Vulva means the external genitals of the woman. It is the area bordered by the venus mound (mons pubis), the groin, and the anus. The vulva has outer labia, and inner labia that cover part of the clitoris, and the vaginal opening. The area around the vagina opening is called the vestibule.
People use many different names to describe this part of the body. Because the outer genital organs of the woman, unlike the male, are hidden, they can be mysterious and confusing. It’s a good idea to know your own body, including your vulva to get rid of this mystery. It is also important to learn the correct names for our genitals so that we can talk about them with each other and with health professionals about experiences (both experiences of pain, but also pleasure).
How do we know what is normal?
Don’t be shy. Many women know their bodies and look closely at their vulva. This can be standing or squatting above a mirror to look at the vulva. Examination of the vulva teaches the woman to recognize the following parts:
Mons pubis: this is a cushion of fat that lies over the pubic bone and this is covered with hair. The hair varies from person to person and the hair thins as we age.
Labia: the word labia means lips in Latin and a single lip is a labium. The outer labia (labia) are 2 folds of skin and adipose tissue that are covered with pubic hair after puberty. They can be large or small, short or long, and even (like breasts) of different sizes. This is all normal and part of what makes us unique. The outer labia are sexually sensitive, and they can swell a little bit when a woman becomes sexually aroused. The vulva is sensitive to the female sex hormone estrogen so changes occur from childhood, during puberty, and in old age. Estrogen makes the labia thicker. The inner labia are also sensitive and swell with excitement. These are the 2 skin folds that run from the foreskin of the clitoris to the back of the vagina. The inner labia can vary in color from pink to brownish-black depending on the color of the woman’s skin. Like nipples, the inner labia can change color as a woman ages or during pregnancy. Sometimes they protrude between the outer labia and they can be wrinkled or smooth. They are thinner because they do not contain fat. The labia may have small sebaceous glands that look like yellow dots. There may also be papillae on it which are small regular bulges on the inner surface. All these variations are normal and not dangerous.
Clitoris: the clitoris is the point where the inner labia meet at the front.
Only the tip of the clitoris (the glans and over it the hood) can be seen. The rest of the clitoris continues into the vagina. The clitoris resembles the male penis and becomes harder during sexual stimulation.
Vestibulum: This is the inner part of the inner labia around the opening of the vagina. It is normally a humid area. Several glands hatch in this area. These glands produce fluid that increases with sexual arousal. The urethra (urethra, the connection between the bladder and the vulva) also extends into this area, just above the opening of the vagina. The hymen (hymen) in childhood is a thin membrane, which partially covers the opening of the vagina. In adults, remnants of this hymen can often be seen around the vaginal opening.
See also for the variations Happy with your pussy – Sex sisters TV – VPRO and the poezenboek.nl
This text is reproduced with permission from the Dutch Society for Vulva Pathology (NVvVP, https://vulvapoli.nl/).
Taking care of your vulva
Good general care of the vulva (inner and outer labia and clitoris) is important. The skin of the vulva is sensitive. Women with complaints of the vulva should only use products that are prescribed or recommended by their doctor.
Clothing and underwear
To minimize irritation from clothing, preferably wear cotton underwear and do not wear pants that are too tight. Change a wet swimsuit or sportswear on time. Preferably sleep without underpants. Wash clothes with perfume-free detergents and do not use fabric softener. Make sure you don’t sit for very long in a row and get up regularly.
Do not wash the vulva with soap
Do not use on the vulva products that can irritate, such as soap, shower gel or shampoo, wet toilet wipes, vaginal showers, intimate sprays, soap-free wax emulsions, or other products. Wash the vulva up to 1 time a day, then gently pat the skin dry. Washing often and drying hard can lead to irritation. Use lukewarm water. After washing and drying the vulva, apply a greasy ointment. You can use Lanette cream or Lanette ointment for daily care.
Other hygiene measures
Ensure smooth bowel movements by eating high fiber and drinking plenty of water. Use soft unscented toilet paper. Do not use damp (baby) wipes after bowel movements; if necessary, put some oil on the toilet paper or cotton wool. Don’t wait until your bladder is overflowing before urinating. Because then there is a chance of leakage of urine and that irritates. Avoid incontinence material if possible.
During menstruation, preferably use perfume-free 100% cotton pads or perfume-free tampons. Change every few hours and choose products with a good fit. Do not use panty liners outside the menstrual period. You can also use a menstrual cup but if you have an IUD this might not be a good combination because while taking out the cup you might also take out the IUD. This is due to the vacuum, or the strings of the IUD might be entangled with the cup
There is always some pressure and friction during sex on the vulva /clitoris. Through sexual arousal, the vulva and vagina are well blooded, the labia swell and the vulva becomes moist. All of that is necessary to be able to have (vaginal, oral, digital) sex. If intercourse becomes painful and penetration is not possible (anymore), for example, because the vulva is narrowed, it is important not to force penetration. There can be all kinds of reasons why intercourse becomes more difficult. For example, because you feel less or no sense and are not sufficiently excited and therefore the vulva is too dry. Or after menopause lubricants can help to reduce friction. Or because you are tense and therefore the pelvic floor muscles are too tense. Please talk about it when you are with us for a consultation. Gynaecologie Amsterdam sees many women every year and you can ask every question and tell your story.
Gynaecologie Amsterdam advises K-Y Jelly and Sensilube as a lubricant and you can also get information at the Condomerie in Amsterdam about all kinds of lubricants /condoms and other aids for sex. In case of burning, an ice bag wrapped in a towel can give you relief. Pelvic floor physiotherapy can help in learning to relax the pelvic floor. It is important to talk about this with your partner in case of pain during intercourse and to look for alternatives: sex without pain, more excitement, saying what excites you and of course sex without penetration. The purpose of sex is to have pleasure. If necessary, discuss it with your doctor and possibly ask for guidance from a sexologist. Gynaecologie Amsterdam works together with two sexologists and can refer you. Invest in your sexual health for the years to come. Depending on the type of problem, you will be referred together with your partner or alone.
Some physical activities also require you to consider your sensitive vulva. Make sure you have a well-fitting bicycle saddle that keeps the pressure on the vulva as low as possible. Before swimming, apply a nourishing fatty ointment. Do not swim in highly chlorinated water or public hot tubs. Horse riding can cause complaints and after exercise, an ice bag wrapped in a towel can give you relief.
Yoga is also a good way to learn to relax.
Do you want more information?
More information can be found on the following websites: