What is the vulva?
Put simply, the vulva is the area of skin between your legs, extending from the mons pubis (the hair-bearing area in front of your pubic bone) to the perineum (the area between the vagina and the anus). Surprisingly, a lot of women are unsure about the anatomy of their vulva, or whether or not their vulva is “normal”– a good place to get additional information is from the Labia Library (http://www.labialibrary.org.au/).
What symptoms might I experience?
- Problems with the vulva may manifest with a variety of symptoms, such as:
- Pain – either all the time, or with certain triggers e.g. sex
- Burning or stinging
- Pins and needles
- Stinging with urination
- Change in vaginal discharge
- Abnormal bleeding
- Colour changes
It is wise to seek advice if any of these symptoms are persistent, or if you are worried or anxious about them.
What might the problem be?
Many generalised skin conditions can be present on the vulva, such as dermatitis, eczema and psoriasis. In addition, some chronic skin changes can cause these symptoms, such as lichen sclerosus or lichen planus, particularly in older women. Rarely, cancers of the vulva can be present, also usually in older women.
Vulval symptoms can also be caused by allergic reactions, or infections such as urinary tract infection, thrush or STIs, and by imbalances in the normal bacteria present in the vulva and vagina – a condition known as bacterial vaginosis. Pelvic floor muscle dysfunction, and nerve injuries e.g. from childbirth, may also manifest as vulval pain.
Occasionally, no cause can be seen for your symptoms – a problem known as vulvodynia. This can be quite frustrating, as you think the pain must be “all in your head”. Please be assured that your pain will be acknowledged and treated after a detailed history and examination is taken to look for potential causes. Often, this condition resolves on its own over time, but you may need medications to manage the symptoms, rather than cure them.
What can I do to try and relieve the symptoms myself?
Simple vulval care measures can be helpful in initially managing all causes of vulval pain and itch – for some helpful tips, see http://www.caredownthere.com.au/_pages/information_care.html.
I would not recommend self-treatment with any medications, without a doctor confirming that there is a problem – for example, I commonly see women treat themselves for thrush multiple times without ever confirming that thrush is present, and the medications themselves can be quite irritating to the skin, leading to further problems.
What if I don’t get better?
If your symptoms are persistent or worsening, causing you distress or impairing your quality of life, or if you are anxious about them, please ask your doctor for help. If your GP isn’t sure how to help you, ask to see a gynaecologist – remember, we are trained in dealing with problems in this area, and there is no need to be embarrassed!