In this article
Why do I need to get familiar with my bits?From a health perspective, how can you know if something has changed unless you know what your normal is?
We all know about examining our breasts for any change in shape or unusual discharge. But what about examining your genitals, perineum and anus?
Your pelvic floor is probably a bit neglected - most people’s are (Paddison 2002). It's the hammock of muscles that sits inside your pelvis and holds up your pelvic organs, which are your bladder, bowel, womb (uterus) and vagina.
It can be really difficult to exercise a part of your body that you’re not really aware of, or to understand how it relates to parts of your anatomy that are out of sight.
If this sounds like you, you're not alone. When asked to label a diagram of female genitals, 44 per cent of women couldn’t correctly point to the vagina and 60 per cent couldn’t label the vulva (Hill-Daniel and Roett 2015).
Most of us haven’t been taught properly about our own bodies, and sex education at school doesn’t usually cover signs of health or otherwise in your reproductive organs and genitals.
Taboos and stigma make it difficult for some women to talk openly about vaginal discharge, dryness or lumps. That is particularly marked among younger women, with 65 per cent of girls and women aged between 16 and 25 saying they don’t like saying the word "vulva" (Hill-Daniel and Roett 2015).
There is nothing wrong with using slang terms for your genitals. However, it's helpful to use accurate language to communicate problems, if you have them.
Lots of women are unclear about what they can reasonably expect from their genitals. About a third of the women who'll be referred to a physiotherapist's clinic have never had a good look at what’s going on between their legs. Most have misunderstood something about their own anatomy. And, almost all of them feel either insecure or ashamed of something about their body (Handelzalts et al 2017, de Waard et al 2002).
Make friends with your bits! Get to know what you have, what it does, what it looks like and what it feels like.
What is the best way to have a look?Get yourself a hand-held mirror and an uninterrupted 10 minutes. This can be challenging when you have children, but it's important to relax and concentrate.
Make yourself comfortable. Lie, propped up on pillows on a bed with your legs flopped open (like you would for a gynae examination), or, perch on the edge of a chair, bath or toilet. Make sure you are comfortable and well-supported.
Good lighting helps. Use a torch, or a desk lamp, or face towards a good source of natural light.
If you're short on time, take a picture with your phone. You can refer back to it when you get the chance.
How can I tell what's what?The media portrayal of women’s genitals is very narrow. Usually tiny, or invisible labia and no pubic hair on very slim women.
These images are typically digitally altered, and this has lead to many women feeling dissatisfied with their genitals, mistakenly thinking that they are abnormal (Clerico et al 2017).
Every person’s genitals are unique, and, as long as your bits are not sore or unpleasantly smelly, they are doubtless completely fine (NHS 2015a).
If your genitals are painful, have an unpleasant odour or are sticky and itchy, then show them to your GP (NHS 2015a).
Take a look at the anatomical diagram below. First and foremost, this is not a standard of what is normal, it’s only a guide.
Once you are positioned comfortably, start exploring from the top:
Your mons pubis is a fat pad which protects your pubic bone and is where your pubic hair grows. It’s the bit you can see when you look down.
Your labia majora (outer lips) come from your mons pubis and are also covered in pubic hair.
Your labia minora (inner lips) are more delicate than the labia majora and have no hair.
Labia come in all sorts of shapes, sizes and colours. It is quite normal to have inner lips protruding beyond the outer lips, or larger outer lips, or one labia that’s longer, fuller, or a different colour than the other. All, or any, of these variations are totally normal (NHS 2015a).
Your clitoris is a very sensitive nub where the labia minora join. Some women’s are tucked away under a hood of tissue, others protrude more.
Your clitoris contains lots of nerve endings, which is what makes it so sensitive. It’s a large, wishbone-shaped organ, most of which is hidden under the skin. You may be able to find its “legs” as sensitive areas along the labia minora.
Your urethra is the tube from your bladder where wee comes from. It can be located anywhere from right underneath your clitoris to just inside your vaginal opening. It is small, and can be tricky to see.
Your vagina leads to your cervix, womb, fallopian tubes and ovaries. It is a clever organ that self-cleans (NHS 2015b), and stretches when you become sexually aroused or are in labour.
Your vagina is an extendable tube, between 7cm and 10cm (3in to 4in) long. When you become aroused, muscles in your vagina lift up your womb (uterus) to make space for penetration during sex. This is called “tenting” (Levin 1998).
When you're pregnant, the muscular support structures in your vagina can become weakened (Dietz 2003). That's another reason why it's important to do your pelvic floor exercises.
Your perineum is a smooth area of skin between the bottom of your vagina and your anus.
Your anus may not be visible if you are sitting. You may need to bend over in front of a mirror and spread your buttocks apart with your hands. It’s a small, wrinkly opening, has a lot of nerve endings and is controlled by a powerful circular muscle, called a sphincter (Miranda 2013).
With clean hands, experiment with touch on each part of your body. See what deep pressure, gentle tapping or light stroking feels like. Lubricant can help with that. You can buy lubricants online or over the counter in your pharmacy.
You could also use coconut oil. However, don’t use oil-based lubricants if you and your partner are relying on condoms or dental dams for protection, as the oil will damage them.
Your vulva is the whole area between your mons pubis down to the perineum. Sometimes, people mistakenly say “vagina” when they mean “vulva”. If you can see it, it’s a vulva, if it’s internal, it’s a vagina. We don’t say “scrotum” when we mean “penis”, and it’s equally important to name women’s organs accurately.
The tissue around the entrance of the vagina, between the outside and the inside, is called the vestibule.
Your pelvic floor has gaps in its criss-crossing muscles for your urethra, vagina and bowel to pass through. That's why your pelvic floor's stability and flexibility affects your sex life, your ability to wee and poo properly, and your sexual and genital health in general.
Can I see anything move down there when I do my pelvic floor exercises?Look carefully at your perineum, the smooth skin between the bottom of your vagina and the top of your anus. There is a large piece of pelvic floor connective tissue under your perineum. If you do a pelvic floor contraction you will see this area of tissue move and tighten.
Take a deep breath in, sigh out, squeeze and lift - and you’ll see the muscle move.
What you shouldn’t see happening is your buttocks or thigh muscles clenching. If you do, then, try again and focus on only lifting your perineum. It’s a small movement, just a squeeze and lift.
How can I keep my bits healthy?The main thing is to get to know what is normal for you. Have a look, keep an eye on everything, and if you notice areas of soreness, redness, itchiness or lumps see your GP sooner rather than later (NHS 2015a).
Getting to know your genitals is important for your health, just like checking your breasts, cleaning your teeth or getting your eyes tested.
Pay attention to your vaginal discharge and how it changes during your menstrual cycle. Before ovulation, there is lots of clear, slippery discharge (NHS 2016a). After you release an egg, it changes to a cloudier and thicker discharge.
Wear clean, cotton underwear that you change every day. Don’t rinse out your vagina. You don't need to, because your vagina is self-cleaning (NHS 2015b). If you have unpleasantly smelly discharge, don't try to cover it up with perfumed products. Instead, see your GP (NHS 2015a, NHS 2015b).
To keep your vulva clean, you only need warm water and a little plain, unscented soap (NHS 2015b). Anything else can affect your vaginal pH and disrupt the “good bacteria” that lives in your vagina, making you vulnerable to thrush (NHS 2016b).
Pubic hair is there for a reason. It's thought to protect you against chafing during sex. It's normal to have pubic hair, and there's no need to remove it for reasons of hygiene (Rowen et al 2016).
If you do choose to remove some, or all, of your pubic hair, be aware that the skin over your genitals can be fragile.
Professional waxing and sugaring are the most gentle types of hair removal, and shaving is the least. Regular gentle exfoliation will help to prevent ingrown hairs.
Lubrication is important for vaginal health. The amount of lubrication you produce will vary during your menstrual cycle, or pregnancy (Murray and Hassall 2014).
Your vagina will produce natural lubrication when you're in the mood for sex to make penetration easier, even if penetration is not something you participate in. If you have sensitive skin and need extra lubrication, you can find PH-neutral lubricants online.
Find out how exercising your pelvic floor can give you better orgasms.