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Vulval health during menopause and throughout your life

Another interesting and informative talk at the recent BMS conference was on Vulval health which was presented by the delightful Dr Kay McAllister who is based at Sandyford Glasgow - I know what a topic, discussed even less than vaginal health, but equally as important.

Ok can we just get this down in black and white as some women I come across are a little hazy as to what the vulva actually includes…these are your external genitals including the labia — the outer and inner ‘lips’ of the vulva know as the labia majora and labia minora. The vestibule surrounds the opening of the vagina, or introitus, and the opening of the urethra, or urethral meatus. The perineum is the area extending from beneath the vulva to the anus. Then there is your clitoris and anus at either end. See diagram below!

One of the main concerns within the medical profession, particularly amongst the younger generation it seems, is the increasing obsession with the appearance of labia, the never ending waxing, shaving and trimming and the over cleaning!

Important point - over washing anywhere on your body is going to cause drying out, think how dried out and prune like your hands get if amongst the soap suds too much - same goes for your genitals, so treat them wisely and simply. If you have a problem with vaginal irritation, dryness or soreness then don’t go using heavily perfumed gels, creams or douches in that area, simple cleaning only is essential and the blander the better. I know how dull but the result is a healthier, happier vulva! So by bland I mean a soap substitute of some sort...think of emollients. Emollient products help to keep your skin feeling protected and hydrated, they soften and moisturise, soothe and cover the skin with a protective film which traps in moisture instead of drying out the skin. There are many companies who make these products, as with anything find one which suits your physiology, e.g. dermal 200 shower or bath 600 emollient. Oh and the vaginas are self cleaning so you don't need to use anything up there to give it a spring clean, it does it itself!

Getting back briefly to the size of labia … now really ladies I know I’ve banged on in the past that we need to give more attention to this area of you body...give as much attention to your vulva and vagina as you do your faces...being one of my favourite phrases, but the size of your labia…have a large word with yourselves. If they were on view for everyone to see I might maybe slightly understand this growing obsession but they aren’t plus, as wonderfully explained by Dr McA, it depends on which angle you actually view your labia from…oh yes lying down they will look completely different to when standing up and hanging down. My advice to you - be happy with what you’ve got, look after it and treat it with respect!

Flippancy aside this is a growing concern particularly amongst the younger population with more than 200 girls under the age of 18 having labiaplasty operations. As such the RCOG and the British Society of Paediatric and Adolescent Gynaecology (Britspag) have jointly produced a booklet for circulation in response to this increasing number of girls and women with cosmetic genital concerns requesting surgery despite having normal anatomy. The book is absolutely brilliant :

For any Health Care Professionals (HCPs) out there some women as well as girls will need reassurance about what actually is the norm…things like it’s normal to have a certain amount of discharge, there can be an odour more often than not and maybe a small amount of irritation, especially if wearing tight clothes…it’s knowing what the norm is for you but then also what definitely needs to be addressed and treated.

However if you are experiencing persistent irritation, dryness, swelling, redness, soreness, have noticed any lumps…I could go on, it is very important to go and get checked. Get checked by someone who knows what they are talking about, definitely make sure they exclude conditions like lichen sclerosis, which appears to be more common than realised, and attend follow up appointments. In short your vulva and vagina are your responsibility to look after as no-one will be asking you on a regular basis how they are!

Another important point - having spoken to many women now about their nether regions it is obvious that a large proportion of women rather than going to see their GP will self medicate and repeatedly self medicate. Unfortunately sometimes they get their diagnosis wrong and I would encourage anyone with symptoms to seek medical advice first and foremost, prime example of this is mistakenly thinking you have thrush. Treating a condition with the wrong lotion and potions will only exacerbate them and could make things worse.

Ok so…don’t put up with discomfort, do go and seek out the right medical care and do it now rather than putting up with symptoms for several years which might result in infections that are harder to treat and do have a peek so you know what is normal for you!

Dr McAllister’s presentation finished brilliantly with a cartoon image with the quote

“ Hey all vulvas out there … you’re lovely as you are”

To remind - they have recently jointly developed with the British Society of Paediatric and Adolescent Gynaecology a booklet titled ‘So what is a vulva anyway’ which …’has been developed in response to an increasing number of girls and women with cosmetic genital concerns requesting surgery despite having normal anatomy.’

Women Health Concern: Let’s Talk Menopause: Let’s Talk Menopause:


Any information is as accurate as possible at time of writing and is for information purposes only. The information and support that Let's Talk Menopause provides is for your own personal use. It is not intended to replace or substitute the judgement of any medical professional you may come in contact with. You should always seek advice from your healthcare professional regarding any medical condition.


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