The vulva is the external parts of the female genitals. It’s an area of your body you can't easily see, but it's important not to ignore it.
In this Q&A with GP and sexual health expert Dr Sara Whitburn, we ask why vulval self-checks are important, how to do them and what to look for.
Why should women get to know their vulva?
Dr Whitburn: It’s so important to be self-aware. Vulvas range in size, shape and colour, and not many women know what is normal for them. It’s common for vulvas to be asymmetrical (different on either side), for example. Getting to know what is normal for you makes it easier to pick up changes that might need to be checked by a doctor.
What’s the best age to start vulval self-checks?
Dr Whitburn: There’s no set age. It’s more about when you feel comfortable looking at or feeling your vulva and describing any concerns to a trusted person or health professional.
When is a good time to get to know your vulva?
Dr Whitburn: When you’re in the bath or shower is a great time to feel your vulva and make sure nothing’s changed. You could also look at it when getting dressed or check your undies for unusual discharge when going to the toilet. If at any point your vulva feels different, it’s important to do a self-check.
If you’ve been diagnosed with a vulval skin (or other) condition, be guided by your doctor who might suggest self-checks when you’re applying your treatments.
The key is to get to know the look and feel of your vulva and try to notice changes.
How do you do a self-check?
Dr Whitburn: To look at your vulva, I recommend using a hand-held mirror, or small mirror on a stand. Make sure you’re in a safe space, and you’ve got clean hands and good lighting.
There are a few different ways to do a self-check. You could:
- squat over the mirror
- sit on the toilet and angle the mirror towards your vulva
- do the self-check standing with one leg propped up onto the bath or a chair.
Holding the mirror with your less-dominant hand, use your other hand to check the areas covered with pubic hair (your mons pubis and labia majora). Then, gently part the outer skin folds and check the inner, hairless folds (labia minora). Check the skin around your vagina and urinary opening (where wee comes out). Finally, look at the skin between your vagina and bottom (perineum).
If you’d prefer not to look, use your fingertips to feel your vulva.
What changes should you be looking for?
Dr Whitburn: It’s about looking for anything out of the ordinary that might be painful, itchy, hard, lumpy, sore or just not ‘normal’ for you. So it might be a new lump, ulcer, cut or rash; new or changing freckles or moles; soreness; itchiness; unusual bleeding or unusual discharge. When checking discharge, look for a change in colour, smell or texture.
Remember, your vulva will naturally change throughout your life. Before puberty, the vulva is hairless, and skin folds (labia) are smaller. As you go through puberty, you usually develop pubic hair and the labia lengthens and develops more folds.
If you become pregnant, the labia may swell and you may develop varicose veins (twisted and enlarged veins). After pregnancy there can be changes to the shape of your vulva.
There’s also menopause. Around this time, the skin can become dryer and more fragile and you may notice changes in your pubic hair.
Although these are normal, natural changes, it’s important to get any unexpected, troubling or concerning changes checked by a health professional.
If there’s a lump, how worried should you be about vulval cancer?
Dr Whitburn: Vulval cancer is uncommon, however, lumps in the vulva are worth getting checked for peace of mind and possible treatment. Sometimes, cysts, sexually transmitted infections (STIs) and rashes cause vulval lumps. Vulval cancer usually occurs in people who’ve got risk factors, such as lichen sclerosus (a skin disorder). If you find a lump or any other change, check in with your GP.
What’s your advice to those who can’t do a self-check?
Dr Whitburn: If you have someone you trust, consider asking them to check for you. Otherwise, if anything’s worrying you or you’ve noticed a change, describe it to your GP who can do an examination.
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Interview by Kate Cross.
Published September 2023
This article is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your medical practitioner.
Jean Hailes for Women’s Health gratefully acknowledges the support of the Australian Government.