Issue 12  •  Spring 2013

What's Inside: The Plumbing

Written by Amisha Upadhyaya
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I still remember seeing fallopian tubes for the first time. Mr. Frasier, our amiable gym/driver’s ed./sex ed. teacher was fond of handouts. One was of the female reproductive system looking oddly similar to a moose skull.

I still remember seeing fallopian tubes for the first time. Mr. Frasier, our amiable gym/driver’s ed./sex ed. teacher was fond of handouts. One was of the female reproductive system looking oddly similar to a moose skull.

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Guess which is the moose skull?

I still recall the flaming red and circled “D” on my test of the female anatomy. I was a hardwired honors student and daughter of Indian immigrants. My parents’ dreams of me becoming a doctor were crushed. It was humiliating; I had nearly flunked anatomy of my own body.

Then again, it’s not so surprising. In “sex ed.” it’s not so much about the “ed.” part. They may as well call it “how not to get knocked up,” since that is really society’s main concern (STD prevention coming in at a close second). Many schools still have sex ed. taught by gym teachers. That leaves most women, not to mention men, capable of buying maxi pads and condoms but mystified about their own bodies.

As a result many women deal with orgasms, birth control that is right for their needs and bodies, and cysts as they arise or over conversations with girlfriends. I, for one, had to wait until my mid-20s before I found out I had PMDD, an intense form of PMS. For the decade beforehand, I thought I was descending into insanity.

So let’s start at the beginning. Let’s take a closer look at the moose skull. Just keep in mind that, just like moose skulls, everybody is different. Even if something is not “average,” it doesn’t always mean it’s out of whack: it’s just the normal for YOU. And so far, no woman I’ve met is “average” across the board.
 

THE OUTSIDE
 

Vulva

The outside part of your vagina. Nothing much can go wrong here unless you get a bad Brazilian wax.
 

Two openings

The urethra:
Where you pee from. We all know what can go wrong here. The dreaded UTI: urinary tract infection. From the inside of the bladder to the outside, the urethra is so short that bacteria can have loads of fun and can easily creep in. During sex, it can get easily irritated since it’s right next to the vaginal opening.
 

The introitus: The vaginal opening where your blood and perhaps one day, a baby’s head will emerge from.

Clitoris: This is where the action happens. What the $11 billion sex industry is trying to stimulate. What your partner gropes for in the dark. The most sensitive nerves in a woman’s reproductive system are here. It puts the OH in orgasm.
 

IN-BETWEEN
 

Vagina

There’s so much written about this that an entire play is devoted to it. For most people, vagina = female reproductive system. The down low is that the vagina is not a muscle unto itself, like the uterus is, but a passage. It’s a 4 to 6 inch long muscular passage between the vulva (opening of vagina that you see) and cervix (opening of the uterus).

Menstrual blood flows through here; if a penis is to be inserted, it will be through here; and perhaps one day, a baby will be pulled out of here. It’s an important passage.

Since it is the passage between the outside and inside world of your body, it forms healthy bacteria, lactic acid, to fight off infections and irritants. This also releases cervical fluid, healthy discharge from the cervix.

Due to this acid formation, the vagina is acidic. How acidic something is is usually measured in terms of pH level. A pH can be anywhere from 0 (alkaline or basic) to 14 (very acidic), with 7 being neutral. The vagina is slightly acidic with a pH balance of between 3.8 and 4.5, depending on a woman’s phase in life.

If it gets too acidic, you may be prone to bacterial vaginosis (BV). On the other hand, if the pH balance drops, you may be prone to infections since there isn’t enough acidity to kill off bacteria. The most common of these infections is a yeast infection. Yeast infections are usually accompanied by symptoms like excessive white discharge, itching, and burning.

Before you gulp down the cranberry juice, check to see if you’re acidic or alkaline. Whether it’s healthy discharge or BV, so many women immediately think anything wrong down there is a yeast infection. An easy way to check is with a home pH kit. Just a swab from your va-jay-jay and compare colors as per the chart.

A low pH can be countered with cranberry juice and probiotics such as yogurt. General pH balance is affected by everything from your diet to your hygiene, soap, fabric softener, and exercise. Any of these can influence your pH levels.

Healthy discharge is normal. If there’s too much or it’s too dry or there’s burning and itching, go to your doctor.

GENERAL HEALTH MAINTENANCE

What Why When
PAP Smear Check for: cervical cancer Once a year
  Ovarian cancer  
  Gonorrhea  
  HPV  
     

 

THE INSIDE
 

Uterus

The uterus is generally the size of a lemon and curves forward. It’s shaped like an upside down pear and is placed between your hip bones. It’s a muscle. Thus, if you’ve ever heard of “contractions” during labor this is what is contracting. Just like a bicep or hamstring, it will contract.

It is basically a womb-in-waiting, so its tissues are all designed for baby forming. It has 3 layers of tissues all ending in –ium. The first layer lining, the uterine wall, is called the endometrium. Whenever you have your period, this lining is what is being shed. The body’s like, there’s no embryo here to hold onto, so I don’t need this lining. Shed it!

However, sometimes, instead of shedding completely, this lining goes backward, back into the abdominal cavity. If this tissue starts going into other areas, like your fallopian tubes or bladder, or even intestines, that’s called endometriosis. No one knows why this happens, but it can happen for up to a quarter of all women and can lead to infertility.

The other two layers are the myometrium—these are the actual muscles that contract--and perimetrium, which covers the other two.

About a quarter of women also have a uterus that tips backwards instead of forwards. It’s called retroversion of the uterus. It sounds serious, but it’s not. It’s like having blue eyes instead of the usual brown or an extra finger, but more common. There are no symptoms, no pain, no discomfort associated with it.

Only an ultrasound will confirm if your gynecologist feels anything is out of place. A tipped uterus doesn’t cause any problems, even with conceiving. However, there are many underlying causes for it. The causes, for example, could be endometriosis or pelvic inflammatory disease, both of which lead to fertility issues.

Again, if you have a tipped back uterus, check with your doctor to find out why. Don’t start doing backbends to correct the problem (I’ve heard of people doing this. What? And no, it will not work).

Cervix

The lower opening of the uterus. It can actually be felt in the upper vagina, and your doctor will often feel it if you’re pregnant to see whether it’s open.

The main disease associated with the cervix is cervical cancer.

Almost all cervical cancers are caused by HPB (human papilloma virus), which is an STD. However, not all HPVs cause cancer: only two strains do. A vaccine called Gardasil is now available to prevent cancer-causing HPV. It’s being explored to ensure that all young girls of sexually active ages get it. Boys can get it too, but we have the burden of periods, pregnancy, and all the rest, so may as well add one more thing to the list! (And hey! It can save our lives!).

In the early stages, this cancer caused by HPV is called dysplasia. It can be detected by a Pap smear and is 100% treatable. So get your annual Pap! Otherwise, there are no symptoms.

Treatments for cervical cancer are explored here:

Ovaries

Ovaries are two almond sized glands that house up to a million ovum or eggs. Ovaries also produce estrogen and progesterone.

A cyst develops in women every time an egg is released. There is no need to sign off on your will just yet. In over 95% of women, cysts are benign and will disappear on their own.

What Symptoms Treatments
BV Gray/white discharge, especially after sex Wait it out, antibiotics
HPV  Raised, flat, pink/flesh-convered genital warts, Watch and wait, removing the abnormal cells
Ovarian Cyst Many cysts do not have symptoms; abdominal discomfort, frequent urination, pelvic pain, nausea Wait it out, birth control, surgery,
UTI Urgent need to urinate, burning during urination, passing small, frequent urine, urine that is strong-smelling, bright red, cloudy, pelvic pain Drink lots of water, antibiotics
   
     



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