The Pelvic Self-Exam: Part 2

Last week we went how to perform a basic self-exam at home. And now you're thinking... hm ok well what's normal? How do I know if I should go see my doctor? 

Normal Differences

Just like snowflakes, each women's vulva is also unique. Natural and normal differences include: 

  • Pubic hair: It may match your natural hair color or be a different shade (like dark haired guys with red beards), be curly or straight, thick or thin, and any combination of the above. 
  • Labia minora: They may be short or extend past the labia majora and they may not be the same size. 
  • Color: The skin of the labia minora and vestibule is typically darker than the labia majora. It can vary in shades of pink to red to a darker brown. 
  • Discharge: Not something we ever discuss right? Discharge is normal. It varies in amount, smell, texture and appearance from woman to woman and throughout the menstrual cycle. It also changes during pregnancy and after menopause. It may be thin or thicker with small clumps. The color may vary from clear to milky white. You may have only a few drops or it may get on your underwear. It might have a smell slightly like sour milk. What's important is to be familiar with what is normal for you.  
  • Odor: Seems like there are so many different products to keep us smelling fresh and clean. Each woman has her own scent and we've been taught to be hyper-vigilant of it so as not to offend anyone. I mean there's a whole industry devoted to it for Christ's sake! Most of these products do nothing more than irritate the sensitive skin of the vulva and aren't necessary. The only people who are actually likely to notice your scent is you and your sexual partners (remember, pheromones are a good thing!) 
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Abnormal Findings

Once you know what's normal for you it'll be easy to identify any changes, but keep in mind that this article isn't meant to help you diagnose yourself. Even if something we discussed above is considered normal, if it's bothering you then bring it up to your healthcare provider.

"Normal" may vary from woman to woman but you should follow up with your healthcare practitioner if you find: 

  • Changes in your skin including color, bumps or sores
  • Changes in discharge such as a cottage cheese like consistency, change in color (gray, yellow, yellow-green) or a change in amount which is abnormal for you 
  • Changes in odor, particularly a fish or ammonia smell which may indicate infection
  • Other symptoms such as itching, burning, or pain

Ok, now before you panic also ask yourself this: Have you changed your routine in any way?

New body washes/lotions, underwear, medications, environments (think beach getaway) and other changes could be the culprit. If switching back to your routine clears up the symptoms then great! If not then don't delay seeking help. 

Bottom Line: If you are questioning whether something is normal then get it checked out. More often then not it will turn out to be something easily treatable or benign (not harmful) or even normal. Best to be proactive when it comes to your health!

Resource: The V Book, A doctor's guide to complete vulvovaginal health By Elizabeth Stewart M.D.