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The vulva is the external visible part of the female genitalia. It includes the entrance to the vagina, the labia or vaginal lips and the clitoris. As with any other part of the body, many different diseases and conditions can affect the skin, mucus membranes and glands of the vulva. These range from vulvar disease, abnormalities of the anatomy, vulvar cancer, infections and skin conditions. Symptoms of vulvar disorders will vary depending on the type of condition. Diagnosis is easy when symptoms are obvious but there are also cases where symptoms may be invisible or absent, making an accurate diagnosis a problem.

Symptoms that indicate that there may be a problem with the vulva include:

• Redness
• Itchiness
• Flaky skin
• Bumps on the skin
• Burning
• Vulvar pain
• Pain during intercourse
• Abnormal discharge
• Bleeding

Common Problems of Vulva include:

• Candidiasis: This refers to a bacterial infection such as vaginitis that causes swelling, itching and redness of the vulva. A white curd-like vaginal discharge is often observed as well. Candidal infections respond well to anti-fungal creams or suppositories.
• Genital Herpes: Caused by the herpes simplex virus, genital herpes are spread through sexual contact. Symptoms include fluid-filled sores and vesicles around the genital area. Treatment includes painkillers, anti-viral therapy, salt baths and avoidance of sexual intercourse until the area is completely healed.
• Genital Warts: The human papilloma virus (HPV) is responsible for genital warts and is usually sexually transmitted. Along with the warts, one may experience pain, bleeding and itching. Cryotherapy or electrocautery are the best options to treat genital warts permanently.
• Lice: Pubic lice can affect the vulvar area and cause itching, redness and swelling. Lice may be sexually transmitted and need to be treated immediately with an insecticide.
• Skin Conditions: Lichen Planus is an especially painful skin condition that affects the vulva. Older women are more prone to this type of skin disorder and suffer from symptoms such as ulcers, swelling, and scarring.
• Oedema of the Vulva: This can occur due to a lymphatic blockage or venous obstruction. Oedema of the vulva is also common among pregnant women. In some cases, oedema of the vulva may indicate sexual abuse or trauma during intercourse.
• Vulvodynia: Vulvodynia is a distressing and painful condition that causes women to experience symptoms such as intense pain, burning sensation and soreness of the vulva over an extended period of time. Vulvodynia can affect sexual relationships and simple day-to-day activities such as walking, sitting, and wearing clothes. Many experts believe that vulvodynia could be a psychosexual problem though research does indicate that the pain is real. Treatment of vulvodynia usually includes the use of topical painkillers, medications such as anti-depressants and anti-convulsants, pelvic floor physiotherapy and biofeedback. In severe cases, surgery may be required to address any anatomical causes of the condition.
• Vulvar Cancer: Vulvar cancer is most common in women over the age of 65. Symptoms of vulvar cancer and Squamous Cell Carcinoma include small wart-like growth on the vulva, long-term itchiness, lumps on the vulva along with skin lesions. Surgery is the best treatment for such cases of cancer.

Medical Treatments

Apart from the above medical treatments, the best way to treat most vulvar diseases is to improve skin care of the region. You can do this by:

• Using hypoallergenic and mild detergents and bathing products
• Using sanitary napkins and tampons made only of 100% cotton
• Wearing cotton underwear
• Avoiding tight and synthetic underwear and clothing
• Washing the vulvar region after urination and intercourse
• Using a water-soluble lubricant during intercourse if necessary
• Avoiding douches and the use of vaginal wipes

References

1. http://www.nlm.nih.gov/medlineplus/vulvardisorders.html