What is the vulva?

What is the vulva? - explicit content warning

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What is the vulva?

The vulva is the external female sex organs plus the urethral opening and anus.

The vagina is the internal passage which runs from the cervix (neck of the womb) at its top end and opens out at its bottom end into the vulva. The vagina is used for having a menstrual period, vaginal sex or giving birth.

Many people informally use the word 'vagina' for the vulva as well as the vagina. Medical professionals use different words for these two body parts because they are physically different, have different kinds of skin and function and are prone to different kinds of disease. Treatments prescribed for use on the vulva may be harmful if used inside the vagina, and vice versa.

On the VPS website, therefore, unless otherwise stated, we use the word 'vulva' to refer to the external organ and 'vagina' just for the internal passage.

What the vulva includes

 

The structures of the vulva - see below for text description

Image of vulva is copyright of the ISSVD and appears here with their permission

The structures of the vulva

Working from the front of the body to the back, and from the outside inwards, the vulva includes these structures:

  • Mons pubis

Fatty pad, covered by hair, which sits over the pubic bone on the front of the body between the legs.

  • Labia

Outer folds of skin (meaning ‘lips’). These contain the labia majora and the labia minora.

  • Labia majora

The outer lips which often hide the inner vulva. These contain fat and are covered with hair.

  • Labia minora

The inner lips. These do not contain fat and are hairless.

  • Clitoris

Located beneath the meeting point of the inner labia (labia minora) at the top of the vulva, just below the mons pubis. The body, or glans, of the clitoris is usually the size of a pea and is covered by the labial skin known as the hood of the clitoris.

  • Urethral opening

The external opening of the urethra, a tube which connects the bladder to the vulva, and is used to pass urine.

  • Hart’s line

This is on the inside of the inner lips and is the line marking the change from the outer vulval skin to the smoother skin of the vestibule.

  • Vestibule

The inner, circular area between the labia minora and the opening to the vagina.

  • Vaginal opening

The point at which the vagina opens out into the vulva.

  • Posterior fourchette

The thin fold of skin formed at the bottom meeting point of the labia minora, between the vaginal opening and the perineum.

  • Perineum

The bridge of skin and muscle which separates the fourchette from the anus.

  • Anus

The external opening of the bowel. The anus is often included when discussing the vulva as many skin conditions of the vulva can involve this area.

Colour of the skin

The skin colour in a normal vulva will vary depending on the skin colour of the rest of the body. Sometimes after pregnancy the skin can be pigmented. The vestibule area can have a ‘red’ appearance as the skin here is thinner than the outer labial skin.

Lumps and bumps

The labia may have small folds of skin (sometimes very small folds, known as papillae). These are variations of normal and are harmless.

What is normal?

Everyone is different and the labia can be large or small, short or long, and even different sizes. The vulva can change throughout a woman’s life from infancy, through puberty and into old age.

Sexual response

The vulva (especially the labia and clitoris) can swell a little when a woman gets sexually aroused. The skin can produce secretions, which are a natural lubricant. The clitoris, like the male penis, becomes erect during sexual stimulation.

How to perform vulval self-examination (for patients)

There are full details of how to perform self-examination on our How to perform vulval self-examination page.

How to carry out a vulval examination (for health professionals)

Following patient counselling and discussion ask the patient to put her ankles together and relax her knees. Use a blanket to cover her lower abdomen. Use a good light and get close!

Examine in the following order:

  • Mons pubis
  • Labia majora (inner and outer folds)
  • Labia minora (inner and outer folds)
  • Clitoris hood and body
  • Vestibule
  • Perineum
  • Anal area

You are looking for lumps, ulcers, fissures (paper cuts), indurated (thickened) skin, lichenification (leathery skin thickening), erosion (loss of epithelium), changes in pigmentation, nodules, areas of pain and tenderness.