Vulvar self examinations are an integral part of feminine hygiene because they allow a woman to recognize her own unique anatomy and help her monitor the normal architecture of her vulva. Examining the tissues and skin, as well as noting the color, odor and normal physiological discharge, will help to distinguish normal from abnormal. Following this advice will provide early recognition of vulvar changes, whether in discharge, color or odor coupled with other symptoms which lead to early detection.
When should the exam be done?
The vulva self-examination should be done approximately once a month between menstrual cycles. If you are no longer having your period/menstrual cycle choose a day of the month (perhaps a birth date or lucky number) that will be easy to remember and do your examination on that specific day monthly. You can consider combining all your personal examinations together and include breast, vulvar and vaginal examinations together and complete them on the same day. Women with specific vulvar diseases, or those who are prone to infection or irritation, may consider doing examinations more often. Women who have a family history of vulvar cancer should consider more frequent medical and self-examinations.
How long should the exam take?
The vulva self exam should typically take no longer than 10 minutes. It is important to find a quiet and private time where you will not be interrupted to complete this examination. Some women prefer to do this examination in the evenings before bedtime or right before their morning showers.
What supplies will I need?
Most women just use their fingers and a hand held mirror to do the examination. Find a safe quiet and private place where you can easily undress and do this examination without interruption. Some women prefer the bathroom and lock the door, while others prefer their master bedroom. Be sure to do the exam during private times, take the phone off the hook, put your cellular phone on vibrate and consider locking the door to prevent unwanted interruptions.
Performing the Vulvar Self-Examination
Find a comfortable place either the couch, bed or in the bathroom. Stand, squat or sit over the genitals, so that with the use of the hand held mirror, the vulvar tissues become visible. Some women prefer to elevate one leg on the toilet seat. Others prefer doing the examination lying down on a bed. A place that has good lighting will help you see clearly. You will hold the mirror in one hand while you examine the vulvar tissues with the other. Make sure your hands are cleaned with mild soap and rinsed well with water to remove any soapy residue. You can always ask your partner or significant other to help with the examination.
Look at the mons pubis or the area where the pubic hair is located. Look for any lesions, warts, ulcers, bumps, lumps, growths or moles. Carefully examine the skin and look for any skin changes or rashes. Look for shaving rashes and ingrown hairs if you are removing any genital hairs.
Next find the clitoris. Look at the tissue and again examine it for any ulcers, bumps, lumps and skin color changes. Note any discharge. Gently retract the prepuce or clitoral hood and look at the bulk of the clitoral tissue. Notice any changes in the tissue.
Find the outer lips or labia majora. This area should also be examined for color changes, discharge bumps, lumps or moles. Make a note of any changes.
The labia minor or inner lips are next and should be examined carefully.
Include an examination of the perineum or the tissue between the vaginal opening and the anus. Notice any skin changes, lumps, bumps or moles.
It is not uncommon for women to have some birth marks or moles in the vulvar region. Some women take pictures of the moles so they can monitor their color, shape, size, area, border and other characteristics. Others prefer documenting their findings in a journal so they can refresh their memory on size and shape. If these vulvar moles change in fashion, color, get bigger or the border becomes irregular, it’s always important to seek professional medical care for a definitive diagnosis and possible biopsy.
What am I looking for?
If you find any new changes in the vulvar area like new growths, bumps or changes in color (pigmentation), it is important to get these areas further evaluated. Ulcers or sores should never be ignored and often warrant further medical evaluation. It may be helpful to keep a vulvar diary to write down any changes. Areas that are tender to touch, have become painful or look irritated should also be evaluated.
It is also important to note that regular vulvar examinations should never take the place of a complete and comprehensive medical evaluation and assessment. Be sure to visit your health care professional or gynecologist on a regular basis so that he or she can address general health concerns and can complete a comprehensive physical and genito-pelvic examination.