Large genitals. Male reproductive system. Psychological problems with enlarged long labia minora

Just a few decades ago, enlargement of the labia was considered a pathology, and in some cases immediate treatment was required. Currently, women pay considerable amounts of money to intentionally change the anatomy of this organ. Some do it for aesthetic purposes, and some do it to give men more pleasure.

Anatomy of the female reproductive system

So, women's are divided into external and internal. The internal ones include the vagina, uterus, ovaries and tubes. To the external ones - the labia majora and minora, as well as the clitoris and pubic area. The labia majora represent two folds of skin within which there is adipose tissue. They are quite abundantly equipped with a network of blood vessels, and are also covered with hair on the outside. All this provides a protective function - preventing infection from entering the internal organs.

At the junction of the left and right labia majora there are commissures, or commissures.

It is interesting that the hair in the pubic area is so abundant that in ancient times, when women did not wear underwear, it helped to warm the organ and protected it from negative weather conditions.

The labia minora are located parallel to the labia majora; they form the vestibule of the vagina. This organ has much less fat, but more blood vessels and nerve endings. Perhaps this is one of the most sensitive organs, which produces mucus abundantly.

Causes of labia enlargement

Many factors can affect women's health, and some make the fairer sex quite worried. After all, any changes in the intimate area always bring both physical and psychological discomfort.

Sexual intercourse

Immediately during or after sexual intercourse during a period of strong arousal, blood flow to the genital organ increases, temporary swelling occurs - an increase in the organ's size, and a large amount of sexual secretion is produced. This condition will go away 30-40 minutes after arousal on its own. It does not require any intervention.

Pregnancy

During pregnancy, enlargement of the labia is a fairly common occurrence. This process occurs against the background of changes in the hormonal status of a woman. The amount of fatty tissue in the abdomen and genitals increases, and slight swelling is observed. Enlargement of the labia during pregnancy is temporary and most often goes away after delivery. Sometimes it can persist for the period of lactation. It is important to understand that after a natural birth, the shape of the labia may change.

Allergy

Enlargement of the labia in a woman may be the result of an allergic reaction. This is possible for an intimate hygiene product or for a synthetic powder used to wash underwear. Do not forget that an allergy may be to the latex from which condoms are made, or to lubricant.

Symptoms will appear almost immediately after contact with the allergen. In this case, you should immediately use an antihistamine and consult a doctor. If you ever experience such reactions, you should avoid using products from these brands.

Bartholinitis

When the Bartholin glands become inflamed, the labia majora and minora also become enlarged. The glands are located near the entrance to the vagina, so their inflammation is most often caused by infections. In this case, both the labia and the vagina acquire a pronounced red color and swelling. A woman is worried about discomfort in the intimate area, itching, burning during urination, as well as pain during sexual intercourse.

Candidiasis

When the microflora of the vagina changes, candida fungi begin to multiply intensively in this area, resulting in the development of thrush, which is accompanied by unbearable itching, hyperemia and enlargement of the labia. Swelling, by the way, can be aggravated by scratching. In this case, in addition to the organ increasing in size, a curd-like discharge from the vagina with a specific odor is observed.

Herpes

Herpetic infections of the anogenital area can cause enlargement of the labia. In addition, herpes affects the nerve endings, which leads to prolonged and severe pain. In the genital area, against a background of inflammation and redness, bubbles with transparent or yellowish contents appear, which can open on their own to form crusts.

Vulvodynia

Vulvodynia is a disease of modern women who, in pursuit of fashion trends, prefer too narrow and tight underwear. All this leads to trauma to the labia majora, and as a result, to severe pain and enlargement.

Medicines

We must not forget that taking certain medications (antibiotics, hormones) and ointments can also provoke changes in the external genitalia. Enlargement of the intimate area may result from long-term use of certain medications.

Poor intimate hygiene

Insufficient hygiene, which results in the development of infectious and bacterial processes, can also cause an increase in a woman’s intimate area. The problem can be solved by following all the rules for caring for the intimate area.

Heredity

The reasons for enlargement of the labia minora most often come from childhood. These may be defects in intrauterine development or consequences of childhood trauma. In adulthood, prolonged and frequent sexual intercourse can lead to enlargement of the labia minora.

Injuries

Enlargement of the labia majora can occur due to injury. Often, in addition to swelling and redness, there is pain, discomfort, and bruising.

Neoplasms

Enlargement of the labia minora and labia majora may result from the development of a formation in the anogenital area. In this case, a tumor in this area will be palpated. You should immediately consult a specialist.

Aesthetic gynecology

Today, various types of aesthetic surgery are very popular. While almost everyone knows about correction of the facial area, less is known about plastic surgery of intimate areas.

Basically, the principle of correction of all areas of the body is similar. It is necessary to choose the correct method of administering the drug and decide on the choice of the administered substance. Important! There are contraindications for aesthetic gynecology:

• all diseases are in the acute stage;
• diabetes;
• blood diseases;
• autoimmune processes;
• immunodeficiency;
• herpetic infection.

Side effects after injections

Any injection is an invasive intervention, which means there will definitely be swelling, which normally should go away after a few hours. The following adverse reactions may occur:

• redness of the area;
• compaction at the injection site;
• bruise;
• inflammation at the injection site;
• allergic reaction to the administered substance.

Indications for intimate contouring

1. Elimination of deformed organs or their asymmetry.
2. Restoring tissue elasticity.
3. Transform your appearance (in conditions where the labia minora are almost the same volume as the labia majora).
4. Restoring shape (after childbirth, weight loss).
5. Moisturizing the mucous membrane by activating rejuvenation processes.

Tactics of the procedure

Enlargement of the labia with filler is carried out only by a gynecologist. Before starting the procedure, you must undergo a minimum amount of general tests and wait until your menstruation ends.

The drug is administered at the following points:

• labia majora and minora;
• clitoris;
• G-spot

The procedure is performed under local anesthesia and does not require hospitalization. After 14 days, you need to see a doctor again to evaluate the result of the work.

Seven days before the filler injection, you must completely shave your pubic area and labia. It is best to choose a time when your period has just ended. Before giving the injections, the doctor will disinfect the areas with an antiseptic.

Result

A woman will see the effect immediately after the aesthetic plastic surgery procedure. It will last up to 12 months, then you need to inject a new portion of the drug.

Women are increasingly undergoing labia augmentation. Before and after surgery, the difference is obvious, and many people really like the result.

We cannot ignore the fact that after the introduction of hyaluronic acid into the intimate area, its sensitivity increases during intimacy. This occurs due to a tighter fit with increasing volume, as well as due to the stimulation of nerve endings by plasma.

Many women note an increase in the production of sexual secretions after the introduction of hyaluronic acid - this improves sensitivity during sexual intercourse.

History of the creation of hyaluronic acid

Back in 1934, two scientists Meyer and Palmer isolated the substance hyaluronate from the vitreous body of a mammal's eye, which later became known as hyaluronic acid. The peculiarity of the complex compound was that it bound to cellular water and prevented it from leaving the tissue. This effect is useful for preventing aging and stimulating cell renewal. Subsequently, hyaluronate began to be synthesized artificially and used in cosmetology.

Hyaluronic acid is part of the fast-wearing tissues in the body: cartilage, joints, skin, eyes. In 2016, a group of scientists announced that a cure for cancer was being developed based on this substance.

Labia enlargement with hyaluronic acid

Many salons offer this procedure at varying prices. It is necessary to understand that the use of low-quality drugs, as well as the administration of the drug by a person without specialized education, is unacceptable.

Before agreeing to the procedure, make sure that the hyaluronic acid serum in this salon has a quality certificate and all expiration dates are normal. It is also necessary to clarify the education, availability of courses and work experience of the specialist performing the procedure.

The filler injection must be carried out in accordance with all standards of asepsis and antiseptics.

Currently in Russia there are only two types of fillers, Bellcontour and Reneall, which are used for transdermal administration in both cosmetology and gynecology.

All women by nature have different external characteristics and, of course, this also applies. Each representative of the fair sex has different types of labia. Some people are quite happy with them, while others suffer from psychological and physical discomfort caused by their irregular shape.

Types of female labia majora

The shape of the labia is formed in utero. But throughout life it can undergo both significant and small changes. The labia majora is a longitudinal fold of skin that normally covers the genital fissure and labia minora from the external aggressive environment. Skin color can be different - it is individual for each woman.

As such, the types of labia majora are not classified in any way. They just come in normal size and thickness, asymmetrical, or underdeveloped, which do not block access to the vulva.

Types of labia minora in women

There are many more structural variations in the labia minora, as opposed to the labia majora. Normally, they represent thin (up to 5 mm) longitudinal folds of skin, passing into the mucous membrane and located lengthwise. Near the clitoris, the lips are divided into medial and lateral legs, stretching from the top to the entrance, ending at the bottom with a posterior commissure that connects them.

The labia minora are located inside the labia majora, and when closed they do not extend beyond them. But this is the classical norm, and in life everything often happens just the opposite. In some cases, deviations from common truths are a pathology, while others have a good chance of being considered a type of norm.

The types of labia minora, or rather the classification of their changes according to shape, are as follows:

• Elongation– with maximum lateral stretching, their size is more than 6 cm. This is degree 4; 4-6 cm are typical for grade 3; from 2 to 4 cm is the normal size of the labia minora, although women feel most comfortable when this size is no more than 1 cm when stretched.
• Prothusia– zero, when in a standing position the small lips do not protrude beyond the large lips; first degree, characterized by protrusion of 1-3 cm; and the second – protrusion of more than 3 cm.
• Scalloped edges– smooth or carved edges of various shapes, which also differ in color.
• True hypertrophy– increase in all parameters – thickness, folding, pigmentation, wrinkling
• Absence of labia minora generally occurs in little girls and women with hormonal abnormalities.

All changes in the labia depend on factors such as excess or deficiency of hormones, childbirth, weight loss, and injury. If the size and shape cause inconvenience not only during sexual intercourse, but also in everyday life, they resort to plastic surgery.

The labia majora and minora are part of a woman's external genitalia. The labia majora are two folds of skin supplied with adipose tissue and venous plexuses. They contain fluids that are necessary to maintain moisture in the vestibule of the vagina. The labia majora begin at the pubis and end at the perineum. Between them there is a genital gap.

The labia minora are located inside the labia majora, but can sometimes protrude beyond them. They look like two skin folds located longitudinally. The labia minora originate from the head of the clitoris, pass through the urethra, vestibule and vagina and, connecting at the back, form a commissure. The organs are distinguished by abundant blood supply and innervation. They contain many different glands.

The function of the labia majora is to protect the vestibule organs from mechanical stress and prevent infection of the genitourinary system. The labia minora are the second layer of protection against infection of the vagina and urethra, and are also largely involved in moisturizing the mucous membrane. In addition, the labia minora take an active part in sexual intercourse. During sex, additional stimulation of the penis occurs with the help of the labia minora. But organs are also involved in a woman's orgasm. Despite the fact that one of the main erogenous zones of the female body is the clitoris, the labia minora are amplifiers of pleasant sensations during sexual intercourse. Because the labia are attached to the clitoris, their movement during sex provides additional stimulation, which helps achieve orgasm.

Types of female labia

The shape and size of the labia minora are individual for each woman. On average, their thickness is half a centimeter, and length 2-4 cm. There are several classifications of the labia minora. By lenght:

• Short (there is a shortening of the distance from the clitoris to the posterior commissure, which is why the organs do not perform their protective function, since they do not close);
• Long (closing, forming additional folds).

According to edge modifications:

• Smooth (very rare);
• Serrated (like cockscombs, observed most often and in many cases are asymmetrical).

By thickness:

• Thin (occurs in adolescents and is characterized by a lack of volume);
• Thick (have significant volume, characterized by decreased turgor).

It should be noted that all of the above variants of the labia minora are normal variants and do not require any correction.

Organ deformities and their causes

Sometimes it happens that the labia minora do not correspond to any of the normal options. In such cases, we talk about deformations, of which the most common are:

1. Hypertrophy (the usual protrusion of skin folds beyond the genital opening is not called hypertrophy, this term implies a total increase in length, thickness and volume, which results in very large labia, causing significant discomfort during sexual intercourse and in everyday life);
2. Elongation (the essence of this deformation is to increase the length of the skin fold with its maximum stretching; depending on the stage, it can vary from 2 to more than 6 cm);
3. Protrusion (this term refers to the protrusion of the labia minora beyond the labia majora, and this phenomenon is not always a deviation from the norm, only in the most advanced cases);
4. Asymmetry (various length and volume of the labia).

Also among the changes in the labia minora one can distinguish their depigmentation or, conversely, hyperpigmentation. More often the second is determined. It is not known exactly what the size and shape of the labia depends on, but there are several reasons:

• Hereditary factor (most often the shape of the labia is embedded in the genes of the female body);
• Hormonal imbalance (increased production of male sex hormones);
• Prematurity and birth trauma (can lead to underdevelopment of any organs and genitals, including);
• Involutionary processes in the body (aging leads to a decrease in turgor and skin elasticity);
• Traumatization;
• Masturbation (it is not completely known whether protrusion of the labia actually occurs during masturbation, but, as practice shows, this is possible);
• Childbirth;
• Various infections and chronic diseases of the genitourinary system;
• Congenital anomalies.

Correction and reduction of the labia minora

For women who have certain complexes or are not sure whether men like large labia, there is such plastic surgery as. This operation is performed to restore the correct shape of the skin folds in case of any deformation. There are no direct indications for surgery. The operation is performed only at the request of the woman. However, like any therapy, this correction has its contraindications:

1. Age up to 18 years (it is not advisable to make changes, since the lips are not yet fully developed);
2. Any infectious, bacterial, fungal diseases in the genital area;
3. Tumor processes;
4. Mental disorders.

To undergo labiaplasty, you should first visit a gynecologist. After consulting with a doctor, you will need to undergo some standard tests, and only then go for surgery. Labia reduction is best done a couple of weeks after the end of menstruation.

This operation is called a one-day operation, since its duration does not exceed one hour, and after the procedure the girl can immediately go home. Anesthesia is most often local, but depending on individual cases, it can also be general. Any discomfort, pain or swelling will disappear within a week. But the resumption of sexual activity should be postponed for a couple of weeks. During rehabilitation, which lasts several weeks, in addition to abstaining from sex, you should avoid open water, elevated temperatures and excessive physical exertion. To prevent infection, antibiotics are prescribed for the first 5 days after surgery. Complications:

• Prolonged pain syndrome;
• Sensitivity disorders in the labia minora;
• Impaired regeneration in a surgical wound;
• Lack of closure of the genital slit, which leads to vaginal gaping;
• Violation of the protective and moisturizing functions of the labia minora;
• during childbirth.

These complications are quite rare, but you should still keep them in mind before deciding to undergo labiaplasty. It should be understood that any surgical intervention on the body can lead to unexpected consequences. And if there is no vital need for it, then it is better not to risk it. We also must not forget that most types of labia minora are normal variants and do not need correction. The operation is advisable only in cases where enlarged or, conversely, small labia bring significant discomfort to everyday life.

External genitalia.
The external female genitalia includes the pubis - the lowest part of the anterior abdominal wall, the skin of which is covered with hair; labia majora, formed by 2 folds of skin and containing connective tissue; labia minora, located medially from the labia majora and containing sebaceous glands. The slit-like space between the labia minora forms the vestibule of the vagina. In its anterior part is the clitoris, formed by cavernous bodies, similar in structure to the cavernous bodies of the male penis. Posterior to the clitoris is the external opening of the urethra, posterior and inferior to which is the entrance to the vagina. On the sides of the entrance to the vagina, the ducts of the large glands of the vestibule of the vagina (Bartholin's glands) open, secreting a secret that moisturizes the labia minora and the vestibule of the vagina. In the vestibule of the vagina there are small sebaceous glands. The boundary between the external and internal genitalia is the hymen.

Pubis- an elevation above the pubic symphysis, formed as a result of thickening of the layer. The pubis in appearance is a triangular-shaped surface located in the lowest part of the abdominal wall. With the onset of puberty, pubic hair begins to grow, and the pubic hair becomes hard and curly. The color of pubic hair, as a rule, matches the color of the eyebrows and hair on the head, but they turn gray much later than the latter. The growth of pubic hair in women, paradoxically as it may sound, is caused by male hormones, which the adrenal glands begin to secrete with the onset of puberty. After menopause, hormonal levels change. As a result, they thin out and their waviness disappears. It is worth noting that pubic hair is determined genetically and varies somewhat depending on nationality.

Thus, women in Mediterranean countries have abundant hair growth, which also extends to the inner thighs and upward, to the navel area, which is explained by the increased level of androgens in the blood. In turn, eastern and northern women have sparse and lighter pubic hair. According to most experts, the nature of pubic hair is associated with the genetic characteristics of women of different nationalities, although there are exceptions. Many modern women are unhappy with the presence of pubic hair and try to get rid of it in different ways. At the same time, they forget that pubic hair performs such an important function as protection from mechanical injuries, and also prevents vaginal discharge from evaporating, preserving natural female protection and odor. In this regard, the gynecologists of our medical center advise women to remove hair only in the so-called bikini area, where it really looks unsightly, and in the pubic area and labia - only to shorten it.

Labia majora
Paired thick folds of skin extending from the pubis posteriorly towards the perineum. Together with the labia minora, they limit the genital opening. They have a connective tissue base and contain a lot of fatty fiber. On the inner surface of the lips, the skin is thinned and contains many sebaceous and sweat glands. Connecting near the pubis and in front of the perineum, the labia majora form the anterior and posterior commissures. The skin is slightly pigmented and, from puberty, covered with hair, and also contains sebaceous and sweat glands, due to which it can be affected by specific diseases. The most common of these are sebaceous gland cysts, which are associated with clogged pores, and boils when an infection enters the hair follicle. In this regard, it is necessary to say about the importance of hygiene of the labia majora: be sure to wash yourself daily, avoid contact with dirty towels of others (not to mention underwear), and also change your underwear in a timely manner. The main function performed by the labia majora is to protect the vagina from germs and retention of a special moisturizing secretion. In girls, the labia majora are tightly closed from birth, which makes the protection even more reliable. With the onset of sexual activity, the labia majora open.

Labia minora
Inside the labia majora are the labia minora, which are thinner folds of skin. Their outer surfaces are covered with stratified squamous epithelium; on the inner surfaces, the skin gradually turns into a mucous membrane. The labia minora have no sweat glands and are hairless. They have sebaceous glands; abundantly supplied with blood vessels and nerve endings that determine sexual sensitivity during sexual intercourse. The anterior edge of each labia minora splits into two stalks. The front legs merge above the clitoris and form its foreskin, and the rear legs join under the clitoris, forming its frenulum. The labia minora are folds of skin, however, located under the labia majora, they are much more tender, thinner and do not have hair. The size of the labia minora varies completely from woman to woman, as does the color (from pale pink to brown), and they may have smooth or peculiar fringed edges. All this is a physiological norm and in no way indicates any disease. The tissue of the labia minora is very elastic and capable of stretching. Thus, during childbirth, it allows the baby to be born. In addition, due to the many nerve endings, the labia minora are extremely sensitive, so when sexually aroused they swell and turn red.

Clitoris
In front of the labia minora there is a female reproductive organ called the clitoris. In its structure, it is somewhat reminiscent of the male penis, but several times smaller than the latter. The standard size of the clitoris does not exceed 3 cm in length. The clitoris has a leg, a body, a head and a foreskin. It consists of two cavernous bodies (right and left), each of which is covered with a dense membrane - the fascia of the clitoris. During sexual arousal, the corpus cavernosum fills with blood, causing an erection of the clitoris. The clitoris contains a large number of blood vessels and nerve endings, making it a source of arousal and sexual satisfaction.

Vaginal vestibule
The space between the internal ones, limited above by the clitoris, on the sides by the labia minora, and behind and below by the posterior commissure of the labia majora. It is separated from the vagina by the hymen. In the vestibule of the vagina, the excretory ducts of the large and small glands open. The large gland of the vestibule (Bartholin's) is a paired organ the size of a large pea. Located in the thickness of the posterior parts of the labia majora. It has an alveolar-tubular structure; The glands are lined with secretory epithelium, and their excretory ducts are lined with multilayer columnar epithelium. During sexual arousal, the large glands of the vestibule secrete a secretion that moisturizes the entrance to the vagina and creates a weak alkaline environment favorable for sperm. Bartholin's glands were named after Caspar Bartholin, the anatomist who discovered them. The bulb of the vestibule is an unpaired cavernous formation located at the base of the labia majora. Consists of two lobes connected by a thin arched intermediate part.

Internal genital organs
The internal genital organs probably constitute the most important part of a woman’s reproductive system: they are entirely intended for conceiving and bearing a child. The internal genital organs include the ovaries, fallopian tubes, uterus and vagina; The ovaries and fallopian tubes are often called the uterine appendages.

Video about the structure of the female genital organs

Female urethra has a length of 3-4 cm. It is located in front of the vagina and somewhat protrudes the corresponding part of its wall in the form of a roller. The external opening of the female urethra opens into the vestibule of the vagina posterior to the clitoris. The mucous membrane is lined with pseudostratified epithelium, and near the external opening - with stratified squamous epithelium. The mucous membrane contains Littre glands and Morgagni lacunae. Paraurethral ducts are tubular branching formations 1-2 cm long. They are located on both sides of the urethra. In depth they are lined with columnar epithelium, and the outer sections are covered with cubic and then multilayered squamous epithelium. The ducts open in the form of pinholes on the lower semicircle of the roller bordering the external opening of the urethra. A secretion is secreted that moisturizes the external opening of the urethra. Ovary- a paired sex gland, where eggs are formed and mature, and sex hormones are produced. The ovaries are located on either side of the uterus, to which each is connected by a fallopian tube. The ovary is attached to the angle of the uterus by its own ligament, and by the suspensory ligament to the side wall of the pelvis. It has an ovoid shape; length 3-5 cm, width 2 cm, thickness 1 cm, weight 5-8 g. The right ovary is slightly larger than the left. The part of the ovary protruding into the abdominal cavity is covered with cubic epithelium. Beneath it is dense connective tissue that forms the tunica albuginea. In the underlying cortical layer there are primary, secondary (vesicular) and mature follicles, follicles in the atretic stage, and corpus luteum at different stages of development. Under the cortex lies the medulla of the ovary, consisting of loose connective tissue containing blood vessels, nerves and muscle fibers.

Main functions of the ovaries are the secretion of steroid hormones, including estrogens, progesterone and small amounts of androgens, which determine the appearance and formation of secondary sexual characteristics; the onset of menstruation, as well as the production of eggs capable of fertilization, ensuring reproductive function. The formation of eggs occurs cyclically. During the menstrual cycle, which usually lasts 28 days, one of the follicles matures. The mature follicle ruptures, and the egg enters the abdominal cavity, from where it is carried into the fallopian tube. In place of the follicle, a corpus luteum appears, functioning during the second half of the cycle.

Egg- a reproductive cell (gamete), from which a new organism develops after fertilization. It has a round shape with an average diameter of 130-160 microns, and is motionless. Contains a small amount of yolk, evenly distributed in the cytoplasm. The egg is surrounded by membranes: the primary is the cell membrane, the secondary is the non-cellular transparent zona pellucida and follicular cells that nourish the egg during its development in the ovary. Under the primary shell is the cortical layer, consisting of cortical granules. When the egg is activated, the contents of the granules are released into the space between the primary and secondary membranes, causing agglutination of spermatozoons and thereby blocking the penetration of several spermatozoons into the egg. The egg contains a haploid (single) set of chromosomes.

The fallopian tubes(oviducts, fallopian tubes) is a paired tubular organ. In fact, the fallopian tubes are two thread-like canals of standard length 10 - 12 cm and a diameter not exceeding a few millimeters (from 2 to 4 mm). The fallopian tubes are located on both sides of the uterine fundus: one side of the fallopian tube is connected to the uterus, and the other is adjacent to the ovary. Through the fallopian tubes, the uterus is “connected” to the abdominal cavity - the fallopian tubes open with a narrow end into the uterine cavity, and with an expanded end - directly into the peritoneal cavity. Thus, in women, the abdominal cavity is not sealed, and any infection that has the opportunity to enter the uterus causes inflammatory diseases not only of the reproductive system, but also of the internal organs (liver, kidneys), and peritonitis (inflammation of the peritoneum). Obstetricians and gynecologists strongly recommend visiting a gynecologist once every six months. Such a simple procedure as an examination prevents complications of inflammatory diseases - the development of precancerous conditions - erosion, ectopia, leukoplakia, endometriosis, polyps. The fallopian tube consists of: the infundibulum, the ampulla, the isthmus and the uterine part. The walls of the fallopian tube, almost like the uterus and vagina, in turn, consist of a mucous membrane covered with ciliated epithelium, a muscular layer and a serous membrane. The funnel is the expanded end of the fallopian tube, which opens into the peritoneum. The funnel ends with long and narrow outgrowths - fimbriae, which “encompass” the ovary. The fimbriae play a very important role - they vibrate, creating a current that “sucks” the egg released from the ovary into the funnel - like into a vacuum cleaner. If something in this infundibulum-fimbria-ovum system fails, fertilization can occur directly in the abdominal cavity, resulting in an ectopic pregnancy. Following the funnel is the so-called ampulla of the fallopian tube, then the narrowest part of the fallopian tube - the isthmus. Already the isthmus of the oviduct passes into its uterine part, which opens into the uterine cavity through the uterine opening of the tube. Thus, the main task of the fallopian tubes is to connect the upper part of the uterus with the ovary.

The fallopian tubes have dense, elastic walls. In a woman’s body, they perform one, but very important function: in them, as a result of ovulation, fertilization of the egg with sperm occurs. Along these lines, the fertilized egg passes into the uterus, where it strengthens and develops further. The Fallopian tubes serve specifically for fertilization, carrying and strengthening the egg from the ovary into the uterine cavity. The mechanism of this process is as follows: an egg matured in the ovaries moves through the fallopian tube with the help of special cilia located on the inner lining of the tubes. On the other hand, sperm move towards her, having previously passed through the uterus. If fertilization occurs, the division of the egg begins immediately. In turn, the fallopian tube at this time nourishes, protects and promotes the egg to the uterine cavity, with which the fallopian tube is connected by its narrow end. This advancement occurs gradually, approximately 3 cm per day.

If any obstacle is encountered (adhesions, adhesions, polyps) or a narrowing of the canal is observed, the fertilized egg remains in the tube, resulting in an ectopic pregnancy. In such a situation, it becomes very important to identify this pathology in time and provide the woman with the necessary help. The only way out in a situation of ectopic pregnancy is its surgical termination, since there is a high risk of tube rupture and bleeding into the abdominal cavity. Such a development of events poses a great danger to a woman’s life. Also in gynecological practice, there are cases when the end of the tube facing the uterus is closed, which makes it impossible for the sperm to meet the egg. At the same time, at least one normally functioning tube is sufficient for pregnancy to occur. If they are both impassable, then we can talk about physiological infertility. At the same time, modern medical technologies make it possible to conceive a child even with such disorders. According to specialists - obstetricians and gynecologists, the practice of introducing an egg fertilized outside a woman’s body directly into the uterine cavity, bypassing the fallopian tubes, has already been established.

Uterus is a smooth muscle hollow organ located in the pelvic area. The shape of the uterus resembles a pear and is intended mainly for carrying a fertilized egg during pregnancy. The weight of the uterus of a nulliparous woman is about 50 g (for nulliparous women - from 30 to 50 g, for those who have given birth - from 80 to 100 g), length - 7 - 8 cm, and the greatest width - approximately 5 cm. Moreover, during pregnancy, thanks to the elastic walls, the uterus is able to increase to 32 cm in height and 20 cm in width, supporting a fetus weighing up to 5 kg. During menopause, the size of the uterus decreases, atrophy of its epithelium occurs, and sclerotic changes in the blood vessels occur.

The uterus is located in the pelvic cavity between the bladder and rectum. Normally, it is inclined anteriorly; it is supported on both sides by special ligaments that do not allow it to descend and, at the same time, provide the necessary minimum of movement. Thanks to these ligaments, the uterus is able to respond to changes in neighboring organs (for example, bladder fullness) and take an optimal position for itself: the uterus can move back when the bladder is full, forward when the rectum is full, and rise up during pregnancy. The attachment of the ligaments is very complex, and it is its nature that is the reason why a pregnant woman is not recommended to raise her arms high: this position of the arms leads to tension in the ligaments of the uterus, to tension in the uterus itself and its displacement. This, in turn, can cause unnecessary displacement of the fetus in late pregnancy. Among the developmental disorders of the uterus, congenital defects are distinguished, such as the complete absence of the uterus, agenesis, aplasia, duplication, bicornuate uterus, unicornuate uterus, as well as positional anomalies - uterine prolapse, displacement, prolapse. Diseases associated with the uterus most often manifest themselves in various menstrual cycle disorders. Diseases of the uterus are associated with women's problems such as infertility, miscarriage, as well as inflammatory diseases of the genital organs and tumors.

The structure of the uterus consists of the following sections:

Cervix
Isthmus of the uterus
Body of the uterus
The fundus of the uterus is its upper part

A kind of muscular “ring” with which the uterus ends and connects with the vagina. The cervix makes up about a third of its entire length and has a special small opening - the cervical canal of the cervix, the cervix, through which menstrual blood enters the vagina and then out. Through the same opening, sperm penetrate into the uterus for the purpose of subsequent fertilization of the egg in the fallopian tubes. The cervical canal is closed by a mucus plug, which is pushed out during orgasm. Sperm penetrate through this plug, and the alkaline environment of the cervix contributes to their persistence and mobility. The shape of the cervix differs between women who have given birth and women who have not given birth. In the first case, it is round or in the shape of a truncated cone, in the second it is wider, flat, cylindrical. The shape of the cervix changes even after abortion, and it is no longer possible to deceive the gynecologist after an examination. The isthmus of the uterus is the area of ​​transition between the cervix and its body, about 1 cm wide. Its main function manifests itself during childbirth - it helps the opening expand and the fetus to come out. Ruptures of the uterus can also occur in this area, since this is its thinnest part.

Body of the uterus- actually its main part. Like the vagina, the body of the uterus consists of three layers (tunics). Firstly, it is the mucous membrane (endometrium). This layer is also called mucosal. This layer lines the uterine cavity and is abundantly supplied with blood vessels. The endometrium is covered with a single-layer prismatic ciliated epithelium. The endometrium “submits” to changes in a woman’s hormonal levels: during the menstrual cycle, processes occur in it that prepare for pregnancy. However, if fertilization does not occur, the superficial layer of the endometrium is rejected. For this purpose, menstrual bleeding occurs. After the end of menstruation, the cycle begins again, and the deeper layer of the endometrium takes part in the restoration of the uterine lining after rejection of the surface layer. In fact, the “old” mucosa is replaced with a “new” one. To summarize, we can say that, depending on the phase of the monthly cycle, the endometrial tissue either grows in preparation for implantation of the embryo, or is rejected - if pregnancy does not occur. If pregnancy does occur, the uterine mucosa begins to act as a bed for the fertilized egg. This is a very cozy nest for the embryo.

Hormonal processes change during pregnancy, preventing endometrial rejection. Accordingly, normally there should be no bleeding from the vagina during pregnancy. The mucous membrane lining the cervix is ​​rich in glands that produce thick mucus. This mucus, like a plug, fills the cervical canal. This mucous “plug” contains special substances that can kill microorganisms, preventing infection from entering the uterus and fallopian tubes. But during the period of ovulation and menstrual bleeding, the mucus “liquefies” so as not to interfere with sperm penetrating into the uterus, and blood, accordingly, flowing out of there. At both of these moments, the woman becomes less protected from the penetration of infections, which can be carried by sperm. If we take into account that the fallopian tubes directly open into the peritoneum, the risk of infection spreading to the genitals and internal organs increases many times over. It is for this reason that all doctors urge women to be very attentive to their health and prevent complications by undergoing preventive examinations with a professional gynecologist once every six months and carefully selecting a sexual partner.

Middle layer of the uterus(muscle, myometrium) consists of smooth muscle fibers. The myometrium consists of three muscle layers: longitudinal outer, annular middle and inner, which are closely intertwined (located in several layers and in different directions). The muscles of the uterus are the strongest in a woman’s body, because by nature they are designed to push out the fetus during childbirth. This is one of the most important functions of the uterus. It is precisely at the time of birth that they reach their full development. Also, the thick muscles of the uterus protect the fetus during pregnancy from external shocks. The muscles of the uterus are always in good shape. They contract slightly and relax. Contractions intensify during sexual intercourse and during menstruation. Accordingly, in the first case, these movements help the movement of sperm, in the second - the rejection of the endometrium.

Outer layer(serous layer, perimeter) is a specific connective tissue. This is part of the peritoneum, which is fused with the uterus in different sections. In front, next to the bladder, the peritoneum forms a fold, which is important during a cesarean section. To access the uterus, this fold is surgically incised, and then a suture is made under it, which is successfully closed.

Vagina- a tubular organ bounded below by the hymen or its remains, and above by the cervix. It is 8-10 cm long and 2-3 cm wide. It is surrounded on all sides by peri-vaginal tissue. At the top, the vagina expands, forming vaults (anterior, posterior and lateral). There are also anterior and posterior walls of the vagina, which consist of mucous, muscular and adventitial membranes. The mucous membrane is lined with stratified squamous epithelium and is devoid of glands. Due to the vaginal folds, which are more pronounced on the anterior and posterior walls, its surface is rough. Normally, the mucous membrane is shiny and pink. Under the mucous membrane there is a muscular layer formed mainly by longitudinally running bundles of smooth muscles, between which ring-shaped muscles are located. The adventitia is formed by loose fibrous connective tissue; it separates the vagina from neighboring organs. The vaginal contents are whitish in color, cheesy consistency, with a specific odor, formed due to the transudation of fluid from the blood and lymphatic vessels and desquamation of epithelial cells.

The vagina is a kind of elastic canal, an easily stretchable muscular tube connecting the vulva area and the uterus. The size of the vagina varies slightly from woman to woman. The average length, or depth, of the vagina is from 7 to 12 cm. When a woman stands, the vagina bends slightly upward, occupying neither a vertical nor horizontal position. The walls of the vagina are 3 - 4 mm thick and consist of three layers:

• Internal. This is the mucous membrane of the vagina. It is lined with stratified squamous epithelium, which forms numerous transverse folds in the vagina. These folds, if necessary, allow the vagina to change its size.
• Average. This is the smooth muscle layer of the vagina. Muscle bundles are oriented predominantly longitudinally, but bundles of a circular direction are also present. In its upper part, the muscles of the vagina pass into the muscles of the uterus. In the lower part of the vagina they become stronger, gradually intertwining with the muscles of the perineum.
• Outdoor. The so-called adventitial layer. This layer consists of loose connective tissue with elements of muscle and elastic fibers.

The walls of the vagina are divided into anterior and posterior, which are connected to one another. The upper end of the vaginal wall covers part of the cervix, highlighting the vaginal part and forming the so-called vaginal vault around this area.

The lower end of the vaginal wall opens into the vestibule. In virgins, this opening is closed by the hymen.

Typically pale pink in color, the vaginal walls become brighter and darker during pregnancy. In addition, the vaginal walls are at body temperature and feel soft to the touch.

Having great elasticity, the vagina expands during sexual intercourse. Also, during childbirth, it can increase to 10 - 12 cm in diameter to allow the fetus to emerge. This feature is provided by the middle, smooth muscle layer. In turn, the outer layer, consisting of connective tissue, connects the vagina with neighboring organs that are not related to the woman’s genital organs - the bladder and rectum, which, respectively, are located in front and behind the vagina.

The walls of the vagina, like the cervical canal(the so-called cervical canal), and the uterine cavity are lined with glands that secrete mucus. This mucus is whitish in color with a characteristic odor, has a slightly acidic reaction (pH 4.0-4.2) and has bactericidal properties due to the presence of lactic acid. To establish the nature of the contents and microflora of the vagina, a vaginal smear is used. Mucus not only moisturizes a normal, healthy vagina, but also cleanses it of the so-called “biological debris” - from the bodies of dead cells, from bacteria, and, due to its acidic reaction, prevents the development of many pathogenic microbes etc. Normally, mucus from the vagina is not secreted externally - the internal processes are such that during the normal functioning of this organ, the amount of mucus produced is equal to the amount absorbed. If mucus is released, it is in very small quantities. If you have heavy discharge that has nothing to do with the days of ovulation, you need to contact a gynecologist and undergo a detailed examination, even if nothing bothers you. Vaginal discharge is a symptom of inflammatory processes that can be caused by both not very and very dangerous infections, in particular chlamydia. Thus, chlamydia often has a hidden course, but causes irreversible changes in the female reproductive system, leading to miscarriages, miscarriages, and infertility.

Normally, the vagina should be moist all the time, which not only helps maintain healthy microflora, but also ensures full sexual intercourse. The process of vaginal secretion is regulated by the action of estrogen hormones. Typically, during menopause, the amount of hormones decreases sharply, as a result of which vaginal dryness is observed, as well as painful sensations during coitus. In such a situation, a woman should consult a specialist. After an examination, the gynecologist will prescribe medications that help with this problem. Individually selected treatment has a positive effect on overall well-being during the premenopausal and menopausal periods.

Located deep in the vagina Cervix, which looks like a dense rounded cushion. The cervix has an opening - the so-called cervical canal of the cervix. The entrance to it is closed by a dense mucous plug, and therefore objects inserted into the vagina (for example, tampons) cannot pass into the uterus. However, in any case, objects left in the vagina can become a source of infection. In particular, it is necessary to change the tampon in a timely manner and monitor whether it causes any pain.

In addition, contrary to popular belief, the vagina contains few nerve endings, so it is not as sensitive and is not a woman's main concern. The most sensitive of a woman's genital organs is the vulva.

Recently, in special medical and sexological literature, much attention has been paid to the so-called G-spot, located in the vagina and capable of giving a woman a lot of pleasant sensations during sexual intercourse. This point was first described by Dr. Gräfenberg, and since then there has been debate as to whether it really exists. At the same time, it has been proven that on the front wall of the vagina, at a depth of about 2-3 cm, there is an area that is slightly dense to the touch, about 1 cm in diameter, the stimulation of which really gives strong sensations and makes orgasm more complete. In this case, the G point can be compared to a man’s prostate, since, in addition to the usual vaginal secretion, it secretes a specific fluid.

Female sex hormones: estrogen and progesterone
There are two main hormones that have the greatest impact on the condition and functioning of the female reproductive system - estrogen and progesterone.
Estrogen is considered a female hormone. It is often referred to in the plural because there are several types. They are constantly produced by the ovaries from the onset of puberty until menopause, but their quantity depends on what phase of the menstrual cycle the woman is in. One of the signs that the girl’s body has already begun to produce these hormones is enlarged mammary glands and swollen nipples. In addition, a girl, as a rule, suddenly begins to grow rapidly, and then growth stops, which is also influenced by estrogens.

In the body of an adult woman, estrogens perform a number of important functions. Firstly, they are responsible for the course of the menstrual cycle, since their level in the blood regulates the activity of the hypothalamus and, consequently, all other processes. But, in addition, estrogens also affect the functioning of other parts of the body. In particular, they protect blood vessels from the accumulation of cholesterol plaques on their walls, causing diseases such as; regulate water-salt metabolism, increase skin density and promote its hydration, regulate the activity of the sebaceous glands. Also, these hormones maintain bone strength and stimulate the formation of new bone tissue, retaining the necessary substances - calcium and phosphorus. In this regard, during menopause, when the ovaries produce a very small amount of estrogens, women often experience fractures or development.

considered a male hormone since it dominates in men (remember that any person contains a certain amount of both hormones). Unlike estrogens, it is produced exclusively after the egg has left its follicle and the corpus luteum has formed. If this does not happen, progesterone is not produced. According to gynecologists and endocrinologists, the absence of progesterone in a woman’s body can be considered normal in the first two years after the onset of menstruation and in the period preceding menopause. However, at other times, a lack of progesterone is quite a serious disorder, as it can lead to the inability to get pregnant. In a woman’s body, progesterone acts only together with estrogens and, as it were, in opposition to them, according to the dialectical law of philosophy about the struggle and unity of opposites. Thus, progesterone reduces the swelling of the tissues of the mammary glands and uterus, promotes the thickening of the fluid secreted by the cervix, and the formation of the so-called mucous plug that closes the cervical canal. In general, progesterone, preparing the uterus for pregnancy, acts in such a way that it is constantly at rest and reduces the number of contractions. In addition, the hormone progesterone has a specific effect on other body systems. In particular, it is able to reduce the feeling of hunger and thirst, affects the emotional state, and “inhibits” the active activity of a woman. Thanks to it, body temperature can rise by several tenths of a degree. It should be noted that, as a rule, mood changes, irritability, sleep problems, etc. are common. in the premenstrual and actual menstrual periods are a consequence of an imbalance of the hormones estrogen and progesterone. Thus, having noticed such symptoms, it is best for a woman to consult a specialist, a gynecologist, in order to normalize her condition and prevent possible health problems.

Infections of the female genital organs.
In recent years, the prevalence of sexually transmitted infections in women has reached alarming proportions, especially among young people. Many girls begin sexual activity early and are not picky about their partners, explaining this by the fact that the sexual revolution took place long ago and a woman has the right to choose. Unfortunately, the fact that the right to choose promiscuous relationships also implies a “right” to illness is of little interest to young girls. You have to deal with the consequences later, while being treated for infertility caused by infections. There are other causes of female infections: a woman becomes infected from her husband or simply through everyday life. It is known that the female body is less resistant to STI pathogens than the male body. Research has shown that the reason for this fact is female hormones. Therefore, women face another danger - when using hormone therapy or using hormonal contraceptives, they increase their susceptibility to sexually transmitted infections, including HIV and herpes viruses. Previously, only three sexually transmitted diseases were known to science: syphilis, gonorrhea and mild chancre. Recently, some types of hepatitis and HIV have joined them.

However, with the improvement of diagnostic methods, many unknown female infections affecting the reproductive system were discovered: trichomoniasis, chlamydia, gardnerellosis, ureaplasmosis, mycoplasmosis, herpes and some others. Their consequences are not as terrible as the consequences of syphilis or HIV infection, but they are dangerous because, firstly, they undermine a woman’s immune system, opening the way to all kinds of diseases, and secondly, without treatment, many of these diseases lead to female infertility or have a damaging effect on the fetus during pregnancy or childbirth. The main symptoms for women are copious discharge from the genital tract with an unpleasant odor, burning, itching. If the patient does not seek medical help in a timely manner, bacterial vaginitis may develop, that is, inflammation of the vagina that affects the woman’s internal genital organs and again becomes the cause. Another complication of sexually transmitted infections in women, which develops in all cases of infection, is dysbacteriosis or dysbiosis, that is, a violation of the vaginal microflora. This is due to the fact that any STI pathogen entering a woman’s genital tract disrupts the natural normal microflora, replacing it with a pathogenic one. As a result, inflammatory processes develop in the vagina, which can also affect other organs of the woman’s reproductive system - the ovaries and uterus. Therefore, when treating any sexually transmitted infection in a woman, the causative agent of the disease is first destroyed, and then the vaginal microflora is restored and the immune system is strengthened.

Diagnosis and treatment of sexually transmitted infections in women is carried out successfully only if the patient consults a doctor in a timely manner. In addition, it is necessary to treat not only the woman, but also her sexual partner, otherwise re-infection will very quickly occur, which will lead to even more serious consequences than the initial one. Therefore, at the first signs of infection of the genital organs (pain, itching, burning, discharge and unpleasant odor from the genital tract) or if there are signs of infection in a sexual partner, a woman should immediately consult a doctor for diagnosis and treatment.

As for prevention, its main method is being selective in choosing sexual partners, using barrier contraception, following the rules of intimate hygiene and maintaining a healthy lifestyle, which will help maintain immunity that prevents infection with STIs. Diseases: HIV, gardnerellosis, genital herpes, hepatitis, candidiasis, mycoplasmosis, thrush, papillomavirus, toxoplasmosis, trichomoniasis, ureaplasmosis, chlamydia, cytomegalovirus.

Let's take a closer look at some of them.

Candidiasis (thrush)
Candidiasis, or thrush, is an inflammatory disease caused by yeast-like fungi of the genus Candida. Normally, Candida fungi in small quantities are part of the normal microflora of the mouth, vagina and colon in absolutely healthy people. How can these normal bacteria cause disease? Inflammatory processes are caused not simply by the presence of fungi of the genus Candida, but by their proliferation in large quantities. Why do they begin to actively grow? Z A common reason is a decrease in immunity. The beneficial bacteria in our mucous membranes die, or the body's defenses are depleted and cannot prevent the uncontrolled growth of fungi. In the vast majority of cases, decreased immunity is the result of some kind of infection (including hidden infections). That is why candidiasis is very often a litmus test, an indicator of more serious problems in the genital organs, and a competent doctor will always recommend to his patient a more detailed diagnosis of the causes of candidiasis , rather than simply identifying candida fungi in a smear.

Video about candidiasis and its treatment

Candidiasis quite rarely “takes root” on the genitals of men. Often thrush is a female disease. The appearance of symptoms of candidiasis in men should alert them: either their immunity is seriously reduced, or the presence of candida signals the likely presence of another infection, in particular, an STI. Candidiasis (another name is thrush) can be generally defined as vaginal discharge, accompanied by itching or burning. According to official statistics, candidiasis (thrush) accounts for at least 30% of all vaginal infections, but many women prefer self-treatment with antifungal drugs to seeing a doctor, so the true incidence of the disease is unknown. Experts note that thrush most often occurs in women between 20 and 45 years old. Thrush is often accompanied by infectious diseases of the genital organs and urinary system. In addition, according to statistics, there are more patients with candidiasis in the group of women susceptible to diabetes. Many women themselves diagnose themselves with “thrush” when discharge appears. However, discharge, itching and burning are not always a sign of candidiasis. Exactly the same symptoms of colpitis (inflammation of the vagina) are possible with gonorrhea, gardnerellosis (), genital herpes, mycoplasmosis, ureaplasmosis, trichomoniasis, chlamydia and other infections. Thus, the discharge you observe is not always caused by Candida fungi. Gynecologists understand thrush (candidiasis) as a STRICTLY defined disease caused precisely by a fungus of the genus Candida. And pharmaceutical companies too. That is why all drugs in pharmacies only help against Candida fungi. This is the reason why these drugs often do not help in self-treatment of thrush. And this is the same reason why, when written complaints bother you, you need to go to a gynecologist for an examination and find out the causative agent, and not self-medicate.

Very often, with unusual discharge, a smear shows candida. But this does not give grounds to assert (neither the patient nor, especially, the gynecologist) that the inflammatory process is only the result of uncontrolled growth of candida in the vagina. As you already know, Candida fungi are part of the vaginal microflora, and only some shocks can cause their rapid growth. The undivided dominance of fungi leads to a change in the environment in the vagina, which causes the well-known symptoms of thrush and inflammatory processes. Imbalance in the vagina does not happen by itself!!! Often, this failure of the microflora may indicate the presence of another infection (others) in the woman’s genital tract, which “helps” candida to actively grow. This is why “candidiasis” is a very good reason for the gynecologist to prescribe you a serious additional examination - in particular, tests for infections.

Trichomoniasis is one of the most common sexually transmitted diseases (STDs) in the world. Trichomoniasis is an inflammatory disease of the genitourinary system. Penetrating into the body, Trichomonas causes such manifestations of the inflammatory process as (inflammation of the vagina), (inflammation of the urethra) and (inflammation of the bladder). Most often, trichomonas do not exist in the body alone, but in combination with other pathogenic microflora: gonococci, yeasts, viruses, chlamydia, mycoplasmas, etc. In this case, trichomoniasis occurs as a mixed protozoan-bacterial infection. It is believed that 10% are infected with trichomoniasis. population of the globe. According to WHO, trichomoniasis is diagnosed annually in approximately 170 million people. The highest incidence of trichomoniasis, according to the observations of venereologists in different countries, occurs among women of childbearing (reproductive) age: according to some data, almost 20% of women are infected with trichomoniasis, and in some areas this percentage reaches 80.

However, such indicators may also be associated with the fact that in women, as a rule, trichomoniasis occurs with pronounced symptoms, while in men, the symptoms of trichomoniasis are either completely absent or are so unexpressed that the patient simply does not pay attention to it Of course, there are a sufficient number of women with asymptomatic trichomoniasis, and men with a pronounced clinical picture of the disease. In a latent form, trichomoniasis can be present in the human body for many years, while the carrier of Trichomonas does not notice any discomfort, but can infect his sexual partner. The same applies to an incompletely treated infection: it can come back at any time. We must also keep in mind that the human body does not produce protective antibodies against Trichomonas, so even after completely curing trichomoniasis, you can very easily become infected with it again from an infected sexual partner.

Based on the characteristics of the course of the disease, there are several forms of trichomoniasis: fresh trichomoniasis chronic trichomoniasis trichomoniasis Fresh is called trichomoniasis, which exists in the human body for no more than 2 months. Fresh trichomoniasis, in turn, includes an acute, subacute and torpid (that is, “sluggish”) stage. In the acute form of trichomoniasis, women complain of the classic symptoms of the disease: heavy vaginal discharge, itching and burning in the external genital area. In men, acute trichomoniasis most often affects the urethra, which causes burning and pain when urinating. In the absence of adequate treatment, after three to four weeks the symptoms of trichomoniasis disappear, but this, of course, does not mean recovery of the patient with trichomoniasis, but, on the contrary, the transition of the disease to a chronic form. Trichomoniasis is called chronic if it is more than 2 months old. This form of trichomoniasis is characterized by a long course, with periodic exacerbations. Exacerbations can be provoked by various factors, for example, general and gynecological diseases, hypothermia or violations of sexual hygiene rules. In addition, in women, symptoms of trichomoniasis may worsen during menstruation. Finally, trichomonas carriage is a course of infection in which trichomonas are detected in the vaginal contents, but the patient does not have any manifestations of trichomoniasis. When carrying Trichomonas, Trichomonas are transmitted from the carrier to healthy people during sexual intercourse, causing them the typical symptoms of trichomoniasis. There is still no consensus among experts regarding the danger or non-danger of trichomoniasis. Some venereologists call trichomoniasis the most harmless venereal disease, while others speak of a direct connection between trichomoniasis and cancer and other dangerous diseases.

The general opinion is that it is dangerous to underestimate the consequences of trichomoniasis: it has been proven that trichomoniasis can provoke the development of chronic forms of prostatitis and. In addition, complications of trichomoniasis can cause infertility, pathology of pregnancy and childbirth, infant mortality, and inferiority of offspring. Mycoplasmosis is an acute or chronic infectious disease. Mycoplasmosis is caused by mycoplasmas - microorganisms that occupy an intermediate position between bacteria, fungi and viruses. There are 14 types of mycoplasmas that can exist in the human body. Only three are pathogenic - Mycoplasma hominis and Mycoplasma genitalium, which are causative agents of genitourinary tract infections, and - a causative agent of respiratory tract infections. Mycoplasmas are opportunistic microorganisms. They can cause a number of diseases, but at the same time they are often detected in healthy people. Depending on the pathogen, mycoplasmosis can be genitourinary or respiratory.

Respiratory mycoplasmosis usually occurs in the form of acute respiratory infections or, in severe cases, pneumonia. Respiratory mycoplasmosis is transmitted by airborne droplets. Symptoms include fever, inflammation of the tonsils, runny nose; in the case of mycoplasma infection, all the signs of pneumonia are present: chills, fever, symptoms of general intoxication of the body. Urogenital mycoplasmosis is an infection of the genitourinary tract, transmitted sexually or, less commonly, through household contact. Mycoplasmas are detected in 60-90% of cases of inflammatory pathology of the genitourinary system. In addition, when analyzing healthy people for mycoplasmosis, mycoplasmas are detected in 5-15% of cases. This suggests that quite often mycoplasmosis is asymptomatic and does not manifest itself in any way as long as the human immune system is sufficiently stable. However, under such circumstances as pregnancy, childbirth, abortion, hypothermia, stress, mycoplasmas are activated, and the disease becomes acute. The predominant form of genitourinary mycoplasmosis is considered to be a chronic infection with few symptoms and a slow progression. Mycoplasmosis can provoke diseases such as prostatitis, urethritis, arthritis, sepsis, various pathologies of pregnancy and the fetus, postpartum endometritis. Mycoplasmosis is common throughout the world. According to statistics, mycoplasmas are more common in women than in men: 20-50% of women in the world are carriers of mycoplasmosis. Most often, mycoplasmosis affects women who have suffered from gynecological diseases, sexually transmitted infections, or leading a hectic lifestyle. In recent years, cases have become more frequent, which is partly due to the fact that during pregnancy a woman’s immunity is somewhat weakened and through this “gap” an infection enters the body. The second reason for the “increase” in the proportion of mycoplasmosis is modern diagnostic methods, which make it possible to identify “hidden” infections that are beyond the reach of simple diagnostic methods, such as a smear.

Mycoplasmosis for pregnant women- a very undesirable disease that can lead to miscarriage or missed pregnancy, as well as to the development of endometritis - one of the most serious postpartum complications. Fortunately, mycoplasmosis, as a rule, is not transmitted to the unborn child - the fetus is reliably protected by the placenta. However, there are frequent cases of a child becoming infected with mycoplasmosis during childbirth, when a newborn passes through an infected birth canal. It should be remembered that early diagnosis, timely treatment of mycoplasmosis, and its prevention will help to avoid all the negative consequences of this disease in the future.

Chlamydia - a new plague of the 21st century

Chlamydia is gradually becoming the new plague of the 21st century, winning this title from other STDs. According to the World Health Organization, the rate of spread of this infection is similar to an avalanche. Numerous authoritative studies clearly indicate that chlamydia is currently the most common disease among diseases transmitted primarily through sexual contact. Modern high-precision laboratory diagnostic methods detect chlamydia in every SECOND woman with inflammatory diseases of the genitourinary tract, in 2/3 of women suffering from infertility, in 9 out of 10 women suffering from miscarriage. In men, every second urethritis is caused by chlamydia. Chlamydia could also win the title of gentle killer from hepatitis, but people die from chlamydia very rarely. Have you already breathed a sigh of relief? In vain. Chlamydia causes a wide range of different diseases. Once it enters the body, it is often not satisfied with one organ, gradually spreading throughout the body.

Today, chlamydia is associated not only with diseases of the genitourinary organs, but also with the eyes, joints, respiratory lesions and a whole range of other manifestations. Chlamydia simply, affectionately and gently, imperceptibly makes a person old, sick, infertile, blind, lame... And it deprives men of sexual potency and children early on. Forever. Chlamydial infection threatens the health of not only adults, but also children, newborns and unborn babies. In children, chlamydia causes a whole bunch of chronic diseases, making them weak. Chlamydia even causes inflammatory diseases of the genital area. Due to chlamydia, newborns suffer from conjunctivitis, pneumonia, diseases of the nose and pharynx... The baby can get all these diseases in the womb from an infected mother, or may not be born at all - chlamydia often provokes miscarriage at different stages of pregnancy. The frequency of chlamydia infection according to various sources fluctuates. But the results are disappointing.

Extensive research shows that at least 30 percent of young people are infected with chlamydia. Chlamydia affects 30 to 60% of women and at least 51% of men. And the number of infected people is constantly growing. If a mother suffers from chlamydia, the risk of infecting her child with chlamydia during childbirth is at least 50%. But the most amazing thing is that you, being infected, suffering from these diseases, may NOT KNOW about the disease AT ALL. This is the hallmark of all chlamydia. Often there may be no symptoms of chlamydia. Chlamydia occurs very “gently”, “gently”, while causing destruction to your body, comparable to the consequences of a tornado. So, basically, patients with chlamydia only feel that something is “wrong” in the body. Doctors call these sensations “subjective.” The discharge may be “not like this”: men often experience the “first drop” syndrome in the morning, while women have unclear or simply heavy discharge. Then everything may go away, or you, having gotten used to it, begin to consider this state of affairs to be the norm. Meanwhile, in both men and women, the infection moves “deeper”, into the genitals, affecting the prostate, testicles in men and the cervix, fallopian tubes in women. The most amazing thing is that it doesn’t hurt anywhere! Or it hurts, but very modestly - it drags, some discomfort appears. AND NOTHING MORE! And chlamydia is doing underground work, causing such an extensive list of diseases, just listing which would take at least a page of text! Reference:

Our elders from the Ministry of Health have not yet introduced the diagnosis of chlamydia into the compulsory medical insurance system. Your clinic will never test you for chlamydia, and for free. In state outpatient and hospital institutions, such diseases of an infectious nature are simply classified as diseases of unknown cause. Therefore, to this day, it is not the state that has to pay for taking care of our health, the health of our loved ones and children, but you and me - the most conscientious citizens. The only way to find out if you are sick is to conduct a quality diagnosis.

Kelly. Fundamentals of modern sexology. Ed. Peter

Translated from English by A. Golubev, K. Isupova, S. Komarov, V. Misnik, S. Pankov, S. Rysev, E. Turutina

The anatomical structure of the male and female reproductive organs, also called genitals, has been known for many hundreds of years, but reliable information about their functioning has only recently become available. Male and female genitalia perform many functions and play an important role, participating in reproduction, and in receiving pleasure, and in the formation of trusting relationships in love.

Oddly enough, most popular sex education manuals traditionally consider the male genital organs primarily as a source of pleasant sexual sensations, and only then discuss their role in childbirth. When studying the female genital organs, the emphasis clearly shifts to the reproductive functions of the uterus, ovaries and fallopian tubes. The importance of the role of the vagina, clitoris and other external structures in sexual pleasure is often overlooked. In this and the next chapters, both the male and female genital organs are described as a potential source of intimacy in human relationships and sexual pleasure, as well as a potential source of the birth of children.

FEMALE GENITAL ORGANS

The female genital organs are not exclusively internal. Many of their important structures, located externally, play a large role in providing sexual arousal, while the internal parts of the female reproductive system are more significant in regulating hormonal cycles and reproductive processes.

The external female genitalia consists of the pubis, labia and clitoris. They are richly innervated and, due to this, sensitive to stimulation. The shape, size and pattern of pigmentation of the external genitalia vary greatly among women.

Vulva

The external female genitalia, located between the legs, below and in front of the pubic joint of the pelvic bones, is collectively called the vulva. The most noticeable of these organs is the pubis ( monsveneris)and labia majora (or labia majora) (labia majora). The pubis, sometimes called the pubic eminence or mount of Venus, is a rounded pad formed by subcutaneous fatty tissue and located above the rest of the external organs, just above the pubic bone. During puberty it becomes covered with hair. The pubis is fairly well innervated, and most women find that friction or pressure in this area can be sexually arousing. The vulva is generally considered the main erogenous zone in women, as it is generally very sensitive to sexual stimulation.

The labia majora are two folds of skin directed from the pubis down towards the perineum. They may be relatively flat and subtle in some women and thick and visible in others. During puberty, the skin of the labia majora darkens slightly, and hair begins to grow on their outer lateral surface. These outer folds of skin cover and protect the more sensitive female genitals located inside. The latter cannot be seen unless the large lips are parted, so a woman may need a mirror that needs to be positioned so as to see these organs.

When the labia majora are spread apart, you can see another, smaller pair of folds - the labia minora (or pudenda). They look like two asymmetrical petals of skin, pink, hairless and irregularly shaped, which connect at the top and form the skin of the clitoris, called the foreskin. Both the labia majora and minora are sensitive to sexual stimulation and play an important role in sexual arousal. On the inside of the labia minora are the exit openings of the ducts of the Bartholin's glands, sometimes called the vulvovaginal glands. At the moment of sexual arousal, a small amount of secretion is released from these glands, which may help moisturize the vaginal opening and, to some extent, the labia. These secretions, however, are of little importance for lubrication of the vagina during sexual arousal, and any other functions of these glands are unknown. Bartholin's glands sometimes become infected with bacteria from feces or other sources, and in such cases, treatment by a specialist may be required. Between the labia minora there are two openings. In order to see them, the labia minora often need to be spread apart. Almost just below the clitoris is a tiny opening called the urethra, or urethra, through which urine is removed from the body. Below is the larger vaginal opening, or entrance to the vagina. This hole is usually not open and can only be perceived as such if something is inserted into it. For many women, especially those in younger age groups, the entrance to the vagina is partially covered by membrane-like tissue - the hymen.

Human reproductive organs are important for both reproduction and pleasure. Historically, sexuality educators have focused on reproductive function and the internal genital organs, especially in women. In recent years, these specialists have also begun to pay attention to those aspects of sexual behavior that are associated with receiving pleasure, and to the external genitalia.

Clitoris

The clitoris, the most sensitive of the female genital organs, is located just below the superior fusion of the labia minora. This is the only organ whose function is only to provide sensitivity to sexual stimulation and to be a source of pleasure.

The clitoris is the most sensitive female reproductive organ. Some form of clitoral stimulation is usually a prerequisite for achieving orgasm, although the most appropriate method varies from woman to woman. The most prominent part of the clitoris usually appears as a rounded projection protruding from under the foreskin, which is formed by the superior fusion of the labia minora. This outer, sensitive part of the clitoris is called the glans. For a long time, the clitoris has been likened to the male penis because it is sensitive to sexual stimulation and capable of erection. Sometimes they even incorrectly considered the clitoris to be an underdeveloped penis. In fact, the clitoris and its entire internal system of blood vessels, nerves and erectile tissue form a highly functional and important sexual organ (Ladas, 1989).

The body of the clitoris is located behind the glans under the foreskin. The glans is the only freely protruding part of the clitoris, and, as a rule, it is not particularly mobile. The part of the clitoris located behind the head is attached to the body along its entire length. The clitoris is formed by two columnar cavernous bodies and two bulbous corpora cavernosa, which are capable of filling with blood during sexual arousal, causing hardening, or erection, of the entire organ. The length of the non-erect clitoris rarely exceeds 2-3 cm, and in a non-excited state only its apex (head) is visible, but with erection it increases significantly, especially in diameter. As a rule, in the first stages of arousal, the clitoris begins to protrude more than in a non-aroused state, but as arousal increases, it retracts again.

The skin of the foreskin contains tiny glands that secrete a fatty substance, which, when mixed with the secretions of other glands, forms a substance called smegma. This substance accumulates around the body of the clitoris, sometimes leading to the development of a harmless infection that can cause pain or discomfort, especially during sexual activity. If smegma buildup becomes a problem, it can be removed by a doctor using a small probe inserted under the foreskin. Sometimes the foreskin is surgically incised slightly, further exposing the glans and body of the clitoris. This procedure, called circumcision in Western culture, is rarely performed on women, and doctors find little rational basis for it.

Vagina

The vagina is a tube with muscular walls and plays an important role as a female organ associated with childbirth and sexual pleasure. The muscular walls of the vagina are very elastic, and unless something is inserted into the vaginal cavity, they become compressed, so that the cavity is better described as a "potential" space. The length of the vagina is about 10 cm, although it can lengthen during sexual arousal. The inner surface of the vagina, elastic and soft, is covered with small ridge-like projections. The vagina is not particularly sensitive, except in areas immediately surrounding the opening or located deep from the opening to about one-third of the length of the vagina. This outer region, however, contains many nerve endings and its stimulation easily leads to sexual arousal.

The vaginal opening is surrounded by two muscle groups: the vaginal sphincter ( sphincter vaginae)and levator anus ( levator ani). Women are able to control these muscles to some extent, but tension, pain or fear can lead to involuntary contraction, which makes inserting objects into the vagina painful or impossible. These manifestations are called vaginismus. A woman can also regulate the tone of the internal pubococcygeus muscle, which, like the anal sphincter, can be contracted or relaxed. This muscle plays a certain role in the formation of orgasm, and its tone, like the tone of all voluntary contracting muscles, can be learned to be regulated with the help of special exercises.

It is important to note that the vagina cannot contract to such an extent that the penis will be held in it ( penis captivus),although it is possible that some have heard the opposite. In Africa, for example, there are many myths about people who become entangled during sex and have to go to hospital to be separated. Such myths appear to serve a social function of preventing adultery ( Ecker, 1994). When breeding dogs, the penis is erected in such a way that it is trapped in the vagina until the erection subsides, and this is necessary for successful mating. Nothing like this happens in people. During sexual arousal in women, a lubricant is released on the inner surface of the vaginal walls.

Douching

Over the years, women have developed a variety of methods for cleaning the vagina, sometimes called douching. It was believed to help prevent vaginal infections and eliminate bad odor. In a study of 8,450 women aged 15 to 44 years, it was found that 37% of them resorted to douching as part of their regular hygiene procedures (Aral , 1992). The practice is especially common among poor women and non-white minorities, for whom the rate can be as high as two-thirds. One National Black Women's Health Project participant ( Black Women's Health Project) speculated that douching may represent black women's response to negative sexual stereotypes. Meanwhile, research is providing growing evidence that douching, contrary to popular belief, can be dangerous. Thanks to it, pathogens can penetrate the uterine cavity, which increases the risk of uterine and vaginal infections. Women who douche more than three times a month are at four times higher risk of pelvic inflammatory disease than those who do not douche at all. The vagina has natural cleaning mechanisms that can be disrupted by douching. Unless specifically indicated for medical reasons, douching should be avoided.

Hymen

The hymen is a thin, delicate membrane that partially covers the entrance to the vagina. It can cross the vaginal opening, surround it, or have several openings of varying shapes and sizes. The physiological functions of the hymen are unknown, but historically it had psychological and cultural significance as a sign of virginity.

The hymen, present at the vaginal opening from birth, usually has one or more holes. There are many different shaped hymens that cover the vaginal opening to varying degrees. The most common type is the annular hymen. In this case, its tissue is located around the perimeter of the entrance to the vagina, and there is a hole in the center. Some types of hymen tissue extend to the opening of the vagina. The ethmoid hymen completely covers the opening of the vagina, but it itself has many small holes. The hymen is a single strip of tissue that divides the opening of the vagina into two clearly visible openings. Occasionally, girls are born with a closed hymen, that is, the latter completely covers the vaginal opening. This can only become clear with the onset of menstruation, when fluid accumulates in the vagina and causes discomfort. In such cases, the doctor must make a small hole in the hymen to allow the flow of menstrual fluid.

In most cases, the hymen has a hole large enough for a finger or tampon to fit through. Attempting to insert a larger object, such as an erect penis, usually results in rupture of the hymen. There are many other circumstances, unrelated to sexual activity, in which the hymen can become damaged. Although it is often claimed that some girls are born without a hymen, recent evidence casts doubt on whether this is actually the case. More recently, a group of pediatricians at the University of Washington examined 1,131 newborn girls and found that each had an intact hymen. From this it was concluded that the absence of a hymen at birth was very unlikely, if not impossible. It also follows that if the hymen is not found in a little girl, the cause is most likely some kind of trauma (Jenny, Huhns, & Arakawa, 1987).

Sometimes the hymen is stretchable enough to survive sexual intercourse. Therefore, the presence of a hymen is an unreliable indicator of virginity. Some peoples attach special importance to the presence of a hymen and establish special rituals for tearing a girl’s hymen before first copulation.

In the United States, between 1920 and 1950, some gynecologists performed special surgery for women who were getting married but did not want their husbands to know that they were not virgins. The operation, called the “lover's knot,” consisted of placing one or two sutures on the labia minora so that a thin closure appeared between them. During intercourse on the wedding night, the bow broke, causing some pain and bleeding (Janus & Janus, 1993). Many in Western society to this day believe that the presence of a hymen proves virginity, which is naive at best. In reality, the only way to physically determine whether copulation has taken place is to detect sperm in a vaginal smear using a chemical test or microscopic examination. This procedure must be performed within a few hours of sexual intercourse, and in cases of rape it is sometimes used to prove that penile-vaginal penetration has occurred.

A rupture of the hymen during sexual intercourse for the first time can cause discomfort or pain and possibly some bleeding when the hymen is torn. The pain can vary from mild to severe among women. If a woman is concerned that her first intercourse will be painless, she can use her fingers to widen the opening of the hymen in advance. The doctor may also remove the hymen or stretch the opening using dilators of increasing size. However, if your partner gently and carefully inserts the erect penis into the vagina, using adequate lubrication, there will usually be no problems. A woman can also guide her partner's penis herself, adjusting the speed and depth of its penetration.

Self-examination of the genital organs by a woman

After becoming familiar with the basics of their external anatomy, women are encouraged to examine their genitals monthly, paying attention to any unusual signs and symptoms. Using a mirror and appropriate lighting, you should examine the condition of the skin under the pubic hair. Then you should pull back the skin of the foreskin of the clitoris and spread the labia minora, which will allow you to better examine the area around the vaginal openings and urethra. Keep an eye out for any unusual swelling, abrasions, or rashes. They may be red or pale, but sometimes they are easier to detect not visually, but by touch. Do not forget to also examine the inner surface of the labia majora and minora. It is also advisable, knowing what your vaginal discharge looks like in normal condition, to pay attention to any changes in its color, smell or consistency. Although certain abnormalities can usually occur during the menstrual cycle, some diseases cause easily noticeable changes in vaginal discharge.

If you notice any unusual swelling or discharge, you should immediately consult a gynecologist. Often all these symptoms are completely harmless and do not require any treatment, but sometimes they signal the onset of an infectious process when medical attention is necessary. It is also important to tell your doctor about any pain or burning when urinating, bleeding between periods, pain in the pelvic area, and any itchy rashes around the vagina.

Uterus

The uterus is a hollow muscular organ in which the growth and nutrition of the fetus occurs until the very moment of birth. The walls of the uterus have different thicknesses in different places and consist of three layers: perimetry, myometrium and endometrium. To the right and left of the uterus there is one almond-shaped ovary. The two functions of the ovaries are the secretion of the hormones estrogen and progesterone and the production of eggs and their subsequent release from the ovary.

The cervix protrudes into the deepest part of the vagina. The uterus itself is a thick-walled muscular organ that provides a nutrient medium for the developing fetus during pregnancy. As a rule, it is pear-shaped, approximately 7-8 cm in length and about 5-7 cm in diameter at the top, tapering to 2-3 cm in diameter in the part that protrudes into the vagina. During pregnancy, it gradually increases to a much larger size. When a woman stands, her uterus is almost horizontal and at right angles to the vagina.

The two main parts of the uterus are the body and the cervix, connected by a narrower isthmus. The top of the wide part of the uterus is called its fundus. Although the cervix is ​​not particularly sensitive to superficial touch, it can sense pressure. The opening in the cervix is ​​called the os. The internal cavity of the uterus has different widths at different levels. The walls of the uterus consist of three layers: a thin outer layer - the perimeter, a thick intermediate layer of muscle tissue - the myometrium and an inner layer rich in blood vessels and glands - the endometrium. It is the endometrium that plays a key role in the menstrual cycle and in the nutrition of the developing fetus.

Internal gynecological examination

The uterus, especially the cervix, is one of the common sites for cancer in women. Because uterine cancer can remain asymptomatic for many years, it is particularly dangerous. Women should undergo periodic internal gynecological examinations and Pap smear tests from a qualified gynecologist. There is disagreement among experts about how often this examination should be done, but most recommend doing it annually. Thanks to the Pap smear, the death rate from cervical cancer was reduced by 70%. Approximately 5,000 women die in the United States from this form of cancer each year, 80% of whom have not had a Pap smear in the past 5 years or more.

During a gynecological examination, first of all, a vaginal speculum is carefully inserted into the vagina, which holds the vaginal walls in an expanded state. This allows direct examination of the cervix. To take the Pap smear (named after its developer, Dr. Papanicolaou), a thin spatula or stem-mounted swab is used to painlessly remove a number of cells from the cervix while the speculum remains in place. A smear is prepared from the collected material, which is fixed, stained and examined under a microscope, looking for any possible indications of changes in the structure of cells that may indicate the development of cancer or precancerous manifestations. In 1996, the Food and Drug Administration ( Food and Drug Administration) approved a new method for preparing a smear by the Pope, which eliminates the entry of excess mucus and blood into it, which makes it difficult to detect altered cells. This made the test even more effective and reliable than before. Recently, it has become possible to use another device, which, when attached to a vaginal speculum, illuminates the cervix with light specially selected for its spectral composition. Under such lighting, normal and abnormal cells differ from each other in color. This greatly facilitates and speeds up the identification of suspicious areas of the cervix that should be subjected to a more thorough examination.

After removing the speculum, a manual examination is performed. Using a rubber glove and lubricant, the doctor inserts two fingers into the vagina and presses them on the cervix. The other hand is placed on the stomach. In this way, the doctor is able to feel the overall shape and size of the uterus and surrounding structures.

If suspicious cells are detected in the Pap smear, more intensive diagnostic procedures are recommended. First of all, to determine the presence of malignant cells, you can resort to a biopsy. If an increase in the number of abnormal cells is shown, another procedure called dilatation and curettage (dilation and curettage) can be performed. The opening of the cervix widens, which allows you to insert a special instrument - a uterine curette - into the internal cavity of the uterus. A number of cells from the inner layer of the uterus are carefully scraped off and examined for the presence of malignant cells. Typically, dilation and curettage is used to clear the uterus of dead tissue after a miscarriage (involuntary abortion), and sometimes to terminate a pregnancy during an induced abortion.

Ovaries and fallopian tubes

On both sides of the uterus, two almond-shaped glands called ovaries are attached to it using the inguinal (pupart) ligaments. The two main functions of the ovaries are the secretion of female sex hormones (estrogen and progesterone), and the production of eggs necessary for reproduction. Each ovary is approximately 2-3 cm long and weighs about 7 grams. At birth, a woman's ovary contains tens of thousands of microscopic sacs called follicles, each of which contains a cell that can potentially develop into an egg. These cells are called oocytes. It is believed that by the time of puberty, only a few thousand follicles remain in the ovaries, and only a small fraction of these (400 to 500) will ever develop into mature eggs.

In a mature woman, the surface of the ovary is irregular in shape and covered with pits - marks left after the release of many eggs through the ovarian wall during the process of ovulation, described below. By examining the internal structure of the ovary, one can observe follicles at different stages of development. Two different zones are also distinguishable: the central medulla and a thick outer layer, cortex. A pair of fallopian, or fallopian, tubes lead from the edge of each ovary into the upper part of the uterus. The end of each fallopian tube, which opens next to the ovary, is covered with fringed projections - fimbriae, which are not attached to the ovary, but rather loosely encircle it. Following the fimbriae is the widest part of the tube - funnel. It leads into a narrow, irregularly shaped cavity stretching along the entire tube, which gradually narrows as it approaches the uterus.

The inner layer of the fallopian tube is covered with microscopic cilia. It is through the movement of these cilia that the egg travels from the ovary to the uterus. For conception to occur, a sperm must meet and penetrate the egg while it is in one of the fallopian tubes. In this case, the already fertilized egg is transported further into the uterus, where it attaches to its wall and begins to develop into an embryo.

CROSS-CULTURAL PERSPECTIVE

Mariam Razak was 15 when her family locked her in a room where five women held her struggling to escape while a sixth cut off her clitoris and labia.

The event left Mariam with a lingering feeling of being betrayed by the people she loved most: her parents and her boyfriend. Now, nine years later, she believes that the operation and the infection it caused robbed her of not only her ability to be sexually satisfied, but also her ability to have children.

It was love that led Mariam to this mutilation. She and her childhood friend, Idrissou Abdel Razak, say they had sex as teenagers and then he decided they should get married.

Without telling Mariam, he asked his father, Idrissa Seibu, to approach her family for permission to marry. His father offered a significant dowry, and Mariam's parents gave their consent, while she herself was told nothing.

“My son and I asked her parents to circumcise her,” says Idrissu Seibu. - Other girls, who were warned in advance, ran away. That's why we decided not to tell her what would be done."

On the day scheduled for the operation, Mariam's boyfriend, a 17-year-old taxi driver, was working in Sokode, a town north of Kpalime. Today he is ready to admit that he knew about the upcoming ceremony, but did not warn Mariam. Mariam herself now believes that together they could find a way to deceive her parents and convince them that she went through with the procedure, if only her boyfriend would support her.

When he returned, he learned that she had to be rushed to the hospital because the bleeding did not stop. She developed an infection in hospital and remained there for three weeks. But while her body was healing, she said, her feelings of bitterness intensified.

And she decided not to marry a man who failed to protect her. She borrowed $20 from a friend and took a cheap taxi to Nigeria, where she lived with friends. It took her parents nine months to find her and bring her home.

It took her boyfriend another six years to regain her trust. He bought her clothes, shoes and jewelry as gifts. He told her that he loved her and begged for forgiveness. Eventually her anger mellowed and they married in 1994. Since then they have lived in his father's house.

But Mariam Razak knows what she's lost. She and her now-husband made love in their youth, before she underwent FGM, and she said sex brought her great satisfaction. Now, they both say, she doesn't feel anything. She compares the permanent loss of sexual satisfaction to an incurable disease that stays with you until you die.

“When he goes into town, he buys drugs that he gives me before we have sex to make me feel pleasure. But it’s not the same,” says Mariam.

Her husband agrees: “Now that she's circumcised, there's something missing in that area. She doesn't feel anything there. I try to please her, but it doesn’t work very well.”

And their sorrows do not end there. They are also unable to conceive a child. They turned to doctors and traditional healers - all to no avail.

Idrissou Abdel Razak promises that he will not take another wife, even if Mariam does not become pregnant: “I have loved Mariam since we were children. We will continue to look for a way out."

And if they ever have daughters, he promises to send them away from the country to protect them from having their genitals cut off. Source : S. Dugger. The New York Times METRO, 11 September 1996

Female genital mutilation

Across cultures and historical periods, the clitoris and labia have been subjected to various types of surgical procedures that have resulted in female mutilation. Based on the widespread fear of masturbation since mid-2000s XIX century and until about 1935, doctors in Europe and the United States often circumcised women, that is, they removed, partially or completely, the clitoris - a surgical procedure called clitoridectomy. These measures were believed to "cure" masturbation and prevent insanity. In some African and East Asian cultures and religions, clitoridectomy, sometimes incorrectly called "female circumcision", is still practiced as part of the rites of passage into adulthood. The World Health Organization estimates that up to 120 million women worldwide have undergone some form of what is now called female genital mutilation. Until recently, almost all girls in countries such as Egypt, Somalia, Ethiopia and Sudan underwent this operation. Although it can sometimes take the form of traditional circumcision, which removes the tissue covering the clitoris, more often the glans of the clitoris is also removed. Sometimes an even more extensive clitoridectomy is performed, which involves removing the entire clitoris and a significant amount of surrounding labia tissue. As a rite of passage marking a girl's transition to adulthood, clitoridectomy signifies the removal of all traces of "male characteristics": since the clitoris in these cultures is traditionally seen as a miniature penis, its absence is recognized as the ultimate symbol of femininity. But in addition, clitoridectomy also reduces a woman's sexual satisfaction, which is important in those cultures where men are considered responsible for controlling women's sexuality. Various taboos are established to support this practice. In Nigeria, for example, some women believe that if the baby's head touches the clitoris during childbirth, the baby will develop a mental disorder ( Ecker, 1994). Some cultures also practice infibulation, in which the labia minora and sometimes the labia majora are removed and the edges of the outer part of the vagina are stitched or held together using plant thorns or natural adhesives, thus ensuring that the woman will not have intercourse before marriage. The bonding material is removed before marriage, although the procedure may be repeated if the husband intends to be away for a long time. This often results in the formation of rough scar tissue that can make urination, menstruation, copulation and childbirth more difficult and painful. Infibulation is common in cultures where virginity is highly valued in marriage. When women who undergo this operation are chosen as brides, they bring significant benefits to their families in the form of money, property and livestock (Eskeg, 1994).

These rites are often performed with crude instruments and without the use of anesthesia. Girls and women undergoing such procedures often become infected with serious illnesses, and the use of unsterile instruments can lead to AIDS. Girls sometimes die as a result of bleeding or infection caused by this operation. In addition, there is growing evidence that such ritual surgery can lead to serious psychological trauma, with lasting effects on women's sexuality, marital life and childbearing (Lightfoot - Klein, 1989; MacFarquhar, 1996). The influence of civilization has brought some improvements to traditional practices, so that in some places today aseptic methods are already used to reduce the risk of infection. For some time, Egyptian health authorities have encouraged this operation to be carried out in medical institutions to avoid possible complications, while simultaneously providing family counseling to end this custom. In 1996, the Egyptian Ministry of Health decided to ban all health workers in both public and private clinics from performing any type of female genital mutilation. However, it is believed that many families will continue to turn to local healers to carry out these ancient prescriptions.

There is growing condemnation of the practice, which is seen by some groups as barbaric and sexist. In the United States, the issue has come under greater scrutiny as it now becomes clear that some girls from immigrant families from more than 40 countries may have undergone the procedure in the United States. A woman named Fauzia Kasinga fled the African country of Togo in 1994 to avoid mutilation surgery and eventually came to the States illegally. She applied for asylum, but an immigration judge initially dismissed her case as unpersuasive. After she spent over one year in prison, the Board of Immigration Appeals ruled in 1996 that female genital mutilation did constitute an act of persecution and was a valid basis for granting asylum to women (Dugger , 1996). While such practices are sometimes seen as a cultural imperative that should be respected, this ruling and other developments in developed countries underscore the idea that such operations constitute a human rights violation that must be condemned and stopped ( Rosenthal, 1996).

Female genital mutilation often has deep roots in the entire lifestyle of a culture, reflecting a patriarchal tradition in which women are viewed as the property of men and female sexuality is subordinated to male sexuality. This custom can be regarded as a fundamental component of initiation rites, symbolizing the girl's acquisition of the status of an adult woman, and therefore serve as a source of pride. But with increasing attention to human rights around the world, including in developing countries, opposition to such practices is growing. There is fierce debate in those countries where these procedures continue to be used. Younger women more familiar with Western lifestyles - often with the support of their husbands - are calling for initiation rites to be made more symbolic in order to retain the positive cultural meaning of the traditional ritual but avoid painful and dangerous surgery. Feminists in the Western world have been particularly vocal on this issue, arguing that such procedures are not only dangerous to health, but are also an attempt to emphasize the dependent position of women. Such disputes represent a classic example of the clash between culture-specific customs and changing global views on sexuality and gender issues.

Definitions

CLITOR - organ sensitive to sexual stimulation located in the upper part of the vulva; When sexually aroused, it fills with blood.

HEAD OF THE CLITOR - the outer, sensitive part of the clitoris, located at the upper fusion of the labia minora.

BODY OF THE CLITORIUM - an elongated part of the clitoris containing tissue that can fill with blood.

VULVA - external female genitalia, including the pubis, labia majora and minora, clitoris and vaginal opening.

PUBIS - an elevation formed by adipose tissue and located above the woman’s pubic bone.

LABIA MAJOR - two outer folds of skin covering the labia minora, clitoris and openings of the urethra and vagina.

LAVIDA MIRA - two folds of skin within the space bounded by the large lips, joining above the clitoris and located on the sides of the openings of the urethra and vagina.

FORESKE - in women, the tissue at the top of the vulva covering the body of the clitoris.

BARTHOLINIY GLANDS - small glands, the secretion of which is released during sexual arousal through excretory ducts that open at the base of the labia minora.

OPENING OF THE URETHRAL CHANNEL - hole through which urine is removed from the body.

ENTRANCE TO THE VAGINA - external opening of the vagina.

VIRGIN HYMN - a connective tissue membrane that may partially cover the entrance to the vagina.

SMEGMA - a thick, oily substance that can accumulate under the foreskin of the clitoris or penis.

CIRCUMCISION - in women - a surgical operation that exposes the body of the clitoris, during which its foreskin is cut.

INFIBULATION is a surgical procedure used in some cultures in which the edges of the vaginal opening are sealed.

CLITORODECTOMY - surgical removal of the clitoris, a common procedure in some cultures.

VAGINISM - involuntary spasm of the muscles located at the entrance to the vagina, making penetration into it difficult or impossible.

pubococcygeal MUSCLE - part of the muscles that support the vagina, is involved in the formation of orgasm in women; women are able to control its tone to some extent.

VAGINA - a muscular canal in a woman’s body that is susceptible to sexual arousal and into which sperm must enter during sexual intercourse for conception to occur.

UTERUS - a muscular organ within the female reproductive system in which a fertilized egg is implanted.

CERVIX - the narrower part of the uterus that protrudes into the vagina.

ISTHmus - narrowing of the uterus directly above its cervix.

FUND (UTERUS) - wide upper part of the uterus.

ZEV - opening in the cervix leading into the uterine cavity.

PERIMETERIES - outer layer of the uterus.

MYOMETRIUM - middle, muscular layer of the uterus.

ENDOMETRIUM - the inner layer of the uterus lining its cavity.

SWAB DAD - microscopic examination of a preparation of cells taken by scraping from the surface of the cervix, carried out to detect any cellular abnormalities.

BARRIERS - a pair of female reproductive glands (gonads) located in the abdominal cavity and producing eggs and female sex hormones.

EGG - female reproductive cell formed in the ovary; fertilized by a sperm.

FOLLICLE - a conglomerate of cells surrounding a maturing egg.

OOCYTES - cells are the precursors of eggs.

FALLOPIAN TUBES - structures associated with the uterus that carry eggs from the ovaries to the uterine cavity.