The vulva is the external part of the female genital area. It includes the outer and inner lips (labia), the clitoris, the opening of the urethra, and the vaginal opening. The vulva protects the internal reproductive organs and is involved in sexual response and urination.
Common Vulvar Conditions
Vulvar symptoms may include itching, burning, pain, swelling, skin changes, or discharge. Many different conditions can affect the vulva, including:
Yeast Infections
Caused by an overgrowth of yeast (usually Candida). Symptoms include itching, irritation, redness, and thick white discharge. Treatment typically involves antifungal medications.
Contact Dermatitis
Irritation or allergy to products such as scented soaps, pads, detergents, wipes, lubricants, or fabrics. Treatment focuses on removing irritants and using soothing topical treatments.
Genitourinary Syndrome of Menopause (GSM)
Caused by decreased estrogen levels in perimenopause or menopause. Symptoms include vaginal dryness, burning, painful intercourse, and recurrent urinary symptoms. Treatment may include vaginal moisturizers, lubricants, and/or low-dose vaginal estrogen therapy.
Lichen Sclerosus
A chronic inflammatory skin condition that can cause itching, thinning of the vulvar skin, and white patches. It is more common after menopause. Treatment typically includes prescription-strength topical corticosteroid ointment and ongoing follow-up.
Lichen Simplex Chronicus
Caused by repeated scratching or irritation, leading to thickened skin and persistent itching. Treatment focuses on breaking the itch-scratch cycle and reducing inflammation.
Herpes Simplex Virus (HSV)
A sexually transmitted infection that causes painful sores or blisters. While herpes is chronic, medications can reduce outbreaks and symptoms.
Trichomoniasis
A sexually transmitted infection caused by a parasite. Symptoms may include irritation, itching, or discharge. It is treated with oral antibiotics.
Vulvar Cancer
Rare, but early detection is important. Risk factors include age, HPV infection, smoking, and lichen sclerosus. Symptoms may include persistent itching, skin changes, or a vulvar lesion that does not heal.
Evaluation and Diagnosis
Your healthcare provider will review your symptoms and perform a gentle pelvic and vulvar examination. Tests may include:
- Swabs or cultures to identify infections
- Blood tests if indicated
- Pelvic ultrasound when needed
- Biopsy of the vulvar skin if changes are persistent or concerning, to confirm diagnosis and guide treatment
Treatment
Treatment depends on the specific condition and may include:
- Antifungal, antibiotic, antiparasitic, or antiviral medications
- Prescription topical ointments to reduce irritation, inflammation, or skin changes
- Vaginal estrogen therapy (for GSM)
- Lifestyle and skin care changes to reduce irritation
- Surgery, chemotherapy, or radiation for confirmed cancer
Vulvar Skin Care Tips
- Use fragrance-free, gentle cleansers or simply warm water
- Avoid scented soaps, bubble baths, douches, and feminine sprays
- Wear cotton underwear; avoid tight clothing
- Use a protective barrier ointment if skin is sensitive or irritated
- Change pads and liners regularly
- Practice safer sex practices to reduce STI risk
