The Vagina.

That’s what most people refer to when discussing the external female genitalia. But in fact, the vagina is a hollow tube found on the inside of the body. What we see on the outside is known as the vulva, and this includes structures such as the labia, clitoris and skin (shown in the picture below).

Maintaining good vulval health is very important as it is common to get vulval infections. The skin overlying the vulva is very sensitive.

Common vulval medical conditions include:

1. Yeast infections (Candidiasis) that can cause itching, a burning sensation of the genitals and a thick white curd-like discharge.

2. Bacterial infections that can present with an unusual vaginal discharge that may have a foul smell and itching/redness.

3. Sexually transmitted infections (STIs) such as herpes, chlamydia and syphilis, present in different ways. Some of the symptoms may include painful or non-painful skin lesions, unusual vaginal discharge and abdominal pain.

4. Skin conditions like eczema, psoriasis and contact dermatitis which can cause skin changes, itching and redness.

5. Vulval cancer includes persistent itching or a burning sensation, skin changes (including colour changes or thickened skin), wounds and bleeding (not menstrual).

If experiencing any of the symptoms above, it is important to consult a doctor and avoid self-treatment as delays can result in worsening of symptoms.

Good vulval health practices

1. Routine self-checks – use a mirror in a private, well-lit room to become familiar with what your genitalia looks like.

2. HPV (Human Papilloma Virus) vaccination – HPV is a risk factor for vulval cancer so vaccination against HPV can offer protection.

3. Wear breathable cotton underwear.

4. Change your underwear after using the gym or if sweating.

5. If using menstrual pads, remember to change them every 4 to 6 hours depending on the volume of bleeding. Soaked pads worn for long periods can irritate the vulva, leading to itching and skin conditions.

6. If using menstrual pads, try to choose fragrance-free menstrual pads made of organic (hypoallergenic) fibres.

7. Do not use harsh fragranced/antibacterial soaps, fem washes or practice douching. In addition to irritating the vulva, it can also lead to vaginal infections as it disrupts the healthy bacteria found in the vagina.

8. Always remember to wash and wipe from front to back (vagina to anus) after using the toilet.

9. Practice safe sex by using a barrier method like a condom which will prevent the transmission of most STIs.

10. If using lubricants during intercourse, make sure it is a non-fragranced water-based lubricant.

Every vulva is different, but vulval health is an important aspect of women’s health.

If you or someone you know experiences any of the vulval/genital symptoms mentioned above, please seek medical advice. Contact the Bloom Medical Clinic at the Family Planning Association of Sri Lanka (+94 779895252, No. 37/27, Bullers Lane, Colombo-07) for further medical advice from a doctor.