Andrew Siegel MD 8/11/2018
Women are capable of releasing a “cocktail” of genital fluids during sexual activity. Controversy exists regarding the nature, volume, and composition of these secretions and their mechanisms of expulsion. Today’s entry delves into the origins of female sexual fluids—vaginal, glandular (Skene and Bartholin glands) and the urinary bladder—and the means of their release. In the image below, the anatomical structures in boldface are those responsible for the genital fluids.
Image below: note Swedish “slida” is vagina (literally “sheath”); note Skenes and Bartholins gland openings, “urinrorsmynning” = urethra; “klitoris” = clitoris
Attribution of image above: By Nicholasolan (Skenes gland.jpg) [GFDL (http://www.gnu.org/copyleft/fdl.html), CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0/) or CC BY-SA 2.5 (https://creativecommons.org/licenses/by-sa/2.5)%5D, via Wikimedia Commons
Vaginal secretions
Lubrication that originates from the vagina is an ultra-filtrate of blood resulting from the increased blood flow and pelvic congestion that happens with erotic and tactile stimulation. The surge of blood to the genitals at the time of arousal results in the seeping of this natural lubrication fluid. There is often a substantial drop in the amount of vaginal lubrication that occurs after menopause with the sudden cessation of estrogen production by the ovaries. By the way, if you are interested in testing your knowledge of female anatomy, visit: how high is your vaginal I.Q.?
Skene gland secretions…the female “prostate”
The Skene glands (a.k.a. para-urethral glands) are homologous to the male prostate gland. These paired glands are located within the top wall of the vagina near the urethra and drain into the urethra and to tiny openings near the urethral opening (see image above). At the time of sexual climax, they can release a small amount of fluid into the urethra, paralleling the male release of prostate fluid at the time of ejaculation.
Bartholin gland secretions…the female “bulbourethral” glands
The Bartholin glands (a.k.a. greater vestibular glands) are paired, pea-size structures located in the superficial perineal pouch. These glands open below and to the sides of the vagina (see image above). They are homologous to the male bulbourethral glands that produce a clear, sticky fluid that lubricates the male urethra, often referred to as “pre-cum.” The Bartholin glands secrete mucus that functions to provide lubrication to the inner labia that helps moisten the opening into the vagina.
Bladder and urethra
Because of the anatomical proximity of the bladder and urethra to the vagina, urine stored in the urinary bladder can be involuntarily released at the time of sexual activity. Urine can be expelled during initial vaginal penetration, in the midst of the act of sexual intercourse, or at the time of sexual climax.
Urinary discharge that occurs during initial vaginal penetration and/or during sexual intercourse often occurs because of the presence of the penis in the vagina that displaces and elevates the bladder (anatomically situated directly above the vagina) and the massaging effect of penile thrusting. This is not uncommonly seen in women who have either stress urinary incontinence, the involuntary leakage of urine with exercising, coughing, sneezing, etc., or bladder prolapse, a condition in which weakened bladder support allows descent of the bladder into the vaginal space.
Urine can also be involuntarily expelled from the urethra at the time of sexual climax. For many women it is unpleasant, highly frustrating and embarrassing situation for which they seek treatment, a condition known as coital incontinence. This orgasmic release of urine often occurs in women who suffer with overactive bladder, a condition in which the bladder contracts without its owner’s permission (a.k.a., involuntary bladder contractions). For other women, the release of urine at the time of climax is viewed positively, correlated with intensive sexual arousal and a powerful and cathartic orgasm. Under these circumstances, this situation is known as “squirting.”
(Excellent reference: Differential diagnostics of female “sexual” fluids: a narrative review Z Pastor and R Chimel, Intern Urogynecological Journal (2018) 29:621-629)
Wishing you the best of health,
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Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery. He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community.
Dr. Siegel has authored the following books that are available on Amazon, iBooks, Nook and Kobo:
MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health
THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health
PROMISCUOUS EATING: Understanding and Ending Our Self-Destructive Relationship with Food
These books are written for educated and discerning men and women who care about health, well-being, fitness and nutrition and enjoy feeling confident and strong.
Dr. Siegel is co-creator of the male pelvic floor exercise instructional DVD (female version is in the works): PelvicRx
New video on female pelvic floor exercises: Learn about your pelvic floor
Tags: Andrew Siegel MD, Bartholin's glands, female sexual fluids, overactive bladder, pelvic organ prolapse, Skene's glands, stress urinary incontinence, urinary bladder, vagina
Our Greatest Wealth Is Health 
March 14, 2020 at 6:55 AM |
[…] the time of climax, some women are capable of “ejaculating.” The nature of this fluid has been controversial, thought by some to be excess lubrication and others to be glandular […]