Vulvar self-examination - womens' guide

By following these simple steps and staying vigilant about changes in your vulvar area, you can take control of your health
and stay proactive about your well-being.

How to Perform Vulvar Self-Examination: A Step-by-Step Guide

The vulva, which is the external part of the female genitalia, includes several important com-ponents

(Figure1): the labia majora (outer lips), labia minora (inner lips), clitoris (sensitive tissue), clitoral hood (skin protecting the clitoris), vestibule (area surrounding the vaginal and urethral openings), and perianal area.

Performing vulvar self-examination (VSE) is an essential way to detect any changes or abnormalities.

This text provides a simple, step-by-step guide on how to perform VSE.

Simple questions 

Who should perform VSE?

All women are encouraged to perform vulvar self-examination regularly.

How often?

Perform vulvar self-examination preferably once every three months or at any time when you experience vulvar itching or pain, pain during sex, or when you detect vulvar lumps or thickening of the skin.
 

What do I need?

• Clean hands
• A small mirror
• Good lighting
• A private space

What should I look for?

During your VSE, be on the lookout for the following signs:

• Any new or changing lumps, bumps, or sores
• Redness, swelling, or irritation
• Bleeding   
• Changes in color or texture of the skin
• Pain or discomfort during examination

Find a comfortable and private space where you can lie down or sit with your knees bent and legs slightly apart. You may use a mirror to help you see better during the examination. The mirror can be held with one hand, placed on the floor, or in the bidet.

Please remember these 4 important steps:

EXAMINE- PALPATE- NOTE-REPORT (E.P.N.R.) 

General Examination

Examine the whole external genital area. Use your index and medium fingers to gently spread the labia (the folds of skin around the vaginal opening) and visually inspect the external genital area.

EXAMINATION: Detailed Examination

• Begin at the 12 o‘clock position, focusing on the clitoris.
• Gently separate the labia majora. Apply delicate pressure to the labia majora on both sides, moving in a clock-wise direction until you return to the 12 o‘clock position.
• Repeat the process with the labia minora on both sides.
• Examine the clitoris for any abnormalities or changes. The clitoral hood should be gently retracted, if possible.
• Proceed to the examination of the vestibule: the mucosal part around the vaginal opening.
• Finally, move downwards to examine the perianal area for any abnormalities or changes.

PALPATION: Palpate the area for abnormalities

Using your fingers, carefully feel the entire vulvar area, including the labia majora and minora, for any unusual lumps, tenderness, or areas of thickening. Pay attention to any changes in sensation or discomfort.

NOTE: Note your findings

Keep a record of your findings, including any changes or abnormalities you notice during the examination. You might consider using your cell phone to take photographic records, then save the photos securely for your privacy. This can help you track any changes over time and serve as a valuable information to your healthcare provider if needed.

REPORT: Follow Up with your Healthcare provider

If you notice any unusual or concerning findings during your VSE, don‘t hesitate to contact your healthcare provider for further evaluation. They can provide guidance, perform additional tests if necessary, and address any concerns you may have.

REMEMBER: early detection is the code so don‘t hesitate to reach out to your healthcare provider if you have any concern.