Vulva or vagina?
People often say "vagina" for what can be seen; it is a misnomer. The vagina is the inner canal. What is visible is called the vulva: the mons pubis, the outer and inner lips, the clitoris and its hood, the vestibule where the urethral opening and the entrance of the vagina open, and the glands that line them. Each of these parts has a function, and each varies enormously from one woman to another — in size, colour and symmetry. There is no "normal" vulva; there are millions of different vulvas, and so-called cosmetic surgery of the lips most often answers a norm invented by images, not a medical problem.
The mons pubis
This cushion of fat above the pubic bone, which grows hair at puberty, cushions the pressure of intercourse and, rich in nerve endings, is sensitive to touch. Pubic hair has a role: it limits friction and forms a barrier against some infections. Removing it entirely is neither good nor bad for health, but slightly increases irritation, ingrown hairs and the transmission of a few skin infections — and, curiously, has all but wiped out pubic lice.
The outer and inner lips
The labia majora, two folds of skin with fat, hair and glands, frame and protect the rest. During arousal the inflow of blood swells and parts them; after the menopause they lose some volume. The labia minora, without hair or fat, run from the clitoral hood to the entrance of the vagina; they are richly innervated, change colour — from pink to dark red — and volume as desire rises, then return to their resting state within minutes. In many women they extend beyond the outer lips, symmetrically or not: that is a variation, not an abnormality, and the "hypertrophy" one used to read about corresponds to no disease. Surgery is only justified for real physical discomfort (painful rubbing, sport), never to resemble a picture.
The clitoris, whole
The clitoris is not the small button one sees: that glans, protected by its hood, is only the emerged part of an organ eight to ten centimetres long. Behind it, the body of the clitoris divides into two crura that run along the pubic branches, and two erectile bulbs surround the entrance of the vagina and the urethra. The complete anatomy was only described precisely in 1998, by the Australian urologist Helen O'Connell, and the glans alone holds more than ten thousand nerve fibres according to the most recent count (2022) — more than the glans of the penis. It is the only organ in the human body whose only known function is pleasure.
During arousal, glans, body, crura and bulbs fill with blood: the clitoris becomes erect, larger and more sensitive, and the glans retracts under the hood just before orgasm, which protects it from direct contact that is often too intense at that point. After orgasm the blood disperses within minutes; without orgasm the congestion can last longer and be uncomfortable. This anatomy explains a fact measured everywhere: most women need clitoral stimulation, direct or indirect, to reach orgasm, and penetration alone rarely suffices — because the vagina itself has few nerve endings over most of its length. What is called the "G-spot" is most probably the area where the internal roots of the clitoris and the urethra come close to the front wall of the vagina. The page on female pleasure draws the practical conclusions.
The vestibule, the urethral opening, the glands
Between the inner lips opens the vestibule, where one finds, from front to back, the urethral opening — the orifice of the urethra, separate from the vagina, which many adults still do not know — and the entrance of the vagina. Two pairs of glands surround it: Bartholin's glands, on either side of the entrance, which secrete a few drops of lubricant during arousal and can sometimes become blocked (a cyst, usually benign but sometimes painful), and Skene's glands, near the urethra, the source of the fluid some women release at orgasm. Lubrication of the vagina itself comes mainly from seepage through its wall under the effect of blood flow: it depends on arousal, hormones, hydration and some medicines, and a lubricant is never an admission of failure.
The hymen, and what it does not prove
The hymen is a thin membrane, crescent-shaped, ring-shaped or pierced with several openings, which lines the entrance of the vagina without closing it — otherwise periods could not flow. It is highly variable, sometimes barely visible, sometimes absent from birth, and it softens with the hormones of puberty. It may or may not tear at first intercourse, with or without bleeding, and it can be altered by sport, a tampon or a medical examination. Nothing in its appearance tells whether a woman has had intercourse: the WHO and the UN called in 2018 for "virginity testing" to be abandoned, as scientifically worthless and contrary to rights. It has no known function.
What changes with age
At puberty the lips and clitoris grow, hair appears, the colour darkens. After a pregnancy the outer lips and the entrance of the vagina sometimes remain a little looser. After the menopause, the fall in oestrogen thins the skin and the mucous membranes, reduces lubrication and can make intercourse painful: it is common, it is treatable (lubricants, moisturisers, local oestrogen), and it need not be endured in silence.
Hygiene, and when to see a doctor
The vulva is washed with water, possibly a mild soap, once a day; the vagina is not washed — it cleans itself, and douching unbalances its flora and encourages infections. See a doctor for persistent itching or burning, unusual discharge, a painful lump, a sore, bleeding outside periods, or pain during intercourse. And a gynaecological examination requires no special preparation: neither hair removal nor special washing.