vaginal

Vaginal is an adjective relating to the vagina, a muscular canal that forms part of the female reproductive system. The vagina extends from the exterior opening of the vulva to the cervix and serves as a passageway for sexual intercourse, menstrual flow, and childbirth.

Anatomy and physiology: The vaginal wall consists of an inner mucosa lined by stratified squamous epithelium, a muscular layer, and an outer connective tissue adventitia. The mucosa can form folds (rugae) that allow distension. The upper vagina forms fornices around the cervix. The vagina opens to the outside at the vaginal orifice, which is surrounded by the labia and supported by pelvic floor muscles.

Microbiology and environment: The normal vaginal microbiome is dominated by Lactobacillus species, which produce lactic acid and keep the pH typically between 3.8 and 4.5. This acidic environment helps protect against many pathogens.

Development and hormonal influence: Estrogen promotes changes in the vaginal epithelium, including thickening and glycogen production, which supports lactobacilli growth. Hormonal fluctuations during puberty, pregnancy, and menopause influence vaginal appearance and function.

Clinical aspects: Common conditions include bacterial vaginosis, vulvovaginal candidiasis (yeast infection), and other infections or inflammations. Atrophic vaginitis can occur with estrogen deficiency. Vaginal cancers are rare. Guidance emphasizes safe sexual practices, avoiding irritants, and seeking medical evaluation for symptoms such as abnormal discharge, odor, itching, or pain. Douching is generally not recommended, as it can disrupt the natural microbiome.