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By Rachel Gelman, DPT

“ Let’s just start with the word vagina. Vagina. It sounds like an infection at best. Maybe a medical instrument. ‘Hurry, nurse, bring me the vagina.’ Vagina. Vagina. It doesn’t matter how many times you say the word, it never sounds like a word you want to say. ”-Eve Ensler, The Vagina Monologues

There are many reasons why I think women have insecurities about their genitalia, but this quote in particular speaks to one reason; vagina is a weird word. No one wants to say it. It becomes like an anatomical Voldemort, the body part that shall not be named. So, when no one wants to say the word, no one wants to talk about it. Without healthy conversation, women are left misinformed. In fact most people do not realize that the area they are referring to is technically not the vagina, but the vulva. Today, I am here to encourage you to grab a mirror, and take the time to look at your vulva.

A majority of my female patients tell me they have never looked “down there.” Many express concerns that their genitals look “bad” or “wrong.” I always find it interesting that my male patients never report concerns about the appearance of their penis. In fact, many of my male patients have given me in-depth descriptions of their genitalia. I always think how impressive it would be if one of my female patients could describe her labia with such accuracy. Obviously, men are at an advantage as the penis is external and easier to check out on a daily basis. However, there is still a level of shame or insecurity surrounding the vulva. There is the obvious history in our culture that has led to this, especially during the Victorian Era, which founded the idea that women should not be sexual beings, and that their genitals are meant to be kept private. One could also look at the impact of pornography and the recent rise in labiaplasties as a contributing factor into why women worry that their genitals don’t look “right”. Now, I think pornography can be a great tool to spice up a relationship, but it should not be used as a way to judge a typical body type. Porn is basically an X-rated Hollywood. When someone worries their genitals do not look the same as an adult film star, it is equivalent to saying, “My face doesn’t look like Angelina Jolie on the cover of Elle!” It is just not a realistic expectation. Women should start to see this part of their body as they would any other physical feature; as something unique to only them. It should be a source of confidence, not discomfort or embarrassment.

I will step down from my feminist soap-box, and now tell you why it is important for your health to look at your vulva. As a woman, your body will go through many changes thanks to hormonal fluctuations that come along with puberty, pregnancy and menopause. Therefore, it is important to be aware of what your “normal” is regarding your genitals, so that you can monitor if any changes occur as you age. Also, there are some dermatological conditions, cancers, STDs and side effects of certain medications that if caught and treated early can be no big deal, but if left unchecked can turn into a bigger issue.

You can also think of this as an opportunity to become friends with your vulva. Even if you just become acquaintances, the more you “get to know” your body the better you will begin to feel about it. That kind of confidence can help with your overall self-esteem and can improve your sexual function. You should know your body best and take pride in it’s uniqueness.

So, what should your vulva look like?

Your vulva should have a few keys parts:

A mound of fatty tissue, usually covered in pubic hair known as the mons pubis

Two outer skin folds which are known as the labia majora

Within the labia majora are a smaller set of skin folds known as the labia minora

At the top, which can be considered 12:00 if the vulva was a clock, is the clitoris, under the clitoral hood

Below the clitoris, is the urethra, the opening where one urinates from

Below that is a larger opening, the vagina, that leads to the vaginal canal

Directly below the vagian is a small patach of skin known as the perineum

The appearance of a woman’s vulva can vary from person to person. There has been a lot of research over the years that supports the fact that there is no “normal” standard regarding female genitalia and, even more, the data collected shows that the dimensions of a woman’s vulva can vary from person to person. Some women’s labia majora and minora are the same size, while other women’s labia minora are bigger than their labia majora. There are many variations, which is why I often tell patients that their vulva’s are snowflakes, each unique in their own special way. So next time you have a moment alone, grab a hand mirror and say “hello” to your vulva. Try to identify the different structures listed above and take note of what your vulva looks like. Are there any moles or markings on the skin? Notice if there is any discoloration of the skin or tissue of the vulva, especially if this is new for you and you are having other symptoms such as pain with intercourse, itching, difficulty with urination etc. Also, vaginal discharge can be normal but contact your doctor if the discharge is any of the following: green or dark yellow, foamy, has a strong odor, or there is a change in the amount or consistency. Try to make a vulvar self-examination part of your health routine, as you would a self breast examination. However, just like brushing your teeth everyday does not replace a trip to the dentist, a vulvar self-examination should not replace your annual trip to the gynecologist.



Hopefully this post has inspired you to bust out your hand mirror and take a peek, but if you are still unsure or maybe just want to read more, I suggest you check out the following sites (some may be NSFW):

http://www.ourbodiesourselves.org/health-info/self-exam-vulva-vagina/

http://www.labialibrary.org.au/

http://101vagina.com/about/vagina-vs-vulva/

http://deconstructingtheidealvulva.tumblr.com/

https://www.kickstarter.com/projects/debbyherbenick/what-do-you-like-about-your-vulva-and-vagina/description

https://pelvicguru.files.wordpress.com/2015/03/exploring-your-genitals-1.pdf

Readers we want to hear from you! How well do you know your vulva? Please share in the comments section below!

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Rachel Gelman, DPT

is a Bay Area native, and currently practices in our San Francisco office. She received her bachelor’s degree in Biology from the University of Washington in Seattle and her Doctorate in Physical Therapy from Samuel Merritt University. Rachel grew up dancing and is excited to have recently returned to the dance studio. Outside of dance, Rachel enjoys going to the gym, discovering new brunch spots and spoiling her adorable niece and nephew.