Vulvar self-examination
To do a vaginal self-examination, you will need a small flashlight and a handheld mirror. Choose a time in between menses, preferably at the same time each month. Do not use creams or douches before the examination.
Wash your hands and sit on a bed. Bend your knees, bring your heels to your bottom, and open your knees to the side so you can see your genital area. Hold or prop the mirror in one hand, and use the other hand to examine the vulva. Look at the:
- Outer and inner fleshy lips of the vulva, also known as the labia
- Tissue covered by a hood of skin at the front of labia, also known as the clitoris
- Urethral opening
- Vaginal opening
Reflect light off the mirror, pull the labia apart
- Look: mole, raised area, wart, lump or other growth, skin color, cuts or sores.
- Feel: pain, itching, or other discomfort.
- Touch: apply gentle pressure to the vulvar skin to check for any lumps.
It is known that vulvar cancers have been increasing in incidence as overall survival has decreased in the past decade. Some potential precursors, such as vulvar inflammatory skin conditions like lichen sclerosus, are present in approximately 1% of women but are under-diagnosed and under-treated. The VSE is particularly encouraged in this population as inflammatory skin conditions are associated with vulvar cancer development in 5-8% of cases. In addition, vulvar scarring in these patients is often irreversible, can cause significant morbidity, and can be prevented with early treatment.
Lastly, please follow the following tips for taking genital photos:
- Often it is easier to get clearer photos if there is someone who can help you like your partner or a family doctor.
- It’s important to have good lighting ie you need to be near a light or use the flash on the camera.
- You may need to place your camera on a stand and use the photo timer option.
- You should lay down with your knees up, legs open, and feet flat.
- It can help to have a photo of the vulva without moving the vulvar lips apart and a second with you pulling the upper labia outward by placing your index fingers on the upper outer labia so that the inner labia can be seen.
- The camera often needs to be a foot away from the vulva
- Do not use a zoom option as it makes the photo fuzzy.
- Please remember that if you use your photo camera or a device with internet to take a picture that your photo may be stored in a cloud and not as secure as you think.
- At Women’s College, the process we have to upload photos to your chart is secure when they are uploaded through myhealthrecord or when your clinician uses a special program in the hospital to take the photos.