Vulvar Disorders: Common Conditions, Symptoms, Diagnosis and Care

The vulva is the outer part of the female genitals, including the clitoris, the vaginal lips and the opening to the vagina. A vulvar disorder is a health problem affecting it, and can cause pain, itching or changes in the skin. Treatment depends on the cause.

Common vulvar disorders

• Vaginitis or vulvovaginitis: swelling or infection of the vulva and vagina.
• Itching (pruritus vulvae) or rashes from allergies or irritation.
• Vulvar cancer.
• Vulvodynia: long-lasting vulvar pain with no known medical cause.
• Lichen sclerosus: thin, itchy, white patches of skin on the vulva.
• Vulvitis: inflammation of the vulva.
• Labial adhesions: the folds of skin around the vaginal opening stick together; most common in young girls.

Who is at higher risk

Vulvar disorders can affect women and girls of any age, but risk is higher for those who are:

• going through or past menopause — lower estrogen can thin the skin and lead to conditions such as lichen sclerosus;
• living with certain skin conditions or allergies.

Symptoms

Symptoms depend on the disorder, but may include:

• redness or swelling;
• itching or burning;
• pain, especially during sex or urination;
• cracks, sores or thickened patches of skin;
• changes in skin colour, such as lighter, darker or white patches;
• lumps, growths or sores that don't heal;
• vaginal bleeding not related to your period.

See your health care provider if symptoms last more than a few days, if you notice a new lump or a sore that won't heal, or if you have vaginal bleeding that isn't normal for you.

Diagnosis

Early diagnosis may make most vulvar disorders easier to treat. Your provider may ask about your health history and symptoms, do a pelvic exam, test for HPV or do a Pap test, and use a magnifying instrument (a colposcope) to look closely at the skin of the vulva.

Treatment

Depending on the cause, treatment may include:

• medicines such as antibiotics or antifungals;
• creams or steroid ointments for irritation or allergic reactions;
• for vulvodynia, pelvic floor physical therapy to stretch and ease the pain, nerve blocks or medicines, counselling, or a combination.

Prevention

Not every vulvar disorder can be prevented, but you can lower your risk by:

• getting the HPV vaccine, which helps prevent infections linked to vulvar cancer;
• not smoking;
• good hygiene, such as wearing cotton underwear and avoiding scented soaps and douches;
• regular checkups, including pelvic exams, so problems are found early.

Sources

• MedlinePlus, U.S. National Library of Medicine, "Vulvar Disorders." https://medlineplus.gov/vulvardisorders.html
• Rewritten in hubnx's own words.