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THE EXTERNAL FEMALE REPRODUCTIVE ORGANS
The next obvious female characteristic and the external part readily visible from the exterior is the area of vaginal entry. When a woman is standing upright, this is usually only partly visible. Where the bony pelvic bones meet at the frontcalled the symphysis pubisis a rounded protuberance, called the mons veneris. This is variously interpreted as the 'Mount of Venus' and 'love mountain', because of its obvious close relationship to the main source of pleasurable love-making. It is covered with pubic hair, usually short and curly. Although the hair is usually black, redheads and brunettes often have pubic hair of a fiery red, a colour that can shock doctors who have usually seen everything a hundred times over.
Text-books on women's complaints sometimes go to great pains to say how the upper margin of the pubic hair is horizontal in women. In men it rises to an apex, frequently extending to the level of the navel. Nobody is sure of the significance, or importance, of this. Maybe it will become increasingly important in theatricals, as productions such as Hair give patrons greater and greater glimpses of the stars in full-frontal nudity; in a flash the discerning patron would know the player's sex although there are other and easier ways to be sure.
Bikini-wearing women should be grateful for this limited hair growth. Even so a perpetual perennial question from sparsely garbed females every summer is how to get rid of obvious pubic hair that sticks out embarrassingly from their flimsy beach gear. The more hair growth the greater the problem. Incidentally, electrolysis is the usual answer for small amounts; depilatory creams (or waxes) for temporary removal of larger areas.
The vaginal entry is guarded externally by the vulva. This is made up of several structures. The labia major ('large lips') are two large full folds which tend to meet in the midline. They are covered with pubic hair on the outer part but not on the inner fold. In childhood and in older age, they contain little fat material and are less obvious than during a woman's reproductive years.
When gently parted, the labia minor ('small lips') are exposed. These are delicate skin folds which contain little fat and are rich in blood and nerve supplies. Above and towards the front, the small lips split to encompass another interesting little organ called the clitoris. One part extends over the upper part of the clitoris, forming what is called the prepuce; the other joins directly under it to form the frenulum. There is no need to remember all these names, although a lot more will be said later about the clitoris.
Lower down, the small lips again join to form the fourchette. During childbirth, this area is nearly always torn as the new baby wiggles its way out.
The cleft between the small lips is called the vaginal vestibule, and is really the entrance into the vaginal canal. Just below the clitoris is a small, barely discernible opening called the external urethral meatus. This is the outside opening of the urethra, a tube that pipes urine from the bladder to the exterior. It is an important little structure, for irritation can easily force germs along its length, giving rise to urinary tract infections.
Nearly every bride suffers from the unpleasant condition popularly known as 'honeymoon' cystitis. Mechanical irritation of the outside outlet, plus enthusiastic and frequent intercourse (usually maximum at this happy time), can force germs from the outside into the bladder, giving rise to infections. Often these can destroy an otherwise happy honeymoon as many brides remember with a heavy heart (and many grooms with a sense of hurt pride and annoyance).
A desire to urinate often, a burning and scalding when it does occur, an uneasy feeling that the bladder is not emptied, the desire to void again, and high feverthese are some of the horrid symptoms of cystitis. We'll talk more about it later (plus what to do) when discussing urinary infections.
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Womens health

 
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UNDERSTANDING THE MENOPAUSE: THE PERI-MENOPAUSAL CYCLE
During the fertile years there is a gradual depletion of ovarian follicles, and hence the egg cells they contain. This process generally becomes more rapid from the age of 35. At the menopause only a few eggs remain. With the depletion of the follicles, the level of fertility is reduced and oestrogen deficiency begins. As the number of granulosa cells in the follicles reduces, inhibin production also decreases, very gradually. The level of follicle-stimulating hormone therefore changes little.
By the early forties the number of granulosa cells has decreased to such a degree that the level of inhibin they secrete will have fallen to a critical point; the level of follicle-stimulating hormone now rises. Although the menstrual periods may still be completely regular and no menopausal symptoms are being experienced, the rising follicle-stimulating hormone level represents the beginning of the peri-menopause.
As follicle depletion continues over the next few years the level of follicle-stimulating hormone will fluctuate, causing the menstrual cycle to become irregular. The amount of menstrual flow also alters, being sometimes lighter and sometimes heavier. By now the follicle-stimulating hormone will be approaching, or have reached, the point at which the peri-menopause can be said to have begun. Conception is now unlikely to happen. Oestrogen production usually remains near-normal in the early years of the peri-menopause, therefore symptoms associated with oestrogen deficiency, such as hot flushes and vaginal dryness, will not yet be evident. As oestrogen levels fall over the next few years the occasional hot flush, increasing tiredness and perhaps dizziness will occur, and menstrual periods may become more irregular with episodes of heavy bleeding.
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Womens health

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