Knowing your Vulva

So, what is the vulva?

As a Mooncup advisor and practising nurse specialist in Sexual and Reproductive Health, vulval and vaginal health is paramount. Awareness of your anatomy and recognising changes can be a tricky business as the complexity of the vulval map can be a little confusing!

Often the term vulva provokes uncertainty, and the word vagina is commonly used as a general overarching name for female genitalia.

We are of course all different- our shapes and body parts are similar but innately unique. For most of us it is not routine to make comparisons or describe this part of our body, so it is not surprising that the vulva can be unfamiliar territory.

You may be interested to know that we have heard from many Mooncup users that switching to a Mooncup® menstrual cup often has the added bonus of helping you become more aware of your anatomy! But if you’re keen to learn a little bit more about your nether regions right now, do read on…

Getting familiar with the intricate folds and openings of this part of our body…

The word vulva aptly means covering (Latin) and refers to the female’s external genitalia, for most this will include:

  • The mons pubis – the mound of fatty tissue that covers and protects the pubic bone.
  • The Labia majora – commonly known as the outer lips. In some of us the labia meet , covering the inner lips and other parts, but for others these parts can be seen, as the labia majora remains slightly parted.
  • The labia minora – the inner lips are located inside the labia majora and the skin is usually darker in colour , though this can vary from person to person, as can the size , shape and length of each side , often there is no symmetry, and it is just a variation of normal to have longer inner lips than outer. The labia minora is home to tiny sebaceous glands that secrete oils for lubrication.
  • The clitoris is usually located between the inner folds of the vulva (labia minora), at the top. Under the clitoral hood is the head of the clitoris known as the glans which varies in size from person to person. It is estimated that there are at least 8000s sensory nerve endings here and it is the central hub of sexual response for most females.
  • The urethral opening is located above the vagina and below the clitoris, and is where were urine is excreted through a tube connected to the bladder.
  • The vestibule refers to the area of skin directly around the vaginal opening and the urethra, outside the body, but inside the labia minora.
  • The vaginal opening is situated below the urethra and is like a muscular tube, that connects with the cervix (neck of womb) to the external vulva. The size and shape of the vagina can vary from one individual to another.
  • The perineum describes the area of skin and muscle between the vagina and anus.

Self examination of the vulva to check for health problems

If you are not already examining your vulva now and again, maybe now is the time. It is always good to be aware of any skin changes for instance earlier rather than later. A comfortable way to do this is to lie down, with back and shoulders propped up with pillows. Hold a mirror in one hand, and use the other hand to part the labia and have a good look.

Any unusual lumps and bumps?

Check for any unusual lumps, warts, breaks to skin, or indeed other changes such as colour, thinning or thickening of the skin to the Labia or surrounding areas. If you have any unusual symptoms it would be wise to get this checked by a doctor or nurse.

Pain, itching, smells or irritation?

Pain, itching, burning and general irritation of the vulva, may be signs a common fungal infection such as thrush (candida). To find out more about thrush check out this article from Sexual Health:24. A change in smell or discharge may  indicate a different type of infection such as bacterial vaginosis.

Sexually transmitted infections such as the Human Papilloma virus (HPV) can cause warty lesions to appear anywhere around the vulva, commonly known as genital warts. Herpes simplex virus (HSV) can cause painful blisters or ulcers/sores which will go away but can reoccur. In these circumstances it would be wise to be seen by your doctor/gynaecologist or local Sexual Health Service who will help manage these infections and offer testing for other infections if appropriate. They may also refer or sign post you to other services such as dermatology or a specialist vulva clinic if necessary.

Other vulval diseases that can cause irritation and itching include inflammatory skin conditions such as Eczema / dermatitis, Lichen Sclerosus, Lichen simplex and Lichen planus. It is important to get the correct diagnosis so that appropriate treatment can be prescribed.

Pain syndromes such as vulvodynia, vestibulitis and vaginismus, to name a few are also experienced by many people. There is still much to be learned regarding these conditions, however help is definitely out there, so do not suffer in silence!

Something more serious?

Vulval cancer is a rare condition in those under 50 who have not yet gone through the menopause. However, it is important to be aware that some signs of vulval cancer can be similar to symptoms experienced by more common infections and so if you notice any changes in the normal appearance of your vulva, this should always be investigated by your GP and/or appropriate specialist services.

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Knowing your Vulva