Female Pelvic Anatomy: Everything Is Connected

Exploring the Connection Between Female Sexuality and the Female Urinary System

Female Pelvic Anatomy: Everything Is Connected [5, 6]:

The clitoris and vagina are not discrete and isolated organs, as they are located immediately adjacent to one another inside the body. The clitoris and outer third of the vagina even share a common nerve, the pudendal nerve. This relationship is often overlooked, as many envision the clitoris as a small external and superficial organ located an inch (2.5 cm) away from the vagina. In reality the clitoris is a much larger organ, one that is largely hidden from view within the body, and surrounds the vaginal passage on three sides.

The female urethra is intimately related to both the vagina and clitoris, as the urethra lies within the same anatomical structure as the vagina. When women urinate the urine travels through their urethra, which is located within the wall of their vagina. One anatomy book even has illustrations that demonstrate how the urethra can project into the vaginal canal, and a photograph on this website clearly shows the swollen glands of the female prostate gland projecting into the vaginal canal. The end result being that women urinate through their vagina, just as men urinate through their penis. This statement is not meant to suggest that urine actually passes through the vaginal canal and orifice, as is the case with menstrual blood; though this does occur when there is a vaginal fistula.

A third organ, the female prostate gland is intimately related to the vagina, clitoris, and urethra. The prostate gland encircles the urethra, and both are embedded within the vaginal wall. As a result, the internal structures of the clitoris surround the urethra, prostate, and vagina on three sides, meaning they are all intimately related and connected. The following images and illustrations help demonstrate this relationship.

Internal Structures of Vulva

In the MRI image and illustration shown above we can see how the urethra and vagina are surrounded on three sides by the legs and bulbs of the clitoris. When a woman urinates, urine flows alongside the internal structures of her clitoris, for at least part of its journey out of her body. In men, these same erectile structures also surround the urethra on only three sides. The male urethra is fully enclosed in an altogether different type of erectile tissue, corpus spongiosum, which corresponds to the inner labia in women.

Cross section of vagina, urethra, female prostate gland

In the illustration shown above we can see how the urethra (U) is enclosed within the prostate gland, represented by the sold black dots, and both are attached to the wall of the vagina (V) by the urethra-vaginal septum (UVS). At this point, the urethra, prostate gland, and vagina are part of a single structure, are fused together, rather than being three discrete organs, as we commonly envision.

The Physical Connection Between Urination and Sex:

The illustrations shown above clearly demonstrate how intimately related a woman's urethra is to her sexual organs. It shouldn't be surprising then that many women experience sensations associated with urination during their sexual experiences. In reality, women cannot engage in sexual activities without some form of direct or indirect stimulation of their prostate gland and urethra. At a minimum, as their erectile structures and vagina become engorged with blood they place a small amount pressure on the urethra and prostate gland. During manual stimulation of the vulva and vagina, and during penile/vaginal intercourse, it is almost impossible not to directly stimulation the urethra. The close proximity and intimate relationship between a woman's urinary and sexual organs makes these experiences unavoidable.

Medical Quote:

Originally Published: July 2010

The female urethra is only 4 cm [1.6 inches] long. Its wall has venous sinuses [cavities] that are filled with blood; in the lining of the urethra are triangular-shaped paracrine [hormone secreting] cells that are thought to have mechanoreceptor [sensory] properties and contain serotonin (5-hydroxytryptamine). Serotonin is known to power the sensitivity of nerve endings. Stretching of the urethra usually occurs during coitus [intercourse] or during digital [fingers] stimulation of the anterior [front] wall and this may well activate these mechanoreceptor cells to release serotonin, thus sensitizing the nerve endings in the urethra, eventually creating pleasurable sensations, and converting a urinary structure into a sexual one.

Source

If women weren't resistant to the idea, isn't it possible that urination would be a normal part of the female sexual experience? I am not saying that it is or should be, only that there is the potential. Should we be surprised if a woman urinated during her sexual experiences, as a result of the stimulation of her urethra, based on her physical anatomy and sensory perceptions?

The Female Urethra:

The female urethra is likely more complex than you envision, and is perhaps more complex than the male urethra, because of the adjacent vaginal passage. The following two illustrations help demonstrate this complexity.

Cross section of vagina and urethraCross section of female urethraColor Code

We have voluntary control over "striated" muscles but do not have conscious or voluntary control over "smooth" muscles. This means a woman can voluntarily contract the outer layer of muscle that encircles her urethra, but not the inner two layers. The female prostate gland is also comprised of smooth muscle fibers, and the significance of this is addressed below.

Muscles of female urethra

In the illustration shown above we can see how the female urethra is encircled in muscular tissue. The highlighted muscles are said to be under a woman's voluntary control when she stops the flow of urine from her body, and performs Kegel contractions. These muscles are normally under a slight amount of tension, keeping the urethral sphincters closed, which allows for the storage of urine inside the bladder until it is full and we voluntary urinate, or the pressure within the bladder becomes too great for the muscles to contain.

Note: At this time, the function and normal state of these muscles is not agreed upon within the medical community.

Small Yet Significant:

To help keep things in perspective, the female urethra, surrounding prostate gland, and muscles are slightly larger than a woman's thumb. The adult urethra is one and a half to two inches (3-5 cm) in length, and a quarter of an inch (6 mm) in diameter. The average female prostate is 1.3 inches long, 0.75 inches wide, 0.4 inches in height (3.3 x 1.9 x 1 cm). The distance between the vagina and pubic bone is only slightly more than three-quarters of an inch (0.8 inches or 2 cm). This means all the anatomy shown above is contained within a relatively small space, though these illustrations may give the impression the organs and spaces are much larger.

The Pelvic Muscles:

Another significant part of a woman's sexual anatomy is her pelvic muscles, the muscles that hold her internal organs in place, and they also influence the intensity of her orgasms. Voluntary or involuntary contraction of these muscles during sexual arousal, and at the point of orgasm, will prevent orgasm from occurring. You can learn more about these muscles here.

The Experience of Urination and Ejaculation:

The connection between urination, orgasm, and ejaculation is likely more obvious to men than women, as men commonly hold their penis in their hand while urinating and masturbating to orgasm. The resulting urine and ejaculate flow through their penis while it is being held in a man's hand, and as a result men are likely able to realize a connection between urination and ejaculation. Even if men are not aware of this connection on a conscious level they probably aren't surprised when confronted with it.

Women on the other hand don't have a penis they can hold during urination and masturbation, are frequently envisioned as not possessing external genitals and the means of ejaculating, and likely see urination as a distinct bodily function that is or should be far removed from their sexual function. Women probably aren't aware of this potential connection within their body, and as a result of social morality, even less likely to be accepting of it. Is it possible for women to acknowledge the fact that they too urinate and ejaculate through their sexual organs, their vagina?

Similarities in Male and Female Anatomy Demonstrated:

If we were to compare photographs showing the external genitals of a typical man and woman we would likely come to the immediate conclusion that there was very little in common. On the other hand if we compare photographs showing a man and woman exhibiting genitals with atypical levels of development, we may come to a totally different conclusion. Let me demonstrate. In the first photograph shown below we see a vulva having a highly developed clitoris that looks very similar to a small penis. We can even see the point at which urine would have flowed out of the clitoral glans had the inner labia fused together to form a urethral canal, had her genetic coding signaled male rather than female, or a variant of intersexuality. In the second photograph we see an example of hypospadias, with the arrow pointing to the location of urethral opening. This is a condition in some boys and men where the urethra does not extend all the way to the glans of the penis. While the anatomy shown in the first photograph is that of a female and the second of a male, there is a significant amount of similarity between their appearance. In both examples urine exits the body about 1 inch (2.5 cm) away from the clitoral/penile glans. Despite their distinctive appearances I feel comfortable assuming these individuals possess the ability to reproduce in the manner of their respective genders, meaning their body is fully functional despite their somewhat unique appearances.

Vulva featuring large clitorisExample of hypospadias
First Image Female - Second Male

A Penis is Not Required of Ejaculation:

In men the mechanisms that result in the forceful expulsion of ejaculate from their body aren't fully understood or agreed upon, but those mechanisms are nevertheless located inside his body, rather than being located within the external and visible portion of his penis. [2] The penis merely provides a means of depositing sperm deep within the vagina. It aids in conception rather than being actively involved in the process of ejaculation, i.e. propelling sperm out of the body. This means the individual with hypospadias shown above has the means of ejaculating even though their urethra doesn't extend to the tip of their penis, and their penis is not fully developed. If the individual shown in the second photo can ejaculate, shouldn't it be possible for the one in the first to ejaculate as well? If men can ejaculate shouldn't women also be able to ejaculate?

The Significance of the Female Prostate Gland:

Note: The article about Female Ejaculation also contains relevant information on this subject.

Note: As of August 2011, the following information concerning the female prostate may apply to only 50 percent of women, read more.

Even though the male and female “internal reproductive organs” share a common initial path of development, at the completion of that development there is almost no commonality in appearance and function. Most of the structures that are responsible for the collection and ejaculation of sperm in the male do not develop in the female, with one notable exception, the female prostate gland.

Relevant Quotes:

“Nevertheless, despite the smaller space available for the female prostate, it possesses all the structural components characteristic of the male prostate (Zaviacic, 1987, 1999).”[3]

“The female prostate possesses histologically the same structures as the prostate of the male, i.e. glands, ducts, and smooth musculature. The ducts are more numerous than the glands and they exceed in number also the ducts of the male prostate. The smooth musculature (musculofibrous tissue) are also more abundant in the female compared to the male prostate (Zaviacic, 1987, 1999; Zaviacic et al. 2000).”[3]

“The contraction of this smooth muscle are stimulated by activation of the sympathetic division of the autonomic nervous system via the hypogastric nerve. Also, electrical stimulation of the hypogastric nerves produced contraction of the bladder neck, prostate, seminal vesicles, and ejaculatory ducts, thereby simulating natural emission. [2]

“The urethral sphincter complex was innervated by…nerve fibers arising from the vaginal nervous plexus and pudendal nerve.” [4]

“The urethral sphincter complex has dual innervation, which pierces into the urethral sphincter complex at different locations.” [4]

“The location of a dense network of autonomic nerves at the level of the vagina supplied by the inferior hypogastric plexus…traveled either along the pathways described above towards the clitoris or towards the proximal a [sic] mid urethral sphincter.” [4]

“The ejaculation mechanism, the biological phenomenon of urethral expulsion in the female, which contrary to the male is not directly involved in reproduction yet remains an attractive phenomenon of female sexuality, is a further mode of evacuation of the prostate in the female.” [3]

The preceding quotes basically state women have a fully functional prostate gland, and the means of expelling or ejaculating the contents of their prostate gland during orgasm. The female prostate produces the same fluids as the male prostate; prostate-specific antigen (PSA), prostate-specific acid phosphatase (PSAP or PAP), and fructose, a sugar. The male and female prostate glands are connected to the hypogastric nerve, which in the male is responsible for the contraction of the involuntary muscles of the prostate, and in part, the ejaculation of sperm during orgasm. This hypogastric nerve is also activated during orgasm in women.

Even though women do not have testicles that produce sperm, their prostate gland contracts involuntarily during orgasm, releasing or expelling its contents through the urethra. While we may not agree on the volume of fluid produced by the female prostate during orgasm, it nevertheless produces at least a trace amount. If there is only a tiny amount of female ejaculate released it may simply mix with the vaginal lubrication present and go totally unnoticed by the woman and her partner. The resulting “wet spot” on their bedding would have trace amounts of prostatic fluids present, even if they weren't aware of her ejaculation.

What if women suppress ejaculation when their body attempts too, wouldn't this impair their ability to experience orgasm? If a woman misinterprets the sensations associated with ejaculation with those associated with urination isn't she more likely to suppress orgasm? What if these unknown sensations simply frighten her, being unlike anything she has experienced before?

Does Urine Pose a Health Hazard?:

While we are raised to believe urine is "dirty," and potentially harmful to ourselves and others, this isn't necessarily or generally true. If we are healthy then our body isn't producing hazardous body fluids, and our urine doesn't pose a health risk. As unappealing as it may sound, it is actually safe to drink our own urine, if we should happen to be motivated to do so. For couples who are already fluid bonded, urine likely poses no greater risk of spreading disease than does vaginal lubrication, or male and female ejaculate. Depending on your believes concerning female ejaculation, it is even possible that many women already expose themselves and their partner to liquid from their bladder, and in this context the liquid is sometimes cultivated and worshipped. This means the exercises and practices mentioned below are not potentially harmful to your health, if we are known to be healthy.

Please see the following references for additional information on this subject.

True or False: It's Safe to Drink Your Urine

Urophagia: Health issues

Go Ask Alice!

Modesty: A Barrier to Self Acceptance and Pleasure:

The reason why we close and often times lock bathroom doors, and have private stales with latching doors in public bathrooms, is so others aren't exposed to our nudity, we do it for reasons of modesty, not to limit health risks. This is particularly true for girls and women, as men generally have urinals that don't provide much in the way of privacy, and frequently have communal showers that provide absolutely no privacy. Men are literally much more likely to let it all hang out than are women.

Women are frequently raised to be so ashamed of their body they are compelled to hide it from themselves, not just others. Many older teens and adult women have written to me and disclosed they have no idea what they look like "down there," nor do they know how they should look. This obviously results in some body image issues, and barriers to intimacy and sexual pleasure. These issues must be addressed and resolved if women are to feel good about their body and enjoy sex to its fullest potential. If my hypothesis were proven true then some preorgasmic women must resolve these issues before they can experience orgasm.

For Which Preorgasmic Women Does this Hypothesis Potentially Apply?:

How does a woman know if her inability to experience orgasm is related to learned control over her urinary organs, and/or the sensations associated with urination? The less appealing the idea of urinating during masturbation and partnered sex is to a woman the greater the likelihood this believe could adversely affect her ability to experience orgasm. The women who are least likely to be preorgasmic for this reason are the minority of women who have demonstrated the ability to voluntarily urinate during partnered sex, when there were no associated negative consequences. If you can urinate in any situation, having demonstrated that you can versus simply believing you can, and have voluntarily urinated on your partner during some activity, you are very unlikely to be preorgasmic for the reasons described above.

Based on the survey results mentioned above, upwards of 90 percent of women are not as comfortable with urine and urination as they could be, which may adversely influence their sexuality to some degree. While they are not all preorgasmic, they may feel a need to control their urinary activities to a degree that is not truly necessary or beneficial. I am not saying you have to urinate on your partner in order to experience orgasm, or find sex enjoyable, only that you shouldn't be fearful of actually doing so, because the fear isn't justified, at least from a purely logical perspective. Admittedly, in reality there is a lot of potential fear and anxiety associated with the idea of urinating during our sexual experiences, which could be difficult to overcome.

Notes and References