What is the vulva?

Vulva is the general name given to the external parts of the female genitals

The vulva includes:

• mons pubis (the pad of fatty tissue covered with pubic hair)
• labia majora (the outer lips which are covered with pubic hair)
• labia minora (inner lips which are hairless)
• clitoris and its hood or covering (positioned at the front of the genital area)
• vestibule (immediately surrounds the vaginal opening and the urethral opening)
• urinary opening
• vaginal opening
• perineum (the area of skin between the vagina and the anus)

What is normal? 

Each woman's vulva is unique in size and appearance including differences between the right and left labia. There is also variation in the size, shape and length between individual women. These differences and variations are normal.

Because it is difficult for women to see their own vulva, many women do not know what their vulva looks like and/or what is normal for them. If you don't know what your vulva looks like, it is a good idea to use a mirror and have a look. Once you are familiar with what is normal for you, it can be a lot easier to detect any changes in appearance, such as changes in colour, bumps, thickening or thinning of the skin or dry, cracked skin. 

What is vulval irritation?

The skin of the vulva is extremely delicate, making it susceptible to a wide range of conditions. Vulval irritation or vulvitis is when a part of the vulva, or sometimes the entire vulva, has some of the following symptoms:

• redness
• swelling
• burning
• itching
• fissuring (skin cracking or splitting)
• leukoplakia (whitening of skin)
• associated vaginal inflammation or discharge

What causes vulval irritation?

Vulval irritation can be caused by any of the following:

• sweating or vaginal secretions
• skin conditions such as dermatitis, eczema, lichen sclerosus
• fungal, bacterial or viral infections such as candida or thrush, trichomonas or herpes
• some medications, preservatives and local anaesthetics
• tight clothing, pantyhose, g-strings
• allergies to substances such as:
• soaps, bath and hair products
• synthetic underwear or sanitary pads
• feminine hygiene products
• perfumes or scents
• laundry detergents
• scented or coloured toilet paper
• wax
• spermicides
• condoms
• lubricants used for intercourse
• douches (vaginal irrigation) – not recommended to be used at all

Diagnosis and treatment 

If your vulva is irritated, see your general practitioner (GP) to determine the cause; don't self diagnose or treat. Investigations such as blood tests, urine tests, vulval or vaginal swab tests, or a vulval biopsy may be necessary. The treatment will depend on the cause of the irritation. You may be prescribed cortisone creams/ointments for some of the possible causes and may be instructed to wash prior to applying the cream/ointment.

Bathing in water with bicarbonate of soda is one suggested bathing technique to reduce irritation. Instructions include: 

• add 2 tablespoons of bicarbonate of soda in a basin of water (e.g. a plastic wash bowl) or 1 cup of bicarbonate of soda in a bath
• sit in the basin/bath with the water covering your vulva for 5-10 minutes
• pat dry then apply the cream/ointment
• bathe once or twice a day

If your symptoms do not improve with the recommended treatment and/or advice, see your GP again. You may need a referral to a specialist gynaecologist, dermatologist or vulvar clinic.

Management of vulval irritation 

The following can help you manage vulval irritation:

• don't use any soap or perfumed bath products to wash your vulva – only use water or a soap substitute
• wear cotton underpants and if possible, wash them in pure soaps
• never use talcum powder on your vulva
• preferably, swim in salt water not chlorinated water
• after swimming change out of swimwear immediately, shower to remove chlorine or salt and avoid wet clothing
• wear loose fitting pants, not tight jeans or g-strings, and avoid pantyhose
• when passing urine, lean slightly forward to avoid burning and always wipe or pat from front to back
• use 100 per cent cotton sanitary pads and tampons
• avoid using commercial lubricants with intercourse; natural oils such as olive or almond oil may be suitable

For further information:

www.jeanhailes.org.au 

www.gain.org.au – Gynaecological Awareness Information Network

www.shfpa.org.au – Sexual Health & Family Planning Australia

Magazine article

Winter 2011: Vulval health & hygiene

Content Updated April 2012