The Vagina - Podcast Version 0:00 / 0:00 1x 0.25x 0.5x 0.75x 1x 1.25x 1.5x 1.75x 2x The vagina is an organ of the female reproductive tract. It is a distensible muscular tube which extends posterosuperiorly from the external vaginal orifice to the cervix. It has several roles within the female reproductive system: Sexual intercourse – receives the penis and ejaculate, assisting in its transport to the uterus. Childbirth – expands to provide a channel for delivery of a newborn from the uterus. Menstruation – serves as a canal for menstrual fluid and tissue to leave the body. In this article, we will look at the anatomy of the vagina – its structure, innervation, vascular and lymphatic supply. By TeachMeSeries Ltd (2026) Fig 1Overview of the female reproductive tract. Pro Feature - 3D Model You've Discovered a Pro Feature Access our 3D Model Library Explore, cut, dissect, annotate and manipulate our 3D models to visualise anatomy in a dynamic, interactive way. Learn More Anatomical Position The vagina is closely related to many of the organs in the pelvic region: Anterior – bladder and urethra. Posterior – rectouterine pouch, rectum and anal canal. Lateral – ureters and levator ani muscle. By TeachMeSeries Ltd (2026) Fig 2Sagittal section of the female pelvis, showing the anatomical relations of the vagina. Pro Feature - Dissection Atlas Sagittal section of the female pelvis. Sagittal section of the female pelvis. You've Discovered a Pro Feature Access our Dissection Image Library Enhance your understanding with high-resolution dissection images showcasing real-life anatomy. Learn More Anatomical Structure The vagina is a fibromuscular tube with anterior and posterior walls – these are normally collapsed and thus in contact with one another. The shape of the vagina is not a round tunnel. In the transverse plane it is more like an “H” lying on the side. At the upper ending, the vagina surrounds the cervix, creating two domes (fornices or vaults): an anterior and a (deeper) posterior one. The posterior fornix is important as it acts like a natural reservoir for semen after intravaginal ejaculation. The semen retained in the fornix liquefies in the next 20-30 mins, allowing for easier permeation through the cervical canal. Kostis Gyftopoulos MD, PhD Fig 3The anterior and posterior vaginal fornices Histology of the Vagina The vagina is composed of four histological layers (internal to external): Stratified squamous epithelium – this layer provides protection and is lubricated by cervical mucus (the vagina itself does not contain any glands). Elastic lamina propria – a dense connective tissue layer which projects papillae into the overlying epithelium. The larger veins are located here. Fibromuscular layer – comprising two layers of smooth muscle; an inner circular and an outer longitudinal layer. Adventitia – a fibrous layer, which provides additional strength to the vagina whilst also binding it to surrounding structures. Vascular Supply and Lymphatics The arterial supply to the vagina is via the uterine and vaginal arteries – both branches of the internal iliac artery. Venous return is by the vaginal venous plexus, which drains into the internal iliac veins via the uterine vein. Lymphatic drainage is divided into three sections: Superior – drains to external iliac nodes Middle – drains to internal iliac nodes Inferior – drains to superficial inguinal lymph nodes. By TeachMeSeries Ltd (2026) Fig 4Posterior view of the arterial supply to the female reproductive tract. Innervation Innervation is predominantly from the autonomic nervous system. Parasympathetic and sympathetic nerves arise from the uterovaginal nerve plexus (in turn a subsidiary of the inferior hypogastric plexus). Only the inferior 1/5 of the vagina receives somatic innervation. This is via a branch of the pudendal nerve, the deep perineal nerve. Clinical Relevance Vaginal (Obstetric) Fistulae A vaginal fistula is an open communication between the vagina and one of the adjacent pelvic organs. It typically occurs as a result of prolonged labour (where a Caesarean section is not available). As the fetus slowly progresses down the vaginal wall, it exerts pressure – obstructing the blood supply and causing tissue necrosis. There are three main types of vaginal fistulae: Vesicovaginal – abnormal communication with the bladder. Urine enters the vagina. Urethrovaginal – abnormal communication with the urethra. Urine only enters the vagina during urination. Rectovaginal – abnormal communication with the rectum. Faecal matter can enter the vagina. Do you think you’re ready? Take the quiz below Pro Feature - Quiz The Vagina Question 1 of 3 Submitting... Skip Next Rate question: You scored 0% Skipped: 0/3 1800 More Questions Available Upgrade to TeachMeAnatomy Pro Challenge yourself with over 1800 multiple-choice questions to reinforce learning Learn More Frequent questions What is the primary function of the vagina in the female reproductive system? The vagina serves multiple essential roles, including facilitating sexual intercourse, providing a birth canal during childbirth, and acting as a passageway for menstrual fluid. These functions are crucial for reproduction and menstrual health. What anatomical structures are closely associated with the vagina? The vagina is positioned adjacent to several pelvic organs: anteriorly to the bladder and urethra, posteriorly to the rectouterine pouch and rectum, and laterally to the ureters and levator ani muscle. This anatomical relationship is important for its function and clinical considerations. How is the vagina structured histologically? The vagina consists of four histological layers: the stratified squamous epithelium for protection, the elastic lamina propria for structural support, a fibromuscular layer with smooth muscle, and an adventitia that binds it to surrounding tissues. These layers contribute to the vagina's resilience and functionality. What is the vascular supply and lymphatic drainage of the vagina? The vagina receives arterial blood from the uterine and vaginal arteries, which branch from the internal iliac artery. Lymphatic drainage is categorised into three regions: superior to external iliac nodes, middle to internal iliac nodes, and inferior to superficial inguinal lymph nodes. What are vaginal fistulae, and what causes them? Vaginal fistulae are abnormal openings between the vagina and nearby pelvic organs, often resulting from prolonged labour that compromises blood flow and causes tissue necrosis. The main types include vesicovaginal, urethrovaginal, and rectovaginal fistulae, each affecting different organ communications. Rate This Article