vagina

腟

　 　

WordNet

1. the lower part of the female reproductive tract; a moist canal in female mammals extending from the labia minora to the uterus; "the vagina receives the penis during coitus"; "the vagina is elastic enough to allow the passage of a fetus"
2. of or relating to the vagina; "vaginal suppository"
3. the condition of being folded inward or sheathed (同)introversion
4. the folding in of an outer layer so as to form a pocket in the surface; "the invagination of the blastula" (同)introversion, intussusception, infolding

PrepTutorEJDIC

1. 膣
2. 膣の(に関する)

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/08/23 07:48:30」(JST)

wiki ja

[Wiki ja表示]

膣
女性器の断面図
ヒトの女性器の写真。図中の4
ラテン語	Vagina
器官	女性器
動脈	腸腰動脈 膣動脈 中直腸動脈

膣（腟、ちつ、ドイツ語: Vagina （ヴァギナ）、英語: Vagina （ヴァジャイナ））は動物の雌性生殖器のうち、体内にあって体外開口部に連なる末端部。機能としては、雄の精子注入装置である陰茎を受け入れるための部分を指す。

動物一般

体内受精をする動物には雄が精子を雌の体内に注入するに当たって、雌の体内に挿入して精子を送り込む管状の構造を発達させるものがあり、これが陰茎である。雌の生殖口にこれを受け入れる構造がある場合、その部分を膣と呼ぶ。それは生殖口の開口部の出入り口にあたり、当然ながら卵や幼生の出る口ともなる。無脊椎動物を含め、体内受精を行う動物ではこの構造を持つ例は少なくなく、下等な方では無腸類にもその例がある。

ただし、雄に陰茎があっても雌に膣があるとは限らない。たとえば昆虫のナンキンムシでは雄はペニスを使い、雌の体表を突き破って精子を送り込む。逆に、陰茎が無くて膣を有する例もある。クモ類では雄の生殖口には特に構造が無く、雌体内への精子注入の装置は触肢にある（触肢器官）。そこには精子を注入する針状の構造があり、それを受け入れる雌性生殖器官の部分はやはり膣と呼ばれる。

脊椎動物の場合

哺乳類ではメスの子宮から体外に通じる管状の器官であり、交接器と産道を兼ねる。また、膣の開口部（膣口）は、外陰部に位置する。鳥類やいくつかの爬虫類および単孔類など一部の哺乳類における膣は、総排出腔（=総排泄腔）であり、昆虫、無脊椎動物においては、卵管（=輸卵管）の末端部である。

ヒトにおいては女性器の一部である。酸性成分に満たされており、膣内に射精された精子も約99%が死滅するほどである。膣の長さは白人の場合思春期前は8cm以下であるが、初経発来時には11cmに拡大する。

以下、この記事はヒトに関するものを扱う。

語源

一般的には「膣」と表記されるが、「腟（しつ）」が使われる場合もある。いずれも常用漢字外である。小川鼎三の「医学用語の起こり」によると、「腟」は『重訂解体新書』（『解体新書』の改訂版）を訳出する際に作成した新字であり「しつ」と読ませようとしたが、既存の似た文字である「膣」に取って代わられ、読みも「ちつ」になったとされている。しかし、いずれの字も『康熙字典』に存在するため、この説には疑問が残る。ちなみに、中国語における「膣」は「肉が出来る」といった意味を表し、この字が女性器を表すのは日本語の用法である。Vagina のことを中国語では「陰道」と言う。

Vaginaはラテン語に由来し、解剖学でいう鞘（さや）（包膜、包被としての役目を担っている構造）を意味する。膣粘膜は、vagina mucosaと呼ぶ。

役割

膣の役割は以下のものがある。

• 卵巣や子宮、膣自体などの内性器からの分泌物や、月経による血液などを、体外に排出する道を提供する。
• 交尾（性交）で雄（男性）の陰茎を受け入れ（この時陰茎は勃起していることが必要。勃起していなければ軟らか過ぎて曲がってしまい、進入出来ない）、締め付けて性的快感を与え射精を促し、その生殖細胞（精子）を卵細胞（卵子）へと導き、受精を実現させる。
• 出産時、胎児を子宮から母体外へ運んでいく経路、すなわち産道を提供する。

処女膜

陰門より奥側、ヒトでは尿道口の下側に処女膜 (Hymen) がある。哺乳動物ではモルモット、ゾウ、鼠、ハクジラ、アザラシ、ジュゴン、キツネザルなどにある。処女膜の役目は、「未成熟な内性器を細菌などから守るものだ」など諸説あるがはっきりしていない。

詳細は「処女膜」を参照

女性の外性器の解剖学

女性の外性器は、よく「膣」であるといわれるが、厳密には、外陰部（=Vulva または、Pudenda（ラテン語で「恥」））のことである。膣の内部とは区別される。

なお、一部医師によって膣内壁の皺襞、疣贅の形状が、尖圭コンジローマによるものと誤診されることがある。

参考文献

• 笠井寛司 『日本女性の外性器 ― 統計学的形態論』 （フリープレス、増補改訂版 2004年） ISBN 4-434-04575-X
• イェルト・ドレント , 塩崎香織（訳） 『ヴァギナの文化史』 （作品社、2005年） ISBN 4-87893-689-4
• キャサリン・ブラックリッジ , 藤田真利子（訳） 『ヴァギナ 女性器の文化史』 （河出書房新社、2005年） ISBN 4-309-20453-8

脚注

関連項目

• スキーン腺
• Gスポット
• 外陰部
• 膣潤滑
• ヴァギナ・モノローグス
• ヴァギナ・デンタタ
• 膣鏡
• 膣圧計

wiki en

[Wiki en表示]

This article is about the body part. For other uses, see Vagina (disambiguation).

Vagina
Vagina in the female human reproductive system.
Vulva with vaginal opening
Latin	Vagina
Gray's	p.1264
Artery	superior part to uterine artery, middle and inferior parts to vaginal artery
Vein	uterovaginal venous plexus, vaginal vein
Nerve	Sympathetic: lumbar splanchnic plexus Parasympathetic: pelvic splanchnic plexus
Lymph	upper part to internal iliac lymph nodes, lower part to superficial inguinal lymph nodes
Precursor	urogenital sinus and paramesonephric ducts
MeSH	Vagina
Dorlands /Elsevier	Vagina
Anatomical terminology

The vagina is a fibromuscular elastic tubular tract (passage) which is a sex organ and mainly functions for the facilitation of sexual intercourse and childbirth. In mammals (especially primates), menstruation, which is the periodic discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina, is another primary function of the vagina and usually signals fertility. The location and size of the vagina varies among species, and may vary in size within the same species. In humans, the vagina leads from the opening of the vulva to the uterus (womb), but the vaginal tract ends at the cervix.

Unlike mammalian males, who usually have only one genital orifice, mammalian females usually have two, the urethra and the vagina. The vaginal opening is much larger than the urethral opening, and both openings are protected by the labia. Regarding amphibians, birds, reptiles and monotremes, the female reproductive tract is generally known among zoologists as a cloaca; in these species, it may additionally serve as intestinal and urinary tracts.

The vagina plays a significant role in human female sexuality and sexual pleasure. During sexual arousal for humans and others animals, vaginal moisture increases by way of vaginal lubrication, to reduce friction and allow for smoother penetration of the vagina during sexual activity. In the absence or presence of sufficient vaginal lubrication, the texture of the vaginal walls can create friction for the penis during sexual intercourse and stimulate it toward ejaculation, enabling fertilization. In addition, a variety of sexually transmitted infections (STIs/STDs) and other disorders can affect the vagina. Because of the risk of STIs/STDs, health authorities, such as the World Health Organization (WHO), or other health outlets, recommend safe sex practices.

Cultural perceptions of the vagina have persisted throughout history; these perceptions range from viewing the vagina as the focus of sexual desire, a metaphor for life via birth, as an organ inferior to the penis, or as visually unappealing or otherwise vulgar.

Etymology and definition

The term vagina is from Latin vāgīna, literally "sheath" or "scabbard." It is often referred to as the birth canal in the context of pregnancy and childbirth, though the term is, by definition, the area between the outside of the vagina and the fully dilated uterus.

The Latinate plural "vaginae" is rarely used in English. Colloquially, the word vagina is often used to refer to the vulva or to the female genitals in general. However, by its dictionary and anatomical definitions, vagina refers exclusively to the specific internal structure.

Structure

Embryonic development

The vagina is derived from the embryonic Müllerian duct. During sexual differentiation (sex development of the differences between males and females), if exposed to testosterone, fusion of the urogenital folds (elongated spindle-shaped structures that contribute to the formation of the urethral groove on the belly aspect of the genital tubercle) allows the urogenital sinus to close completely and form the spongy urethra, while the labioscrotal swellings unite to form the scrotum. In the absence of testosterone, the urogenital sinus persists as the vestibule of the vagina, the two urogenital folds form the labia minora, and the labioscrotal swellings enlarge to form the labia majora.

General structure and histology

The human vagina is an elastic muscular canal that extends from the cervix (or uterine cavity) to the vulva. It, along with the inside of the vulva, is reddish pink in color, and it connects the superficial vulva to the cervix of the deep uterus. The vagina is posterior to the urethra and bladder, and reaches across the perineum superiorly and posteriorly toward the cervix; at approximately a 90 degree angle, the cervix protrudes into the vagina.

The vagina's internal lining consists of stratified squamous epithelium. Beneath this lining is a smooth muscle layer, which may contract during vaginal intercourse and when giving birth. Beneath the muscle is a connective tissue layer called adventitia.

Maternal estrogen, from birth to 10-14 days, is the reason newborn females have a stratified squamous epithelium. After this age range, through to the prepubertal age and in the post-menopause age, the epithelium thins out and is composed of a few layers. The epithelium is absent of glands, from puberty up until menopause. Consisting of three different layers of cells  – superficial cornified cells, intermediate cells and basal cells  – estrogen supplies the intermediate and superficial cells with glycogen. The cells layering the vaginal area of the cervix become stable with the intermediate and superficial cells, and the intermediate and superficial cells reach to the squamocolumnar junction (the area of the cervix where the columnar epithelium takes the place of the uterus squamous lining of the vagina) at the external orifice of the uterus (external os). The superficial cells exfoliate continuously, especially while in an inflammatory or neoplastic (tumorous) state. The basal cells replace the superficial cells, and keratinization results when the epithelium is exposed to the dry external atmosphere.

For blood and nerve supply, relevant arteries are the cervicovaginal (the uterine cervix and the vagina) branch of the uterine artery, the vaginal artery, middle rectal artery, and the internal pudendal artery. The veins are connected by anastomosis (the connection of separate parts of a branching system to form a network), resulting in the formation of the anterior and posterior azygos (unpaired) arteries. The nerve supply of the vagina is provided by the sympathetic and parasympathetic areas of the pelvic plexus, with the pudendal nerve supplying the lower area.

Regions and layers

Where the vaginal lumen surrounds the cervix of the uterus, it is divided into four regions of fornices (the vaginal fornix); these are the anterior, posterior, and the right lateral and left lateral (the lateral fornix). The posterior is deeper and the anterior is shallow. While the anterior and posterior walls are placed together, the lateral walls, especially their middle area, are relatively more rigid; because of this, they have an H-shape across the section.

Supporting the vagina are its upper third, middle third and lower third. The upper third concerns the levator ani muscles (transcervical, pubocervical) and the sacrocervical ligaments; these areas are also described as the cardinal ligaments laterally and uterosacral ligaments posterolaterally. The middle third of the vagina concerns the urogenital diaphragm (also described as the paracolpos and pelvic diaphragm). The lower third concerns the perineal body; it is sometimes described as containing the perineal body, pelvic diaphragm and urogenital diaphragm.

Three layers, sometimes categorized as four layers, compose the vaginal walls. When listed as three layers, the walls may be described as follows:

• the first layer is made up of a stratified squamous non-keratinized epithelium and is an underlying lamina propria of connective tissue (a layer of connective tissue that is highly vascular under the base area lining the epithelium)
• the second layer is the muscular layer, which is composed of smooth muscle fibers and situated longitudinally and circularly
• the third layer is the adventitia, which is a dense connective tissue that blends with the fascia surrounding the area

When categorized as four layers, the vaginal walls may be described in significantly more detail:

• the first layer is an inner layer of non-keratinized squamous epithelium, which forms the folds or rugae and facilitate the vagina's ability to expand large enough for child birth. The rugae are a series of ridges produced by folding of the wall of the outer third of the vagina; they are transverse epithelial ridges and their function is to provide the vagina with increased surface area for extension and stretching
• the second layer of the vagina is connective tissue, which contains blood vessels
• the third layer is the muscle layer; it is an outer layer of longitudinal muscle, as well as the inner layer of circular muscle
• the fourth layer is an outer layer of connective tissue; it is continuous with the other pelvic organs and is made up of blood and lymphatic vessels and fibers

The upper one-fourth of the vagina is separated from the rectum by the recto-uterine pouch. Above the vagina is a cushion of fat called the mons pubis which surrounds the pubic bone and provides protective support during vaginal intercourse.

Vaginal opening and hymen

The vaginal opening (or orifice) is at the caudal end of the vulva, behind the opening of the urethra, resting at the posterior end of the vestibule. It is closed by the labia minora in female virgins and in females who have never given birth (nulliparae), but may be exposed in females who have given birth (parous females).

The hymen is a membrane of tissue that surrounds or partially covers the vaginal opening. The effects of vaginal intercourse and childbirth on the hymen are variable. If the hymen is sufficiently elastic, it may return to nearly its original condition. In other cases, there may be remnants (carunculae myrtiformes), or it may appear completely absent after repeated penetration. Additionally, the hymen may be lacerated by disease, injury, medical examination, masturbation or physical exercise. For these reasons, it is not possible to definitively determine whether or not a girl or woman is a virgin by examining her hymen.

Lubrication

The Bartholin's glands, located near the vaginal opening and cervix, were originally thought to be the primary source for vaginal lubrication, but they provide only a few drops of mucus for vaginal lubrication; the significant majority of vaginal lubrication is generally believed to be provided by plasma seepage from the vaginal walls, which is called vaginal transudation. Vaginal transudation, which initially forms as sweat-like droplets, is caused by vascular engorgement of the vagina (vasocongestion); this results in the pressure inside the capillaries increasing the transudation of plasma through the vaginal epithelium.

Before and during ovulation, the cervix's mucus glands secrete different variations of mucus, which provides an alkaline environment in the vaginal canal that is favorable to the survival of sperm. "Vaginal lubrication typically decreases as women age, but this is a natural physical change that does not normally mean there is any physical or psychological problem. After menopause, the body produces less estrogen, which, unless compensated for with estrogen replacement therapy, causes the vaginal walls to thin out significantly."

Variations and size

Main article: Human vaginal size

In its normal state, there is anatomical variation in the length of the vagina of a woman of child-bearing age. The length is approximately 7.5 cm (2.5 to 3 in) across the anterior wall (front), and 9 cm (3.5 in) long across the posterior wall (rear), making the posterior fornix deeper than the anterior. During sexual arousal, the vagina expands in both length and width.

If a woman stands upright, the vaginal tube points in an upward-backward direction and forms an angle of approximately 45 degrees with the uterus and of about 60 degrees to the horizontal.

Organs of the female reproductive system, with the vagina seen in the center

The vaginal opening and hymen can vary in size; in children, although a common appearance of the hymen is crescent-shaped, many shapes are possible.

Function

Secretions

The vagina provides a path for menstrual blood and tissue to leave the body. In industrial societies, tampons, menstrual cups and sanitary napkins may be used to absorb or capture these fluids. Vaginal secretions are primarily from the uterus, cervix, and transudation of the vaginal epithelium in addition to miniscule lubrication from the Bartholin's glands upon sexual arousal. It takes little vaginal secretion to make the vagina moist. The secretions may be minor in excess during sexual arousal, the middle of the menstrual cycle, a little prior to menstruation, or during pregnancy.

Sexual activity

Further information: Human sexual activity and Human female sexuality

The concentration of the nerve endings that lie close to the entrance of a woman's vagina (the lower third) can provide pleasurable vaginal sensations during sexual activity when stimulated, and many women additionally derive pleasure from a feeling of closeness and fullness during penetration of the vagina. The vagina as a whole, however, lacks nerve endings, which commonly hinders a woman's ability to receive sufficient sexual stimulation, including orgasm, solely from vaginal sexual activity. The outer one-third of the vagina, especially near the opening, contains the majority of the vaginal nerve endings, making it more sensitive to touch than the inner two-thirds of the vaginal barrel. This factor is considered to make the process of child birth significantly less painful, because an increased number of nerve endings means that there is an increased possibility for pain as well as pleasure.

There are a variety of ways that pleasure can be received from vaginal stimulation in addition to penile penetration, including by masturbation, fingering, oral sex (cunnilingus), or by specific sex positions (such as the missionary position or the spoons sex position). Some women use sex toys, such as a vibrator or dildo, for vaginal pleasure. Foreplay is often used to incite sexual arousal, and may include one or more of the aforementioned sexual activities. The clitoris additionally plays a part in vaginal stimulation, as it is a sex organ of multiplanar structure containing an abundance of nerve endings, with a broad attachment to the pubic arch and extensive supporting tissue to the mons pubis and labia; it is centrally attached to the urethra, and research indicates that it forms a tissue cluster with the vagina. This tissue is perhaps more extensive in some women than in others, which may contribute to orgasms experienced vaginally.

During sexual arousal, and particularly the stimulation of the clitoris, the walls of the vagina lubricate. This reduces friction or injury that can be caused by insertion of the penis into the vagina or other penetration of the vagina during sexual activity. With sexual arousal, the human vagina lengthens rapidly, to an average of about 4 in.(10 cm), but can continue to lengthen in response to pressure. As the woman becomes fully aroused, the vagina tents (last ²⁄₃) expands in length and width, while the cervix retracts. The elastic walls of the vagina stretch or contract, with support from the pelvic muscles, to the size of the inserted penis or other object, stimulating the penis and helping to cause the male to experience orgasm and ejaculation; this in turn enables fertilization.

Structure of the wall of vagina

An area in the vagina that may be an erogenous zone is the G-spot (also known as the Gräfenberg spot); it is typically defined as being located at the anterior wall of the vagina, about five centimeters in from the entrance. Some women experience intense pleasure, and sometimes an orgasm, if this area is stimulated during sexual activity. A G-spot orgasm may be responsible for female ejaculation, leading some doctors and researchers to believe that G-spot pleasure comes from the Skene's glands, a female homologue of the prostate, rather than any particular spot on the vaginal wall. Other researchers consider the connection between the Skene's glands and the G-spot to be weak. They contend that the Skene's glands do not appear to have receptors for touch stimulation, and that there is no direct evidence for their involvement. The G-spot's existence, and existence as a distinct structure, is still under dispute, as its location can vary from woman to woman, appears to be nonexistent in some women, and it is hypothesized to be an extension of the clitoris and therefore the reason for orgasms experienced vaginally.

Childbirth

During childbirth, the vagina provides the channel to deliver the newborn from the uterus to its independent life outside the body of the mother. During birth, the elasticity of the vagina allows it to stretch to many times its normal diameter.

Vaginal ecosystem and acidity

Main article: Vaginal flora

The vagina is a nutrient rich environment that harbors a unique and complex microflora. It is a dynamic ecosystem that undergoes long term changes, from neonate to puberty and from the reproductive period (menarche) to menopause. Moreover, under the influence of hormones, such as estrogen (estradiol), progesterone and follicle stimulating hormone (FSH), the vaginal ecosystem undergoes cyclic or periodic changes, i.e. during menses and pregnancy. One significant variable parameter is the vaginal pH, which varies significantly during a woman‘s lifespan, from 7.0 in premenarchal girls, to 3.8-4.4 in women of reproductive age to 6.5-7.0 during menopause without hormone therapy and 4.5-5.0 with hormone replacement therapy. Estrogen, glycogen and lactobacilli are important factors in this variation.

Clinical significance

General

An ultrasound showing the urinary bladder (1), uterus (2), and vagina (3)

Further information: Vulvovaginal health

The vagina is self-cleansing and therefore usually needs no special treatment. Doctors generally discourage the practice of douching. Since a healthy vagina is colonized by a mutually symbiotic flora of microorganisms that protect its host from disease-causing microbes, any attempt to upset this balance may cause many undesirable outcomes, including but not limited to abnormal discharge and yeast infection.

The vagina is examined during gynecological exams, often using a speculum, which holds the vagina open for visual inspection of the cervix or taking of samples (see pap smear). Medical activities involving the vagina, including examinations, administration of medicine, and inspection of discharges, are also referred to as being per vaginam (or p.v.).

Dilating vaginal speculum inflating vagina and light illuminating (cervical brush inserts through top inlet)

The healthy vagina of a woman of child-bearing age is acidic, with a pH normally ranging between 3.8 and 4.5. This is due to the degradation of glycogen to the lactic acid by enzymes secreted by the Döderlein's bacillus. This is a normal commensal of the vagina. The acidity retards the growth of many strains of pathogenic microbes.

Intravaginal administration is a route of administration where the substance is applied to the inside of the vagina. Pharmacologically, it has the potential advantage to result in effects primarily in the vagina or nearby structures (such as the vaginal portion of cervix) with limited systemic adverse effects compared to other routes of administration.

Sexually transmitted infections and other disorders

The herpes simplex virus (HSV), which can be transmitted sexually, can infect the vulva, vagina, and cervix, and this may result in small, painful, recurring blisters and ulcers. It is also common for there to be an absence of any noticeable symptoms. Other sexually transmitted infections (STIs/STDs) that may infect the vagina include gonorrhea, chlamydia, trichomoniasis and human papillomavirus (HPV), which may cause genital warts. HIV/AIDS can be contracted through the vagina during vaginal intercourse, but it is not associated with any local vaginal or vulval disease. Health authorities and other health outlets recommend safe sex practices when engaging in sexual activity.

Vaginismus, which is not the same thing as vaginitis (an inflammation of the vagina), is an involuntary tightening of the vagina due to a conditioned reflex of the muscles in the area during vaginal penetration. It can affect any form of vaginal penetration, including sexual intercourse, insertion of tampons and menstrual cups, and the penetration involved in gynecological examinations. Various psychological and physical treatments are possible to help alleviate it.

With regard to other vaginal health issues, an increased pH of the vagina (with a commonly used cut-off of pH 4.5 or higher) can be caused by bacterial overgrowth, as occurs in bacterial vaginosis and trichomoniasis, or rupture of membranes in pregnancy. Vaginal cancer is very rare, but its symptoms include abnormal vaginal bleeding or vaginal discharge. Vaginal prolapse may result in the case of weakened pelvic muscles, which is a common result of childbirth; in the case of this prolapse, the rectum, uterus, or bladder pushes on the vagina, and severe cases result in the vagina protruding out of the body. Kegel exercises have been used to strengthen the pelvic floor, and may help prevent or remedy vaginal prolapse.

In the case of oral sex, a fatal condition known as an air embolism, in which an air bubble travels throughout the bloodstream and can obstruct the vessel, can result if air is blown into a pregnant woman's vagina during cunnilingus; this is because pregnant women have an increased vascularity of the vagina and uterus, and an air embolism can force air into the uterine veins.

Another vaginal disorder is persistent genital arousal disorder (PGAD), which results in a spontaneous, persistent, and uncontrollable genital arousal, with or without orgasm, unrelated to any feelings of sexual desire. Because PGAD is relatively rare and, as its own concept apart from clitoral priapism (a rare, potentially painful medical condition in which, for an unusually extended period of time, the erect clitoris does not return to its relaxed state), has only been researched since 2001, there is little research into what may cure or remedy the disorder. In some recorded cases, PGAD was caused by, or caused, a pelvic arterial-venous malformation with arterial branches to the clitoris; surgical treatment was effective in these cases.

Lumps

The presence of unusual lumps in the wall or base of the vagina is always abnormal. The most common of these is Bartholin's cyst. The cyst, which can feel like a pea, is formed by a blockage in glands which normally supply the opening of the vagina. This condition is easily treated with minor surgery or silver nitrate. Other less common causes of small lumps or vesicles are herpes simplex. They are usually multiple and very painful with a clear fluid leaving a crust. They may be associated with generalized swelling and are very tender. Lumps associated with cancer of the vaginal wall are very rare and the average age of onset is seventy years. The most common form is squamous cell carcinoma, then cancer of the glands or adenocarcinoma and finally, and even more rarely, melanoma.

Discharge

Most vaginal discharges occur due to normal bodily functions such as menstruation or sexual arousal (vaginal lubrication). Abnormal discharges, however, can indicate disease.

Normal vaginal discharges include blood or menses (from the uterus), the most common, and clear fluid either as a result of sexual arousal or secretions from the cervix. Other non-infective causes include dermatitis. Non-sexually transmitted discharges occur from bacterial vaginosis and thrush or candidiasis. The final group of discharges include the sexually transmitted diseases gonorrhea, chlamydia, and trichomoniasis. The discharge from thrush is slightly pungent and white, that from trichomoniasis more foul and greenish, and that from foreign bodies resembling the discharge of gonorrhea, greyish or yellow and purulent (pus-like).

Sores

All sores involve a breakdown in the walls of the fine membrane of the vaginal wall. The most common of these are abrasions and small ulcers caused by trauma. While these can be inflicted during rape most are actually caused by excessive rubbing from clothing or improper insertion of a sanitary tampon. The typical ulcer or sore caused by syphilis is painless with raised edges. These are often undetected because they occur mostly inside the vagina. The sores of herpes which occur with vesicles are extremely tender and may cause such swelling that passing urine is difficult. In the developing world, a group of parasitic diseases also cause vaginal ulceration, such as leishmaniasis, but these are rarely encountered in the west. All of the aforementioned local vulvovaginal diseases are easily treated. Often, only shame prevents patients from presenting for treatment.

Modification

The vagina may be an aspect of genital modification during vaginoplasty or labiaplasty; for example, alteration to the inner labia (also known as the vaginal lips or labia minora). There are two main categories of women seeking cosmetic genital surgery: those with congenital conditions such as an intersex condition, and those with no underlying condition who experience physical discomfort or wish to alter the appearance of their genitals because they believe they do not fall within a normal range.

Female genital mutilation (FGM), another aspect of female genital modification, may additionally be known as female circumcision or female genital cutting (FGC). The most severe form of FGM is infibulation, in which there is removal of all or part of the inner and outer labia (labia minora and labia majora) and the closure of the vagina; this is called Type III FGM, and it involves a small hole being left for the passage of urine and menstrual blood, with the vagina being opened up for sexual intercourse and childbirth.

Society and culture

Biological perceptions, symbolism and vulgarity

There have been various perceptions of the vagina throughout history, ranging from it being the center of sexual desire, a symbol of sexual power, a metaphor for life via birth, inferior to the penis, visually unappealing or inherently "smelly," or otherwise vulgar. In Ancient times, it was often considered equivalent (homologous) to the penis; anatomists Galen (129 AD – 200 AD) and Vesalius (1514–1564), regarded the organs as structurally the same, except for the vagina being inverted. Anatomical studies over latter centuries, however, showed the clitoris to be the penile equivalent.

The release of vaginal fluids were considered by medical practitioners to cure or remedy a number of ailments; various methods were used over the centuries to release "female seed" (via vaginal lubrication or female ejaculation) as a treatment for suffocation ex semine retento (suffocation of the womb), female hysteria or green sickness. Methods included a midwife rubbing the walls of the vagina or insertion of the penis or penis-shaped objects into the vagina. Supposed symptoms of female hysteria included faintness, nervousness, insomnia, fluid retention, heaviness in abdomen, muscle spasm, shortness of breath, irritability, loss of appetite for food or sex, and "a tendency to cause trouble". Women considered suffering from the condition would sometimes undergo "pelvic massage" — stimulation of the genitals by the doctor until the woman experienced "hysterical paroxysm" (i.e., orgasm). Paroxysm was regarded as a medical treatment, and not a sexual release. The categorization of female hysteria has ceased to be recognized as a medical condition since the 1920s.

The vagina has been termed many vulgar names, two being cunt and pussy. Cunt is used as a derogatory epithet referring to people of either sex. This usage is relatively recent, dating from the late nineteenth century. Reflecting different national usages, cunt is described as "an unpleasant or stupid person" in the Compact Oxford English Dictionary, whereas Merriam-Webster has a usage of the term as "usually disparaging and obscene: woman", noting that it is used in the U.S. as "an offensive way to refer to a woman"; and the Macquarie Dictionary of Australian English states that it is "a despicable man". When used with a positive qualifier (good, funny, clever, etc.) in Britain, New Zealand and Australia, it can convey a positive sense of the object or person referred to. Pussy, on the other hand, can indicate "cowardice or weakness", and "the human vulva or vagina" or by extension "sexual intercourse with a woman".

In contemporary art and literature

The Vagina Monologues, a 1996 episodic play by Eve Ensler, has been noted for its success in making female sexuality a topic of public discourse. It is made up of a varying number of monologues read by a number of women. Initially, Ensler performed every monologue herself, with subsequent performances featuring three actresses; latter versions feature a different actress for every role. Each of the monologues deals with an aspect of the feminine experience, touching on matters such as sexual activity, love, rape, menstruation, female genital mutilation, masturbation, birth, orgasm, the various common names for the vagina, or simply as a physical aspect of the body. A recurring theme throughout the pieces is the vagina as a tool of female empowerment, and the ultimate embodiment of individuality.

In Japan, artist Megumi Igarashi has drawn attention for her work featuring vaginas, which she considers "overly hidden" in Japan compared to male genitalia.

Reasons for vaginal modification

With the exception of voluntary vaginoplasty or labiaplasty, modification of the vagina is generally a matter of FGM. Significant controversy surrounds FGM, with the World Health Organization (WHO) being one of many health organizations that have campaigned against the procedures on behalf of human rights, stating that "FGM has no health benefits" and that it is "a violation of the human rights of girls and women" and "reflects deep-rooted inequality between the sexes". The practice has existed at one point or another in almost all human civilizations, most commonly to exert control over the sexual behavior, including masturbation, of girls and women. Custom and tradition are the most frequently cited reasons for FGM, with some cultures believing that not performing it has the possibility of disrupting the cohesiveness of their social and political systems, such as FGM also being a part of a girl's initiation into adulthood. Often, a girl is not considered an adult in a FGM-practicing society unless she has undergone FGM.

FGM is carried out in several countries, especially in Africa, and to a lesser extent in other parts of the Middle East and Southeast Asia, on girls from a few days old to mid-adolescent, often to reduce sexual desire in an effort to preserve vaginal virginity. It may also be that FGM was "practiced in ancient Egypt as a sign of distinction among the aristocracy"; there are reports that traces of infibulation are on Egyptian mummies.

Other animals

See also: Mammal female reproductive system

The vagina (along with the penis) is a general feature of animals in which the female is internally fertilised (other than by traumatic insemination). The shape of the vagina varies among different animals.

In placental mammals and marsupials, the vagina leads from the uterus to the exterior of the female body. Female marsupials have two lateral vaginas, which lead to separate uteri, but both open externally through the same orifice. The urethra and vagina of the female spotted hyena exits through the clitoris, allowing the females to urinate, copulate and give birth through the clitoris.

In birds, monotremes, and some reptiles, a homologous part of the oviduct leads from the shell gland to the cloaca. In some jawless fish, there is neither oviduct nor vagina and instead the egg travels directly through the body cavity (and is fertilised externally as in most fish and amphibians). In insects and other invertebrates, the vagina can be a part of the oviduct (see insect reproductive system).

In 2014, the scientific journal Current Biology reported that four species of Brazilian insects in the genus Neotrogla were found to have sex-reversed genitalia. The male insects of those species have vagina-like openings, while the females have penis-like organs.

See also

• Artificial vagina
• Gynoecium
• Human sexuality
• Kegel exercise
• Vaginal weightlifting
• Pubic hair

References

External links

• Media related to Vaginas at Wikimedia Commons
• The dictionary definition of vagina at Wiktionary

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

• 1. 先天性膣奇形の診断およびマネージメント diagnosis and management of congenital anomalies of the vagina
• 2. 女性骨盤の外科解剖学 surgical female pelvic anatomy
• 3. 思春期前の小児における外陰膣に関する愁訴 vulvovaginal complaints in the prepubertal child
• 4. 外陰部の皮膚炎 dermatitis of the vulva
• 5. 股ひろげ損傷 straddle injuries

English Journal

• Cervicovaginal human papillomavirus (HPV)-infection before and after hysterectomy: evidence of different tissue tropism for oncogenic and nononcogenic HPV types in a cohort of HIV-positive and HIV-negative women.

• D'Souza G, Burk RD, Zhong Y, Minkoff H, Stewart Massad L, Xue X, Heather Watts D, Anastos K, Palefsky JM, Levine AM, Colie C, Castle PE, Strickler HD.SourceDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. gdsouza@jhsph.edu.
• International journal of cancer. Journal international du cancer.Int J Cancer.2012 Sep 15;131(6):1472-8. doi: 10.1002/ijc.27363. Epub 2012 Jan 3.
• Human papillomavirus (HPV) is detected in nearly all cervical cancers and approximately half of vaginal cancers. However, vaginal cancer is an order of magnitude less common than cervical cancer, not only in the general population but also among women with HIV/AIDS. It is interesting therefore that
• PMID 22120980

• Detection of spermatozoa following consensual sexual intercourse.

• Astrup BS, Thomsen JL, Lauritsen J, Ravn P.SourceInstitute of Forensic Medicine, University of Southern Denmark, J.B. Winsløwsvej 17, 5000 Odense C, Denmark.
• Forensic science international.Forensic Sci Int.2012 Sep 10;221(1-3):137-41. Epub 2012 May 17.
• INTRODUCTION: In cases of sexual assault, the finding of semen can provide crucial evidence. The presence of spermatozoa serves as proof of a sexual act and may give the identity of the alleged perpetrator through DNA-profiling. In most western countries, there are guidelines for standardized examin
• PMID 22607978

• Vaginal morcellation: A new strategy for large gynecological malignant tumor extraction: A pilot study.

• Favero G, Anton C, Silva E Silva A, Ribeiro A, Araújo MP, Miglino G, Baracat EC, Carvalho JP.AbstractOBJECTIVE: Evaluate feasibility and safety of a novel technique for uterine morcellation in patients scheduled for laparoscopic treatment of gynecologic malignances.
• Gynecologic oncology.Gynecol Oncol.2012 Sep;126(3):443-7. Epub 2012 May 24.
• OBJECTIVE: Evaluate feasibility and safety of a novel technique for uterine morcellation in patients scheduled for laparoscopic treatment of gynecologic malignances.BACKGROUND: The laparoscopic management of uterine malignancies is progressively gaining importance and popularity over laparotomy. Nev
• PMID 22634019

Japanese Journal

• 症例報告 腟壁に由来し腟腔内増殖性を示した犬の平滑筋腫の1例

• 佐藤 良彦
• 獣医畜産新報 65(4), 293-297, 2012-04
• NAID 40019260703

• 症例報告 鎖肛・肛門膣前庭瘻にMayer-Rokitansky-Kuster-Hauser症候群を合併した1例

• ？澤 慎也,五藤 周,内田 広夫 [他]
• 日本小児外科学会雑誌 48(1), 68-71, 2012-02
• NAID 40019196622

• A病院における飛び込み分娩の実態と産婦・家族支援の検討

• 永田 智子,佐世 正勝,徳原 多賀子,伊藤 悦子
• 母性衛生 52(4), 578-583, 2012-01
• 目的:飛び込み分娩の実態を明らかにし,緊急対応や産婦・家族支援の方向性を見出す。方法:平成18年4月〜平成20年3月までにA病院1施設で飛び込み分娩となった9名を対象とし,診療録および地域関係機関への質問紙調査よりデータを収集分析した。結果:年齢は17〜37歳,初産6名,経産3名,入院時未婚は7名であった。未受診の理由として,初産婦は未婚,経産婦は貧窮,多忙,健診不要をあげていた。分娩時にすべての …
• NAID 110008898053

Related Links

• The Great Wall of Vagina - Body casting

For this, my latest major sculpture, I cast, over the course of 5 years, the vaginas ( well the vulva area in fact) of hundreds of volunteers. The Great Wall of Vagina is an exploration of women's relationships with their genitals. When I assembled ...

• Vagina Dentata Video

My History · Animation · News&Links · Groups · Forum · Live Chat · GET PAID $$$ · Upload. Vagina Dentata. Views: 300169. (3). Flash Player 9 or later required to view this video. Please visit Adobe to get the latest version of the Flash Player. ...

Related Pictures

---

★リンクテーブル★

リンク元	「vaginalis」「腟」
拡張検索	「vaginal」「vaginal smear」

「vaginalis」

　　[★]

• n.

• 腟、膣

関

vagina、vaginal

• Trichomonas vaginalis、Gardnerella vaginalis

「腟」

　　[★]

英

vagina

同

膣　ここでは簡単な字体を採用することにする。

「vaginal」

　　[★]

• adj.

• 腟の、膣の

関

vagina、vaginalis

　 　

「vaginal smear」

　　[★] 腟スミア、腟塗抹、膣スミア、膣塗抹