The vulva consists of the mons pubis, labia majora, labia minora, clitoris, and vaginal vestibule. An understanding of normal female anatomy is necessary to adequately evaluate and treat vulvar pathology and female sexual dysfunction.

Mons pubis

The mons pubis is the rounded eminence located anterior to the pubic symphysis. It consists of a pad of fatty connective tissue and is covered with pubic hair. It's size increases after puberty, and decreases after the menopause.

Labia minora

The labia minora are a pair of folded skin around 5 cm in length and 0.5 cm in thickness. They provide protection to the urethral and vaginal orifices. They fuse anteriorly to form the prepuce of the clitoris. They contain mostly elastic fibers and connective tissue, covered by a skin that is free of hair, and contains eccrine sweat glands but no apocrine glands.

Labia majora

The labia majora fuse with the mons pubis anteriorly, and with the perineal body posteriorly. They consist of fat and connective tissue covered with pigmented skin that contains numerous hair follicles, eccrine sweat, and sebaceous apocrine glands. Most vulvar tumors arise from the labia majora.The innervation of both labia minora and majora is through the perineal and posterior labial branches of the pudendal nerve. Different forms of injury to that nerve may result in pudendal neuralgia &/or pelvic muscle myalgia.

Clitoris

The clitoris is cylindrical in shape and has 3 parts: The outermost glans, the midline corpus or body and the innermost two crurae. The crurae consist of vascular erectile smooth muscle. The clitoris has many nerve endings and is highly sensitive to touch, pressure and temperature. In some women, difficulty and pain associated with clitoral stimulation and engorgement, leads to sexual arousal disorder and orgasmic disorder.

Vaginal vestibule

The vaginal introitus and urethral meatus open into the vaginal vestibule between the labia minora. Surrounding the vaginal opening are the secretory minor vestibular glands, and the paired major vestibular glands (Bartholin glands). These glands can occasionally get inflamed and lead to vulvar vestibulitis syndrome and dyspareunia.