The Vaginal Introitus: Anatomy, Health Conditions, and Care - Verywell Health

Introitus, a word derived from the Latin words for "to go" and "into," means an entrance to a canal or tunnel.

The term is most often used to refer to the entrance ofthe vagina, the external opening that leads to the vaginal canal.

Read on to learn about anatomy of the vaginal introitus, various health conditions that can cause pain, discomfort, or itching in this area, and tips for keeping your introitus healthy.

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Anatomy

The introitus is the external opening of the vaginal canal—a muscular tunnel that extends from the external female genitalia to the cervix (the opening to the uterus).

The introitus is found toward the rear of the external female genitalia (the vulva). The vulva contains inner and outer fleshy folds of skin, known as the labia minora (the inner folds) and labia majora (the outer folds). The introitus sits between the labia minora, behind (or below) the clitoris and urethral opening.

Prior to the first act of sexual intercourse or penetration, the introitus is covered by the hymen, a thin, tough sheath of tissue. An intact hymen normally has a half moon shape that covers only part of the vaginal opening, allowing for the passage of menstrual blood.

Imperforate Hymen

Sometimes the hymen fully covers the introitus, a condition known as an imperforate hymen. An imperforate hymen can prevent menstrual flow and force menstrual blood back into the vaginal canal. The backing up of blood, in turn, can cause abdominal pain, back pain, and problems urinating.

The muscles and tissues of the introitus and vaginal canal are flexible and stretch during penetration and childbirth.

Health Conditions

Because of its location, the introitus and surrounding tissues are subject to a number of health conditions, including sexually transmitted infections (STIs), fungal infections, and cysts (fluid-filled sacs).

These conditions are sometimes without symptoms, but they can cause discomfort, itching, pain, or foul odors.

Cysts

Several types of cysts can develop in the area around the introitus. Most cysts cause no symptoms. Occasionally, cysts become infected, becoming red and tender and causing pain during sexual intercourse.

Large cysts may block the opening to the vaginal canal. You may need surgery to remove large or infected cysts, including the following:

• Bartholin's cysts: The Bartholin's glands, found on the labia near the introitus, produce a fluid that lubricates the vagina. These glands sometimes develop cysts, often because of an infection or injury. Some Bartholin's cysts resolve on their own. Infected Bartholin's cysts, also called abscesses, can cause pain or discomfort, and may require medical treatment.
• Inclusion cysts: The most common cysts in the vulva, inclusion cysts develop from the surface tissue of the vulva. They often arise from injuries, such as tears during childbirth. These cysts are usually white or yellow in color, small, and painless.
• Epidermal cysts: These cysts develop when the sebaceous (oil-producing) glands of the vulva become blocked. The glands' normal secretions build up under the surface, producing a cyst.
  

Yeast Infections (Candidiasis)

Yeast is a normal part of the vaginal microbiome—the collection of bacteria and other microscopic organisms that live on the surface of the vagina and surrounding tissues.

An overgrowth of yeast in the vagina and surrounding tissues can lead to a yeast infection, which causes:

• Redness
• Swelling
• Itching inside and around the vagina
• White, cheese-like discharge
• Pain or discomfort upon urination or during sexual intercourse

Odor is not a common symptom of a yeast overgrowth and infection. The presence of a strong odor usually indicates bacterial vaginosis or another infection.

Bacterial Vaginosis

Bacterial vaginosis (BV) occurs when there is an overgrowth of certain bacteria, which disrupts the normal bacterial balance and acidity in the vagina.

Symptoms of BV include:

• Pain, itching, or burning in the vagina or surrounding tissues
• A thin, white or gray vaginal discharge
• A strong fishy odor, which is especially noticeable after sex
• Burning during urination

The causes of bacterial vaginosis are unclear. The condition is associated with having a new sexual partner, having multiple sexual partners, using an intrauterine device, and douching.

BV increases your risk of contracting an STI and becoming infected with human immunodeficiency virus (HIV). If you are pregnant, bacterial vaginosis raises your risk of premature birth.

BV is treated with antibiotics. Unfortunately, BV tends to recur even after treatment.

Vulvodynia

Vulvodynia refers to chronic pain, a burning sensation, soreness, or discomfort in the introitus and surrounding tissue. To be considered vulvodynia, the pain or discomfort must:

• Last for at least three months
• Have no identifiable cause

The symptoms of vulvodynia vary from person to person. Pain may come and go, occur only when the area is touched, or may persist throughout much of the day.

Vulvodynia can cause severe pain with intercourse or even after sitting for long stretches of time.

If you think you have vulvodynia, seek medical attention. A healthcare provider can rule out alternative explanations and help treat your symptoms.

Prolapse

Pelvic organ prolapse occurs when weakening of the muscles and supporting tissues of the pelvic organs (the bladder, uterus, or rectum) causes the organ to protrude into the vagina or through the introitus.

Anything that causes trauma or physical strain in the pelvic region can lead to pelvic organ prolapse, including:

• Injury
• Surgery
• Sustained abdominal pressure
• Heavy weight-lifting
• Multiple vaginal births
• Giving birth to a baby weighing more than 8.5 pounds
• Menopause-related hormonal shifts

Depending on the severity, pelvic organ prolapse may be treated with pelvic floor exercises, a pessary (a device placed in the vagina that helps support the uterus), or surgery.

Vaginal Stenosis

Vaginal stenosis occurs when scar tissue stiffens, narrows, or shortens the vaginal canal, causing dryness and pain during sexual intercourse and vaginal exams.

Cancer-related surgery and radiotherapy of the pelvic area are the main causes of vaginal stenosis. Chemotherapy can worsen the condition.

Vaginal stenosis can be treated with dilators, moisturizers, and hormonal therapy.

Lichen Sclerosis

Lichen sclerosis is an uncommon, immune-related condition that affects the skin around the vulva and rectum. It is most common before puberty and after menopause.

It may cause no symptoms, or it may lead to intense itching, discomfort, and white shiny patches of skin. Topical steroids can help resolve symptoms. Untreated, the condition can lead to permanent scarring and difficulty with urination, defecation, and vaginal penetration.

Sexually Transmitted Infections (STIs)

STIs are infections that spread by direct skin-to-skin contact and may have no symptoms.

Condoms, when used consistently and correctly, reduce your risk of contracting an STI, including the following:

• Herpes is a common viral infection that affects more than 1 in 6 adults. Herpes can cause periodic eruptions of painful blisters inside and around the vaginal opening.
• Genital warts are small, raised, painless bumps that may grow in clusters. These warts are caused by the human papillomavirus (HPV).
• Gonorrhea is a very common STI. In women, gonorrhea may cause bleeding between periods, increased vaginal discharge, and a burning sensation during urination, but often produces no symptoms. Antibiotics can cure gonorrhea. Left untreated, it can lead to pelvic inflammatory disease, scarring of the fallopian tubes (the tubes which carry fertilized eggs from the ovaries to the uterus), and infertility.
• Chlamydia is another very common STI that often causes no symptoms, but it may result in abnormal vaginal discharge and a burning sensation when you urinate. Antibiotics can cure chlamydia. Untreated chlamydia can cause pelvic inflammatory disease (PID), scarring of the fallopian tubes, and infertility.
• Trichomoniasis is a common STI caused by a protozoan parasite. As with other STIs, trichomoniasis often does not cause any symptoms, but sometimes leads to vaginal and vulvar itching, burning or soreness, pain with urination or intercourse, a fishy odor, and a change in vaginal discharge.
  

Care and Hygiene

The vaginal introitus maintains its own acidity with the help of its microbiome, which naturally keeps your vagina clean and helps prevent infections.

To keep this area healthy and its microbiome in balance:

• Change or wash your underwear daily.
• Wear breathable, cotton underwear.
• Avoid synthetic fabrics that trap moisture.
• Avoid using excess laundry detergent.
• Keep the area clean by washing once a day with warm water.
• If you do need to use soap, use a mild, unscented soap.
• Avoid over bathing, which can result in dryness and itching.
• Avoid sprays, perfumed or scented creams or sprays, and douching, which can disrupt the microbiome and increase the risk for infection and bacterial vaginosis.
• Promptly change out of sweaty underwear and wet swimsuits.
• Do not use talcum powder or talc-based products.

A Word From Verywell

Your introitus and vaginal canal have a remarkable ability to naturally clean themselves and lower your risk of infections. It's best to not interfere with this natural process: Avoid potentially harmful products like douches and feminine sprays, and wash only with warm water or mild, unscented soap.

Be sure to see a healthcare provider promptly when you have concerns. Most health conditions affecting the introitus are highly treatable, but some can lead to serious complications if left untreated.