Vulval Conditions

What's a Vulval Condition?

Vulval conditions are a wide range of diseases affecting the vulva – an umbrella term for the outer parts of the female genitals (the mons pubis, labia minora and majora, clitoris, urethral opening, vestibule, and perineum). They’re very common, and most women will experience one at some point in their lifetime.

Many vulval conditions can be resolved with treatment, but some can be ongoing or need lifelong management. If you’re tired of dealing with discomfort ‘down there’, don’t wait: give us a call and see how we can help.

What’s Vulvodynia?

Vulval Pain and discomfort (also called vulvodynia) can be caused by a number of conditions. It can be experienced during intercourse, or it can be constant or intermittent pain.

Vulvodynia can often be a symptom of a serious underlying condition which warrants immediate treatment, so see your doctor if it persists. Any visible abnormalities – things like lesions, skin whitening, rash, ulceration, swelling or lumps, bleeding, itching or burning – are causes for investigation.

You can learn more about vulvodynia and vulval discomfort by reading our article here.

What’s Lichen Sclerosus?

Lichen Sclerosus (LS) is a skin condition that can appear on almost any skin on your body, but is usually found around the genital area. It’s most common in women, it can start at any age, and it usually continues for life once it starts.

Although a specific cause of LS is yet to be identified, evidence supports a genetic component and autoimmune connection. As a result, it’s not contagious – you can’t give it to your partner or catch it from them.

What does LS Look Like?

LS usually shows as whitened skin around your vulva, perinium, and anus. It can also show as lesions which look like bruises and blisters.

If left untreated for a long time, LS may cause severe scarring which results in the loss of the labia minora (inner lips of the vagina) and reduces the size of the vaginal opening. This can make penetrative sex very painful or impossible.

How is it treated?

Lichen sclerosus treatment varies depending on the severity of the condition and your individual situation. Your doctor may recommend moisturisers or steroid creams to minimise discomfort, or other medications to manage pain. They may also recommend an at-home self-care routine.

Since lichen sclerosus is a precancerous condition, treatment of LS also involves ongoing monitoring by your gynaecologist.

 

Vulval Candida (Thrush)

Thrush (also known as ‘monilial’ or yeast infection) is a very common condition in women of all ages – about 75% of all women will contract it at some point during their lifetime. It causes an itchy and uncomfortable feeling in the vulva and vagina. It is caused by the fungus Candida, a type of yeast which occurs naturally on the body.

Who is at risk?

As the fungus thrives in high sugar environment, patients with uncontrolled diabetes are prone to thrush and a low sugar diet is recommended to reduce the risk of infection.

How is it treated?

Home remedies – things like yoghurt, probiotics, and vinegar – are very popular, but haven’t been clinically shown to benefit.

Thrush is usually treated with a single-dose tablet or anti-fungal pessaries – your gynaecologist can let you know which optin is best for you, they and are usually available over-the-counter.

What if it won’t go away?

Thrush can usually be easily managed with medications, but chronic and ongoing thrush should be assessed by a gynaecologist. Ongoing thrush can be a symptom or misdiagnosis of another condition, such as vulval candida. As a result, it’s best to monitor ongoing cases.

Can I give it to my partner?

Thrush is caused by the Candida fungus, which can be spread to your partner during sex. However, your partner usually won’t need to be treated for thrush if they don’t show any symptoms.

Can I still get pregnant with PCOS?

Because this condition affects your eggs, it can make it harder for you to get pregnant. Around 70-80% of women with PCOS also have reduced fertility. But it’s not impossible - many women with PCOS do have children. If you are having trouble getting pregnant, fertility treatments are available to help improve your chances of ovulation.

It’s important to be aware that PCOS can cause complications during pregnancy such as high blood pressure and gestational diabetes. It is also linked to higher levels of premature delivery and miscarriage. If you get pregnant with polycystic ovaries, your gynaecologist and obstetrician will discuss risk management with you, and monitor you carefully.

Losing weight and lowering your blood sugar levels can also help improve your odds of a healthy pregnancy.

Washing your Vulval Skin

Remember that using soaps will make your vulval skin more sensitive, especially if they’re used frequently. Abrasive washers, wet wipes, and douches should all be avoided – instead, try a soap substitute such as QV wash, or simply soak in the bath.

The best bath additive for vulval conditions is a bath oil formulated for sensitive skin, or just a handful of plain salt. Avoid bubble bath, perfumed oils, medicated bath oils and antiseptics, and make sure your bath isn’t too hot.

Saline is especially useful for cleaning inflamed vulval skin – you can buy it at your local pharmacy, or make it at home by dissolving two teaspoons of salt in a litre of water. It’s best applied using a wad of cotton wool, or used to soak in a bowl.

After washing, you can dry your vulva by gently patting it dry with a clean towel or with a hairdryer set to the coolest setting.

Avoiding irritating substances

Avoid using perfumed products, feminine sprays, antiseptics, and old medications from previous conditions – these can aggravate vulval conditions. Methylated spirits, aloe vera and tea-tree oil are popular remedies for vulval skin conditions, but they can be very irritating and can even make the afflictions worse.

It’s better to use tampons for managing your periods (rather than pads) if possible – the plastic backing on pads isn’t breathable, which promotes bacteria growth. The same is true with liners (even the ‘breathable’ kind) – if you have heavy discharge, it’s best to change your underwear at lunchtime and put the used item in a snap-lock plastic bag to wash at home.

Tight pants, control briefs, nylon underwear, and G-string cuts aren’t breathable either, and can aggravate your vulval condition. If you go swimming in a chlorinated pool, it’s best to remove your batehrs and wash them immediately to minimise bacteria growth.

Excess wiping after a bowel motion can also cause irritation. A simple solution is to put a thick layer of petroleum jelly (Vaseline) over the anal skin before going to the toilet – this protects the skin and makes cleaning much easier. It’s also best to use hypoallergenic toilet paper (such as Sorbent) to clean with, as it’s less likely to cause abrasion.

Things you could be allergic to

Many commonly used items can cause allergic reactions resulting in vulval discomfort. These include:

  • Toilet paper
  • Lubricants
  • Any medication, either prescribed or over-the-counter
  • Perfumed products
  • Antifungal creams and pessaries
  • Antiseptics
  • Nail polish
  • Latex condoms
  • Semen

If you think something in your day-to-day life may be causing or worsening your condition, avoid contact with it and ask your doctor about allergy screening.

 

Sexual function

Most women with a vulval problem have found that it has interfered with their sex life in some way. Sexual arousal may be less easy, leading to anxiety, dryness, and sometimes painful vaginal spasms. While it’s normal for women to take longer to become aroused than men, and it is important  that you don’t attempt penetrative sex if it causes you pain. Instead, wait until your condition has settled, or try something different – it’s possible to have a sex life without penetration!

Many women with vulval conditions find that lubricants are helpful. Choose a water-based lubricant free from antiseptics, sugars, spermicides, or other medications and additives – these often sting and can aggravate your condition. Your gynaecologist can recommend options best for your individual case.

Living a full life with a vulval condition

Northside Gynaecology is a female-only practice located at convenient North Brisbane locations including Kedron, North Lakes, and Caboolture. To book an appointment with one of our vulval experts, call us on 07 3088 9005.

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