Define Vagina : The vagina is a fibromusculo-membranous sheath communicating the uterine cavity with the exterior at the vulva.

We have described:

Anatomy of Vagina

Blood supply of Vagina

Nerve supply of Vagina

Describe the changes in the vaginal epithelium at different ages?


Anatomy of the Vagina :

Direction: The canal is directed upwards and backwards forming an angle of 45 degree with the horizontal in erect posture.

Diameter :About 2.5cm being widest in the upper parts and narrowest at its introitus.

Walls: An anterior posterior and two lateral walls. The length of the anterior wall is about 7cm and that of the posterior wall is about 9 cm.


  • Anterior: The upper one -Third is related with the pouch of Douglas, the middle-thirds are with the urethra.
  • Posterior : The Upper one-Third is related with the pouch of Douglas, The middle-Third with the anterior rectal wall separated by retrovaginal septum and the lower-third is separated from the canal by the perineal body.
  • Lateral walls: The upper one-third is related with pelvic cellular tissue at the base of broas ligament  and which the ureter and the uterine artery lie approximately 2 cm from the lateral fornices. The middle – Third is blended with the levator ani and the lower- third is related with the bulbocavernous muscles, vestibular bulbs and Bartholin’s glands.

Structures: Layers from within outwards are 

  •  Mucous Coat.
  • Submucosa layer.
  • Muscular Layer
  •  Fibrous coat derived from the endopelvic fascia and is highly vascular.

Blood supply of Vagina

 Arterial supply:

  • Cervicovaginal branch of the uterine artery.
  • vaginal artery a branch of anterior division of internal iliac or in common origin with the uterine artery.
  •  Middle rectal artery.
  • Internal pudendal artery.

Venous drainage : Drain into internal iliac veins and internal pudendal veins.

Nerve supply of Vagina

  • Sympathetic and parasympathetic from the pelvic plexus.
  • The lower part is supplies by the pudendal nerve.

Changes in the vaginal epithelium at different ages:

Newbron: The vagina of the newborn is under the influences of oestrogen which has crossed the placenta from maternal circulation.


  • The epithelium is moderately well developed well and contains glycogen.
  • Lactobacilli appear on the 3rd or 4th day when the vaginal acidity approaches that of an adult.
  • By the 10-14 days the oestrogen stimulus is lost and the epithelium atrophies and becomes devoid of glycogen.
  • the pH then rises to approximately 7 and remains at the level unit the approach of the puberty.
  • Lacltobacilli are predominant organism after puberty.

Pregnancy: During pregnancy the amount of glycogen is increased to a maximum and the acidity of the vagina is high.

Menopause: After the menopause the epithelium atrophies and losses the glycogen. Lactobacilli are found in fewer numbers and the pH rise to range of 6-8.

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