[suggestions for good diagrams?]
Q. How deep is a woman's vagina? Can you "lose" something in your vagina?
A. The vagina is usually between 3 and 7 inches from the opening to the cervix, which is the muscle between the vagina and the uterus. However, the vagina can stretch to be much larger during sexual intercourse and childbirth. The cervix is usually closed very tightly (except during childbirth) so while it is possible that something may be toward the back of the vaginal canal, it will not get lost in the body cavity, nor the uterus.
Q. Do healthy vaginas have a smell?
A. They can, but it is probably most noticeable to the woman herself. Because of this many women try to clean out their vagina, or douche, which is unnecessary and actually harmful. The vagina is a self-cleaning system and some odor can be a normal part of the cleaning process. The vagina cleans itself in part through vaginal secretions, or leucorrhea, which range from thick and white-ish to slippery and clear. If you notice something out of the ordinary for you, you should talk to your health care provider.
Q. Can a woman get pregnant before she has her first period?
A. Yes, it is possible for a woman to become pregnant before she experiences her first period, or menarche. This is because a woman can ovulate up to a year before her first period, or bleeding, appears.
Q. What is the cervix?
A. The cervix, which literally means "neck," is the thick muscle at the bottom of the uterus. If you look at it from the vaginal opening, it looks like a peeled plum. You can look at your own cervix - take a hand mirror to your next gynecological exam and look along, or do a self-exam at home. For more information, check out the "guide to a vaginal self-exam" on PEP's website.
Q. What is a pap smear?
A. A pap smear is a test, usually done by a gynecologist or other health care provider, to check for any changes in the cells in the cervix. The cervix has a tiny opening, called an "os," which is an opening into the uterus. By gently inserting a tiny brush into the os and swabbing, the cells can be saved and tested for any pre-cancerous cells.
Q. Is the pelvic exam supposed to hurt?
A. The pelvic exam shouldn't hurt, though you may feel some pressure. As a female-bodied person gets nervous, her kegel muscles tense, making it more difficult to open the speculum, therefore increasing the pressure and potential for pain. If it does hurt, tell your clinician! If you feel nervous focus on your breath and try to relax your muscles.
Q. How big is the speculum?
A. A small spec, usually used for women who have not had a vaginal childbirth, is about the length of one finger, and not even the width of two. A medium spec, usually used for women who have had a vaginal childbirth, is about the length of one finger and just about the width of two. Large specs, which are rarely used, are the width of two fingers, but about the length of a finger and a half.
Q. Okay… There are a lot of parts of the vagina. If I take a mirror and look, what exactly will I see?
A. There are the outer labia (labia majora), and the inner labia (labia minora), which are the two most noticeable structures. The labias vary greatly in length and size. The three structures that can be easily seen are: the introitus, which is the vaginal opening (where the period comes from, where the penis/sex toy/fingers, etc. enters, where a baby comes from); the urethra, which can be an "innie," a tiny slit, or an "outie," which looks like a fleshy beak, where urine comes from; and the clitoris, which is a bundle of nerves at the top of the vaginal opening that most women find gives them pleasure when touched.
Q. Is there actually a "g-spot?"
A. Yes, there is a spot inside the vagina that most women like to have stimulated. It is located on the abdominal side of the vaginal canal. While g-spot stimulation is often highly pleasurable, not all women enjoy it.
Q. What should I be looking for during a self-breast exam? What is the difference between a lump and a cyst, in breast tissue?
A. Visually, you should look for the four "S's": size, skin, symmetry, and shape, as well as any puckering or retraction (tissue that holds to the breast wall when it shouldn't). There is no one correct standard for each of the "s" categories, but rather, it is important to notice any changes.
Not all lumps and cysts adhere to these rules all the time. This is just the "rule of thumb" knowledge. Please remember that there are always exceptions.
A cyst will have almost a "jelly bean" sort of consistency, in that it will give a little when it is pinched, but ultimately, it is a hard, distinct mass, which is often round in shape. It will be mobile if pushed, and often, cysts are painful. Sometimes they even come seasonally or with certain types of food allergies.
If cancerous cells form a lump, it will feel like a frozen pea or frozen grape-thoroughly hard. A lump may or may not be round. It will be immobile, and painless, which makes them hard to detect-and makes self-breast exams so important!
Q. What are some of the major structures on or near the breast?
A. First, there is the sternum (the center of the rib cage), and the inframammary ridge (fibrous connective tissue over a rib right under where the breast is) (**if you wear bras, it is more or less where the bottom of the cup would be**). Then, there are the milk ducts (above the nipple, extending upward, and the hollow indent underneath the nipple… try feeling it; it's really cool!). You may also feel the infraclavicular lymph nodes, near the sternum, under the tissue. Finally, the tail of Spence is the ligament that connects the breast tissue to the top of the chest wall. You can feel it underneath the armpit.
Q. How do I do a self-breast exam?
A. It's a good idea to get in the habit of doing self-breast exams once a month, so that you get familiar with your body and can spot things that are abnormal for you. Some suggest doing self-exams when your period ends every month.
1. Stand up and put one hand behind your head. Hold the fingers of the other hand flat. Now, gently touch every part of the breast below the raised arm. Feel for lumps, bumps, or thickening. Then do the other breast.
2. Stand in front of a mirror. Put your hands on your hips. Inspect each breast for changes in size, shape, and form. Do it again with your arms raised above your head.
3. Lie back with a pillow or folded towel under your right shoulder. Place your right hand behind your head. Examine every part of your breast with the fingers of the left hand held flat. Gently press in small circles. Start at the top outermost edge and spiral in to the nipple. Feel for lumps, bumps, or thickening. Now do the other breast. Be sure to follow a consistent pattern and do not miss any part of the breast.
4. Rest your arm on a firm surface like the top of a bookshelf. Examine the underarm. Feel for lumps, bumps, or thickening in the same way. Now do the other underarm.
Q. When do women get their first period?
A. Menarche, or the beginning of the menses, often occurs between 12 and 13. However, some young women get it as early as eight and some as late as 16. It really just depends on the person!