Self-examination of the vulva - Newcastle Hospitals NHS Foundation Trust

Why should I examine my vulva?

There are many conditions that affect the vulval skin such as infections, skin conditions (e.g. eczema or lichen sclerosis).

Sometimes pre-cancerous changes can occur and very rarely, cancer. More and more women are visiting their doctors with these vulval conditions.

The sooner treatment can be given, the less likely it is that side effects will occur. Early treatment may also reduce the extent of treatment needed.

What is the vulva?

This term refers to a women’s external genital organs, which include the inner and outer ‘lips’ and clitoris.

This is a black and white line diagram of the vulva. The vulva is viewed from the front, looking between the legs, with the woman lying on her back and the vulva spread open to show its inner parts. When performing self-examination using a mirror, this is the image seen in the mirror.

Working from top to bottom of the diagram, so from the front to the back of the body, and from the outside inwards, the parts of the vulva shown are as follows:

Mons pubis – the hairy area on the front of the body, just above the vulva
Labia majora – the hairy outer lips that surround the inner vulva
Labia minora – the non-hairy inner lips
Clitoris – a pea-sized organ located at the top meeting point of the labia minora below the mons pubis
Urethra – the opening used to pass urine, located between the labia minora, below the clitoris and above the vaginal opening
Vestibule – the entrance to the vagina, located between the labia minora around the vaginal opening
Perineum – the bridge of skin and muscle located at the bottom meeting point of the labia majora, between the vaginal opening and the anus
Anus – the external opening to the bowel, located below and behind the perineum towards the back.

How to perform vulval self-examination

Find a private place such as your bedroom and hold a mirror in one hand. Try and get a good view of the vulval area by separating the outer lips. The diagram indicates the different parts of the vulva which should be examined individually.

Each area can be both looked at and touched gently with a finger. Start at the top with the ‘mons pubis’ then work down checking the clitoris, labia minora, labia majora, perineum and finally the anus.

How often should vulval self-examination be performed?

Once a month in between periods or at any time when you develop vulval itching or pain, pain during sex, or when you feel vulval lumps or thickening of the skin.

Who should perform vulval self-examination?

Women who are sexually active and all women over the age of 20 years.

What should I look for?

Changes in the vulval skin.

Some examples of changes include

Any changes in the colour of the vulval skin such as whitening or discrete area of darker skin (pigmentation)
Any thickening of the skin such as warts or skin tags
Any ulcers or sores in the skin
Any symptoms of persistent itching or soreness.

Remember – skin cancer of the vulva is very rare, but to be certain, report all changes to your GP.

What should I do if I think that I have found an abnormal area?

If you find an abnormal area, get in touch with your GP for an examination. If you are already under the care of the specialist vulva clinic we would encourage you to get in touch via the secretarial team in case a sooner appointment is advised by your consultant.

What will happen if a new abnormal area is found?

In the majority of cases, a simple check-up is all that is needed. Your doctor may advise you to apply some skin emollient to soothe the area and stop it from being dry. They may recommend a short course of steroid cream. Occasionally, if you find an abnormal area, the doctor may advise for you to have a small biopsy to test the area.

Leaflet adapted from information from the Vulval Pain Society.

For further information

Contact details

PALS (Patient Advice and Liaison Service) for help, advice and information about NHS services. You can contact them on freephone 0800 032 02 02, email [email protected].