Some Facts About the Vulva
What sort of symptoms will I be experiencing if I have a vulval problem?
There are many things that you may experience but the commonest is itch. Other common symptoms are:
- Pain with urination
- Pain with sex
- Discharge and wetness
- Feeling like there are cuts on your skin
- Stinging when you apply creams
- Crawling or stabbing feelings
- Just being aware that you have a vulva
If you experience anything like this, it is not normal and you don’t have to put up with it. It’s time to seek help.
What stops people getting help?
Many women with vulval problems put up with their symptoms for months or even years without mentioning them to anyone. This is almost always because they are embarrassed. It’s difficult to talk to friends and family about something so personal and many patients find it difficult to even mention this to a doctor. But remember doctors are trained health professionals and they won’t be embarrassed, even if you are. Many women find it a lot easier to talk to a female doctor, so if this is going to personally make it easier for you to get help, seek one out.
Where do vulval problems belong medically?
The vulva is part of the skin and most of the things that go wrong there are skin conditions that happen on other parts of the skin. This includes common skin problems like dermatitis, psoriasis and allergic reactions. Some of the skin conditions that involve the vulva are not common on other parts of the skin, and this includes a condition called lichen sclerosus.
Which is the right specialty?
The first place to go if you have a vulval problem is your own general practitioner or a women’s health service such as the Family Planning Organisation. There is no single speciality that is the best for vulval disease. Many different specialists have expertise in this area and this includes dermatologists, gynaecologists, sexual health physicians and GP’s with an interest in women’s health.
Is Thrush the commonest reason for vulval disease?
Thrush is a common reason for vulval disease but it is by no means the only one. Don’t assume that thrush is the cause for your symptoms because there are many other conditions that can cause vulval problems. Every year women spend a huge amount of money on unnecessary anti-fungal creams and pessaries. If a single dose hasn’t helped you at all, don’t just try again and again; go and see your doctor.
I am not sure what to call it!
People often don’t know what the medical names of the genital area are. Have a look at the diagram below
I am not sure what is normal down there
This is a rough guide but there are lots of variation and if you are not sure see your doctor
The outside of the vulva is usually about the same colour as the rest of your skin, but if you are a naturally dark skinned person it may look darker than the skin on say your abdomen. The inside of your vagina is pinker than the outside skin and as a rule of thumb should be about the same colour as the inside of your mouth.
The vagina is a blind tube and contains many glands that make watery and slightly slimy material. As a result all women have some degree of vaginal discharge which is completely normal. It is usually heavier in the middle of the month when you ovulate.
Some women have more discharge than others and have different amounts of discharge at different times of their lives and different times of the month. If your discharge is clear to yellowish, does not have a smell and is not itchy and irritating it is very likely to be normal. A heavy, sticky, itchy, smelly or brown discharge should be a reason to seek help.
I’ve noticed some lumps: what are they?
The inside of the labia minora (inner lips) are a lot like the insides of your lips. There are many small glands that may look like little yellowish bumps 1-2 mm in size. These are completely normal.
On the inside of your vagina, you may see larger lumps that have a smooth pink surface. This is also completely normal. The inside surface of the vagina is quite folded. You may also notice some dimples. These are normal gland openings.
What’s inside? Can a tampon get lost in there? Is it OK to put my finger inside?
The vagina is a blind ended tube with the opening in the middle of the vulva. The opening to your urethra (the tube that leads from your bladder to the outside) is just inside the opening of the vulva.
At the upper end is your cervix, the opening to the uterus (womb). This is where your doctor takes a pap smear from. A tampon can not get lost in your vagina because of this blind end. It is perfectly OK to put your finder inside to find the string of the tampon if it gets bunched up inside your vagina.
Pubic hair is normal and there is a big variation in what is normal. Some women have very little and some have a lot. Whatever you have, take care removing it. Shaving and waxing pubic hair can cause a lot of irritation particularly if you have sensitive skin. If you develop red spots and sores after doing this, let the hair grow back and cut or clip it next time.
Tenderness and Pain: Is the vulva more sensitive than other parts of the skin?
The clitoris is more sensitive than other parts of the skin, but the rest of your vulva should be no different. It is not normal to be aware of vulval discomfort or for your vulva to be so sensitive that normal touching causes pain. It is also not normal for sex to be severely painful. Don’t believe everything you read about sex: it isn’t always magical, but it certainly shouldn’t be excruciating. If this is happening to you, seek help.