Understanding Vulvar Disorders
The female genital region includes the labia minora, labia majora, the clitoris, urethra and the entrance to the birth canal also referred to as the introitus. The tissue in this area is composed of skin, mucous membrane, glands, and hair bearing structures. Abnormalities can occur in any of these areas. The problems that arise can be due to infection, inflammation, or as a result of a benign or malignant process.
The most common symptom is itching which is typically the first sign of a yeast (candida) infection. This is usually self-limiting but highly annoying and simple to treat. Itching however can be a symptom of other problems and therefore persistent itching warrants further evaluation. Other infectious processes include folliculitis, which arises from the hair follicles, herpes simplex infection, which has other characteristic features, and syphilis, which also has other classic findings.
Cancer can certainly occur in the vulvar area but is quite rare. This is, however, the greatest concern whenever an unexplained, persistent problem occurs. Early diagnosis is paramount since treatment is possible when cancer is found at an early stage. Vulvar cancer should be suspected if there is an ulcer that does not heal or a mass that is fleshy and bleeds easily. Other concerning signs are hard nodules, a warty looking growth and a single lesion especially in postmenopausal women.
Other signs of malignancy include lesions which are asymmetric, has irregular borders and color variation. A rapidly changing lesion, one that bleeds and does not heal is also highly suspicious for cancer. A biopsy should be taken of any area of concern. This is easily performed in the outpatient setting with a local anesthetic.
Vulvar disorders can result from a number of causes and is a common reason for gynecologic visits. It is important to understand the symptoms of potentially serious problems so that prompt evaluation is undertaken. Vulvar biopsy is a simple procedure and is the best way to determine the cause of a vulvar lesion. You are responsible for your health. If you are concerned about a vulvar lesion seek care and be persistent if you feel that you don’t have an adequate explanation. You may even need to change doctors. Remember, doctors don’t know everything and even the best doctors can miss a problem. Become your own health advocate.
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