Vulval Problems

The Amara Clinic offers expert assessment and treatment of vulval problems.

If you are worried about changes in your vulva’s appearance or are experiencing pain, itching or other symptoms, The Amara Clinic’s specialist team can assess your symptoms, examine your vulva and arrange diagnostic tests in a private, safe and stress-free environment.

What is the vulva?

The vulva is the medical term for the female external genitals. There are two pairs of labia (lips): the fleshy outside lips are variable in size and colour, have pubic hair and are called the labia majora. The inner labia are thinner, may be darker or lighter in colour andare called the labia minora. At the front, where the lips join, is the clitoris. The labia protect the three intimate holes, which are the urethra (entrance to the bladder), vagina (entrance to the womb) and anus (entrance to the large bowel).

Vulval problems are often misunderstood. This is, because symptoms are usually not very obvious or can be non-specific. Some women are embarrassed, shy, or reluctant to familiarise themselves with their vulvas or talk about problems. As a result, vulval issues are often diagnosed much later than menstrual problems, even when women seek medical advice from their GPs.Regular self-examination and knowing what's normal for you is the key starting point to diagnosis.

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Diagnosis and treatment of vulval problems at The Amara Clinic

Please do not be embarrassed, hesitant or ashamed to seek health advice for a vulval problem, particularly if it has been a longstanding issue. The experienced health professionals at The Amara Clinic are here to listen to your concerns, examine your vulva, arrange any necessary tests, and develop a bespoke treatment programme for your needs.

The expert team understands that some women feel uncomfortable or self-conscious sharing an intimate problem; they will be professional, discreet, and sensitive throughout.

Types of vulval problems

Vulval problems can affect women of all ages. Many conditions can affect your vulva, including vulval skin disorders, vulval pain or vulvodynia and vulval aesthetic problems.

Vulval skin disorders

The vulva can develop skin diseases. Common symptoms include pain, itching, rashes, soreness and changes in the skin. Some of these skin conditions only affect the vulva- but many can affect the rest of the body as well. Vulval skin conditions include:

  • Lichen sclerosus: A skin problem that causes itchy white patches to appear on your vulva and other parts of the body. It usually develops after the menopause but can affect women of all ages. We can’t cure lichen sclerosus, but we have excellent treatments to keep it under control. Some women with lichen sclerosus are at risk of developing pre-cancerous changes in the vulva so the team will keep a close eye on you.
  • Lichen planus: A skin condition that causes pain and discomfort. It can affect skin anywhere on the body but the soft membranes of the mouth and vulva are particularly vulnerable. The skin can look bright red and inflamed.
  • Vulval dermatitis: Also known as lichen simplex or vulval eczema, this can cause intense itching, inflammation and thickening. Stress, perfumes and soaps can trigger a flare-up.
  • Vulval atrophy: The vulval tissues can become thin due to falling oestrogen levels after the menopause which results in collagen depletion. The vulval skin can become pale, itchy, uncomfortable and lose elasticity.
  • Psoriasis: Psoriasis can affect the vulva, as well as the scalp, nails and skin all over the body. It causes skin thickening and dryness.
    Candida or thrush infection: Thrush causes soreness, irritation and burning. It may also cause a lumpy white discharge, especially if the vagina is also infected.
  • HPV or genital warts: Human Papillomavirus can infect the vulva causing warty growths. The virus is sexually transmitted and very common. It’s important to attend screening if you have contracted HPV because some strains of the virus are linked to the development of cervical cancer.
  • VIN: VIN stands for vulval intraepithelial neoplasia. It’s the medical term for pre-cancerous cells that develop in the vulva, similar to the abnormal cells that we look for in your cervical smear test. If we are worried about VIN, we may refer you for a colposcopy examination to inspect your vulva, cervix and vagina with a microscopic camera and take biopsies.
  • Vulval cancer: Vulval cancer is thankfully rare. It usually affects women over 50 after the menopause. If you notice a lump, ulcer, thickened patches or rash that doesn't settle, you should make an appointment with a medical professional. You should also get a check-up if you have an ongoing blood-stained discharge or symptoms of pain, itching or burning that don't resolve.

Vulval pain or vulvodynia

Vulvodynia can be uncomfortable and distressing. It triggers different types of pain – from burning and stinging to an aching or throbbing sensation. Whatever the pain, it may be felt across the entire vulval area or be more localised, with some women experiencing pain that only affects the clitoris, for example.

Vulvodynia can affect your work, your sex life and your quality of life. Everyday acts like inserting a tampon, having intercourse or wearing tight-fitting underwear can all act as potential triggers.

Aesthetic vulval problems

Normal vulvas come in all shapes and sizes. Lop-sided labia, dangly labia minora, wrinkles and dark or purple skin are all extremely common. However, some women are not happy with the appearance of their vulva. If you’re concerned that your vulva lacks symmetry, are unhappy with its shape, or want to reduce the size of the labia minora so that they are enclosed within the outer lips, intimate aesthetic surgery can help.

Managing vulval problems

The team at The Amara Clinic will work with you to treat and manage your vulval skin condition. Moisture, heat and rubbing or itching can worsen your vulval problems. You can ease your symptoms if you:

Avoid soaps, shower gels, scented products and deodorants in the sensitive genital area.

Wear underwear and clothing in natural fabrics to let the skin breathe.
Don't pick, scratch or rub. We know it's tricky, but scratching will irritate the area and damage the delicate skin. If you're scratching at night, keep your nails trimmed short to minimise the damage.

Treat your partner if you have Candida; the infection can be transmitted during sex.

Make an appointment with the specialist team at The Amara Clinic for assessment and advice. They can exclude serious problems like VIN or vulval cancer, prescribe creams to treat your skin condition, ease your symptoms and prescribe treatment to address any infections and STIs.

Managing vulvodynia

The medical team at The Amara Clinic use a holistic structured approach to help you manage the pain associated with vulvodynia and improve the long term outcome.

We have a multi-faceted approach to address the problems which lead to vulval pain, including prescription medication where necessary. Self-care and dietary changes are also key.

Managing aesthetic vulval problems

Many aesthetic vulval concerns can be corrected by labiaplasty.. Labiaplasty is bespoke cosmetic surgery to reduce the size of your inner vulval lips. Labiaplasty makes the labia minora smaller, more symmetrical and neatly enclosed within the labia majora.

Labiaplasty is about more than having a 'designer vagina'; it can restore your body confidence and self-esteem. After labiaplasty surgery, women feel better and have more sexual confidence. It also resolves any problems with the labia catching or rubbing in tight clothing, when cycling or during sport.

The team at The Amara Clinic will be happy to discuss your concerns about vulval appearance and, where appropriate, arrange labial surgery for you which will be carried out by Miss Anne Henderson.

When should you get specialist help for vulval problems?

Whatever symptoms you are experiencing, you should seek specialist advice sooner rather than later. The general rule is that if you’ve had symptoms for four weeks or more, it’s time to book an appointment. But if you're in pain and distress, please come and see us at an earlier stage.

Why choose The Amara Clinic?

Consultant-led care

The clinic is led by Miss Anne Henderson, a highly experienced Consultant Gynaecologist and accredited British Menopause Society (BMS) specialist, one of only 200 specialists across the UK. She works with an experienced multi-disciplinary team to support women during the menopause and throughout their reproductive lives.

Seamless service

All your requirements including consultations, investigations diagnostic tests, surgical procedures and prescriptions can be accessed in-house through a seamless process which rarely requires external referrals. Most women will see the same practitioner throughout their treatment journey, receiving not only a high level of expertise but also continuity of care.

One-stop service

At The Amara Clinic our mission is to make it easy for all women to access the quality healthcare they need. We offer a wide range of services including face-to-face and virtual appointments depending on your needs and location. We can also provide an extensive range of investigations including blood tests and imaging, treatments and private prescriptions. Our medical team cover a comprehensive selection of health concerns including general gynaecology, perimenopause and menopause, cervical screening and Well Woman health checks.

Healthcare by women for women

We offer personalised treatment and sensitive support in a comfortable, private space. The Amara Clinic offers exceptional bespoke health and menopause care in a boutique clinic in the heart of Tunbridge Wells as well as virtual consultations for patients across the world.

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