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Amazing women! | the art of menstruation | artists (non-menstrual) | asbestos | belts | bidets | founder bio | Bly, Nellie | MUM board | books: menstruation and menopause (and reviews) | cats | company booklets directory | contraception and religion | costumes | menstrual cups | cup usage | dispensers | douches, pain, sprays | essay directory | extraction | famous women in menstrual hygiene ads | FAQ | founder/director biography | gynecological topics by Dr. Soucasaux | humor | huts | links | masturbation | media coverage of MUM | miscellaneous | museum future | Norwegian menstruation exhibit | odor (olor)| pad directory | patent medicine | poetry directory | products, current | religion | your remedies for menstrual discomfort | menstrual products safety | science | shame | slapping, menstrual | sponges | synchrony | tampon directory | early tampons | teen ads directory | tour of the former museum (video) | underpants directory | videos, films directory | Words and expressions about menstruation | Would you stop menstruating if you could? | What did women do about menstruation in the past? | washable pads
More articles by Dr. Soucasaux: Anatomical drawings - Anovulatory cycles - Archetypal aspects of the female genitals - The breasts: some morphological aspects - Colposcopy - Comments on the corpus luteum and related aspects - The curious relations between androgens and estrogens in women - Endocrinology of menstruation - The Fallopian tubes - Female sexual response - The Gräfenberg Spot (G-Spot) - The Gynecologic Palpation (descendant of "The Touch") - Gynecological assistance: the three basic areas - Gynecology and Gynecologic Surgery - Gynecologist versus obstetrician: what lies behind the combination? - "Gyneco-obstetric-surgical" stubborness and the perpetuation of one of the greatest mistakes of women's medicine - Hypermenorrhea and/or Menorrhagia (Prolonged and/or Excessive Menstrual Bleedings) - Hypertrichosis, Hirsutism and Androgenic Manifestations in Women - Mayer-Rokitansky-Kuster-Hauser (MRKHauser) Syndrome - Menstrual toxin: An old name for a real thing? - Nature and the ovaries - On the Strange Nature of the Ovaries - Oral hormonal contraceptives (the "Pill") - The Ovaries: Some Functional and Archetypal Considerations - Peculiarities of the Female Genitals' Sensory Innervation - Physiology of menstruation - Polycystic ovaries syndrome - The Possibility of Becoming Pregnant, Its Implications for Women, and Abortion - Premenstrual congestion of the breasts - Premenstrual syndrome (PMS) - The Psychology of Gynecology part 1 (part 2) - Psychosomatic and symbolic aspects of menstruation - Psychosomatic gynecology - Some Details on the Function of the Hypothalamus-Pituitary-Ovaries Axis - Stanislav Grof's Perinatal Matrixes of the Unconscious and Women's Medicine - Symmetric Patterns in the Female Genitals - Thoughts on Female Sexual Psychology - Uninterrupted use of hormonal contraceptives for menstrual suppression: why I do not recommend it - The uterine cervix - Uterine contractility - The Uterus and the Female "Passive-Active" - Women's corporeal consciousness and experience - Women's Experience of the Breasts - Women's Undesired Pregnancies and Women's Right to Abortion and see his Art of Menstruation


Peculiarities of the Female Genitals' Sensory Innervation

Dr. Nelson Soucasaux , Brazilian gynecologist

The purpose of this article is to introduce and comment on some peculiarities of the female genitals' sensibility and some of its implications for women and gynecologic practice. The female genitals basically possess two different kinds of innervation and, consequently, of sensibility: the "somatic" and the visceral (vegetative) ones.

Sensations originating in parts of the body whose innervation is of the "somatic" type are perceived in a very accurate, precise and well-localized form (see Note below). Conversely, sensations originated in the visceral organs (whose innervation is of the visceral or vegetative type) usually are extremely imprecise, diffuse and very difficult to be exactly "localized." Visceral pain often has, for instance, the characteristic of projecting itself on areas of the body that do not correspond to the exact origin of the painful stimulus, and this happens due to extremely intricate reflex pathways of metameric origin. (Metameric: related to the embryonic development of the nervous system.)

In women, the external genitals (vulva), the lower part of the vagina (basically the vaginal entrance) and the perineal muscles possess the "somatic" type of innervation and, as areas directly related to the sexual response, they have an extremely precise and localized sensitivity for all kinds of stimuli. Conversely, the vaginal inner or upper two-thirds (that is, most of the vagina), the uterus, Fallopian tubes, ovaries and respective ligaments and surrounding structures possess the visceral (vegetative) type of innervation. These facts have several implications in gynecologic practice, in the female sexual response and in the ways through which women experience their sexual organs.

We can therefore understand why the vagina is an organ of sexual expression whose greatest part (the inner or upper two-thirds) presents a relatively small sexual sensitivity, behaving more as a visceral organ than as a sensory one. Sensations that come from the vaginal inner part present the diffuse, imprecise and vaguely localized features typical of the visceral kind of sensibility. Only the external third of this organ (next to the vulva) possesses a great sexual sensibility, as well as the other characteristics of the "somatic" type of sensibility.

The inner or upper two-thirds of the vagina have a restricted sexual sensitivity and the sensations originating there are vague and imprecise. For all these reasons, in repose conditions (that is, in the absence of sexual intercourse and other forms of vaginal stimulation), the greater part of the vagina almost does not send any kind of information to women. (That's the reason why the existence of her vagina may not be known to a child, because it is not sensed.)

The aforementioned peculiarities of the kind of sensitivity of most of the vagina and all the woman's internal genitals perhaps may contribute to the creation, in the female psychology, of many mysterious fantasies regarding these organs. There is, for instance, the idea of the vagina as an "obscure and mysterious tunnel that leads to the intimacy of the female body." It is obvious that a great part of these fantasies are also due to the action of mythological and archetypal elements, and also to an extremely rich symbology.

These features of the innervation of the woman's sexual organs also have consequences in the routine of gynecologic consultations, mostly in anxious patients. During the gynecological examination, the dislike and discomfort that many women demonstrate even in procedures that, in normal circumstances, do not cause pain - procedures such as the intravaginal introduction and movement of the speculum, the taking of smears for vaginal and ectocervical cytology - make evident this peculiarity of the female anatomy and physiology.

As women have well-defined and correctly localized sensations only at the vulva and vaginal entrance, it is probable that, regarding the examination procedures performed at the inner part of the vagina and the uterine cervix, the sensations that reach their consciousness are very imprecise, diffuse and confused. The patient feels that "something" is being done inside her genitals, but she is not able to evaluate exactly what we are doing, and this can generate anxiety even when we explain in detail all that is being done.

Obviously the psychological features of this group of women aggravate the situation (mostly if they exhibit neurotic attitudes concerning the gynecologic examination), transforming the smaller stimuli originating from the examination into pain and discomfort. On the other hand, with regard to the taking of smears for endocervical cytology, the occurrence of some pain and uterine cramps is normal because the painful sensitivity of the cervical canal to mechanical stimulation is often great.

During the bimanual palpation of the uterus, Fallopian tubes and ovaries, the occurrence of some pain or discomfort even in the absence of pathology is also normal, because we need to press these organs through the vagina and the abdominal wall in order to perform the examination. The ovaries possess an especially great sensitivity to compression.

Considering that the purpose of this article was to analyse some clinical aspects of the sensitive innervation of the female genitals, all the other functions of the visceral (vegetative) and "somatic" innervation of these organs were not discussed here. For a detailed study of the innervation of the female pelvic organs, see my article "Fundamentos para o Estudo das Influências Neurovegetativas em Ginecologia."*(after the article) An introductory discussion about the still obscure functions of the vegetative innervation of these organs (that is, their sympathetic and parasympathetic innervation) can be found in this article.

Note: The "somatic" type of innervation is that of the skin, skeletal muscles and joints, also including most of the structures close to the surface of the body.

*Soucasaux, Nelson "Fundamentos para o Estudo das Influências Neurovegetativas em Ginecologia" ("Basis for the Study of the Neurovegetative Influences in Gynecology") in: Jornal Brasileiro de Medicina, Vol 57, nº 4, October 1989, Rio de Janeiro.


The article above is an adapted excerpt from my book "Novas Perspectivas em Ginecologia" ("New Perspectives in Gynecology"). For information on the book, see page http://www.nelsonginecologia.med.br/novas.htm, from my Web site www.nelsonginecologia.med.br .

Copyright Nelson Soucasaux 1990, 2003

_______________________________________________

Nelson Soucasaux is a gynecologist dedicated to clinical, preventive and psychosomatic gynecology. Graduated in 1974 by Faculdade de Medicina da Universidade Federal do Rio de Janeiro, he is the author of several articles published in medical journals and of the books "Novas Perspectivas em Ginecologia" ("New Perspectives in Gynecology") and "Os Órgãos Sexuais Femininos: Forma, Função, Símbolo e Arquétipo" ("The Female Sexual Organs: Shape, Function, Symbol and Archetype"), published by Imago Editora, Rio de Janeiro, 1990, 1993.

Website (Portuguese-English): http://www.nelsonginecologia.med.br

Email: nelsons@nelsonginecologia.med.br

NEWS | homepage | LIST OF ALL TOPICS | MUM address & What does MUM mean? | e-mail the museum | privacy on this site | who runs this museum?? |
Amazing women! | the art of menstruation | artists (non-menstrual) | asbestos | belts | bidets | founder bio | Bly, Nellie | MUM board | books: menstruation and menopause (and reviews) | cats | company booklets directory | contraception and religion | costumes | menstrual cups | cup usage | dispensers | douches, pain, sprays | essay directory | extraction | famous women in menstrual hygiene ads | FAQ | founder/director biography | gynecological topics by Dr. Soucasaux | humor | huts | links | masturbation | media coverage of MUM | miscellaneous | museum future | Norwegian menstruation exhibit | odor (olor)| pad directory | patent medicine | poetry directory | products, current | religion | your remedies for menstrual discomfort | menstrual products safety | science | shame | slapping, menstrual | sponges | synchrony | tampon directory | early tampons | teen ads directory | tour of the former museum (video) | underpants directory | videos, films directory | Words and expressions about menstruation | Would you stop menstruating if you could? | What did women do about menstruation in the past? | washable pads
More articles by Dr. Soucasaux: Anatomical drawings - Anovulatory cycles - Archetypal aspects of the female genitals - The breasts: some morphological aspects - Colposcopy - Comments on the corpus luteum and related aspects - The curious relations between androgens and estrogens in women - Endocrinology of menstruation - The Fallopian tubes - Female sexual response - The Gräfenberg Spot (G-Spot) - The Gynecologic Palpation (descendant of "The Touch") - Gynecological assistance: the three basic areas - Gynecology and Gynecologic Surgery - Gynecologist versus obstetrician: what lies behind the combination? - "Gyneco-obstetric-surgical" stubborness and the perpetuation of one of the greatest mistakes of women's medicine - Hypermenorrhea and/or Menorrhagia (Prolonged and/or Excessive Menstrual Bleedings) - Hypertrichosis, Hirsutism and Androgenic Manifestations in Women - Mayer-Rokitansky-Kuster-Hauser (MRKHauser) Syndrome - Menstrual toxin: An old name for a real thing? - Nature and the ovaries - On the Strange Nature of the Ovaries - Oral hormonal contraceptives (the "Pill") - The Ovaries: Some Functional and Archetypal Considerations - Peculiarities of the Female Genitals' Sensory Innervation - Physiology of menstruation - Polycystic ovaries syndrome - The Possibility of Becoming Pregnant, Its Implications for Women, and Abortion - Premenstrual congestion of the breasts - Premenstrual syndrome (PMS) - The Psychology of Gynecology part 1 (part 2) - Psychosomatic and symbolic aspects of menstruation - Psychosomatic gynecology - Some Details on the Function of the Hypothalamus-Pituitary-Ovaries Axis - Stanislav Grof's Perinatal Matrixes of the Unconscious and Women's Medicine - Symmetric Patterns in the Female Genitals - Thoughts on Female Sexual Psychology - Uninterrupted use of hormonal contraceptives for menstrual suppression: why I do not recommend it - The uterine cervix - Uterine contractility - The Uterus and the Female "Passive-Active" - Women's corporeal consciousness and experience - Women's Experience of the Breasts - Women's Undesired Pregnancies and Women's Right to Abortion and see his Art of Menstruation