Ladies – I implore you… please examine your lady bits, the external part called the vulva, including the outer and inner labia. I mean really pay attention. Get a hand mirror, move skin around, and learn what is YOUR normal. When I ask my patients if they’ve noticed any changes in the color or shape to their vulva and I am met with silence… that’s not the answer that I want. Read on for my top 4 things to watch for.

Before you can identify changes, you need to know what’s normal. It’s normal to see some color variation as you move through your monthly cycle – different shades of pink with hormone changes. So, examine yourself at different times of the month. It’s also normal to have a bit of lightening of color, or a loss of pinkness, particularly around the urethral area during breast-feeding, and even more changes in color after menopause. This is due to changes in hormones in both of these life stages and can be treated if bothersome. There are hormonal treatments, but there are non-hormonal treatments too.

“You should be able to identify your own vulva in a line-up.”

YOU NEED TO KNOW WHAT IS NOT NORMAL. Watch for these 4 types of changes:

  1. White patches – Large white patches, small white spots, drastic shortening of inner labia, fusing (sticking) together of labia, loss of clitoral hood flexibility, or the skin becoming kinda “shiny”. I often see women who have a condition called lichens sclerosis. Anyone one can get it, at any age, though it tends to appear around menopause in women. It usually starts with itching and pain, is often mistaken as a yeast infection, but can lead to the skin of the vulva stiffening and/or fusing together.
  2. Color changes – darker or lighter spots, red, pink or brown. From things as simple as ingrown hairs, to sexually transmitted infections, to vulvar cancers…. You need to monitor for changes in color.
  3. Texture changes – Bumps and lumps, wart-like in appearance, growing alone or in clusters warrant a trip to the doctor. Thickening of the skin, or patches with raised edges should also be heavily monitored. But also more simple things like dryness. Women don’t seem to know when their vulvar skin is dry. My general rule of thumb is if you need a moisturizer for your arms and legs, then you probably need on for your vulva.
  4. Fissures, rashes and sores – this happens so often. Women will have pain and once I take a look they have cracks in the skin called fissures (see the dryness info above). This can be A source of their pain or THE source of pain. Same goes for rashes, particularly from wearing pads daily, or open sores from scratching aggressively.

The good news is, if caught early, many of these conditions can be treated easily enough. With any condition, the sooner treatment begins the better. The problem is that so many women don’t notice the initial changes, wait too long to see their doctor, get misdiagnosed… time is of the essence ladies.
So please, grab a mirror, take a deep breath and do a thorough investigation. You should be able to identify your own vulva in a line-up. Know what your normal looks like, so that you can notice changes as soon as possible.

Katie Kelly, PT

BSc., MSc. Physiotherapy