Anatomical Structure Of The Vulva

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The vulva consists of the mons pubis, the labia majora and minora, the clitoris, and the vestibule of the vagina. The external urethral orifice is situated in the vestibule, as are the ducts of the mucus-secreting paraurethral and Bartholin's glands.

The mons pubis and the outer aspects of the labia majora are covered with hairy skin that is similar to that of the scalp and axillae. The labia majora contain numerous sebaceous glands, along with apocrine glands and eccrine sweat

Table 1 Anatomical Features of Vulvar Skin Relevant to Microbial Ecology

Eccrine

Apocrine

Epithelium

sweat

sweat

Sebaceous

Structure

type

Hair

glands

glands

glands

Mons pubis

Keratinized

+

+

-

+

Clitoris

Nonkeratinized

-

-

-

-

Labia majora

Keratinized

+

+

+

+

Labia minora

Nonkeratinized

-

+/ -

-

+

Vestibule—outside Hart's line

Keratinized

-

-

-

+

Vestibule—inside Hart's line

Nonkeratinized

-

-

-

-

glands. The labia minora, in contrast, are free from hair, and are covered with stratified squamous epithelium, which can have a thin layer of keratinized cells at its surface. Sebaceous glands are present, but as the skin is glabrous, these glands open directly at the surface. Eccrine sweat glands are found occasionally on the labia minora but apocrine glands are absent. The clitoris is covered with a thin, nonkeratinized, stratified squamous epithelium and contains nerve bundles and erectile tissue. From the innermost surface of the labia majora to the vagina, the epidermis gradually changes from the keratinized epithelium typical of other external body surfaces to the mucosal epithelium typical of the vagina and other mucous membranes. The vulvar vestibule extends laterally from the hymenal ring to a line of more keratinized skin on the labia minora (Hart's line). The overall structural diversity of the vulva is summarized in Table 1. An organ with this degree of structural diversity is unlikely to harbor a single microbial ecosystem, as the diverse habitats that result create unique ecological pressures that are likely to shape unique populations of microorganisms.

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