What happens to the female genital organs with age. Physical changes during puberty
It is clear that the most pronounced changes occur in the uterus. In addition to its size, shape and position, its consistency and excitability to various kinds of stimuli also change. The increase in the size of the uterus is ensured by hypertrophy and hyperplasia of muscle fibers, as well as the presence of growth of newly formed muscle elements, mesh-fibrous and arginophilic “framework”.
Ultimately, the weight of the uterus increases from 50 g to 1000-1500 g, and the walls of the uterus are at their greatest thickness in the middle of pregnancy - 3-4 cm. Subsequently, the increase in muscle fibers no longer occurs, and the increase in size is associated with stretching of the fibers in length. Simultaneously with this process, a proliferation of loose connective tissue and an increase in the number of elastic fibers occur. The combination of these processes leads to a softening of the uterus, increasing its plasticity and elasticity. Significant changes occur in the mucous membrane of the uterus; it undergoes restructuring and the so-called decidua is formed. No less changes are observed in the vascular network of the uterus: arteries, veins and lymphatic vessels; they expand and lengthen, as well as the formation of new ones.
The processes of hypertrophy and hyperplasia are less pronounced in the isthmus of the uterus. Nevertheless, loosening of the connective tissue and an increase in elastic fibers in this area occur. Subsequently, the isthmus becomes overstretched due to the descent of the fertilized egg into it (in the fourth week of pregnancy).
Analyzing changes in the cervix during pregnancy, it should be noted that the processes of hypertrophy in it are slightly expressed due to the smaller number of muscle elements in its structure. Nevertheless, an increase in elastic fibers and loosening of connective tissue occurs. The vascular network of the cervix undergoes quite serious changes. The cervix resembles spongy (cavernous) tissue, and congestion gives the cervix a bluish discoloration and swelling. The cervical canal itself during pregnancy is filled with viscous mucus. This is the so-called mucus plug, which prevents microorganisms from penetrating the fertilized egg.
Looking in more detail at the changes occurring in the muscle layer of the uterus, one can note an increase in the amount of actomyosin, mainly in the muscles of the uterus.
There is also a decrease in ATP - actomyosin activity and conditions are created for carrying the pregnancy to term. In the muscular layer of the uterus, phosphorus compounds, creatine phosphate and glycogen accumulate. For pregnancy, an important point is the accumulation of biologically active substances in the uterus: serotonin, catecholamines, etc. Their role is quite large, for example, serotonin is an analogue of progesterone and a synergist of estrogen hormones.
Examining the reactivity of the uterus to various kinds of stimuli, it can be noted that excitability decreases significantly in the first months of pregnancy and increases quite strongly towards its end. However, irregular and weak contractions of the uterus, which the woman does not feel, are observed throughout pregnancy. Their role is to improve blood circulation in the system of intervillous spaces.
Due to a significant increase in the size of the uterus, the ligamentous apparatus of the uterus also increases, which plays a huge role in maintaining the uterus in its normal position. I would like to note that the round uterine and sacrouterine ligaments undergo the greatest hypertrophy. For example, the round uterine ligaments are palpated during pregnancy through the anterior abdominal wall in the form of dense cords. The location of these ligaments depends on the placenta insertion. If it is located along the anterior wall of the uterus, then the arrangement of the round uterine ligaments is parallel or they diverge slightly downwards. If the placenta is located on the back wall, they, on the contrary, converge downward.
Changes in the fallopian tubes and ovaries are minor. The fallopian tubes become somewhat thicker due to hyperemia and serous saturation of the tissues. Their location changes due to the growth of the uterine body; they move down along the lateral surfaces of the uterus. The ovaries increase in size slightly. During pregnancy, they move from the pelvis to the abdominal cavity.
Particularly noteworthy is the change in color of the vagina, which acquires a bluish tint. This process is explained by increased blood supply to the vagina. Other changes in the vagina can be characterized by its lengthening, widening and greater protrusion of the folds.
The types of labia are completely different. This is due to the different anatomical development of the female reproductive organs. Moreover, throughout the entire life cycle, the genitourinary system undergoes many changes, both internal and external.
In the anatomical structure of the female genitourinary system, there are 2 types of labia: the labia minora and labia majora. The small ones perform the function of a tight grip around the penis during coitus. But the large lips of the female reproductive system perform a protective function, the result of which is to protect the vagina from the penetration of foreign objects and various infections.
The labia majora is a common longitudinal fold of skin, the color of which depends on the individual characteristics of the female body. Doctors classify them only by external signs as follows:
- lips of normal length and thickness;
- asymmetrical folds;
- underdeveloped organs.
The structure of the labia minora has much more differences. In normal condition, their thickness should not exceed 5-6 mm. In this case, the longitudinal folds of the female genital organs should immediately pass into the mucous membrane. In the clitoral area, the skin folds of the female genital organs are divided into lateral and medial crura. These legs extend into the upper and lower parts of the genitourinary system. They end at the very beginning of the vagina and at the lower commissure.
The labia minora can have completely different shapes and are divided according to the type of change that occurs to them. Among such changes, doctors distinguish elongation, protrusion, scalloping and hypertrophy of the genital folds.
Elongation is characterized by a large stretching of the skin ridges, which can exceed 60-70 mm. In normal condition, their size should be 20-30 mm. With protrusion, a rather strong protrusion of the internal folds is observed. In this condition, the labia majora are not able to fully protect the female genitourinary system.
Scalloping is observed only at the edges of the lips and is characterized by a change in their color and shape. If such changes are observed for a fairly long period of time, then the patient may experience hypertrophy of the skin ridges. As a result, large wrinkles will appear on the internal organs, and pigmentation of the skin will occur.
Reasons for changing forms
As noted above, each woman’s genitals have a completely individual shape. At the same time, doctors have not established fairly clear criteria that determine their color and shape. Although an experienced gynecologist, upon visual examination, can detect abnormal changes occurring in the vaginal organs.
Most often, such changes are a consequence of hormonal imbalance in the body, resulting in an increase in the level of androgen (male sex hormone). A similar phenomenon causes polycystic ovary syndrome, increased hair growth on the extremities (arms, legs) and infertility.
Also among the reasons influencing changes in the shape of the vagina are mechanical damage (tight underwear) and heavy physical activity that affects the groin area. In addition, frequent and prolonged masturbation not only causes changes in the shape of internal organs, but also leads to other dangerous diseases.
It is impossible not to note the various diets that the female sex quite often adheres to. An incorrectly selected diet can lead to a sharp change not only in the patient’s weight, but also cause damage to his internal organs.
At the same time, young girls whose age does not exceed 25 years are most at risk. This is due to the fact that the anatomical formation of their body has not yet been completely completed.
As a rule, any changes in the vaginal organs lead to problems in intimate life.
If such problems occur, you should not despair. Modern medicine allows us to solve problems with changes in the shape of skin folds using medication or plastic surgery.
Drug treatment allows you to cope with diseases only in the initial stages of their manifestations. For this, antihistamines and antiseptics (Fluconazole, Metronidazole, Doxycycline, Acyclovir, Diflucan) are used, which eliminate itching and various pain sensations. In addition, the body's hormonal levels should be restored.
This can be done with the help of a special diet, which should be rich in mint, vegetable oil and white yeast bread. In the case where the problem cannot be eliminated with medications, they resort to surgical elimination of the disease.
Organism, then imagine gray hair, crow's feet and changes in the body. You cannot even imagine that the genitals will also undergo changes due to age. And guess what? The vagina ages just like the rest of the body.
The author of the article, intern Catriona Harvey-Jenner, spoke with obstetrician-gynecologist Dr. Karen Morton to find out the whole truth about what to expect from the body as it ages. During the conversation, it became clear that with age, a number of changes occur that directly affect the vagina and external genitalia.
How female genital organs change
You are probably waiting for facts about how the female genital organs will lose their shape, how the labia minora and majora, the entrance to the vagina and the clitoris will change color... As for their appearance, they are getting smaller. If it changes, it changes too. The fact that the genital organs are shrinking is definitely surprising, because usually over the years a person gains weight in everything else.
Just as your skin loses its elasticity over time, your vagina also experiences changes, and hormones are to blame, says Dr. Morton. “The labia surrounding the vaginal opening and the vagina itself are healthy thanks to the estrogen produced in the ovaries.
"The skin inside the vagina is as pink and moist as the inside of the mouth - estrogen production decreases. The vaginal mucosa gradually loses its bright color due to the fact that the blood supply decreases. In addition, the vagina thins and becomes less elastic," he continues to explain doctor.
Women are designed to be "elastic" by nature so that they can have sex and produce children, but the elasticity is lost as hormones decrease due to age.
What are the risks of genitourinary infections
Dr. Morton also notes that older women are more prone to bacterial infections and may experience candidiasis (thrush). “The vaginal microflora (the millions of healthy bacteria that live there) suffers as a result,” says the gynecologist.
Older women are more prone to bacterial infections such as thrush.
In old age, genitourinary tract infections are common as the bladder also suffers due to estrogen deficiency, making urination more frequent and therefore more susceptible to infection.
What's it like with sex as you get older?
Yes, the prospects for natural aging of the body are far from rosy... I would like to note that the issue of taking hormones during menopause should be discussed only with a gynecologist and risk factors taken into account. Also, do not forget that many products contain phytoestrogens, which help prolong youth in all respects. In addition, pay attention to Japanese women, whose menopause surprisingly occurs after 60 years and does not bring any discomfort. Perhaps this is due to the peculiar diet of the inhabitants of the Japanese islands. In any case, we think about the good, hope for the best, and choose what suits us.
First of all, these changes develop in the woman’s genitourinary apparatus and are characterized mainly by atrophy and proliferation of connective tissue. During menopause, these changes are little noticeable, but with the cessation of menstruation, during menopause, atrophic changes and proliferation of connective tissue begin to progress rapidly, reaching their limit in old age (senium).
First of all, they begin to change ovaries: primordial follicles stop developing and reaching the maturity of the Graafian vesicle, lose the ability to secrete full-fledged egg cells and form corpus luteum. The entire ovary shrinks, decreases in volume and, due to the proliferation of connective tissue, and in places due to the deposition of lime, becomes dense and lumpy. According to W. Miller, the ovary of a 40-year-old woman weighs on average 9.3 g, and the ovary of a 60-year-old woman weighs only 4 g.
Histological examination of the ovary during menopause reveals a gradual disappearance of follicles and the absence of corpora lutea. However, in some cases, even during a long menopause, single follicles are found in the ovaries, the development of which does not reach its peak and does not end with ovulation. This probably partly explains the presence in the urine of women who have been in menopause for many years (another source of estrogens can be the adrenal glands during menopause (see below).
In the ovarian parenchyma, connective tissue grows significantly, and hyaline lumps appear in the places of the former corpora lutea. In the vessels (arteries and veins) of the ovary, hyaline transformation and sclerosis are also noted.
Experimental studies in recent years have established that when an ovary from an old animal is transplanted into a young animal, follicles can form and mature in it [R. Stieve]. These studies are consistent with the data of F. S. Otroshkevich, who back in 1896 established that there is no direct connection between the degeneration of ovarian vessels and the cessation of their function; the ovaries cease their function when the number of vessels degenerated in them is insignificant and the nutrition is little changed. The main role in the complex process leading to the cessation of ovarian function, according to F. S. Otroshkevich, is played by the nervous system. Structural changes in the ovary do not always correspond to its function in all respects. N.I. Kushtalov (1918) came to the same conclusions while studying the ovaries of women 65-112 years old. He did not see a strict relationship between ovarian decline and a woman’s age. The importance of the nervous system in the development of age-related changes is currently confirmed by experimental studies by I. A. Eskin and N. V. Mikhailov, which showed that old animals, compared to young animals, respond to unfavorable factors with an altered reaction, and these changes are not associated with a violation formation of adrenocorticotropic hormone (ACTH) in the pituitary gland or with a weakening of the adrenal cortex's response to ACTH, and with age-related changes in the central nervous system that regulates the release of ACTH.
Uterine (fallopian) tubes also undergo regression: the muscular layer of the tube becomes thinner, gradually being replaced by connective tissue; folds of the mucous membrane atrophy, lose their cilia; the lumen of the tube narrows - partial atresia or complete obliteration of the lumen of the tube appears.
Uterus at the beginning of menopause (hyperfolliculin phase) it is somewhat enlarged, juicy, softened, then it begins to decrease in volume, its muscle fibers atrophy and are replaced by connective tissue, the vessels become sclerotic. The average weight of the uterus of women aged 21-30 years is 46.43 g, and at the age of 61-70 years it is 39.51 g. The uterine cavity narrows and shortens. The endometrium changes especially dramatically: first its functional and then its basal layer gradually atrophies. During menopause, when the follicles finally disappear, the lining of the uterus gradually disappears. turns into atrophic senile mucosa, in which differentiation into functional and basal layers is completely absent.
During menopause, true glandular-cystic hyperplasia (occurs no earlier than a year after menopause) and simple cystic enlargement of the glands (with prolonged menopause) are often observed in the uterine mucosa. These forms of mucosa are not functionally active, since the cause of their occurrence and development are mechanical factors, a kind of ovula Nabothii of the endometrium [E. I. Quater, Alcohol (N. Speert), McBride (J. M. McBride)]. During menopause, the endometrium becomes increasingly atrophic. With low estrogenic activity, endometrial polyps are often observed. The spiral tortuosity of the arterioles disappears. The venous network appears to be located close to the surface of the mucous membrane. Ruptures of these veins can cause uterine bleeding during menopause. The glands shrink and their secretion decreases. The cervix and its vaginal part decrease significantly in size, sometimes the partio vaginalis completely disappear. The cervical canal narrows; In old age, stenosis and synechiae form in it, causing its complete obstruction. In such cases, secretions may accumulate in the uterine cavity, which, if infected, can cause pyometra (accumulation of pus). Due to the developing atrophy of the ligamentous apparatus and wrinkling of the pelvic connective tissue, the pelvic floor and the position of the uterus change: anteflexio turns into retroflexio, atrophy of the pelvic floor muscles often leads to prolapse of the uterus.
Vagina at the beginning of menopause, it is hyperemic, later it becomes dry, smooth, low-elastic, the mucous membrane loses its folds, in places it loses its epithelium (on this basis, adhesions of the vaginal walls sometimes develop), in general the vagina is smoothed out and shortened. A decrease in glycogen and lactic acid reduces the pH of the vaginal contents, which leads to disruption of the normal vaginal flora and a weakening of the “protective” properties of the vagina. Senile colpitis, trophic disorders and stenotic processes (Craurosis fornicis vaginae) begin.
Age-related changes occurring in the vagina are reflected in the cytological picture of vaginal smears and indicators of the functional state of the ovaries.
Changes that occur in the vagina during menopause and at all periods of a woman’s life are presented in Table 5 (Davis and Pearl).
Table 5
Age-related changes occurring in the vagina (according to Davis and Pearl). A diagram showing the role of the estrogen hormone in the biological state of the vagina, the structure of its mucosa and the nature of its secretion.
In newborns, the vaginal mucosa is developed as a result of exposure to estrogenic hormones from the mother; in the period from infancy to puberty, the vaginal wall is poorly developed, there is scanty discharge of an alkaline reaction, and contains mixed coccal microflora. With the onset of puberty, the vagina undergoes rhythmic cyclic changes, during which the thickness and structure of the vaginal epithelial lining changes.
External genitalia during menopause they also change: the pubis and labia majora lose the subcutaneous fat layer and become flabby. Pubic hair thins and turns grey. Pathological pigmentation (vitilago) is often observed. The labia minora become flabby, gradually atrophying and turning into thin leathery folds. A decrease or absence of follicular hormone during menopause is often the cause of painful itching, the appearance of leukoplakia and kraurosis.
In some women during late menopause, the clitoris becomes enlarged, apparently as a result of the increasing influence of androgenic hormones during this period. The clitoris sometimes becomes quite sensitive, which leads to eroticism. We had to observe a significantly enlarged and sharply painful clitoris in some mentally ill women who had been in menopause for 10-12 years and suffered from hypersexuality and masturbation; There was also a case of significant growth of the clitoris after a six-month use of methyltestosterone by a patient for uterine bleeding caused by uterine fibroids. Similar phenomena are described by E. Guiley.
Accordingly, with the regression of the genital organs, the mammary glands. Their glandular tissue atrophies and becomes denser. Often the size of the mammary glands increases due to fat deposition. In women who have lost weight, the mammary glands completely atrophy, leaving only a significantly pronounced, highly pigmented nipple, surrounded by single bristly hairs.
Significant anatomical and morphological changes during menopause and menopause occur in the urinary system. From the side of urination: urinary incontinence and frequent urination. These phenomena occur both with previously changed genitourinary organs (colpo-colpo-cystocaelae - prolapse of the vaginal walls along with the bottom of the bladder), and with completely healthy ones.
E. Held (E. Held) out of 1000 women suffering from urinary disorders, only 75 showed pronounced prolapse of the bladder (cystocoelae), which was discovered for the first time only during menopause. These disturbances soon disappeared with the introduction of follicular hormone, which, according to the author, by causing an increase in the tone of the bladder, contributed to the normalization of urinary function.
Currently, in accordance with the studies of Wasserman (L. L. Wasserman), Langreder (W. Langreder), Ellers (G. Ellers) and others, the pathogenesis of these disorders has received a slightly different coverage. In the bladder in the area of Liethod's triangle and in the posterior wall of the urethra, i.e. in areas of the urinary system lined with multilayered epithelium, the same changes occur as in the vagina. These changes depend on the saturation of a woman’s body with hormones at different periods of her life: before and after childbirth, with ovarian insufficiency during menopause. In the latter case, the urethral mucosa becomes atrophic, its folds become sparse, insufficiently filling the lumen of the urethra, which causes the phenomenon of functional urinary incontinence. The introduction of small doses of estrogen or androgen preparations normalizes the condition of the urethral mucosa. Long-term administration of androgens in high dosages causes atrophy of the urethral epithelium and increases the symptoms of urinary incontinence. Disorders of urination during menopause are aggravated by subsequent atrophic processes that occur in the walls of the bladder and in the urethra.
Pronounced anatomical and morphological changes are observed in the endocrine glands. Particularly noticeable changes are observed in the pituitary gland (mainly in the adenohypophysis). In the adenohypophysis, from the beginning of puberty until the complete extinction of ovarian activity, cyclic changes occur. These changes consist in the transformation of chromophobe cells into chromophilic cells, which, depending on their relationship to color, can be basophilic, perceiving basic color, and eosinophilic, perceiving acidic color. In basophilic cells, follicle-stimulating hormone, thyroid-stimulating, adrenocorticotropic and growth hormone are formed, in eosinophilic cells - luteonizing and lactogenic hormones. With normal ovarian function, the adenohypophysis undergoes a cyclic process of granulation - chromophilic (basophilic or eosinophilic) cells appear - and a process of degranulation, when staining cells disappear. The degree of intensity of granulation and degranulation depends on the level of estrogen contained in the blood. During menopause (especially with surgical or radiation castration), the cyclic process is disrupted. In basophilic cells, there is a tendency to vacuolization, as a result of which the production and excretion of follicle-stimulating hormone in the urine increases. During physiological menopause, the anterior lobe of the pituitary gland hyperplasias and hypertrophies. During menopause, resp. after surgical castration, the appearance of “castration cells”, highly vacuolated, chromophobic cells, is noted in the pituitary gland. Timely administration of estrogens and androgens can delay these changes.
Thyroid gland during menopause it begins to increase, and the increase that was before menopause can pass into the struma. It has been experimentally shown that castration causes an increase in thyroid function. Thyroid dysfunction often occurs for the first time during menopause and manifests itself in the form of hyperthyroidism or Graves' disease, and sometimes in the form of myxedema. Apparently, increased excretion of thyroid-stimulating hormone often plays a significant role in thyroid dysfunction.
During menopause, the adrenal cortex hypertrophies, hyperplasias, and a large number of lipoid-containing cells are formed in it (Steve). It has been clinically and experimentally established that this hyperplasia of the adrenal cortex is formed due to an increase in the zona fasciculate, its parenchyma. Patients with menopausal disorders are often characterized by increased sensitivity to adrenaline, expressed by increased blood pressure, increased heart rate, sugar in the blood and urine, as well as other manifestations characteristic of increased activity of the sympathetic nervous system.
In 50 women aged 38-59 years suffering from pathological manifestations of menopause, N.V. Svechnikova and V.F. Saenko-Lyubarskaya found a significant increase in the amount of total adrenaline in the blood - up to 20-60% versus 5-10% in healthy women the same age. Apparently, increased levels of adrenaline and increased activity of the sympathetic nervous system, associated with increased reactivity of the hypothalamus, lead to neurovegetative and vasomotor disorders.
In the pancreas during menopause, hypertrophy, hyperplasia and hypersecretion of the insular apparatus are observed.
With alimentary and parenteral administration of glucose in women during menopause, reduced tolerance to carbohydrates is detected [A. Liepelt (A. Liepelt)]. According to Wiesel, nutritional glycosuria, in contrast to true diabetes, often occurs during menopause in women, both thin and obese. Pancreatic disorders appear to be largely associated with increased excretion of pancreatic hormone by the adenohypophysis.
With age, not only a woman’s face and body change, but also her genitals. Unfortunately, over the years, the skin loses its elasticity and firmness and inevitably begins to sag, but if a lot of cosmetic procedures have been invented to maintain a youthful face, the female genital organs have been deprived of the attention of many aesthetic medicine specialists. But as practice shows, women are very upset by the external changes that occur to their vulva and vagina throughout their lives.
Certain changes can be noticed already from the age of twenty. Sagging skin in the pubic area and labia is possible, in particular, due to sudden weight loss - just as it happens, for example, in the chest area. In this case, stretch marks also form inside the vagina, and with age, the pelvic muscles also weaken. All this leads to significant discomfort and can cause self-doubt and sexual dissatisfaction, because, as studies show, women with such problems feel constrained in bed and do not experience satisfaction from sexual life.
However, today aesthetic medicine has come to the aid of the fair sex, and genital rejuvenation procedures are becoming increasingly popular. But plastic surgery can be avoided altogether by adhering to the simple rules described below.
Avoid sudden weight fluctuations
If you lose weight suddenly, your vulva may sag. To maintain the beauty and youth of the genital organs, weight should always remain normal, because women who are too thin can have no less problems than overweight ones. A woman's vulva can be compared to her face - she can look younger or older than her age, and the appearance largely depends on whether the weight is normal.
Do Kegel exercises
Kegel exercises for strengthening vaginal muscles are very popular, but even if you do them regularly, can you be sure that you are following all the rules?
Many women do not exercise long enough or irregularly. The correct technique involves contracting the vaginal and pelvic muscles for 5 seconds, then relaxing. The number of repetitions should be at least one hundred, and the exercises will be effective if done three times a day. Working out can even be fun if you use your partner's penis instead of a machine.
Get rid of your office chair
If you use a Swiss ball for at least fifteen minutes a day instead of a regular office chair, this will provide additional training to your vaginal muscles. The pelvic muscles will contract on their own, and you can always keep them in good shape without much effort.
Limit cycling
Cycling is an enjoyable pastime for many women, but you should be aware that constant rubbing of the perineum against the seat can cause the skin in that area to stretch. Representatives of the fair sex with large labia should be especially careful.
Don't overdo it with hygiene procedures
Soap that causes dry skin, all kinds of scrubs and other hygiene products are not at all suitable for delicate and sensitive skin of the genitals and often lead to irritation. Regular hygiene is, of course, very important, but it must be done using special, non-aggressive means.
Be sexually active
The tissues and muscles in the perineal area are especially susceptible to age-related changes if they do not receive regular stimulation and blood flow. Normal blood flow ensures the release of lubrication in sufficient quantities and helps a woman achieve orgasm, which, unfortunately, becomes increasingly rare with age.
You should also keep in mind that male sperm also has a rejuvenating effect due to the content of certain hormones and fatty acids.
Change your position
The missionary position, of course, is considered one of the most popular, but the fact is that when your partner independently regulates the depth of penetration and intensity of movements, he may not calculate and involuntarily cause you discomfort and stretch the muscles of the perineum. If you are on top, you will be in control of the situation, and you will also be able to train your vaginal muscles by squeezing your partner’s penis.