Vulvar Disorders

What are vulvar disorders?

The vulva is the outer part of the female genitals. This includes the clitoris, vaginal lips, and the opening to the vagina. A vulvar disorder is a health problem that affects your vulva. These problems may cause pain, itching, or skin changes of the vulva. Treatment depends on the cause.

Common vulvar disorders include:

• Vaginitis or vulvovaginitis, which is swelling or infection of the vulva and vagina
• Itching (pruritus vulvae) or skin rashes due to allergies or irritation
• Vulvar cancer
• Vulvodynia, which is long-lasting vulvar pain without a known medical cause
• Lichen sclerosus, which is thin, itchy, white patches of skin on the vulva
• Vulvitis, which is inflammation of the vulva
• Labial adhesions, which is when the folds of skin around the vaginal opening stick together (most common in young girls)

Who is more likely to develop vulvar disorders?

Vulvar disorders can affect women and girls of any age, but certain factors may raise their risk. This includes those:

• Going through or past menopause. Lower estrogen can lead to thinning skin and conditions like lichen sclerosus.
• Having certain skin conditions or allergies, which can raise your risk of vulvar skin problems.

What are the symptoms of vulvar disorders?

Symptoms depend on the specific disorder. Common symptoms may include:

• Redness or swelling
• Itching or burning
• Pain, especially during sex or urination (peeing)
• Cracks, sores, or thickened patches of skin
• Changes in skin color, such as lighter, darker, or white patches
• Lumps, growths, or sores that don't heal
• Vaginal bleeding that isn't related to your menstrual period

Talk to your health care provider if symptoms last more than a few days, you notice a new lump or a sore that won't heal, or you have vaginal bleeding that's not normal for you.

How are vulvar disorders diagnosed?

Early diagnosis may make most vulvar disorders easier to treat. To diagnose a vulvar disorder, your provider may:

• Ask about your health history and symptoms
• Do a pelvic exam
• Test for HPV or do a Pap test
• Use a magnifying tool (colposcope) to look closely at the skin of your vulva

What are the treatments for vulvar disorders?

Treatment depends on the cause. It may include:

• Medicines, such as antibiotics, antifungals, or other medicines
• Creams or steroid ointments for irritation or allergic reactions
• Pelvic floor physical therapy (to stretch and ease vulvodynia pain), nerve blocks or medicines, counseling, or a combination of these treatments

Can vulvar disorders be prevented?

Not all vulvar disorders can be prevented, but you can lower your risk by:

• Getting the HPV vaccine to help prevent infections linked to vulvar cancer
• Not smoking
• Practicing good hygiene, such as wearing cotton underwear and avoiding scented soaps or douches
• Getting regular checkups, including pelvic exams, so problems can be found early

Questions for your care team

General prompts to help prepare for your appointment.

• How does this information apply to my situation?
• Which symptoms or results need evaluation?
• Which tests are useful, and what can they tell us?
• What care options, benefits, and risks should we discuss?
• When should I seek urgent help, and whom should I call?
• When is follow-up, and how will we know whether the plan is working?