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The Vagina and The Vulva

The Vagina and the Vulva

The Vulva

Lets face it, the vulva is like no other part of your body. Being comfortable and confident with this area will allow you to be truly satisfied during both daily and sexual activities. If you have a rash, pain, discharge, itching, an odour, bleeding or if you are not happy with the way it looks or feels, your inner being can be turned upside down. The way you feel about your vulva and your desire and capacity for sex are intimately linked. There is so much you can do to help maintain the vulva area. Depending on your personal preferences, you can use natural skin protectors and moisturizers, hair grooming with waxing, shaving, trimming and laser hair removal and general common sense care. If you have sensitive skin, this is especially important.

What is the Vulva Area?

The vulva includes the outer labia (outer lips or labia majora), the inner labia (labia minora) and the vestibule (entrance to the vagina before the hymen). The vagina itself is just inside the hymen ring. Although some women refer to the genital area as the “vaginal area”, the vagina is really only the area deep inside the hymen. There is a lot going on in the vulvar area: the clitoris plays a role in sexual satisfaction and orgasm; the urethra, found below the clitoris, is where urine is passed, and; below the urethra is the hymen which is the doorway to the vagina. Between the opening to the vagina (vestibule) and the anus is the perineum muscle bridge. The outer labia are usually covered with hair, while the inner labia have none. Sometimes the inner labia are too large and protrude far beyond the outer labia. If this is a problem for you, we offer simple surgery to correct this. The top part above the clitoris and below the bikini line is the mons pubis which acts as cushioning during intercourse. The hymen is the ring of tissue at the entrance to the vagina tube which is usually closed until puberty and then opens with time due to movement and activity, (like running, cycling and playing). It is most often already open before you ever have intercourse, although it may be a little tight or narrow causing pain when having vaginal sex for the first time. Sometimes the hymen is only partially open and opens a little further during sex for the first few times resulting in bleeding. With so many functions, and with the varied skin types and tissues together in one area, care is needed to protect the skin and to avoid irritation and infection, especially during sex and exercise.

Vagina and Vulva Care

  • Your vulva and vaginal areas are important to you, your sexuality and your self confidence.
  • It is difficult to see the area clearly without having to do acrobatics using a mirror.
  • You may think that you do not look normal or sexy “down there”.
  • You may be embarrassed during sex, or avoid having sex. You often think there is an odour?
  • You may wonder if the vulva lips are too small or too large. Should you laser, wax, shave, trim or be natural?
  • You may be sensitive to comments by partners and sometimes imagine the worst and develop a complex about that area, thinking it is ugly or unappealing.
  • Your vulva and vaginal areas are certainly normal in appearance. You look just like everyone else, with small differences that make you unique.
  • If your inner lips (labia minora) are very large there is minor surgery that can correct the problem.
  • Don’t be shy to ask your Gynecologist to show you the area using a live monitor. You will suddenly realize how perfect and normal you are.
  • If you feel irritation, burning, itchiness or see a rash, it is wise to have it checked at a center that can show you the area, preferably using a viewing monitor, to help you understand and feel confident about yourself. (See our section: “Gynecology Examination”)
  • A discharge is common and can be a normal vaginal response. (see our information about “Vaginal Discharge”.)
  • Taking good care of your vulva skin can increase your comfort, the softness of the skin and make sex more enjoyable. This area of skin is often more sensitive. Taking steps to keep it healthy is sensible and should be part of your daily routine.
  • Your skin type and genital area are unique. You may not need to use all of these suggestions and some may not work for you.
  • During Menopause, taking extra care of your skin and using vegetable oil for moisturizing and lubrication can help you feel sexually confident and invigorated.’

Hair grooming

Although it is natural to have hair in the pubic area, many women prefer to groom this hair. There are many variations, depending on your own preferences. Today, all of these are common and acceptable. Variations include trimmed hair, hair removal on the sides and top (Bikini), a small strip of hair left on the top, or complete pubic hair removal (Brazilian). The key to hair grooming is to protect your skin and prevent burns from hot wax or Laser Hair Removal, skin trauma from pulling off wax, cuts from a razor, or dermatitis from depilatory products. Always first try a “test area”; when using products to see how your skin reacts. Waxing and shaving can cause skin irritation, burning, infection and irritating ingrown hairs (which usually resolve without treatment, but which can cause skin infections). You should not wax or shave the vulva area if this irritates your skin or if you have active infections (like warts or active Herpes). Try using a hair trimmer instead because it won’t harm or disrupt the skin layer. If you are looking for a permanent solution, where the hair may not grow back again, we recommend Laser Hair Removal (LHR) which, once complete, avoids ongoing skin trauma from repetitive waxing and shaving. Be very cautious where you have your laser hair removal done. We recommend that you do due diligence when choosing a hair removal clinic-a suitable, properly maintained laser machine and a qualified aesthetician are essential (see our article about  LHR).

Laundry Products

  • Use a detergent free of dyes, enzymes, and perfumes (such as Zero and Woolite) on any clothing that comes in contact with your vulva, such as underwear, exercise clothes, towels, or pajama bottoms. Use 1/3 to 1/2 the suggested amount per load. Other clothing may be washed in the laundry soap of your choice. (Avoid regular Tide.)
  • Do not use fabric softeners (e.g. Downy) in the washer on clothes that come in contact with your vulva.
  • Avoid fabric softeners (e.g. Bounce) in the dryer. The chemicals can irritate your vulva skin.
  • When using a stain removing product on your underwear and towels, soak and rinse it off in clear water before washing in a regular washing cycle.

Underwear

  • Choose cotton fabrics or, preferably, technical fabrics that are quick-dry whenever you can.
  • If you are sensitive or have a rash, wear boy-short panties.
  • Avoid underwear at night. Wear shorts, pj’s or nothing.
  • Avoid pantyhose. If you must wear them either wear quick-dry or cotton underwear with them, cut out the diamond crotch (leave some fabric near the seam to prevent running), or wear thigh high hose.
  • Remove wet bathing and exercise clothing as soon as you can.

Dampness and keeping dry

Some women may have problems with chronic dampness. Although it’s long been a standby for grandmothers and babies, the use of talcum powder is no longer recommended: for starters, it is unnecessary, and furthermore, it is an irritant and can cause contact dermatitis. There are also data suggesting an increased risk of ovarian cancer in women who use talcum powder (view article). Our advice is: don’t use talcum powder-ever! There are far better ways to stay dry and to protect your skin:

  • Choose cotton fabrics or technical fabrics that are quick-dry whenever you can.
  • Protect your skin from being irritated by dampness by applying a natural moisturizer or vegetable oil.
  • Keep an extra pair of underwear with you in a small bag and change regularly if you become damp during the day at work/school.
  • Change into dry underwear after you have worked out.

Bathing

  • Do not use hygienic products that irritate your genital skin. Avoid bath soaps, lotions, gels, etc. which contain perfumes. These may smell nice but can be irritating.
  • Never douche – ever! It promotes infections by destroying the normal, good, protective organisms in the vagina. (Do not believe old wives tales about using vinegar or yogurt in your vagina either)
  • Try changing your soap if your skin is irritated (we recommend Dove, Ivory or Pear soap or any natural, organic soap).
  • If you are particularly sensitive, do not use soap directly on the vulva skin, and do not scrub the vulva area with a wash cloth. Using your hand to wash with warm water will keep the vulva area clean without irritating the skin.
  • Avoid bubble baths, bath salts and scented oils if you are sensitive.
  • Pat dry rather than rubbing with a towel if you have any irritation.

Itching (Pruritis)

  • If you have new itching and you recognize this as a yeast infection, use an over the counter anti-yeast cream, especially if you have a white vaginal discharge as well. If this is not successful or if you have a rash, see your doctor to rule out an atypical yeast infection, or other skin conditions that can easily be treated (such as eczema or lichen sclerosis).
  • If you are itching, avoid scratching. Scratching may feel good and relieve the itch momentarily, but it really aggravates the problem, causing more histamine release which then causes more itching. If you scratch enough, you can cause bleeding, infections and skin thickening (lichenification). Therefore, don’t scratch and if necessary, wear gloves at night to avoid causing damage when you are asleep.
  • Sitz baths can be used to relieve itching. This is a warm-water bath taken in the sitting position that covers only the hips and buttocks. Soak Burosol Powder in the water (a soothing wet dressing for irritated skin). You can also use 4-5 tablespoons of baking soda to help soothe itching and burning. Soak 1-3 times a day for 10-15 minutes.

Hygiene and toilet issues

  • Use white, unscented, soft toilet paper.
  • Avoid adult or baby wipes unless absolutely necessary.
  • Pour lukewarm water over the vulva after urinating if urine causes burning of the skin.
  • Wipe from front to back when having a bowel movement.
  • Avoid the use of deodourized pads and tampons.
  • Tampons are safe for most women, but wearing them for too long may result in vaginal infection, increased discharge, odour or toxic shock syndrome. Change pads and tampons regularly – at least every 6-8 hours.
  • If you use a menstrual cup, keep it clean and empty it often.

Skin Moisturizer

  • The best moisturizer for your Vulva area is pure Coconut Oil, Grape Seed Oil or Jojoba Oil.
  • I recommend Coconut oil: it is solid so easier to apply and melts upon contact with your warm skin. Less messy that liquid oils. Great for skin and sex.
    • Coconut/Vegetable/Grape Seed oil:
    • Natural oil is clean and has no chemicals or preservatives in it!
    • Natural oil keeps the fragile vulva skin protected and comfortable without irritating it.
    • Use small amount to prevent staining your underwear.
    • Natural oil is cheap!
    • Oil is great fun during foreplay for you and your partner. It avoids pain during sex by being the best lubricant. (See below for the type of condoms needed when using vegetable oil.)
  • Avoid over the counter creams or ointments, except A and D Ointment (Made by Schering, found in the diaper care areas of the drug store) or other non irritating barrier products (zinc ointment, etc). Apply small amounts as often as needed to protect your skin.

Sex

Sex should be enjoyable and pain-free. There are things you can do to prevent vulva skin damage, irritation, tearing and soreness afterwards:

  • Use natural, clean vegetable oil as a lubricant to make sex more comfortable and enjoyable.
    • Use Vegetable oil (Sesame, sunflower or canola oil) during foreplay to have fun and help lubricate you and your partner before vaginal intercourse. This can decrease friction and soreness on the vulva, vagina, urethra and the clitoral area.
    • Please note: Vegetable oil cannot be used with latex condoms (causes breakdown of latex and the condoms break) but is safe to use with Avanti condoms (by Durex).
    • Pour the vegetable oil into a pretty smaller container… a large bottle of Sunflower oil on you bedside table may not exactly set the scene you were looking for!
    • If you are in Menopause, Sunflower oil is a must during sex to help with smooth, longer lasting lubrication and to prevent small tears at the opening and in the vagina. It also protects the skin during masturbation.
    • Avoid synthetic water based products like K-Y Jelly, Replens or Astroglide  which dry during intercourse causing further dryness and irritation. They also contain chemicals and preservatives-many women have been frustrated with lubricants that cause irritation.
    • Latex condoms often cause skin sensitivity and allergic reactions. This can result in vulva irritation. Use Avanti condoms instead of regular latex condoms. (Polyurethane condoms). They may be more expensive, but if irritation and latex sensitivity/allergy is avoided, it is well worth it.
    • Avoid having sex when you have a vaginal infection.
    • Always use condoms to help prevent infections from spreading.

Painful sex:

  • If you have pain during sex especially at the opening, please see us. There is a common problem (Vestibulodynia) that causes pain during sex or tampon insertion. We can help you treat it successfully. (See our article: Vulvodynia.)
  • If you are in Menopause and experience painful sex, please see us for local treatment which can improve your sex life immensely.
  • Remember to urinate immediately after sex to prevent a bladder infection.
the vagina and vulva

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