Women and Children – Gynaecology
When a woman is first told that she has a vulval or vaginal disorder that requires further investigation at the vulval clinic, her reaction is usually one of anxiety.
Disorders of the genital tract are among the most embarrassing of all gynaecological complaints for women to talk about and we appreciate that it has probably taken a lot of courage for you to discuss the problem in the first instance.
We understand how you might be feeling and want to assure you that we will deal sympathetically and frankly with your particular problem.
This leaflet is intended to provide general information and to answer some of the most common questions women want to know about their visit to the vulval clinic. By understanding more about what is happening, and what to expect, we hope that you will feel less anxious when you come to the clinic.
The leaflet, however, is not a personalised document and you should remember that there might be some differences between the information given here and your particular case.
Additional patient information leaflets relating to your specific clinical condition may be given to you by the clinic staff once you have had your consultation and a diagnosis has been made.
What happens when I come to the clinic?
The clinic is relaxed and friendly and you will be given the opportunity to discuss any worries or concerns before anything is done. A nurse will be in attendance throughout your consultation and examination.
At your first visit a member of the medical team will take a detailed clinical history from you. We will want to know whether you have any other illnesses, and whether you are taking any medication.
You may be asked to produce a sample of urine prior to seeing the doctor. The nurse will inform you if this is necessary. We may also want to take some routine blood samples from you.
Before the examination you will be asked to undress from the waist downwards. You may wish to wear a loose fitting skirt or dress so that you do not have to remove all your lower clothing.
For the actual examination, the nurse will help you to position yourself on the examination couch and will make sure that you are comfortable throughout the procedure. We understand that the examination may be embarrassing for you but we will do our best to preserve your dignity and to make you feel at ease.
The doctor will examine your vulval area and may use a magnifying microscope to see more clearly. The magnifying equipment is not inserted into the vagina in any way so does not cause any discomfort.
We may need to take swabs from the vagina to check for any infections which may be causing your symptoms.
Sometimes it is necessary to take a very small piece of skin (biopsy) from the vulval or vaginal area so that it can be examined further in the laboratories. This will be done using a local anaesthetic cream so there should only be a small amount of discomfort, if any.
The biopsy site might be slightly sore when the anaesthetic wears off and you may need to use mild painkillers (such as paracetamol) for a few days until it settles. If you do need to use painkillers, please make sure that you follow the instructions on the package. The biopsy site should heal over quite quickly, but you may have a slight vaginal discharge, or slight spotting, for a few days. This is normal.
If the biopsy site is persistently painful with swelling and tenderness, it may mean that the biopsy site has become infected.
If in doubt, arrange an appointment with your GP and get it checked out.
You can help to avoid infections by keeping the area clean. You should bath or shower as preferred but do not attempt to douche inside the vagina. Wash gently, avoiding the use of heavily perfumed soaps, talcum powders and vaginal deodorants as these may cause irritation and increase the risk of infection.
During the examination there is a possibility that we will ask your permission to take photographs of the vulval area. This is for clinical reasons and allows us to monitor changes in your clinical condition and to assess responses to treatment.
What is wrong with me?
Understandably, many women with vulval or vaginal disorders are worried about the possibility of cancer, but reassuringly, cancers of the vulva and vagina are very rare. There are many different types of vulval disorders. Most of them are not serious and can be treated successfully.
Your diagnosis will be explained fully, together with any treatment recommendations, when we have the results of any investigations carried out. Patient information leaflets relating to your specific clinical condition will be given to you by the clinic staff once you have had your consultation and a diagnosis has been made.
Is there anything I can do to help myself?
Various self-help remedies have been found to be effective in relieving some of the symptoms relating to vulval disorders
Your condition may be helped by following the advice given below:-
Avoid wearing tight restricting clothes
This includes tight jeans and underwear
Try to avoid wearing tights, especially in warm weather
Wear stockings or go without
Try to wear cotton underwear
It is cooler and more comfortable than synthetic fibres
Avoid using biological detergents when washing underclothes
Wash underwear on the hottest wash possible and do not add scented fabric conditioners. Rinse well
Many women with vulval or vaginal problems feel unclean. This is a normal reaction and concern but is rarely the case.
Most vulval complaints are not caused by inadequate hygiene and are in fact, often caused by quite the opposite. We would advise that you do not become obsessed or over-zealous with washing the vulval area. Too frequent washing actually disrupts the normal vaginal secretions which are necessary to keep this area of the body healthy. There is no need to wash yourself after every visit to the toilet … neither do you need to bath or shower more than twice a day
Some vulval conditions are made worse by heat
Avoid having the bath water too hot
Avoid using soaps and bubble-bath preparations
They tend to have a drying effect on the skin and can increase soreness and irritation. We suggest using Acqueous cream as a soap substitute for cleansing
After washing the vulval area, pat the skin dry rather than rubbing it
Avoid the use of talcum powder and vaginal deodorants
Some women find that their symptoms are made worse after sexual intercourse. If this is the case, it might help to rinse the vulval area with cool water after intercourse
An ice pack might help to reduce soreness and inflammation
Many women suffer from a variety of vulval disorders, so try not to feel unusual in any way. Equally do not be afraid or embarrassed to ask questions if you are unsure of anything. Remember, we are here to help you.
It is very important that you attend the clinic when any appointment is made for you. Non-attendance will delay your assessment and also wastes an appointment that could be used by someone else.
If you cannot attend, for any reason, please let us know so that the appointment time can be allocated to another patient and an alternative appointment can be arranged for you.
The vulval pain society is a support group which can provide help and information to women suffering from a variety of different vulval or vaginal conditions
They can be contacted at the following address:
The Vulval Pain Society, PO Box 7804, Nottingham, NG3 5ZQ
Visit the vulval pain society website
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.