Women's Health

Female reproductive anatomy

The female reproductive organs are the vulva, vagina, uterus (womb), fallopian (uterine) tubes, ovaries and breasts. Most of the female reproductive organs are inside the body.

The internal female reproductive organs

The vagina is a muscular canal about 10 centimetres long that extends from the cervix (neck of the uterus) to the vaginal entrance. The vagina has three functions:

it is where the menstrual blood leaves the body during a period
it is where the penis is inserted during sexual intercourse
it is the birth canal (where a baby comes out of the woman’s body during childbirth)

Because of its muscular walls the vagina can expand and contract. This allows it to become narrower (to hold a tampon in place) and wider (to allow a baby to pass through during childbirth). The vagina's muscular walls are lined with mucous membranes, which keep it protected and moist.

The uterus is a muscular organ, shaped like a small upside down pear and can stretch a great deal to accommodate a growing baby. Its lining is called the endometrium. The cervix (bottom part of the uterus) is connected to the vagina.

The Fallopian tubes extend from the top of the uterus, one on each side and open near an ovary. They are about 10 centimetres long and carry the ovum (egg) from the ovary to the uterus.

The ovaries, one on either side of the uterus, are two small almond-shaped glands that contain ova (eggs). The ovaries also produce the female sex hormones.

The main function of the breast is to feed a baby. They are also important because they can give a woman pleasure when touched and for many women they are an important part of their sexual activity.

The external female reproductive organs

The genital area on the outside of the female body is called the vulva. At the top of the vulva is a mound of fatty tissue called the mons pubis. This area becomes covered with hair at puberty. Below the mons pubis there are two folds of skin called the labia majora (outer lips) and labia minora (inner lips). The labia majora are also covered with hair after puberty. The labia minora are thinner than the labia majora, sensitive to touch and moist because of lubricating fluid produced by glands in the labia.

At the top of the labia minora is the clitoris. The clitoris has many nerve endings and is the most sensitive part of the genital area. The labia minora form a fold of skin or hood over the clitoris. When a female is sexually aroused the clitoris becomes more exposed and firm.

Inside the labia minora there are two openings. The opening at the front is the urethral opening (the urethra is a small tube that carries urine from the bladder to the outside). The other opening is the vaginal opening and leads to the vagina.

The hymen is a piece of tissue that lines the vaginal opening. During puberty the vagina grows and the hymen may stretch and tear. It may also stretch and tear when a girl plays sport, masturbates or uses tampons. Even if it doesn’t tear before puberty small holes in the hymen allow menstrual blood to come out. When a women has sexual intercourse for the first time the hymen may tear and even bleed a little. If this happens the woman may experience slight pain and tenderness.

The perineum is the area between the anus and the vulva. During child birth the perineum stretches and in some cases may need to be cut to widen the birth canal to help the delivery of the baby and avoid a jagged tear of the perineum. This procedure is called an episiotomy.

Vagina and Vulval Health The vagina is a closed muscular canal that extends from the the outside of the female genital area (vulvar) to the neck of the uterus (cervix). Various factors such as sex and your general health can affect the health of your vagina and vulvar. The vulva is the name given to the external female genital organs.

The vagina is a closed muscular canal that extends from the the outside of the female genital area (vulvar) to the neck of the uterus (cervix). Various factors such as sex and your general health can affect the health of your vagina and vulvar. The vulva is the name given to the external female genital organs.

Vaginal problems

At the top of the vulva is the mons pubis. Below the mons pubis there are two folds of skin called the labia majora (outer lips) and labia minora (inner lips).

The labia minora changes during puberty and often become more prominent. This is completely normal, like all of the other changes that take place during puberty. The appearance of the vulva continues to change throughout your life because of hormonal changes and age. The appearance of the vulva also varies between females.

Many women put up with vulvar discomfort, either because they are embarrassed and are not sure where to seek help. Many issues can be treated, others may need a long term plan to provide symptom relief. All symptoms or changes noticed in this part of the body should be checked by a medical professional to exclude uncommon but serious causes.

Vulvar problems

The skin in the vulval area is very sensitive and some women experience discomfort such as:

itchiness
burning sensation
pain
swelling
lumps
ulcers
vaginal discharge

These symptoms can be caused by a range of conditions such as:

allergy and hypersensitivity (soap, laundry detergent, toilet paper, sanitary pads, underwear)
skin conditions (dermatitis, psoriasis)
infections (thrush, genital herpes, genital warts)
vulvodynia (pain in the vulva)
pre-cancerous and cancerous conditions
vulval varices (varicose veins)

If you do have any of these symptoms it is important to have a check-up so the problem can be diagnosed and treated.

For more information, please see the following fact sheets:

Vulval and vaginal health from True (PDF 174.4KB)

What is Cervical Screening?The cervix is often referred to as the ‘neck of the womb’ which sits at the inside end of the vagina. Cervix or Cervical cancer is a cancer of the cells of the cervix and is preventable. Cervical screening can detect changes in the cells of the cervix BEFORE they become cancerous.

Cervical screening

What is Cervix (Cervical) Cancer?

The cervix is often referred to as the ‘neck of the womb’ which sits at the inside end of the vagina.

Cervix or Cervical cancer is a cancer of the cells of the cervix and is preventable.

Cervical screening can detect changes in the cells of the cervix BEFORE they become cancerous.

The new Cervical Screening Test will prevent even more cancers

A cervical screening test (Pap test) is a simple test that checks for early changes to the cells of the cervix. These changes may lead to cervical cancer but having cervical screening significantly reduces this risk.

Regular cervical screening saves many lives each year from cervical cancer. About eighty percent of people who develop cervical cancer have not had regular cervical screening tests or have never had one.

The National Cervical Screening program (NCSP) is changing. Due to a better understanding of the Human Papilloma Virus (HPV) and its natural history, HPV school vaccination programs and availability of new technology, the program has been updated to further reduce the risk of cervical cancer in Australia.

The current system of having two yearly cervical screening is being replaced by HPV testing with cytology (if required) every five years. Using knowledge about the HPV types that cause cell changes, and new technology, we can now look for the virus with better accuracy than we could look for abnormal cells.

After 1 December 2017, anyone with a cervix and aged between 25 and 74 years who have been sexually active will be invited to attend cervical screening every five (5) years. This includes people who have had the HPV vaccine because the vaccine does not protect against all types of HPV. See HPV and HPV vaccinations for more information.

	New changes	Before the changes
Cervical Screening test	HPV testing If HPV test positive, then liquid-based cytology is also performed	Pap test (cytology)
Sample collection	Using a speculum, cells are collected from the cervix	Using a speculum, cells are collected from the cervix
Sample preparation	Liquid-based cytology	Pap smear slide or liquid-based cytology
Screening Interval	Five years*	Two years*
Age range for participation	25-74	18-69

*if no abnormalities found

What will cervical screening involve?

During the procedure, which only takes a few minutes, the doctor or nurse gently inserts an instrument called a speculum into the vagina, so that the cervix can be seen. A tiny brush is then inserted into the vagina to collect cells from the cervix. These cells are added to a solution called liquid-based cytology (LBC) which is sent to the laboratory for HPV testing. The results are usually available within a couple of weeks. If HPV virus is detected, then the laboratory will report whether the cervical cells are normal or not.

This quick procedure might feel a bit uncomfortable, but it shouldn’t hurt. If it does hurt at any stage throughout the procedure tell the doctor/nurse immediately.

Occasionally, the laboratory will report that the sample was unsatisfactory and another cervical screen has to be taken. Usually, this is because not enough cells were collected. This doesn’t mean your cervical screening is abnormal, but more likely that the laboratory has received an insufficient amount of cells.

I’m under 25 years of age, why don’t I get offered screening anymore?
Evidence shows that:

There are low rates of cervical cancer in this age group
Before the introduction of the new cervical screening (HPV testing), cervical screening was not very effective in this age group at preventing cancer
HPV vaccination programs have reduced the incidence of HPV in vaccinated and unvaccinated populations
Most young persons will clear the HPV virus all by themselves
Younger generations are at risk of overtreatment in the current cervical screening program
More cervical cancers are predicted to be prevented using the new cervical screening program

However, it is important that you visit your local health care professional if you have symptoms such as unexpected vaginal bleeding or unusual discharge.

If you have any questions which aren’t answered here, email cervicalscreening@true.org.au or talk to your local health care professional.

To book a cervical screening test at one of our clinics, please go to https://www.true.org.au/clinic.

Abnormal cervical screening results:
Abnormal results will be reported in two stages; the first will about be the HPV virus being detected. The second result will whether or not there is an abnormality found in the cervical cells on the cervical screening test.

If the results of your cervical screen are abnormal this does not mean you have cancer. Often abnormal results are caused by an inflammation or infection that will clear up naturally. Sometimes you may need to have cervical screening more often.

The Pap test and the new HPV test can only screen for possible problems, not diagnose them. If your cervix appears abnormal during the pelvic examination or you have an abnormal test, your doctor may organise for you to have a colposcopy. A colposcopy is a simple procedure that is performed in a doctor’s office. The doctor uses a device called a Colposcope, which is large microscope that is positioned approximately 30cm from your vagina. A bright light on the end of the Colposcope allows the doctor to see the cervix more clearly. The procedure is painless and takes about 10 to 15 minutes.

If the doctor sees abnormal cells they will take a biopsy. A biopsy involves taking a sample of the abnormal cell tissue from the cervix. It is not usually painful but may be uncomfortable. The sample is sent to the laboratory for testing. When the results come back, your doctor will recommend either treatment, another colposcopy in the future, more frequent cervical screening or no further action may be necessary.

Some types of abnormal cells may require specialist treatment. Make sure you talk to your doctor, nurse or health worker about what is best for you.

For information about cervical cancer prevention and information in other languages, go to Cancer Screening Australia

For information about cervical cancer prevention in the LGBTIQ+ communities, go to LGBTIQ - PapScreen Victoria.

For information about cervical cancer prevention for Indigenous communities, go to Information about cervical screening for Aboriginal women.

For more general information, visit the Cancer Council.