It’s not surprising, really, that most women are seriously misinformed about their nether region. In a recent survey of 2,000 women, 10 percent couldn’t identify a diagram of female genitalia: 25 percent missed the vagina; 46 percent didn’t know where the cervix was; almost 60 percent misidentified the uterus.
Besides not knowing where our organs are, we also have a lot of misconceptions about their function, especially as it pertains to menstruation (responses varied from “the way we pee” to “some kind of detoxification”) and menopause (10 percent thought it meant a woman had turned 40; 13 percent thought it meant a woman had missed a period).
"I've traveled the country talking to college-age women and am shocked at how uninformed they were," says Lissa Rankin, M.D., an ob-gyn and author of What's Up Down There? in an article for Glamor. "There'd be 60 people in the room, and I'd get 300 cards with queries on them—and these were not advanced questions."
This ignorance is unsurprising because, not only is female genitalia largely internal and not easy to see, but there’s also a lot of function in a small space. Elimination, birth, and sex all happen in a remarkably compact area. In fact, it’s “one of the most complex systems in the human body,” according to Danela Zagar, global brand manager for Intimina, the sponsor of the survey.
Female function and anatomy has been—and continues to be—the locus of myth and misunderstanding that often informs our self-image. Menstruation is still considered “unclean” in many cultures. And face it, don’t we often consider our own natural odor and vaginal discharge “gross” and “dirty?” We call menstruation “the curse.” Is it possible that these lingering and deeply rooted cultural mythologies diminish our acceptance of and willingness to learn about this anatomy that is so critical to our female identity?
And aren’t we always quick to jump on the insecurity bandwagon? Do we look “different” down there? Misshapen? Are we “normal”? The truth is that we all look different, indeed, and that’s pretty normal. Take a look at this art installation of plaster casts of 400 female vaginas, titled The Great Wall of Vagina: changing women’s body image through art. You will be amazed at the variation among us.
Whatever the root of our ignorance, it affects our lives—often in important ways. All these parts and functions, from elimination to sex to creating and gestating babies; from childbirth to menstruation to menopause, all these systems coexist more or less harmoniously within a very tight space. Which means that they all impact and interact with each other. The vagina is connected to the pelvic floor, which is connected to the urethral opening and the anus. What happens to one part of the system affects everything else. Nothing happens in isolation.
For example, we talk a lot here on MiddlesexMD about the “genitourinary syndrome of menopause”: That medical term attempts to convey that the effects of menopause aren’t limited to the vagina, but instead affect all the systems in the area. Menopause can cause our urinary systems to lose tissue health just like our vagina; it can cause more urinary tract infections (UTIs) and it can cause both our bladder and rectum to prolapse, as well as the uterus.
Knowing your anatomy is helpful in understanding what gives you sexual pleasure and how to enhance that. Knowing how your parts function helps you to understand what’s happening and when things might be going awry. Some women have mentioned that, with greater understanding, they could be better advocates for themselves and ask their doctors better questions.
Dr. Barb DePree, M.D., has been a gynecologist and women’s health provider for almost 30 years and a menopause care specialist for the past ten.