Vulvar Disorders

The vulva is the external female genital area that covers and protects a female’s sexual organs and urinary opening. It includes the labia majora, labia minora and tissue at the opening of the vagina.

There are many things that can cause irritation to the vulva, including infection, environmental factors and skin conditions. Some conditions cause minor discomfort, while others can make urination and sex very painful.

Most vulvar skin problems can be managed, but treatment differs based on the condition. The only way to know which one you have, and the best treatment course, is to see your healthcare provider.

Common Vulvar Disorders

Yeast infection

The vagina naturally has a certain amount of Candida yeast, but an overgrowth can cause a fungal infection.

Yeast infections are more common in individuals who:

• Are pregnant
• Use hormonal contraceptives
• Have diabetes
• Have a weakened immune system
• Are taking or have recently taken antibiotics

Symptoms of a yeast infection are:

• Vulvar swelling and redness
• Itching, burning and irritation
• Painful urination and sex
• Thick, white vaginal discharge that looks like cottage cheese

Common treatments include:

• Over-the-counter antifungal creams applied inside the vagina
• Oral fluconazole prescribed by your doctor

Other treatments may be required for severe infections that either don’t get better or keep recurring.

Vulvitis/dermatitis

Vulvitis/dermatitis is an inflammation and irritation of the vulva caused by:

• Allergens
• Chemicals found in household soaps, detergents and feminine products
• Skin irritation caused by tight clothes or activities like horseback or bike riding
• Hot tubs or bubble baths
• Wearing a wet bathing suit or damp, sweaty underwear for long periods of time
• Symptoms to watch for:
• Chronic itching
• Redness
• Swelling
• Rash
• Treatments include:
• Topical corticosteroid cream
• Antihistamines
• Switching to hypoallergenic detergents and soaps

Genital Herpes

Genital herpes is a common STD caused by the herpes virus. While there is no cure, it is manageable.

Signs of genital herpes are blistering and painful lesions on the vulva and surrounding areas. It is contracted through vaginal, anal or oral sex with an infected partner. You can get herpes if you have contact with:

• Herpes sores
• Saliva or the mouth of a partner with an oral herpes infection
• Genital fluids or skin in the genital area of a partner with a genital herpes infection
• Herpes infections are treated with antiviral medications to reduce the frequency and severity of attacks as well as lower a person’s risk of spreading the virus to others.

Genital Warts

Genital warts are an STD caused by the human papillomavirus (HPV). They vary in size, shape and color on the vulva, but are usually painless. They can cause:

• Itching
• Burning
• Bleeding during intercourse
• Genital warts can only be removed through freezing or burning them off. Genital warts can be treated with topical medications, freezing, burning, laser procedures or excision.

Trichomoniasis

Trichomoniasis is an STD caused by parasites (like pinworms, scabies and lice) that causes inflammation of the vulva.

• Trichomoniasis symptoms vary, but you may experience:
• Vulvar itching, burning, redness or soreness
• Foul-smelling white, yellow or green discharge
• Discomfort when urinating or during sex

Trichomoniasis is treated with antibiotics, but it can be contracted again. All sexual partners should be treated with antibiotics and engage in protected sex.

Lichen Sclerosus

Lichen sclerosus is a non-contagious, inflammatory vulvar skin disorder more common in postmenopausal people. Its cause is unknown, but some doctors believe overactive immune systems play a role.

Symptoms include:

• Intense itching
• Tenderness
• Painful sex
• White, wrinkled or split patches on the vulva that can lead to bleeding or scarring

While there is no cure, symptoms can be managed with corticosteroid cream for several weeks. Regular monitoring is important because the affected skin can increase the risk for vulvar cancer if not treated properly.

Bacterial Vaginosis

Bacterial vaginosis occurs when there is an imbalance of ‘good’ and ‘bad’ bacteria in the vagina. This condition typically occurs in sexually active individuals. Those who use douching products, don’t use condoms or have multiple sexual partners are at an increased risk for developing it.

Symptoms to watch for:

• Thin, white-grey discharge
• A strong fish-like odor

Treatment includes a prescription antibiotic. In some cases, bacterial vaginosis can return after treatment.

For more information on vulvar disorders, schedule an appointment with one of our specialists by calling 330.375.4094.