When Something Feels “Off” – Understanding Vulval and Vaginal Conditions

Many women experience changes, discomfort, or irritation in their vulva or vagina at some point in their lives, but too often, they feel
awkward bringing it up. Whether it’s itching, burning, pain, or changes in skin texture, these symptoms are worth attention, not embarrassment.

I thought I would talk about some of the more common vulval and vaginal conditions, how
they present, and when to seek help. And I hope this helps whoever is reading this.

Vulval irritation and itching
Irritation can happen for many reasons, and not all of them are infections.
● Dermatitis or allergic reactions: Fragranced soaps, pads, or laundry detergents are
common culprits.
● Lichen sclerosus: A chronic skin condition that causes thin, white, itchy patches on
the vulva. It’s not contagious, but it does need long-term management to prevent
scarring or narrowing of the vaginal opening.
● Lichen planus: Similar to lichen sclerosus but can affect the vagina as well,
sometimes causing soreness or small erosions.
These conditions often need topical prescription creams and ongoing monitoring, not
over-the-counter antifungal treatments, a reason why you need to seek proper medical
advice.

Pain and burning
Pain or burning in the vulva or vagina isn’t “normal,” even if you’ve been told it’s just
sensitivity. Possible causes include:

● Vulvodynia: Chronic pain without an obvious cause. It can feel like burning, stinging,
or rawness, often triggered by touch, sex, or even tight clothing.
● Atrophic vaginitis: Thinning of the vaginal tissue due to low oestrogen, especially
after menopause, breastfeeding, or long-term hormonal suppression.
● Infections: While yeast infections and bacterial vaginosis are common, if treatment
isn’t working, further testing may be needed to confirm the cause.
Persistent pain deserves a proper assessment, including a gentle physical exam and
sometimes swabs or a biopsy to clarify the diagnosis.

Changes in skin, discharge, or appearance
Noticing a lump, bump, colour change, or patch of thickened skin on the vulva can be
unsettling. Most are benign (like cysts or skin tags), but occasionally, they can indicate a
precancerous or cancerous change.

Warning signs to have checked include:
● Persistent pain or itching that doesn’t settle
● Ulcers or raised patches
● Bleeding, cracking, or pigment changes in the vulval skin
● Unusual or persistent discharge
Early assessment makes a huge difference. Vulval and vaginal cancers are rare, but
catching them early leads to far better outcomes.

Why women delay seeking care
Many women hesitate to bring up these types of symptoms. Sometimes it’s embarrassment;
sometimes it’s the assumption that discomfort is “just normal” after childbirth, menopause, or
ageing. Others have been dismissed in the past or told it’s “in their head.”
But your comfort, confidence, and sexual wellbeing matter.
At SHE Medical, we aim to make these conversations straightforward, respectful, and
private. You deserve to feel comfortable in your own body and to get answers when
something doesn’t feel right.

If you’ve noticed ongoing vulval or vaginal changes, irritation, pain, itching, or anything new –
please don’t ignore it. Most conditions are manageable with the right treatment plan, and
early assessment helps rule out more serious causes.
Your body is speaking to you. We’re here to listen.

Dr Sean Holland