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Check Your Vulva Monthly

compact mirror with light .jpg

How to Check Your Vulva

  1. Perform the check once a month, ideally after bathing.

  2. With a clean hand, use a compact mirror (a lighted compact would be ideal) and good lighting to examine the entire vulvar area, including the clitoris, labia majora and minora, perineum, and anus.              (Click to See Diagram)

  3. Look for:

    • Changes in color, texture, or symmetry.

    • Lesions, lumps, or sores.

    • Areas of thickening, thinning, or whitening.

    • Signs of irritation, redness, or abnormal discharge.​​

  4. My recommendation is to keep a journal (like a notebook or even on your phone) with dates and things that you want to note. ​​

    1. Note any persistent symptoms such as itching, burning, or pain.

    2. Write down questions you have for your doctor.

  5. If you have the privacy available on your phone, you could also take a photo of your vulva in case you have a difficult time distinguishing changes between checks.

Regular vulvar self-examinations, combined with routine gynecological visits, are a simple yet powerful tool for maintaining vulvar health and preventing complications.

Why You NEED to Check Your Vulva Monthly

Regular self-examinations of the vulva are a crucial component of proactive vulvar health care, especially for individuals with conditions like vulvar lichen sclerosus (VLS) or other vulvovaginal disorders. Research highlights several reasons why routine checks are important:

1. Early Detection of Changes in Vulvar Tissue

  • Rationale: Vulvar lichen sclerosus and other vulvovaginal conditions can lead to structural changes, such as whitening (leukoplakia), atrophy, or fissures. These changes can sometimes progress to squamous cell carcinoma (SCC) if left unchecked.

  • Evidence: Studies suggest that vulvar SCC arises in approximately 4-5% of individuals with untreated or severe VLS (Kirtschig, 2016). Regular monitoring enables early identification of suspicious lesions, improving outcomes.

    • Reference: Kirtschig, G. (2016). Lichen sclerosus—Presentation, diagnosis and management. Dtsch Arztebl Int, 113(19), 337–343. doi:10.3238/arztebl.2016.0337

2. Prevention of Late-Stage Diagnosis

  • Rationale: Many vulvar conditions are diagnosed at advanced stages due to delayed reporting of symptoms, often because individuals feel embarrassed or unaware of vulvar self-care practices. Monthly checks help normalize self-awareness and encourage earlier medical consultations.

  • Evidence: A cross-sectional study by Melgaard et al. (2022) found that individuals with VLS experienced a significant reduction in quality of life due to symptoms, but many delayed seeking care for several years.

    • Reference: Melgaard, T. T., et al. (2022). Quality of life and sexuality in women with lichen sclerosus: A cross-sectional study. Clinical and Experimental Dermatology, 47(2), 343–350. doi:10.1111/ced.14893

3. Promoting Awareness of Normal and Abnormal Anatomy

  • Rationale: Monthly checks improve familiarity with the vulvar landscape, helping individuals distinguish normal anatomical features from abnormal changes.

  • Evidence: Research indicates that women with chronic vulvar conditions often express dissatisfaction with the appearance of their vulva after changes occur (Ontalvilla, 2022). Routine self-exams encourage a proactive relationship with one’s body, fostering empowerment and reducing stigma.

    • Reference: Ontalvilla, P. G. (2022). So, I have Vulvar Lichen Sclerosus. What do I do now? Independently published.

4. Monitoring Treatment Progress

  • Rationale: For individuals managing chronic conditions like VLS with treatments such as clobetasol propionate, regular checks allow them to monitor the effectiveness of therapy and report persistent or worsening symptoms to their healthcare provider.

  • Evidence: Maintenance therapy with topical corticosteroids significantly reduces the risk of cancer and symptom recurrence (Chi, C. C., & Kirtschig, G., 2017). Self-monitoring helps ensure adherence and responsiveness to treatment.

    • Reference: Chi, C. C., & Kirtschig, G. (2017). Evidence-based practice: Topical corticosteroids in vulvar lichen sclerosus. Journal of the European Academy of Dermatology and Venereology, 31(4), 573–579. doi:10.1111/jdv.13947

5. Building Confidence in Discussing Vulvar Health

  • Rationale: Regular self-checks can help reduce embarrassment and hesitancy in discussing vulvar health with healthcare providers. This is particularly relevant given the intimate and stigmatized nature of vulvar conditions.

  • Evidence: Educating individuals about vulvar self-care has been shown to improve patient-provider communication and ensure timely care (Guthrie et al., 2020).

    • Reference: Guthrie, J. R., et al. (2020). Vulvar health awareness and education: Addressing a neglected area of women’s health. Menopause, 27(8), 1002–1007. doi:10.1097/GME.0000000000001553​

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