I’m a gynecologist and this is what you really need to know about your vulva

Do you know your vulva from your vagina? Your labia majora from your labia minora?

It turns out there’s a lot of confusion surrounding the entire vulva that encompasses the exterior female genitals.

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In fact, recent research from YouGov suggests more than half of Britons can’t locate their vagina on a chart.

So if you’re ready for an anatomy refresher lesson, these are the “down there” parts that definitely exist, and how to get them in the best possible health.

THE DISC

The vagina is a muscular tube that extends from an opening on the outside of your body to your cervix.

It’s for sex, menstruation and childbirth – all the big stuff.

That vagina in fact, it houses more bacteria than anywhere else in the body except the gut — but don’t panic — and ditch that “private lingerie.”

These are friendly bacteria.

“Leave it alone!” says consultant gynecologist Tania Adib from Lister Hospital.

“It completely cleans itself and any debris comes out as a clear or white discharge.

“Please don’t take a shower or anything, it’s so harmful.

“If you flush away the good bacteria, pathogenic bacteria are more likely to cause a problem, such as an infection like bacterial vaginosis (BV).”

BV is characterized by a “fishy” smelling discharge and needs to be treated with antibiotics – one to avoid.

The labia

These “lips,” the outer labia majora and inner labia minora, protect the underlying clitoris, vagina, and urethra.

“The tissue of the labia is sensitive, as is the entire vulva area,” says Tania.

“You can wash with very mild soap or regular moisturizer, but nothing scented.”

Also, that Love Island-style polyester number may not be the right one.

“It’s best to wear cotton underwear,” says Tania. “Tight, synthetic fabrics and thongs make the area humid and warm, and bad bacteria love that atmosphere.”

Our vulva needs moisture just like the rest of our skin, so give your labia some gentle moisture.

“Creams act as a protective barrier and prevent abrasions,” says Tania. “Some women use coconut oil, which is wonderful.”

Many women fret that their labia aren’t “normal,” but a study of more than 650 women found that healthy labia vary greatly in size and shape.

For reassurance, check out the labia library (labialibrary.org.au) showing hundreds of different labia.

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THE CLITORIS

Hopefully you’re familiar with your clitoral glans, the bump near the top of your vulva that’s the pathway to orgasm for most women (one study of 1,000 women found that only 18 percent climax through vaginal penetration alone).

But that’s just the visible part – the clitoris actually extends inward up to 13 centimeters and branches out on either side of the vaginal canal.

It swells to twice its size when switched on and is packed with 8,000 nerve endings – twice as many as in the penis.

You don’t have to do anything special to take care of your clitoris – just treat it with care.

But if you want to unlock its potential, omgyes.com is a science-backed website offering endless “hands-on techniques to increase clitoral pleasure” for a one-time fee of £39.

The urethra

This tube carries urine out of the bladder and opens between the clitoris and the vagina.

Men have one too, but in women it’s usually much shorter, making them more susceptible to urinary tract infections (UTIs) because bacteria don’t have to travel as far to reach the bladder.

We often overlook the urethra, but it’s important to take care of it – as anyone who’s experienced the extreme “youch” of a UTI can tell you.

“Always wipe front to back (especially number two) after the toilet,” says Tania.

This makes it less likely for germs to get into the urethra.

“Also, always pee after sex.” This helps flush out bacteria that may have made their way into the urethra (literally).

How to care for your vulva – no matter what age…

Be honest, have you ever really looked “down there”? If not, you are not alone.

“It’s hard to see, and a lot of women don’t like to look,” says Tania.

“But it helps to get out a mirror about once a month. If you notice any changes — lumps, bumps, whiteness, or pigmentation — see your GP.”

In your 20s

When you’re living your best single life, it’s especially important to use condoms and get regularly screened for sexually transmitted infections (STIs).

Whilst you will always get the most reliable results from your GP or a sexual health clinic, you can now have test kits mailed to your local NHS Trust or at high roads such as: lloydspharmacy.com.

Look for a CE quality assurance mark – if the kit does not have one or is damaged do not use.

In your 30s

It’s time to work those pelvic floor muscles, the muscles that support your bladder, uterus, and bowel, and that run through your urethra, vagina, and posterior.

Exercise can help prevent incontinence down the line (especially if you’re going through pregnancy and childbirth).

Try squeezing at the same time, as if you want to stop a bowel movement, hold a pee, and grab something inside your vagina—upright, sitting, or lying down.

Hold for ten seconds, ten times, then ten times as fast as possible, repeating the whole process three times a day.

Then keep it all up forever.

“Use prompts to make it a part of your routine,” says Tania.

“Do it when you’re washing dishes or when you see a bus… whatever works.”

You can also use an app like the NHS-approved Squeezy (£2.99, The App Store) to set reminders and guide you through the exercises.

In your 40s

This could be the decade to see a women’s health physical therapist, especially if you’re struggling with incontinence.

“I see a lot of fit, healthy women in their 40s licking,” says Tania. “We don’t talk enough about it”

If you are suffering, your GP should be able to refer you to a specialist who can guide you through tailored exercises for your private parts, or you can refer yourself.

In your 50s

Menopause can bring debilitating vaginal dryness that causes burning, itching, and painful sex.

Tania recommends using an internal vaginal moisturizer.

“The most effective ones contain hyaluronic acid, which locks in moisture,” she says. “And when you have sex, use a gentle lube.”

Since menopause brings with it a drop in estrogen, the next step is to see your GP for vaginal estrogen, which activates the estrogen receptors in the vagina to keep it hydrated.

“You have to use it every day for a couple of weeks, then twice a week forever,” says Tania.

A win for The Sun’s Fabulous Menopause Matters campaign. Vaginal estrogen pills will be available over the counter for the first time, bringing hope to up to 80 percent of menopausal women plagued by vaginal dryness.

In your 60s

“About 50 percent of women in their 60s have incontinence, and about a third will experience a prolapse (when the pelvic organs slide down and bulge into the vagina),” says Tania.

“These are terrible conditions that can ruin your self-esteem.”

The message for this decade? Don’t assume you have to put up with it.

Your GP should be able to refer you for a range of treatments, from electrical stimulation to a probe (contraction of your pelvic floor muscles) to various types of surgery.

Tania raves about cutting-edge, non-invasive radiofrequency and laser techniques that rejuvenate the collagen and elastin in the vagina and treat dryness and incontinence, but they’re not yet available to most people in the NHS.

“It’s going to be huge,” she says. “As it becomes more mainstream, a lot of women will benefit from it.”

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