Vulvar and vaginal health: What's normal and what's not?
6/11/2020 by Danielle O'Laughlin, PA-C, MS
The health of the vulva, or external portion of the female genitalia, and the vagina are important components in a women's overall health; however, often women are embarrassed or afraid to mention new or concerning symptoms. It's important to know what symptoms can be normal and what symptoms warrant further evaluation with your health care team.
It's normal to have some vaginal discharge, called physiologic discharge. The average woman has 2 to 3 tablespoons of discharge per day. This discharge is often transparent to white, thick, odorless and without irritating symptoms. Hormonal changes, such as during ovulation, contraceptive use, or menopause, can alter this discharge and may increase or decrease the amount or consistency of the discharge.
Abnormal discharge that may indicate an underlying medical condition can present with a change in color, odor or amount of discharge. Vulvar or vaginal skin changes including redness, itching, burning, pain, urinary symptoms, incontinence, ulcers, masses, or a bulge warrant further evaluation. Evaluation is also recommended if there is any abnormal menstrual bleeding, such as bleeding between periods, after intercourse or after menopause.
In order to maintain vulvar and vaginal health it is recommended to wash the vulva with warm water only. You should wear underwear with a wide fit that are white and made with a cotton material. Underwear should be washed in very hot water and with half the amount of laundry soap compared to other loads. Avoid hand washing underwear and wearing thong-fitting underwear. It is recommended that you sleep without underwear or wear loose clothing to bed.
Avoid common vulvar and vaginal irritants such as soaps, scented pads and tampons, spermicides, lubricants, sprays, dyes, fragrances, softeners, bleach, bubble bath, shampoo, hot tubs, chlorine, over-the-counter prescriptions, shaving, douching, oral sex, and over cleansing.
Be sexually responsible — utilize condoms and be screened for sexually transmitted infections. It is also important to limit alcohol and tobacco use, which can decrease sexual function and arousal. Be sure to follow guideline recommendations for Pap smear screening and vaccinations, and report any new or concerning symptoms to your health care team.
Danielle O'Laughlin, PA-C, MS, is a physician assistant and assistant professor in Primary Care in Rochester and Kasson's Division of Community Internal Medicine (CIM). She serves as the team lead of the Primary Care Obstetrics and Gynecology Clinic and is the clinical skills co-director of the Mayo Clinic Physician Assistant Program.