Vulva: Location, Anatomy, Function, Conditions and Care

What is the vulva?

The vulva is the external part of the female genitalia. It includes several structures:

● Mons pubis:

A fatty area over the pubic bone.

● Labia majora:

The outer "lips" that surround the other parts of the vulva.

● Labia minora:

The inner "lips" that are located inside the labia majora.

● Clitoris:

A small, sensitive organ located at the top of the vulva.

● Urethral opening:

The opening through which urine exits the body.

● Vaginal opening:

The opening to the vagina, which leads to the internal reproductive organs.

The vulva plays a role in protection of the internal genital organs, sexual arousal, and sensation.

What is the function of the vulva?

The vulva serves several important functions:

■ Protection:

 The vulva protects the internal reproductive organs from pathogens and physical injury.

■   Arousal and Sensation:

 The vulva contains many nerve endings, particularly in the clitoris, making it highly sensitive and important for sexual arousal and pleasure.

■ Urination: 

The vulva includes the urethral opening, which allows urine to pass out of the body.

■ Reproductive Role:

 The vaginal opening in the vulva allows for the passage of menstrual flow, sexual intercourse, and childbirth.

■ Lubrication: 

Glands in the vulva secrete lubricating fluids to maintain moisture and reduce friction during sexual activity and other movements.

Where is your vulva located?

The vulva is located in the pelvic region, on the external surface of the female body, between the legs. It encompasses the area from the mons pubis (the fatty tissue over the pubic bone) down to the perineum (the area between the vaginal opening and the anus). It is situated below the pubic hair region and above the anus.

Pubic mound (“mons veneris,” “mons pubis” or “mons” for short)

The pubic mound, also known as the "mons veneris," "mons pubis," or simply "mons," is a rounded, fatty area located over the pubic bone. This region is typically covered with pubic hair after puberty and provides cushioning and protection for the underlying bone and tissues during physical activities and sexual intercourse. It is a prominent part of the external female genitalia and contributes to the overall appearance and structure of the vulva.

Labia majora (outer labia/lips)

The labia majora, also known as the outer labia or outer lips, are the larger, fleshy folds of skin that enclose and protect the other external genital structures. They extend from the mons pubis down to the perineum and are typically covered with pubic hair on their outer surfaces. The labia majora contain sweat and sebaceous glands, which help to maintain moisture and protect against infections. They also provide cushioning and protection for the more delicate structures within the vulva, such as the labia minora, clitoris, and vaginal opening.

Labia minora (inner labia/lips)

The labia minora, also known as the inner labia or inner lips, are the smaller, thinner folds of skin situated just inside the labia majora. They extend from the clitoral hood at the top, down alongside the vaginal opening. The labia minora vary greatly in size, shape, and color from person to person.

Functions of the labia minora include:

● Protection: 

They protect the vaginal and urethral openings.

● Lubrication:

 They contain sebaceous glands that help to lubricate and keep the vulva moist.

● Sexual Sensation: 

They are highly sensitive and contribute to sexual arousal and pleasure due to their rich supply of nerve endings.

The labia minora help to cover and shield the clitoris, vaginal opening, and urethral opening, playing a crucial role in both protection and sexual function.

Clitoris

The clitoris is a small, highly sensitive organ located at the top of the vulva, just above the urethral opening and the labia minora. It has a significant role in female sexual arousal and pleasure. The clitoris consists of several parts:

■ Glans:

 The visible, external part of the clitoris, often covered by the clitoral hood.

■ Clitoral Hood:

 A fold of skin that partially or fully covers the glans, protecting it.

■ Crura:

 Internal extensions of the clitoris that extend downward along the sides of the vaginal canal.

The clitoris contains numerous nerve endings, making it extremely sensitive to touch. Stimulation of the clitoris can lead to sexual pleasure and orgasm. Unlike other reproductive organs, the clitoris has no direct role in reproduction but is solely involved in sexual sensation and arousal.

Urethral opening

The urethral opening, also known as the urinary meatus, is the external opening of the urethra, through which urine is expelled from the body. In females, it is located below the clitoris and above the vaginal opening within the vulva.

Key points about the urethral opening:

● Function: 

Its primary function is to allow urine to exit the bladder during urination.

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● Location: 

It is situated in the vestibule of the vulva, a region that also contains the vaginal opening.

● Protection: 

The surrounding tissues, including the labia minora and the vestibular glands, help protect the urethral opening from infection and irritation.

The urethral opening is a crucial part of the urinary system, facilitating the removal of urine from the body.

Vaginal opening

The vaginal opening, also known as the introitus, is the external entrance to the vagina. It is located within the vulva, below the urethral opening and above the perineum. This opening leads to the internal vaginal canal and is surrounded by the labia minora.

Key functions of the vaginal opening include:

■ Menstrual Flow: 

It allows the passage of menstrual blood from the uterus out of the body.

■ Sexual Intercourse:

 The vaginal opening accommodates penetration during sexual intercourse.

■ Childbirth:

 It expands significantly to permit the passage of a baby during childbirth.

The vaginal opening is typically covered by a thin membrane called the hymen, which may be partially or fully present in some individuals. The size and shape of the vaginal opening can vary greatly among individuals.

What are the common conditions and disorders that affect your vulva?

Several conditions and disorders can affect the vulva, causing discomfort, pain, or other symptoms. Common conditions include:

● Vulvovaginitis:

 Inflammation of the vulva and vagina, often due to infections, irritants, or allergies.

● Yeast Infections:

 Caused by the overgrowth of Candida, leading to itching, redness, and discharge.

● Bacterial Vaginosis:

 An imbalance of vaginal bacteria, causing discharge, odor, and discomfort.

● Sexually Transmitted Infections (STIs):

 Infections like herpes, HPV, chlamydia, and gonorrhea can affect the vulva.

● Lichen Sclerosus:

 A chronic skin condition causing white patches, itching, and thinning of vulvar skin.

● Lichen Planus:

 An inflammatory condition that can cause sores, redness, and discomfort.

● Vulvodynia:

 Chronic vulvar pain without an identifiable cause, often described as burning or stinging.

● Bartholin’s Cyst:

 Blockage of the Bartholin's glands, leading to the formation of a cyst, which can become infected and painful.

● Dermatitis:

 Skin irritation or allergic reactions causing redness, itching, and inflammation.

● Vulvar Cancer: 

A rare cancer that can cause lumps, itching, pain, or changes in skin color and texture.

These conditions can significantly affect comfort and quality of life, so it is important to seek medical advice if symptoms arise.

Infections

Infections affecting the vulva can be caused by various organisms and can lead to discomfort, itching, pain, and other symptoms. Here are some common types of infections that can affect the vulva:

■ Yeast Infections (Candidiasis):

 Caused by an overgrowth of Candida fungus, typically Candida albicans. Symptoms include itching, burning, redness, swelling, and a thick white discharge.

■ Bacterial Vaginosis:

 Caused by an imbalance in the vaginal bacteria, with an overgrowth of harmful bacteria such as Gardnerella vaginalis. Symptoms include a thin, grayish-white vaginal discharge with a fishy odor, itching, and irritation.

■ Trichomoniasis:

 Caused by the parasite Trichomonas vaginalis, which is usually transmitted through sexual contact. Symptoms include frothy, greenish-yellow vaginal discharge with a strong odor, itching, and discomfort.

■ Sexually Transmitted Infections (STIs):

 Various STIs can affect the vulva, including herpes simplex virus (HSV), human papillomavirus (HPV), chlamydia, gonorrhea, and syphilis. Symptoms can vary widely but may include genital sores, lesions, discharge, itching, and pain.

■ Urinary Tract Infections (UTIs):

 While primarily affecting the bladder and urethra, UTIs can sometimes cause discomfort and irritation in the vulvar area due to proximity. Symptoms include burning sensation during urination, frequent urination, cloudy or bloody urine, and pelvic discomfort.

■ Fungal Infections (Dermatophytosis): 

Fungal infections like ringworm can occasionally affect the vulvar area, causing itching, redness, and a scaly rash.

■ Bacterial Skin Infections: 

Conditions like folliculitis (infection of hair follicles) or cellulitis (infection of deeper skin layers) can also occur in the vulvar region, causing redness, swelling, pain, and sometimes discharge.

It's essential to seek medical evaluation and treatment if you suspect you have a vulvar infection, especially if symptoms are persistent or severe. Proper diagnosis is crucial to determine the appropriate treatment and prevent complications.

Skin conditions

Skin conditions affecting the vulva can vary widely in their causes and symptoms. Some common skin conditions that can affect the vulva include:

● Lichen Sclerosus:

 A chronic, inflammatory condition characterized by thinning, whitening, and hardening of the skin. It can cause itching, pain, discomfort during sex, and may increase the risk of tearing and scarring.

● Lichen Planus:

 An inflammatory condition that can affect the vulva, causing shiny, flat-topped bumps, and possibly ulcers. It may also lead to itching, burning, and pain.

● Contact Dermatitis: 

An allergic reaction or irritation caused by contact with irritants (like soaps, perfumes, dyes, or latex) or allergens (like certain fabrics or chemicals). Symptoms include redness, itching, swelling, and sometimes blisters.

● Atopic Dermatitis (Eczema): 

A chronic skin condition characterized by dry, itchy, inflamed skin that can appear on the vulva as well. It may be triggered by allergens, irritants, or stress.

● Psoriasis:

 An autoimmune condition that leads to thickened, red patches of skin covered with silvery scales. It can affect the vulva and cause itching, burning, and discomfort.

● Seborrheic Dermatitis:

 A condition that causes red, scaly patches and dandruff-like flakes. It can affect the vulva, particularly around the folds of skin.

● Folliculitis:

 Infection or inflammation of hair follicles, which can occur on the vulva and cause red, swollen bumps or pustules.

● Genital Warts: 

Caused by human papillomavirus (HPV), genital warts can appear on the vulva as small, flesh-colored bumps or clusters.

Diagnosing and treating vulvar skin conditions often requires a medical evaluation by a healthcare provider, preferably a gynecologist or dermatologist. Treatment may involve topical creams or ointments, oral medications, lifestyle changes, and management of triggers to alleviate symptoms and prevent recurrence.

Other conditions

In addition to infections and skin conditions, several other health issues can affect the vulva. These conditions can vary widely in their causes and symptoms, and they may require medical attention for diagnosis and treatment. Some of these include:

■ Vulvodynia: 

Chronic pain or discomfort in the vulvar area without an identifiable cause. It can be characterized by burning, stinging, soreness, or rawness. The exact cause of vulvodynia is often unknown and may involve multiple factors including nerve irritation, muscle spasms, or hormonal changes.

■ Bartholin's Gland Cysts or Abscesses:

 The Bartholin's glands are located on each side of the vaginal opening and can become blocked, leading to the formation of a cyst or abscess. Symptoms may include pain, swelling, and discomfort, especially during sexual activity or walking.

■ Vulvar Cancer:

 Although rare, cancer can develop in the tissues of the vulva. Symptoms may include persistent itching, pain, changes in skin color or texture, lumps or sores that don't heal, and bleeding that is not related to menstruation.

■ Pelvic Floor Disorders:

 Conditions such as pelvic organ prolapse or pelvic floor dysfunction can cause symptoms that may affect the vulvar area, including discomfort, pressure, or a feeling of fullness.

■ Menopause-related Changes:

 During menopause, hormonal changes can lead to thinning and drying of the vulvar tissues (vulvar atrophy), which can cause itching, burning, and discomfort, especially during intercourse.

■ Sexual Dysfunction:

 Conditions such as dyspareunia (painful intercourse) or vaginismus (involuntary tightening of the vaginal muscles) can affect the vulva and may be related to physical, psychological, or relational factors.

■ Congenital Anomalies: 

Rarely, congenital conditions affecting the structure of the vulva or reproductive organs may be present from birth and can cause various symptoms depending on the specific anomaly.

If you experience any symptoms or concerns related to your vulva, it's important to consult with a healthcare provider for proper evaluation, diagnosis, and appropriate treatment. Early detection and intervention can help manage symptoms effectively and prevent complications.

What are the common signs or symptoms of a condition affecting my vulva?

Conditions affecting the vulva can present with various signs and symptoms, depending on the specific condition. Some common signs and symptoms to be aware of include:

● Itching:

 Persistent or intense itching in the vulvar area, which can be accompanied by redness or irritation.

● Pain or Discomfort:

 Pain in the vulva, which may be constant or occur during specific activities such as urination, sexual intercourse, or sitting.

● Burning Sensation:

 A sensation of burning or stinging in the vulvar region, particularly during urination or contact with irritants.

● Swelling or Redness:

 Visible swelling or redness of the vulvar skin, indicating inflammation or irritation.

● Changes in Skin Color or Texture: 

Changes in the color or texture of the skin on the vulva, such as thickening, thinning, scaliness, or development of sores or ulcers.

● Abnormal Discharge:

 Unusual vaginal discharge that may be thick, thin, foul-smelling, or different in color from your usual discharge.

● Painful Intercourse (Dyspareunia):

 Pain or discomfort during sexual intercourse, which may be localized to the entry of the vagina or more widespread across the vulva.

● Bumps or Lesions:

 Presence of bumps, blisters, sores, or lesions on the vulva, which may indicate infections or other skin conditions.

● Foul Odor: 

Unpleasant odor emanating from the vulvar area, which can be associated with infections such as bacterial vaginosis or sexually transmitted infections.

● Urinary Symptoms:

 Symptoms such as frequent urination, pain or burning during urination, or difficulty urinating, which may indicate a urinary tract infection or inflammation affecting the nearby vulvar tissues.

It's important to note that some vulvar conditions may not cause noticeable symptoms in their early stages or may present with symptoms that overlap with other conditions. If you experience any persistent or concerning symptoms related to your vulva, it's advisable to seek medical evaluation and guidance from a healthcare provider. They can conduct a thorough examination, perform necessary tests or cultures, and recommend appropriate treatment to address the underlying cause. Early diagnosis and treatment can help alleviate symptoms and prevent complications.

What are some tips for caring for my vulva?

Caring for your vulva is an important part of maintaining overall genital health. Here are some tips for vulvar care:

■ Gentle Cleansing:

 Use mild, unscented soap and warm water to wash the vulvar area. Avoid harsh soaps, douches, and feminine hygiene products that can disrupt the natural pH balance and irritate the skin.

■ Pat Dry:

 After washing, gently pat the vulvar area dry with a soft, clean towel. Avoid rubbing vigorously, as this can cause irritation.

■ Wear Comfortable Underwear: 

Choose cotton underwear and avoid tight-fitting clothing that can trap moisture and heat, promoting bacterial growth. Cotton allows for better air circulation and helps keep the vulva dry.

■ Practice Safe Sex: 

Use condoms to reduce the risk of sexually transmitted infections (STIs). If using lubricants, choose water-based ones to avoid irritation.

■ Avoid Irritants:

 Steer clear of perfumed products, harsh detergents, fabric softeners, and other potential irritants that can cause allergic reactions or disrupt the natural balance of the vulvar area.

■ Change Wet Clothes Promptly: 

After swimming or exercising, change out of wet clothing promptly to prevent moisture buildup, which can contribute to irritation or infections.

■ Practice Good Hygiene During Menstruation:

 Change sanitary pads or tampons frequently (every 4-6 hours) to maintain cleanliness and prevent bacterial overgrowth. Consider using fragrance-free menstrual products.

■ Maintain Regular Gynecological Check-ups: 

Schedule regular visits with your healthcare provider for pelvic exams and screenings. This helps detect any potential issues early and ensures overall reproductive health.

■ Use Lubrication: 

During sexual activity, use water-based lubricants to reduce friction and enhance comfort, especially if experiencing dryness.

■ Be Mindful of Physical Activity: 

If participating in activities that may cause friction or irritation (such as cycling or horseback riding), consider using protective clothing or padding to minimize discomfort.

■ Monitor Changes: 

Pay attention to any changes in the appearance, smell, or sensation of your vulva. Consult your healthcare provider if you notice persistent or unusual symptoms.

By following these tips, you can help maintain the health and comfort of your vulvar area and reduce the risk of irritation, infections, and other complications. If you have specific concerns or questions about vulvar care, don't hesitate to discuss them with your healthcare provider.

Conclusion:

Caring for your vulva is essential for maintaining overall health and comfort. By adopting simple yet effective practices, you can promote hygiene, reduce the risk of infections, and enhance your overall well-being. Remember:

Gentle Cleansing: Use mild soap and water, avoiding harsh products that can disrupt the natural balance.
Comfortable Clothing: Opt for breathable cotton underwear and avoid tight-fitting clothing to minimize irritation.
Safe Practices: Practice safe sex, change menstrual products regularly, and be mindful of potential irritants.
Regular Check-ups: Schedule regular visits with your healthcare provider for screenings and exams to monitor your reproductive health.
Taking proactive steps to care for your vulva not only ensures physical health but also promotes confidence and comfort in daily life. If you have any concerns or notice changes, seek medical advice promptly for appropriate evaluation and treatment. Your health and well-being deserve attention and care.