. Between them is the vestibule of the vagina, which becomes visible only when diluting the labia minora. Anteriorly, where the labia minora meets the clitoris, they divide into two small folds that merge around the clitoris. The upper folds join over the clitoris and form the foreskin of the clitoris; the lower folds join on the underside of the clitoris and form the frenulum of the clitoris.

Clitoris - located between the anterior ends of the labia minora under the foreskin. It is a homologue of the cavernous bodies of the male penis and is capable of erection. The body of the clitoris consists of two cavernous bodies enclosed in a fibrous membrane. Each cavernous body begins with a stalk attached to the medial edge of the corresponding ischio-pubic branch. The clitoris is attached to the pubic symphysis by a suspensory ligament. At the free end of the body of the clitoris is a small elevation of erectile tissue called the glans.

bulbs of vestibule . Adjacent to the vestibule along the deep side of each labia minora is an oval-shaped mass of erectile tissue called the bulb of the vestibule. It is represented by a dense plexus of veins and corresponds to the spongy body of the penis in men. Each bulb is attached to the inferior fascia of the urogenital diaphragm and is covered by the bulbospongiosus (bulbocavernous) muscle.

Vaginal vestibule located between the labia minora, where the vagina opens in the form of a vertical slit. The open vagina (the so-called hole) is framed by nodes of fibrous tissue of varying sizes (hymenal tubercles). Anterior to the vaginal opening, approximately 2 cm below the head of the clitoris in the midline, is the external opening of the urethra in the form of a small vertical slit. The edges of the external opening of the urethra are usually raised and form folds. On each side of the external opening of the urethra there are miniature openings of the ducts of the glands of the urethra (ductus paraurethrales). A small space in the vestibule, located behind the vaginal opening, is called the fossa of the vestibule. Here, on both sides, the ducts of the Bartholin glands (glandulaevestibularesmajores) open. The glands are small lobular bodies about the size of a pea and are located at the posterior edge of the bulb of the vestibule. These glands, along with numerous minor vestibular glands, also open into the vestibule of the vagina.

Internal sex organs (genitalia interna). The internal genital organs include the vagina, uterus and its appendages - the fallopian tubes and ovaries.

Vagina (vaginas.colpos) extends from the genital slit to the uterus, passing upward with a posterior inclination through the urogenital and pelvic diaphragms. The length of the vagina is about 10 cm. It is located mainly in the cavity of the small pelvis, where it ends, merging with the cervix. The anterior and posterior walls of the vagina usually join each other at the bottom, shaped like an H in cross section. The upper section is called the fornix of the vagina, since the lumen forms pockets, or vaults, around the vaginal part of the cervix. Because the vagina is at a 90° angle to the uterus, the posterior wall is much longer than the anterior, and the posterior fornix is ​​deeper than the anterior and lateral fornixes. The lateral wall of the vagina is attached to the cardiac ligament of the uterus and to the pelvic diaphragm. The wall consists mainly of smooth muscle and dense connective tissue with many elastic fibers. The outer layer contains connective tissue with arteries, nerves, and nerve plexuses. The mucous membrane has transverse and longitudinal folds. The anterior and posterior longitudinal folds are called fold columns. The stratified squamous epithelium of the surface undergoes cyclic changes that correspond to the menstrual cycle.

The anterior wall of the vagina is adjacent to the urethra and the base of the bladder, and the final part of the urethra protrudes into its lower part. The thin layer of connective tissue that separates the anterior wall of the vagina from the bladder is called the vesico-vaginal septum. Anteriorly, the vagina is indirectly connected to the posterior part of the pubic bone by fascial thickenings at the base of the bladder, known as the pubocystic ligaments. Posteriorly, the lower part of the vaginal wall is separated from the anal canal by the perineal body. The middle part is adjacent to the rectum, and the upper part is adjacent to the recto-uterine recess (Douglas space) of the peritoneal cavity, from which it is separated only by a thin layer of peritoneum.

Uterus (uterus) outside of pregnancy is located along the midline of the pelvis or near it between the bladder in front and the rectum in the back. The uterus has the shape of an inverted pear with dense muscular walls and a lumen in the form of a triangle, narrow in the sagittal plane and wide in the frontal plane. In the uterus, the body, fundus, neck and isthmus are distinguished. The line of attachment of the vagina divides the cervix into vaginal (vaginal) and supravaginal (supravaginal) segments. Outside of pregnancy, the convex bottom is directed anteriorly, and the body forms an obtuse angle with respect to the vagina (tilted forward) and bent anteriorly. The front surface of the body of the uterus is flat and adjacent to the top of the bladder. The back surface is curved and turned from above and behind to the rectum.

The cervix is ​​directed downward and backward and is in contact with the posterior wall of the vagina. The ureters come directly laterally to the cervix relatively close.

The body of the uterus, including its bottom, is covered with peritoneum. In front, at the level of the isthmus, the peritoneum folds over and passes to the upper surface of the bladder, forming a shallow vesicouterine cavity. Behind, the peritoneum continues forward and upward, covering the isthmus, the supravaginal part of the cervix and the posterior fornix of the vagina, and then passes to the anterior surface of the rectum, forming a deep recto-uterine cavity. The length of the body of the uterus is on average 5 cm. The total length of the isthmus and cervix is ​​about 2.5 cm, their diameter is 2 cm. The ratio of the length of the body and cervix depends on the age and number of births and averages 2:1.

The wall of the uterus consists of a thin outer layer of the peritoneum - the serous membrane (perimetry), a thick intermediate layer of smooth muscles and connective tissue - the muscular membrane (myometrium) and the internal mucous membrane (endometrium). The body of the uterus contains many muscle fibers, the number of which decreases downward as it approaches the cervix. The neck consists of an equal number of muscles and connective tissue. As a result of its development from the merged parts of the paramesonephric (Müllerian) ducts, the arrangement of muscle fibers in the uterine wall is complex. The outer layer of the myometrium contains mostly vertical fibers that run laterally in the upper body and connect with the outer longitudinal muscular layer of the fallopian tubes. The middle layer includes most of the uterine wall and consists of a network of helical muscle fibers that are connected to the inner circular muscle layer of each tube. Bundles of smooth muscle fibers in the supporting ligaments intertwine and merge with this layer. The inner layer consists of circular fibers that can act as a sphincter at the isthmus and at the openings of the fallopian tubes.

The uterine cavity outside of pregnancy is a narrow gap, with the anterior and posterior walls closely adjacent to each other. The cavity has the shape of an inverted triangle, the base of which is on top, where it is connected on both sides to the openings of the fallopian tubes; the apex is located below, where the uterine cavity passes into the cervical canal. The cervical canal in the isthmus is compressed and has a length of 6-10 mm. The place where the cervical canal enters the uterine cavity is called the internal os. The cervical canal expands slightly in its middle part and opens into the vagina with an external opening.

Appendages of the uterus. The appendages of the uterus include the fallopian tubes and ovaries, and some authors also include the ligamentous apparatus of the uterus.

The fallopian tubes (tubaeuterinae). Laterally on both sides of the body of the uterus are long, narrow fallopian tubes (fallopian tubes). The tubes occupy the top of the broad ligament and curve laterally over the ovary, then down over the posterior medial surface of the ovary. The lumen, or canal, of the tube runs from the upper corner of the uterine cavity to the ovary, gradually increasing in diameter laterally along its course. Outside of pregnancy, the tube in a stretched form has a length of 10 cm. There are four of its sections: intramural area located inside the wall of the uterus and connected to the uterine cavity. Its lumen has the smallest diameter (Imm or less). The narrow section extending laterally from the outer border of the uterus is called isthmus(istmus); further the pipe expands and becomes tortuous, forming ampoule and ends near the ovary in the form funnels. On the periphery on the funnel there are fimbriae that surround the abdominal opening of the fallopian tube; one or two fimbriae are in contact with the ovary. The wall of the fallopian tube is formed by three layers: the outer layer, consisting mainly of the peritoneum (serous membrane), the intermediate smooth muscle layer (myosalpinx) and the mucous membrane (endosalpinx). The mucous membrane is represented by ciliated epithelium and has longitudinal folds.

ovaries (ovarii). The female gonads are oval or almond-shaped. The ovaries are located medially to the folded part of the fallopian tube and are slightly flattened. On average, their dimensions are: width 2 cm, length 4 cm and thickness 1 cm. The ovaries are usually grayish-pink in color with a wrinkled, uneven surface. The longitudinal axis of the ovaries is almost vertical, with the upper extreme point at the fallopian tube and with the lower extreme point closer to the uterus. The back of the ovaries is free, and the front is fixed to the broad ligament of the uterus with the help of a two-layer fold of the peritoneum - the mesentery of the ovary (mesovarium). Vessels and nerves pass through it and reach the gates of the ovaries. The folds of the peritoneum are attached to the upper pole of the ovaries - ligaments that suspend the ovaries (funnel pelvis), which contain the ovarian vessels and nerves. The lower part of the ovaries is attached to the uterus by fibromuscular ligaments (the ovaries' own ligaments). These ligaments connect to the lateral margins of the uterus at an angle just below where the fallopian tube meets the body of the uterus.

The ovaries are covered with germinal epithelium, under which there is a layer of connective tissue - the albuginea. In the ovary, the outer cortical and inner medulla layers are distinguished. Vessels and nerves pass through the connective tissue of the medulla. In the cortical layer, among the connective tissue, there are a large number of follicles at different stages of development.

The ligamentous apparatus of the internal female genital organs. The position in the small pelvis of the uterus and ovaries, as well as the vagina and adjacent organs, depends mainly on the state of the muscles and fascia of the pelvic floor, as well as on the state of the ligamentous apparatus of the uterus. In a normal position, the uterus with fallopian tubes and ovaries hold suspension apparatus (ligaments), fixing apparatus (ligaments fixing the suspended uterus), supporting or supporting apparatus (pelvic floor). The suspensory apparatus of the internal genital organs includes the following ligaments:

Round ligaments of the uterus (ligg.teresuteri). They consist of smooth muscles and connective tissue, they look like cords 10-12 cm long. These ligaments extend from the corners of the uterus, go under the anterior leaf of the broad ligament of the uterus to the internal openings of the inguinal canals. Having passed the inguinal canal, the round ligaments of the uterus branch out fan-shaped in the tissue of the pubis and labia majora. The round ligaments of the uterus pull the fundus of the uterus anteriorly (anterior tilt).

Broad ligaments of the uterus . This is a duplication of the peritoneum, going from the ribs of the uterus to the side walls of the pelvis. In the upper sections of the wide ligaments of the uterus, the fallopian tubes pass, the ovaries are located on the back sheets, and fiber, vessels and nerves are located between the sheets.

Own ligaments of the ovaries start from the bottom of the uterus behind and below the place of discharge of the fallopian tubes and go to the ovaries.

Ligaments that suspend the ovaries , or funnel-pelvic ligaments, are a continuation of the wide uterine ligaments, go from the fallopian tube to the pelvic wall.

The fixing apparatus of the uterus is a connective tissue strand with an admixture of smooth muscle fibers that come from the lower part of the uterus;

b) backwards - to the rectum and sacrum (lig. sacrouterinum). They depart from the posterior surface of the uterus in the area of ​​​​the transition of the body to the neck, cover the rectum on both sides and are attached to the anterior surface of the sacrum. These ligaments pull the cervix backwards.

Supporting or supporting apparatus make up the muscles and fascia of the pelvic floor. The pelvic floor is of great importance in keeping the internal genital organs in a normal position. With an increase in intra-abdominal pressure, the cervix rests on the pelvic floor, as on a stand; the muscles of the pelvic floor prevent the lowering of the genitals and viscera. The pelvic floor is formed by the skin and mucous membrane of the perineum, as well as the muscular-fascial diaphragm. The perineum is the diamond-shaped area between the thighs and buttocks where the urethra, vagina, and anus are located. In front, the perineum is limited by the pubic symphysis, behind - by the end of the coccyx, laterally ischial tubercles. The skin limits the perineum from the outside and below, and the pelvic diaphragm (pelvic fascia), formed by the lower and upper fascia, limits the perineum from deep above.

The pelvic floor, using an imaginary line connecting the two ischial tuberosities, is divided anatomically into two triangular regions: in front - the genitourinary region, behind - the anal region. In the center of the perineum between the anus and the entrance to the vagina there is a fibromuscular formation called the tendon center of the perineum. This tendon center is the site of attachment of several muscle groups and fascial layers.

Urogenitalregion. In the genitourinary region, between the lower branches of the ischial and pubic bones, there is a muscular-fascial formation called the "urogenital diaphragm" (diaphragmaurogenitale). The vagina and urethra pass through this diaphragm. The diaphragm serves as the basis for fixing the external genitalia. From below, the urogenital diaphragm is bounded by the surface of whitish collagen fibers that form the lower fascia of the urogenital diaphragm, which divides the urogenital region into two dense anatomical layers of clinical importance - the superficial and deep sections, or perineal pockets.

Superficial part of the perineum. The superficial section is located above the lower fascia of the urogenital diaphragm and contains on each side a large gland of the vestibule of the vagina, a clitoris leg with the ischiocavernosus muscle lying on top, a bulb of the vestibule with the bulbous-spongy (bulb-cavernous) muscle lying on top and a small superficial transverse muscle of the perineum. The ischiocavernosus muscle covers the clitoral stalk and plays a significant role in maintaining its erection, as it presses the stalk against the ischio-pubic branch, delaying the outflow of blood from the erectile tissue. The bulbospongiosus muscle originates from the tendinous center of the perineum and the external sphincter of the anus, then passes behind around the lower part of the vagina, covering the bulb of the vestibule, and enters the perineal body. The muscle can act as a sphincter to compress the lower part of the vagina. The weakly developed superficial transverse muscle of the perineum, which has the form of a thin plate, starts from the inner surface of the ischium near the ischial puff and goes transversely, entering the perineal body. All muscles of the superficial section are covered with deep fascia of the perineum.

Deep section of the perineum. The deep section of the perineum is located between the lower fascia of the urogenital diaphragm and the indistinct upper fascia of the urogenital diaphragm. The urogenital diaphragm consists of two layers of muscles. The muscle fibers in the urogenital diaphragm are mostly transverse, arising from the ischio-pubic branches of each side and joining in the midline. This part of the urogenital diaphragm is called the deep transverse perineal muscle. Part of the fibers of the sphincter of the urethra rises in an arc above the urethra, while the other part is located around it circularly, forming the external urethral sphincter. The muscle fibers of the urethral sphincter also pass around the vagina, concentrating where the external opening of the urethra is located. The muscle plays an important role in restraining the process of urination when the bladder is full and is an arbitrary constrictor of the urethra. The deep transverse perineal muscle enters the perineal body behind the vagina. When contracted bilaterally, this muscle thus supports the perineum and the visceral structures passing through it.

Along the anterior edge of the urogenital diaphragm, its two fasciae merge to form the transverse ligament of the perineum. In front of this fascial thickening is the arcuate pubic ligament, which runs along the lower edge of the pubic symphysis.

Anal (anal) area. The anal (anal) region includes the anus, the external anal sphincter, and the ischiorectal fossa. The anus is located on the surface of the perineum. The skin of the anus is pigmented and contains sebaceous and sweat glands. The sphincter of the anus consists of superficial and deep parts of striated muscle fibers. The subcutaneous part is the most superficial and surrounds the lower wall of the rectum, the deep part consists of circular fibers that merge with the levator ani muscle. The superficial part of the sphincter consists of muscle fibers that run mainly along the anal canal and intersect at right angles in front of and behind the anus, which then fall in front of the perineum, and behind - in a mild fibrous mass called the anal-coccygeal body, or anal-coccygeal. coccygeal ligament. The anus externally is a longitudinal slit-like opening, which is probably due to the anteroposterior direction of many muscle fibers of the external anal sphincter.

The ischiorectal fossa is a wedge-shaped space filled with fat, which is externally bounded by the skin. The skin forms the base of the wedge. The vertical side wall of the fossa is formed by the obturator internus muscle. The inclined supramedial wall contains the levator ani muscle. Ischiorectal adipose tissue allows the rectum and anal canal to expand during a bowel movement. The fossa and the fatty tissue contained in it are located anteriorly and deeply upward to the urogenital diaphragm, but below the levator ani muscle. This area is called the front pocket. Behind the fatty tissue in the fossa runs deep to the gluteus maximus muscle in the area of ​​the sacrotuberous ligament. Laterally, the fossa is bounded by the ischium and the obturator fascia, which covers the lower part of the obturator internus muscle.

Blood supply, lymph drainage and innervation of the genital organs. blood supply external genitalia is mainly carried out by the internal genital (pubescent) artery and only partially by branches of the femoral artery.

Internal pudendal artery is the main artery of the perineum. It is one of the branches of the internal iliac artery. Leaving the cavity of the small pelvis, it passes in the lower part of the large sciatic foramen, then goes around the sciatic spine and goes along the side wall of the ischiorectal fossa, transversely crossing the small sciatic foramen. Its first branch is the inferior rectal artery. Passing through the ischiorectal fossa, it supplies blood to the skin and muscles around the anus. The perineal branch supplies the structures of the superficial perineum and continues as posterior branches to the labia majora and labia minora. The internal pudendal artery, entering the deep perineal region, branches into several fragments and supplies the bulb of the vestibule of the vagina, the large gland of the vestibule and the urethra. When it ends, it divides into the deep and dorsal arteries of the clitoris, approaching it near the pubic symphysis.

External (superficial) genital artery departs from the medial side of the femoral artery and supplies blood to the anterior part of the labia majora. External (deep) pudendal artery also departs from the femoral artery, but more deeply and distally. Having passed the wide fascia on the medial side of the thigh, it enters the lateral part of the labia majora. Its branches pass into the anterior and posterior labial arteries.

The veins passing through the perineum are mainly branches of the internal iliac vein. For the most part they accompany the arteries. An exception is the deep dorsal vein of the clitoris, which drains blood from the erectile tissue of the clitoris through a gap below the pubic symphysis to the venous plexus around the bladder neck. The external pudendal veins drain blood from the labia majora, passing laterally and entering the great saphenous vein of the leg.

Blood supply to the internal genital organs It is carried out mainly from the aorta (the system of the common and internal iliac arteries).

The main blood supply to the uterus is provided uterine artery , which departs from the internal iliac (hypogastric) artery. In about half of the cases, the uterine artery independently departs from the internal iliac artery, but it can also originate from the umbilical, internal pudendal, and superficial cystic arteries. The uterine artery goes down to the lateral pelvic wall, then passes forward and medially, located above the ureter, to which it can give an independent branch. At the base of the broad uterine ligament, it turns medially towards the cervix. In the parametrium, the artery connects to the accompanying veins, nerves, ureter, and cardinal ligament. The uterine artery approaches the cervix and supplies it with several tortuous penetrating branches. The uterine artery then divides into one large, very tortuous ascending branch and one or more small descending branches, supplying the upper part of the vagina and the adjoining part of the bladder. . The main ascending branch goes up along the lateral edge of the uterus, sending arcuate branches to her body. These arcuate arteries surround the uterus under the serosa. At certain intervals, radial branches depart from them, which penetrate into the intertwining muscle fibers of the myometrium. After childbirth, the muscle fibers contract and, acting like ligatures, compress the radial branches. The arcuate arteries rapidly decrease in size towards the midline, so there is less bleeding with median incisions of the uterus than with lateral ones. The ascending branch of the uterine artery approaches the fallopian tube, turning laterally in its upper part, and divides into tubal and ovarian branches. The tubal branch runs laterally in the mesentery of the fallopian tube (mesosalpinx). The ovarian branch goes to the mesentery of the ovary (mesovarium), where it anastomoses with the ovarian artery, which originates directly from the aorta.

The ovaries are supplied with blood from the ovarian artery (a.ovarica), which extends from the abdominal aorta on the left, sometimes from the renal artery (a.renalis). Going down along with the ureter, the ovarian artery passes along the ligament that suspends the ovary to the upper section of the wide uterine ligament, gives off a branch for the ovary and tube; the terminal section of the ovarian artery anastomoses with the terminal section of the uterine artery.

In the blood supply of the vagina, in addition to the uterine and genital arteries, the branches of the inferior vesical and middle rectal arteries are also involved. The arteries of the genital organs are accompanied by corresponding veins. The venous system of the genital organs is highly developed; the total length of the venous vessels significantly exceeds the length of the arteries due to the presence of venous plexuses, widely anastomosing with each other. The venous plexuses are located in the clitoris, at the edges of the bulbs of the vestibule, around the bladder, between the uterus and ovaries.

lymphatic system genital organs consists of a dense network of tortuous lymphatic vessels, plexuses and many lymph nodes. Lymphatic pathways and nodes are located mainly along the course of blood vessels.

Lymphatic vessels that drain lymph from the external genitalia and the lower third of the vagina go to the inguinal lymph nodes. The lymphatic pathways extending from the middle upper third of the vagina and cervix go to the lymph nodes located along the hypogastric and iliac blood vessels. The intramural plexuses carry lymph from the endometrium and myometrium to the subserous plexus, from which the lymph flows through the efferent vessels. Lymph from the lower part of the uterus enters mainly the sacral, external iliac and common iliac lymph nodes; some also enters the lower lumbar nodes along the abdominal aorta and the superficial inguinal nodes Most of the lymph from the upper part of the uterus drains laterally into the broad ligament of the uterus, where it joins With lymph collected from the fallopian tube and ovary. Further, through the ligament that suspends the ovary, along the course of the ovarian vessels, the lymph enters the lymph nodes along the lower abdominal aorta. From the ovaries, lymph is drained through the vessels located along the ovarian artery, and goes to the lymph nodes lying on the aorta and inferior vena cava. There are connections between these lymphatic plexuses - lymphatic anastomoses.

In innervation The genital organs of a woman involve the sympathetic and parasympathetic parts of the autonomic nervous system, as well as the spinal nerves.

The fibers of the sympathetic part of the autonomic nervous system, innervating the genitals, originate from the aortic and celiac ("solar") plexuses, go down and form the upper hypogastric plexus at the level of the V-lumbar vertebra. Fibers depart from it, forming the right and left lower hypogastric plexuses. Nerve fibers from these plexuses go to a powerful uterovaginal, or pelvic, plexus.

The uterovaginal plexuses are located in the parametric tissue on the side and behind the uterus at the level of the internal os and cervical canal. Branches of the pelvic nerve (n.pelvicus), which belongs to the parasympathetic part of the autonomic nervous system, are suitable for this plexus. Sympathetic and parasympathetic fibers extending from the uterovaginal plexus innervate the vagina, uterus, internal parts of the fallopian tubes, and the bladder.

The ovaries are innervated by sympathetic and parasympathetic nerves from the ovarian plexus.

The external genital organs and the pelvic floor are mainly innervated by the pudendal nerve.

Pelvic tissue. Blood vessels, nerves and lymphatic tracts of the pelvic organs pass through the tissue, which is located between the peritoneum and the fasciae of the pelvic floor. Fiber surrounds all the organs of the small pelvis; in some areas it is loose, in others in the form of fibrous strands. The following fiber spaces are distinguished: periuterine, pre- and paravesical, periintestinal, vaginal. The pelvic tissue serves as a support for the internal genital organs, and all its departments are interconnected.