Understanding the vulva
Vulva is the name of the external, visible parts of the female genitalia, which includes:
- The clitoris
- Labia majora – outer lips
- Labia minora – inner lips
- Mons pubis
- The vestibule
- The urinary opening
- The perineum
The vulva also includes a number of glands that produce fluids to moisturise, lubricate and cleanse the vagina. The main purposes of the vulva are protection for the vaginal canal and reproductive organs, elasticity during childbirth and as a sexual component of women’s bodies. The protects your internal organs, urinary opening, vagina and vestibule. During sex, the mons pubis makes intercourse more comfortable. In childbirth, the connective tissue of the vulva and the perineum softens to make it easier.
Like other parts of the body, cysts, pimple, lumps and rashes can be present on the vulva, which may lead to excessive washing or itching, and irritate the condition. You should speak to your healthcare professional if symptoms persist. Not all vulvar conditions need to be treated, and may disappear on their own.
After waxing or shaving, the vulva can develop ingrown hairs, which can result in a pimple or cyst on the surface of the skin. Sebaceous cysts are caused by a blockage in skin glands and occur on the vulva as small, hard lumps that are generally painless. These do not require treatment unless they cause discomfort.
What are the different types of vulval conditions?
Some conditions that can affect the vulva include:
- Lichenoid conditions – lichen sclerosus, lichen planus, lichen simplex chronicus
- Psoriasis (known as genital psoriasis)
- Bartholin’s glands cyst
- Genital herpes
- Genital warts
Dermatitis is a skin condition and is the most common cause of chronic vulvar symptoms. Different types of dermatitis have different causes. Some cases of vulvar dermatitis are caused by a genetic predisposition to allergies and hypersensitivity, while some of you may have other allergic conditions such as hay fever, asthma or eczema. Vulvar contact or allergic dermatitis can also be caused by contact with allergens or irritants such as:
- Toilet paper and moist toilet wipes
- Sanitary pads, tampons and panty liners
- Laundry detergent
- Bath powders, shower gels and soaps
- Latex in diaphragm or condoms
- Spermicides and lubricants
- Over-the-counter medication
The main symptom of vulvar dermatitis is itching. Scratching can result in thickened and broken skin, stinging or burning, and pain during sex or going to the bathroom. Dermatitis treatments usually involve the use of topical cream and changes in skin care. It is important to identify and avoid any allergens or irritants that could be causing the dermatitis.
Dermatitis often persists and recurs, and women may also develop secondary infections such as thrush.
Lichen Sclerosus (LS)
LS is a long-term autoimmune condition of the vulva. The main symptom is severe itching, which can even lead to sleep disturbances. Scratching can cause broken skin, stinging, burning or pain during sex or urination. The cause is unknown, but some cases are associated with autoimmune disorders.
LS can affect women of all ages, and occurs less in men and children. It is not an infection and is not contagious. If LS is left untreated, it can cause severe scarring of the vulva, which can include the shrinking of the labia and narrowing of the vaginal entrance. This inflammation can cause the normal anatomy of the vulva to change and is associated with a small increased risk of vulvar cancer.
Women who have psoriasis of the vulva tend to have skin conditions on other parts of their body too, but it can exist on its own. Psoriasis is an immune system disorder and involves scaly, red plaques on the vulva. Other symptoms that may point to psoriasis can include scalp scaling, nail pitting and a family history of the condition.
Bartholin’s Gland Cyst
The Bartholin’s glands are located on each labia minora near the vaginal opening. The glands produce the fluid that lubricates the vagina, and as they are ducts, they can develop cysts if they become blocked. The cysts can become tender and uncomfortable when you walk or sit. Smaller cysts may not cause any discomfort and only need to be monitored. If cysts become infected they can develop into an abscess that can be drained by a doctor.
Thrush can be caused by an overgrowth of a fungi called Candida, and is not considered to be an STI. It is a very common condition and roughly 70 per cent of all women will experience it at least once in their life. The symptoms can include:
- Redness or itchiness of the vulva and vagina
- Discomfort or pain during sex
- A thick, white vaginal discharge
Genital herpes is caused by the herpes simplex virus and is can be transmitted through vaginal, anal or oral sex. Symptoms tend to appear within four to 14 days of exposure, and can include flu-like symptoms and painful blisters around the vulva. Some people will only experience a single outbreak, while others will have several.
There is no cure for genital herpes, but antiviral medication can be used to reduce the duration and frequency of outbreaks.
Genital warts are caused by specific types of HPV, a virus, and are able to be transmitted through skin-to-skin contact during vaginal, anal or oral sex. Warts can be found on the clitoris, cervix, vulva, inside the vagina or urethra, and around or in the anus. The warts do not usually cause pain, and can be successfully removed.