a cavity search. Lacerations or other injuries to the vagina can occur during sexual assault or other sexual abuse. These can be tears, bruises, inflammation and abrasions. Sexual assault with objects can damage the vagina and X-ray examination may reveal the presence of foreign objects. If consent is given, a pelvic examination is part of the assessment of sexual assault. Pelvic exams are also performed during pregnancy, and women with high risk pregnancies have exams more often. Medications Intravaginal administration is a route of administration where the medication is inserted into the vagina as a creme or tablet. Pharmacologically, this has the potential advantage of promoting therapeutic effects primarily in the vagina or nearby structures (such as the vaginal portion of cervix) with limited systemic adverse effects compared to other routes of administration. Medications used to ripen the cervix and induce labor are commonly administered via this route, as are estrogens, contraceptive agents, propranolol, and antifungals. Vaginal rings can also be used to deliver medication, including birth control in contraceptive vaginal rings. These are inserted into the vagina and provide continuous, low dose and consistent drug levels in the vagina and throughout the body. Before the baby merges from the womb, an injection for pain control during childbirth may be administered through the vaginal wall and near the pudendal nerve. Because the pudendal nerve carries motor and sensory fibers that innervate the pelvic muscles, a pudendal nerve block relieves birth pain. The medicine does not harm the child, and is without significant complications. Infections, diseases, and safe sex Vaginal infections or diseases include yeast infection, vaginitis, sexually transmitted infections (STIs) and cancer. Lactobacillus gasseri and other Lactobacillus species in the vaginal flora provide some protection from infections by their secretion of bacteriocins and hydrogen peroxide. The healthy vagina of a woman of child-bearing age is acidic, with a pH normally ranging between 3.8 and 4.5. The low pH prohibits growth of many strains of pathogenic microbes. The acidic balance of the vagina may also be affected by pregnancy, menstruation, diabetes or other illness, birth control pills, certain antibiotics, poor diet, and stress (such as from a lack of sleep). Any of these changes to the acidic balance of the vagina may contribute to yeast infection. An elevated pH (greater than 4.5) of the vaginal fluid can be caused by an overgrowth of bacteria as in bacterial vaginosis, or in the