What’s in a name? 

Well as it turns out quite a lot. 

One of the biggest challenges for women seeking medical care for pelvic floor issues can be the terminology. 

When people we perceive to have authority (like doctors and specialists) use language we don’t understand to describe our own bodies, this takes away our autonomy and our agency. 

It leaves us intimidated, frightened and overwhelmed. We are unclear about how we will know if things are working properly or what our expectations should be. This stops us from making progress in our recovery. 

Fundamentally, if we’re not using the proper names for our anatomy to describe our symptoms, it can cause confusion and can take longer to get an accurate diagnosis.

You can easily see how this causes problems. If you have pain, for example, the doctor will ask you where it is. If you say your vagina hurts when you really mean your vulva, you could end up with an unnecessary internal examination.

Proper names for our intimate body parts are something that, culturally, we have been taught to shy away from (read Pelvic Floor Health is a Feminist Issue). Thankfully, this is changing now. My own daughter has proudly discussed issues with her ‘gina’ from when she could talk and schools are insisting children learn and use the proper names for their body parts. 

But often, this education falls short. Details are left out. And when you have difficulties with pelvic floor function, details are exactly what you need to get to the bottom of your issues. 

If you visit a medical professional to get help with pelvic floor issues like incontinence, pain and prolapse, you will be asked to describe your symptoms. This is pretty straight forward when it comes to how often you don’t make it to the toilet in time but becomes much more complex when you're asked to describe pain in the area.

How can you say it hurts if you don’t know what it’s called?

Knowing the proper names for your anatomy gives you ownership of your body and allows you to be part of the discussion with your medical professionals about what might work for you and your unique circumstances. 

Knowing the proper names is the first step in knowing what is normal for you, what you want to get help with and asking for the right help if and when you need it. 

If you are in a position where surgical options are being discussed, knowing the proper names for your anatomy will be a big help in assessing risks and understanding any side effects. 

If there is ever a point where you don’t understand what a medical professional is telling you, ask. It’s their job to help you understand. Appointments can be overwhelming - from overcoming your own anxieties about attending and answering awkward questions to receiving lots of new information quickly. Ask for a leaflet, article or website where you can get more information. 

Knowledge is power. 

So here is your anatomy lesson for the day. 

1. Genitalia/genitals. External organs of reproduction. In women this is the vulva.
2. Pubic bone/pubis. This is the bone at the front of your pelvis which protects the soft tissues of your clitrois and vulva underneath. This is the one that hurts like hell when you accidentally land on the cross bar of a bike. 
3. Mons pubis/pubic mound is an area of soft tissue that covers the pubic bone. It is covered in pubic hair (more protection for those delicate tissues).
4. Clitoral hood/prepuce. This is a fold of skin that surrounds and protects the glans of the clitoris.
5. Clitoris. 90% of the clitoris is not visible - we can only see the glans which is under the clitoral hood. The clitoris is extremely rich in nerve endings which are intertwined with the vagina, labia and urethra.  
6. Vulva. Vulva is the term for all the outer (visible) parts of our sex organs incorporating the clitoral hood, glans of the clitoris, vagina vestibule and the labia.
7. Labia majora. Also known as the outer lips. These are a pair of skin folds that are totally unique to your body. Size, shape, colour, and amount of hair all vary hugely between individuals. It is extremely unlikely that your labia will be the same - just like the rest of your body there will be some asymmetry. There is no standard of ‘normal’ for how the labia look. The labia majora folds cover and protect the labia minora, clitrois, and vagina vestibule. 
8. Labia minora (inner lips). These are a pair of folds of smooth tissue which lie under the labia minora. These tissues also vary greatly from person to person. In an unstimulated condition these cover the vaginal opening but become more open when aroused. 
9. Urethral opening. This is the end of your wee pipe (urethra) where wee exits the body. It is a muscular structure that helps hold wee in and release it. It opens into the vestibule (area between the labia minora). It sits just above the vaginal opening. 
10. Vaginal vestibule. This is the area in between the labia minora and contains the clitoris, urethral opening and vaginal opening (introitus). 
11. Vaginal opening/introitus. This is the entrance to the vagina. It is where menstrual blood leaves the body, where a baby can exit the body and can be used for penetrative sex.
12. Vagina. This is an internal muscular tube that runs from the vulva to the cervix (entrance to the womb/uterus). It is incredibly stretchy and can facilitate penetrative sex, cervical smears and birthing a baby, among other things. When not being stretched it returns to its normal size and the walls often rest against each other.  
13. Hymen. The hymen is made up of small folds of mucous tissue that sit 1-2cm inside the vaginal opening. They can feel like little bumps under your finger. They are uniquely shaped in every female. Many women are born with very little of this tissue and some can feel like there is none at all. For some the tissue can tear on first penetration but this is not always the case. The presence or absence of a hymen says absolutely nothing about whether a woman has had sex or not. 
14. Perineum. This is the area between the bottom of the vulva and the anus. This is the area we are sometimes told to massage in pregnancy to prepare for birth. It is also the area that might be affected if you tear or have an episiotomy while giving birth.
15. Anus. This is the opening at the bottom of the rectum where poo exits the body. 

Our pelvic floor muscles are intimately intertwined with our sex organs (internal and external), bladder and rectum.

They start at our tail bone/coccyx just above the anus and run underneath our pelvis, attaching to the pubic bone at the front. 

They encircle the rectum, the vagina and the urethra and help with the function of all of our pelvic organs (bladder, bowel, etc.). They form the foundation of our core muscles and enable us to breathe. 

Having a basic knowledge of your anatomy and how it works will help you find the solutions that work for you and improve your health outcomes quicker. It will also help you feel more confident in your medical appointments and your own personal research. 

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Lastly, if there is a woman out there you think might need to hear any of this, please share. Talking about these issues is essential if we're going to help women move past them.