physiology of the vagina

7/28/2019 Physiology of the Vagina

1/19

PHYSIOLOGY OF THE

VAGINA

Sri Kadarsih Soejono

Bagian Ilmu Faal


2/19

Both proliferation and maturation of the

vaginal epithelium are influenced by

estrogen and progesteron


3/19

Three types of vaginal cells are exfoliated:

1. mature superficial cellwhich are squamous

epithelial cells with pyknotic nuclei

2. intermediate cells, which relatively maturesquamous epithelial cells whith vesicular,

non pyknotic nuclei

3. para basal cells, which are thick , small, round,

immature cells, with large vesicular nuclei


4/19

Para basal cells predominate before

puberty, post menopause, and women

with estrogen-deficient forms of

amenorrhea


5/19

When ovarium estrogen secretion is low

in the early follicular phase, the vaginal

epithelium is thin and pale


6/19

and

As estrogen levels increase in the

follicular phase, there is an increase in the

number of cells, the thickness of the

epithelium, and the number of cornified

superficial cells


7/19

Under the influence of progesterone duringthe luteal phase, the percentage of cornifiedcells decreases

While

the number precornified intermediate cellsincreases, and there are increased numbers

of polymorphonuclear leukocytes andincreased cellular debris and clumping ofshed cells


8/19

Thus, the ratio among the various

desquamated vaginal cell obtained by

fixing a scraping from the upper third of

the lateral vaginal wall on a microscopeslide, can be used to evaluate estrogen

effect

This ratio has been termed thematuration index


9/19

Cervix and cervical mucus

Under the influence of estrogen, cyclic

channges occur in the diameter of the

external cervical os, the dimension of the

external cervical canal, the vascularity of

cervical tissues, and the amount andbiophysical properties of cervical mucus


10/19


11/19

During the follicular phase, there is aprogressive increase in cervical vasculariy

congestion and edema, as well as in the

secretion of cervical mucus


12/19

The external cervical os opens to adiameter of 3 mm at ovulation, and then

decreases to 1 mm


13/19

Under the influence of increasing levels ofestrogen, several changes in cervicalmucus occur

1. a 10- to 30- fold increase in the amount ofcervical mucus

2. the elasticity of the mucus (spinnbarkeit)increases

3. just before ovulation, palm leaf arborization(ferning) become prominent

4. the pH of the mucus increases to about 8.0at midcycle


14/19

This ferningis result of the increasedsodium chloride concentration in the

cervical mucus induce by rising levels

estrogen


15/19


16/19

and

Under the influence of progesterone

during the luteal phase, :

1. cervical mucus thicken

2. less watery

3. loses its elastisity and ability to fern


17/19

These charateristics of cervical mucus canbe used clinically to help evaluate the

stage of the menstrual cycle, and to help a

woman time her ovulation (the Billingmethod)


18/19

This mucus can indicate whether you arefertile or infertile by its sensation and

appearance

It is produce by the cervix , which is the

part of the uterus that joins with the

vagina, and which is under the control ofthe reproductive hormones


19/19

Scientific research has shown not onlydoes the mucus signal the fertile state, it

also appears to be essential if conception

is to take place

For without the mucus, sperm transport

is impeded and the sperm cells die quicklyin the acid environment of the vagina

physiology of the vagina

Documents