Disorders of the Vulva

It is important to know the outside (external) area of the female genitalia to properly examine yourself. The vulva or labia, sometimes also called the lips around the vagina, covers the pubic bone and surrounds the vagina. The larger or outer labia is called the labia majora. The inner or smaller labia is called the labia minora. The clitoris is at the top of the vulva. It is covered by a small area of tissue called the hood. Below the clitoris is the opening of the tube from the bladder, which is the urethral opening. Just below the urethral opening is the opening of the vagina. This area is called the vestibule. Inside the vestibule are bartholin and skene glands that lubricate the outside of the vagina during sexual intercourse. The perineum is the area that lies between the vagina and anus. You should examine your external genitalia once a month just as you do your self breast examination.

SIGNS AND SYMPTOMS TO LOOK FOR DURING YOUR EXAMINATION:

  • Swelling.

  • Redness.

  • Bumps.

  • Blisters.

  • Black or white areas.

  • Itching.

  • Bleeding.

  • Burning.

TYPES OF VULVAR PROBLEMS

  • Infections.

  • Yeast (fungus) is the most common infection that causes redness, swelling, itching and a thick white vaginal discharge. Women with diabetes, taking medicines that kill germs (antibiotics) or on birth control pills are at risk for yeast infection. This infection is treated with vaginal creams, suppositories and anti-itch cream for the vulva.

  • Genital warts (condyloma) are caused by the human papilloma virus. They are raised bumps that can itch, bleed, cause discomfort and sometimes appear in groups like cauliflower. This is a sexually transmitted disease (STD) caused by sexual contact. This can be treated with topical medication, freezing, electrocautery, laser or surgical removal.

  • Genital herpes is a virus that causes redness, swelling, blisters and ulcers that can cause itching and are very painful. This is also a STD. There are medications to control the symptoms of herpes, but there is no cure. Once you have it, you keep getting it because the virus stays in your body.

  • Contact dermatitis. Contact dermatitis is an irritation of the vulva that can cause redness, swelling and itching. It can be caused by:

  • Perfumed toilet paper.

  • Deodorants.

  • Talcum powder.

  • Hygiene sprays.

  • Tampons.

  • Soaps and fabric softeners.

  • Wearing wet underwear and bathing suits too long.

  • Spermicide.

  • Condoms.

  • Diaphragms.

  • Poison ivy.

Treatment will depend on eliminating the cause and treating the symptoms.

  • Vulvodynia.

  • Vulvodynia is "painful vulva." It includes burning, itching, irritation and a feeling of rawness or bruising of the vulva. Treating this problem depends on the cause and diagnosis. Treatment can take a long time.

  • Vulvar Dystrophy.

  • Vulvar Dystrophy is a disorder of the skin of the vulva. The skin can be too thick with hard raised patches or too thin skin showing wrinkles. Vulvar dystrophy can cause redness or white patches, itching and burning sensation. A biopsy may be needed to diagnose the problem. Treatment with creams or ointments depends on the diagnosis.

  • Vulvar Cancer.

  • Vulvar cancer is usually a form of squamus skin cancer. Other types of vulvar cancer like melenoma (a dark or black, irregular shaped mole that can bleed easily) and adenocarcinoma (red, itchy, scaly area that looks like eczema) are rare. Treatment is usually surgery to remove the cancerous area, the vulva and the lymph nodes in the groin. This can be done with or without radiation and chemotherapy.

HOME CARE INSTRUCTIONS

  • Look at your vulva and external genital area every month.

  • Follow and finish all treatment given to you by your caregiver.

  • Do not use perfumed or scented soaps, detergents, hygiene spray, talcum powder, tampons, douches or toilet paper.

  • Remove your tampon every 6 hours. Do not leave tampons in overnight.

  • Wear loose-fitting clothing.

  • Wear underwear that is cotton.

  • Avoid spermicidal creams or foams that irritate you.

SEEK MEDICAL CARE IF:

  • You notice changes on your vulva such as redness, swelling, itching, color changes, bleeding, small bumps, blisters or any discomfort.

  • You develop an abnormal vaginal discharge.

  • You have painful sexual intercourse.

  • You notice swelling of the lymph nodes in your groin.