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The vagina is a canal-like organ located inside the body that connects to the cervix and uterus at the top and opens outside the body at the bottom. The vaginal support structures are made up of muscles, bones, ligaments, tendons, membranes, and fascia, which are all part of the pelvic floor. The pelvic floor muscles help to stabilise the core and assist with essential bodily functions, such as urination, defecation, and sexual intercourse. These muscles can be deliberately controlled, similar to flexing a bicep. When contracted, they lift the internal organs of the pelvis and tighten the openings of the vagina, anus, and urethra. Conversely, when relaxed, they widen these passages, allowing for urination and defecation.
| Characteristics | Values |
|---|---|
| Vaginal support structures | Muscles, bones, ligaments, tendons, membranes, fascia |
| Muscles that support the vagina | Pelvic floor muscles, perineal body, pubococcygeus, levator ani, bulbocavernosus, transverse perinei, ischiocavernosum |
| Pelvic floor muscles | Hold major organs in the pelvis in place, protect them, and help with bodily functions like peeing, pooping, and sex |
| Relaxing pelvic floor muscles | Widens passages to allow urination or defecation |
| Contracting pelvic floor muscles | Lift internal organs of the pelvis and tighten openings of the vagina, anus, and urethra |
| Weak pelvic floor muscles | Can lead to conditions like incontinence, pelvic organ prolapse, or vaginismus |
| Pelvic floor muscle exercises | Can help strengthen weak pelvic floor muscles |
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What You'll Learn
Pelvic floor muscles widen the vagina
The pelvic floor muscles are a group of muscles that support the bladder, bowel, and uterus (womb). They stretch from the pubic bone at the front of the body to the tailbone (coccyx) at the back. The pelvic floor muscles help stabilise the core while assisting with essential bodily functions, such as urination, defecation, and sexual intercourse.
The pelvic floor muscles support the vagina and help maintain its position within the pelvic cavity. They also provide flexibility during intercourse and vaginal childbirth. The muscles wrap around the vagina, urethra, and anus, and can be squeezed or relaxed to control the widening or narrowing of these passages. For example, relaxing the pelvic floor muscles widens the vaginal opening, while squeezing them narrows it.
Pelvic floor muscles can weaken over time due to various factors, including injury, pregnancy, obesity, age, and hormonal changes. Weakening of these muscles can lead to conditions such as incontinence, pelvic organ prolapse, and vaginismus. It is important to maintain strong pelvic floor muscles through specific exercises, as this can help prevent and manage these conditions.
The perineal body, a pyramidal structure of muscle and connective tissue located between the anus and vagina, also provides support for the vagina. It is composed of smooth muscle, elastic connective tissue fibres, and nerve endings. Additionally, the levator ani muscle, composed of the iliococcygeus and pubococcygeus, surrounds the openings of the urethra, rectum, and vagina, contributing to their function.
In summary, the pelvic floor muscles, including the perineal body and levator ani muscle, play a crucial role in supporting the vagina and maintaining its position and function within the pelvic cavity. Relaxing and contracting these muscles can widen or narrow the vaginal opening, respectively, and it is important to maintain their strength through appropriate exercises.
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Pubococcygeus muscles
The pubococcygeus muscle, also known as the PC muscle, is a hammock-like muscle that forms the intermediate part of the levator ani muscle complex. It is one of the three muscles that make up the levator ani, the other two being the iliococcygeus and the puborectalis. The levator ani is a broad, thin muscle group situated on either side of the pelvis. The pubococcygeus muscle originates from the obturator fascia and pubis and passes posteriorly, caudally, and medially to decussate with fibres from the contralateral side.
The pubococcygeus muscle stretches from the pubic bone to the coccyx (tailbone), forming the floor of the pelvic cavity and supporting the pelvic organs. It provides stability and support to the abdominal and pelvic organs. It also controls urine flow, contracts during orgasm, and assists in male ejaculation. A strong pubococcygeus muscle has been linked to a reduction in urinary incontinence and the proper positioning of the baby's head during childbirth.
The pubococcygeus muscle is subdivided into the pubourethralis, pubovaginalis, puboanalis, and puborectalis muscles. The names describe the attachments of the muscles to the urethra, vagina, anus, and rectum. For example, the pubovaginalis muscle in females fuses with the perineal body, prostate, and vagina, forming part of the longitudinal muscle bundle. The perineal body is a pyramidal structure of muscle and connective tissue that provides support to the pelvis and vagina.
The pelvic floor muscles, including the pubococcygeus, help stabilise the core while assisting with essential bodily functions like urination, defecation, and sexual intercourse. They can weaken over time due to injury or the ageing process, leading to conditions like incontinence or pelvic organ prolapse. Pelvic floor exercises, such as Kegel exercises, can help strengthen the pelvic floor muscles, including the pubococcygeus.
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Perineal body
The perineal body is a fibromuscular structure located in the midline of the perineum, at the junction of the anus and urogenital triangle. It is composed of skeletal muscle, smooth muscle, collagenous and elastic fibres, and nerve endings. The perineal body acts as a central point of attachment for various muscles, including the bulbospongiosus, deep transverse perineal muscle, compressor urethrae (in females), external anal sphincter, and external urethral sphincter muscles. It also provides support for the pelvic floor and helps maintain its integrity.
In females, the perineal body is positioned between the anus and the posterior limit of the vulvar orifice, just posterior to the vaginal vestibule. It acts as a tear-resistant body between the vagina and the external anal sphincter, supporting the posterior part of the vaginal wall and preventing prolapse. The lower vagina is attached to the perineal body by the pubococcygeus, perineal muscles, and the anal sphincter.
The perineal body is particularly important during childbirth, as it may rupture or be damaged during vaginal delivery. This can potentially widen the gap between the levator muscles and predispose women to prolapse of the rectum, uterus, or urinary bladder. To prevent uncontrolled tearing of the perineal body during childbirth, an episiotomy (a surgical cut in the perineum) may be performed. While this inevitably damages the vaginal mucosa, it helps to avoid potential tearing of the perineal body.
The perineal body is also relevant in the surgical resection of anorectal tumours. Its identification ensures the achievement of a tumour-free circumferential resection margin, reducing the risk of local recurrence. Overall, the perineal body plays a critical role in maintaining the integrity of the pelvic floor and supporting the pelvic organs, particularly during childbirth and surgical procedures.
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Vaginal support structures
The vagina is a stretchy, muscular tube located in the pelvis, between the bladder and the rectum. It is a crucial part of the female body, playing a role in sex, menstruation, conception, and childbirth.
The vaginal support structures are those muscles, bones, ligaments, tendons, membranes, and fascia of the pelvic floor that maintain the position of the vagina within the pelvic cavity. These support structures allow the vagina and other reproductive structures to function normally.
The pelvic floor muscles stretch from the pubic bone in front to the tailbone (coccyx) in the back. The muscles extend outward on both sitting bones (ischial tuberosity) on the right and left sides of the pelvis. The pelvic floor muscles hold the vagina and other major organs in the pelvis in place and protect them. These muscles can be controlled, allowing the body to squeeze and relax them to pass waste from the body.
The perineum, a grouping of muscles that constrict to close the urogenital openings, supports and functions as a sphincter at the opening of the vagina. The perineal body, located between the anus and vagina, is a tendon formed by the convergence of several muscles. The lower vagina is attached to the perineal body by the pubococcygeus, perineal muscles, and the anal sphincter. The perineal body is made up of smooth muscle, elastic connective tissue fibres, and nerve endings.
The vagina is attached to the pelvic walls by endopelvic fascia, which is covered by the peritoneum, the external layer of skin that provides additional support to the pelvic floor. The endopelvic fascia is a continuous sheet of tissue that varies in thickness and contains elastic collagen fibres in a mesh-like structure, as well as fibroblasts, smooth muscle, and vascular vessels. The cardinal ligament supports the apex of the vagina and gains strength from vascular tissue.
The muscular pelvic diaphragm is composed of the bilateral levator ani and coccygeus muscles, which attach to the inner pelvic surface. The levator ani surrounds the openings of the urethra, rectum, and vagina. The pubococcygeus muscle is subdivided into the pubourethralis, pubovaginal muscle, and the puborectalis muscle, which attach to the urethra, vagina, anus, and rectum.
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Vaginal muscular layer
The vagina is a stretchy, muscular tube located in the pelvis. It has three layers: the internal mucosal layer, the intermediate muscularis layer, and the external adventitial layer.
The muscularis layer, or the vaginal muscular layer, consists of two indistinct layers of smooth muscle fibres, which cannot be controlled. These layers are the circular layer, lying close to the mucosal layer of the vagina, and the longitudinal layer, adjacent to the adventitia (outer) layer of the vagina. The muscular layer lies between the mucosal and adventitial layers.
The muscular walls of the vagina support the bladder and the rectum. The muscular layer can also distend during childbirth. The smooth muscle fibres in the vaginal muscular layer help expel fluids (discharge) from the vagina.
The vagina is attached to the pelvic walls by endopelvic fascia, which is a continuous sheet of tissue that varies in thickness. The fascia contains elastic collagen fibres in a 'mesh-like' structure, as well as fibroblasts, smooth muscle, and vascular vessels. The perineal body, which is made up of smooth muscle, elastic connective tissue fibres, and nerve endings, is located below the vagina and the uterus.
The pelvic floor muscles help stabilise the core while assisting with essential bodily functions, such as eliminating waste, urination, and sexual intercourse. These muscles also help hold the major organs in the pelvis in place and protect them.
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Frequently asked questions
Pelvic floor muscles are a group of muscles that stretch from the pubic bone to the tailbone and support the bladder, bowel, and uterus. They help stabilise your core and assist with essential bodily functions like pooping, peeing, and having sex.
Pelvic floor muscles help keep the vagina in place and protect it. Squeezing these muscles tightens the vaginal opening, while relaxing them widens it.
Pelvic floor muscles can be deliberately controlled, similar to flexing a bicep. Pelvic floor muscle exercises can help strengthen them at any age.
