According to gynaecologists, too many women in the UK delay seeing their doctor for advice about new symptoms because of embarrassment or lack of knowledge about their bodies. To help demystify the subject, we’ve asked the experts to talk us through everything they want women to know.
The right words: Research shows that many women are unable to correctly describe the different parts of their genitals. “The bits of your genitals that you can see from the outside are called the vulva,” explains Sachchidananda Maiti, consultant gynaecologist and obstetrician at Pall Mall Medical. “This is often referred to as the vagina, but the vagina is actually just the canal between the vulva and the womb.
“The vulva includes your labia majora (outer lips), labia minora (inner lips), clitoris (covered by the clitoral hood), urethral opening from which you urinate and the vaginal opening.
“Cancers such as vaginal cancer and vulval cancer can present symptoms in these exterior parts of your genitals, so it’s important for you to be aware of what each part is and its purpose.”
Your vulva may change shape: Our bodies naturally alter as we get older and your vulva is no different, especially as your hormones change. “Menopausal changes will lead to changes in the vulva,” explains Julie Bowring, consultant gynaecologist in sexual and reproductive health at London Gynaecology.
“Our collagen levels decrease as part of the ageing process and a result of this is that the overall volume of the vulva may appear reduced, with thinner and less obvious labia.”
It may also change colour: “As we age the tissues of the vulva are exposed to changes in hormone levels,” says Rhiannon Bray, urogynaecologist at New Victoria Hospital. “Pregnancy can cause swelling and a deepening in colour due to the increased blood supply to the area.
“As we reach menopause the decreasing levels of oestrogen can cause the tissues to ‘atrophy’. They can appear pale and this is often associated with reduced lubrication and discomfort.
“The good news is that this can easily and safely be treated with oestrogen cream or tablets which are placed directly into the vagina and restore the health of the tissues.”
Itching is never normal: “Persistent itching could be a sign of thrush, but without the accompanying symptoms – such as thick discharge and pain when urinating or having sex – it could be a precancerous sign of vulval cancers,” warns Narendra Pisal, consultant gynaecologist at London Gynaecology.
“This may also present as tenderness of the vulva, pain or a burning sensation. If you do experience any of these symptoms, don’t panic (vulval cancers are not common so it’s more likely to be something else) but make sure you see your GP.”
Everyone is different: Many women compare themselves to others and worry that their genitals don’t look “normal”. But it’s important to know that no two vulvas are the same.
“Vulvas are as different as we are,” says Rhiannon Bray. “Just as they change with ageing, they are all different to start with.
“The inner and outer lips, the clitoral hood and the mons pubis (the mound of fatty tissue which sits on the pubic bone above the labia), can all be varied and come together to form a vulva that is totally unique to you.”
Discharge is good: Discharge from your vagina is a natural thing and can help fight off harmful bacteria and infection. “Normal physiological vaginal discharge that is not itchy or irritated is good as it cleanses the vagina and reduces friction,” says Julie Bowring. The amount you have differs from person to person and can fluctuate throughout your menstrual cycle.
“However, if your discharge smells, it can be a sign of infection, such as bacterial vaginosis or candida infection, so if you are experiencing smelly, thick or discoloured discharge then see your GP.”
You should check yourself regularly: Research has shown that women are so often focused on taking care of others, that 55 per cent admit they neglect their own health. But getting to know your own body and reporting any changes is vital, and that includes your genitals.
“Everybody should be checking themselves regularly for any changes or abnormalities such as discharge, new sensations, outgrowth or inflammation that is persisting longer than a couple of weeks,” says Mr Maiti.
“Be aware of any changes that may occur and raise these with your GP or gynaecologist accordingly. It might seem silly but grab a mirror and check yourself out, it might just save your life.”