Location, Function, and Associated Diseases

Your vagina is a muscular, stretchy canal that connects your uterus to the outside of your body. It’s different than the vulva, which refers to the area where the vaginal lips (outer and inner), urethra, and clitoris are located. The vagina refers specifically to the canal inside the body, which connects to the uterus.

The function of the vagina changes throughout the different stages of your life—for example, puberty, pregnancy, and menopause. It’s sometimes referred to as the “birth canal” because babies may pass through the vagina during birth.

However, the vagina plays many other important roles in sexual health. It’s where menstrual blood flows through to leave the body, it’s an area of sexual reproduction and pleasure, and it helps protect the uterus from infections.

Most people don’t experience significant medical conditions associated with their vaginas. Conditions include bacterial and yeast infections, sexually transmitted infections (STIs), dryness, vaginal prolapse, and—very rarely—cancer.

The vagina is located in your pelvic area (between the hips). It’s a tube-like structure with an average length of 2.5 inches.

The vagina is a flexible muscular organ that can change in shape, size, and texture. The outer layer of your vagina is made of fibrous connective tissue. The middle layer is made up of smooth muscle cells, and the inner layer is made up of mucosal cells.

The vagina connects the uterus to the outside world. It sits in front of the rectum (the lowest part of the large intestine) and behind your bladder. Other nearby reproductive organs include the ovaries and fallopian tubes. The outside of the vagina and surrounding organs include the following:

• Vulva: Includes all external female genital parts, including the inner and outer labia (vaginal lips), vaginal opening, urethra, clitoris, and anus
• Clitoris: Located toward the top of the vulva, contains many nerve endings
• Urethra: A tiny hole where urine exits
• Cervix: Located in the rear of your vaginal canal, connects your uterus and vagina

Anatomical variations and congenital (from birth) abnormalities of the vagina are rare. However, it’s possible to be born:

• Without a vagina
• With a vagina that has no opening
• With more than one vagina
• With a vagina that opens to the urinary tract rather than the uterus

Your vagina plays multiple functions in your body. For example:

• Menstruation: When the uterine lining sheds during a period, it exits the body through the uterus as menstrual blood.
• Sexual pleasure: Nerves in the vagina contribute to sexual pleasure and arousal. This causes vaginal lubrication.
• Pregnancy and childbirth: Sperm enters the vagina during penile-vaginal sexual intercourse. The vagina is also the canal where babies are born during vaginal birth.

The vagina also protects the uterus from harm. The vagina is a barrier between the outside world and your uterus. It’s also a self-cleansing organ. If microorganisms enter the vagina, they are usually killed by the pH (moderate acidity) of the vaginal canal.

While most people don’t have significant issues with their vagina, the vagina can become infected with various pathogens, be injured, experience aging, and develop cancer (though this is extremely rare).

Vaginitis, or vulvovaginitis, is vaginal inflammation or infection. It’s common and includes the following:

• Bacterial vaginosis (BV): Overgrowth of unhealthy bacteria in the vagina
• Vaginal yeast infection: Overgrowth of the fungus Candida
• Trichomoniasis: A sexually transmitted infection (STI) caused by a parasite

Other health conditions that may affect the vagina include:

• Other sexually transmitted infections (STIs): Chlamydia, genital herpes, and HPV are examples.
• Vaginal trauma: For example, tearing can occur during sexual intercourse (e.g., due to vaginal dryness) or a vaginal birth.
• Vulvovaginal atrophy: Vaginal tissue thins as estrogen levels drop during menopause.
• Vaginal prolapse: Ligaments and walls of the vagina weaken and the vagina drops lower into the pelvis.
• Vaginal dryness: This may happen as hormones change, such as during menopause or after childbirth.
• Vaginal cancers: This is extremely rare.

Symptoms

Vaginal discharge—even large amounts—is completely normal. This discharge can change throughout your lifetime and during your menstrual cycle. It keeps your vagina balanced, clean, well-lubricated, and healthy.

Normal vaginal discharge might be white, clear, thick and tacky, creamy, or slippery. It does not have a strong or unpleasant odor.

Abnormal discharge might have a strong odor or be a different color or texture than normal. Other possible symptoms of a vaginal condition include:

• Pain
• Burning
• Itching
• Abnormal bleeding

Diagnosing a vaginal condition may include:

• Pelvic exam: The provider will insert a speculum inside your vagina, which helps them view the inside of the vagina and the vaginal walls. They will look for any vaginal abnormalities and may also look at any cervical abnormalities.
• Biopsy: Taking a tissue sample and examining it for things like bacterial overgrowth, yeast overgrowth, STIs, or cancer.
• Examining fluids: Examining fluids like discharge, checking for odor, and testing vaginal pH are some examples.
• Imaging tests: Ultrasound and magnetic resonance imaging (MRI) scans are two tests used to visualize possible vaginal abnormalities.

You don’t have to have a pelvic exam every time you visit your OB-GYN or midwife. Pelvic exams are usually only done if there is a known or suspected condition, if you are pregnant, or if routine testing (such as pap smears) is required.

Your vagina is naturally self-cleaning and stays at a consistent pH to keep itself healthy and balanced. Keeping your vagina healthy is often more about what to avoid. For example:

• Keep your vagina area dry, towel drying off after showers and baths, and avoid staying in wet swimwear or underwear for long
• Wash your vaginal area with warm water only most of the time, and use plain soap sparingly or only when needed
• Wear breathable, cotton underwear
• Use protection—e.g., condoms—during sexual intercourse
• Change diaphragms, cervical caps, and menstrual caps each time you use them
• Avoid douching
• Consider taking probiotics or eating yogurt with probiotics, especially if you are prone to yeast infections or have recently taken an antibiotic

See your healthcare provider whenever you experience symptoms of vaginal conditions, such as pain, burning, itchiness, or unusual discharge.

The vagina refers to the canal inside your body that leads to your cervix and uterus. One role of the vagina is to protect your uterus from pathogens. The vagina is where menstrual fluid exits your body, where babies are often born, where sexual intercourse takes place, and where sperm is deposited during reproduction. The vagina is also an area of sexual pleasure.

Getting to know your vagina and the surrounding organs is important for sexual and reproductive health. Visit your healthcare provider if you have any questions about your vagina or vaginal health. Symptoms of a vaginal condition include burning, itching, pain, or a change in discharge or bleeding.