What is a "normal" vagina?

Read about the author Megan Barnett

People often worry that there’s something wrong down there, but knowing what’s normal for you means that any changes will be noticed more quickly with regular checks.

Is there such a thing as a normal vagina?

Every woman’s body is unique, and vulvas vary in colour, shape and size. The vulva is the female’s external genitalia. The labia majora are the outer lips where pubic hair grows, and the labia minora are the inner lips that extend from the clitoris. Some women have small, smooth, pink labia while others have larger, wrinkled and dark labia. With regular checks, you will be aware of what is healthy and “normal” for you.

Get clued up

Worryingly, a survey by The Eve Appeal (2016) found that half of young women aged 16-25 couldn’t locate the vagina on a medical diagram. Results also found that 65% of the women surveyed found it difficult to use the word vagina itself.

Additional research by the Eve Appeal (September 2016) found that 93% of daughters say parents never discussed ‘women’s issues’ with them, with 1 in 7 mothers saying that it is not their job to talk to their daughters about gynaecological issues. This is why the theme for gynaecologicalcancer awareness month for the Eve Appeal 2019 was getting the conversation going across the generations between mothers, grandmothers, aunties, sisters, daughters, grandaughters and other friends and family members.

This highlights a problem that younger women have when talking about sexual health and gynaecological issues, especially their GP. It also shows that this subject isn’t being properly discussed by parents and in sex education lessons in schools, thus depriving children of the opportunity to learn about their bodies and getting them to use the correct terminology.

If we compare these statistics to a recent YouGov survey for Cosmopolitan Magazine, however, it’s clear that women are more comfortable exposing their vulvas than talking about them. 98% of women groom their bikini line, and 1 in 2 women under 30 have removed all of their pubic hair.

Perhaps this is because it is widely regarded that pubic hair is somehow dirty or unattractive, a message that has been perpetuated by pornography. Furthermore, if we’re not talking about what is natural regarding our bodies or using the correct terminology for genitalia, young people will be left confused and concerned that they are somehow abnormal.

How do I check my vulva?

According to Cancer Research UK, less than 1% of cancer cases reported every year are linked to vulval cancer. It’s more common in women who have gone through the menopause, but younger women have been diagnosed with early stages of vulvular cancer too.

Self examination is recommended on a monthly basis, unless you have had any vaginal procedure which could lead to an infection, in which case you must wait until you are fully healed. In order to carry out your examination, sit in a comfortable position in a well lit room, and make sure your hands and vagina are clean.

Positioning a mirror with one hand so that you can see the vaginal area, use your other hand to expose the labia and entrance to the vagina. Use your fingers to gently feel for any lumps or bumps. If you feel any abnormalities, experience any itching, unusual discharge, irregular bleeding or pain when passing urine, make an appointment with your doctor. If symptoms persist, ask to be referred to a gynaecologist for further tests. Lichens sclerosus is a skin condition which can affect the vulva and vagina. While Lichen Sclerosus itself is not cancerous, it does increase the risk of women developing vulval cancer in the future, affecting around 1 in 20 women according to the NHS

Be aware of signs and symptoms of gynaecological cancers

Gynaecological cancers are the second most common cancer for women after breast cancer. Therefore, be symptom aware and seek medical advice if you notice anything abnormal. Remember that cancer do not know your age, it can affect you whatever your age.

There seem to be a myth that some gynaecological cancers only affect older women, such as womb cancer, which is true for the majority but younger women can get them too.

Signs and symptoms include:

• Bleeding after sexual intercourse
• Bleeding between periods
• Post-menopausal bleeding (bleeding when your periods have stopped)
• Abnormal vaginal discharge – from pink and watery to brown, and any blood clots
• Lumps and bumps
• Skin discolouration
• Itching
• Pain or sore skin
• Pain or discomfort during sex
• The need to pee more
• Persistent Pelvic or abdominal pain
• Bloated abdomen, increase abdomen size or abdominal pain
• Difficulty eating or feeling full quickly, or nausea

Always get abnormal bleeding checked!

If you were bleeding for another part of your body, you would seek medical advice yet when it comes to our vaginas, some people just ignore it!

Eve Appeal research for Go Red (2020) found that 80% of women who were surveyed (Freeda Media poll) wouldn’t get an unexpected vaginal bleed investigated despite it being one of the symptoms of all gynaecological cancers. Often there is another reason for abnormal bleeding but it always needs to be checked out by your GP.

Fustratingly COVID19 has created yet another barrier for people not getting bleeding checked. NHS urgent cancer referrals are down 20% and fear of going to the GP during coronavirus is just another thing that may prevent women from getting their abnormal bleeding symptom investigated.

Eve Appeal have created this comprehensive list Get Bleeding Checked

Everyone needs to be educated about gynaecological health

Research conducted by the Eve Appeal 2017 found around one in six men know nothing about gynaecological health issues and don’t feel that they need to know, as it is a female issue.

As a result of their research their campaign for Gynae Cancer Awareness Month (2017) was about raising awareness about knowing what is normal for women and included men which is brilliant #IAmAdam

Team Eve asked all “Eves” and all the “Adams” in their lives from their partners, sons, dads, uncles, godfathers, grandads and male friends to be aware of the sign and symptoms associated with gynecological cancers. It’s not just a “female” thing, and men need to encourage their loved ones to seek help if they notice anything abnormal.

The theme of the Eve Appeal Campaign in 2018 was “Get Lippy” to get everyone talking about gynaecological health and cancers to help them overcome embarrassment of this subject. It is so important that women feel more comfortable about talking to their partner, family, friends and GP about any abnormalities. This could save their life, or the life of their mum, nanna, sister, daughter, aunty, godmother or best friend

One of the main symptoms of ovarian cancer is persistent bloating, not a vaginal issue. But according to Target Ovarian Cancer only a third of the women recently polled by YouGov (2018) for the charity said they would see a doctor if they experienced those symptoms. Half said they would adjust their diet with measures such as cutting out gluten and eating probiotic yoghurts.

Anyone who is feeling bloated most days for three weeks or more should visit their doctor.

Gynaecological problems do not just impact upon the health of women but also affect their partners, relationships and families which is why everyone needs to get clued up about #gynaehealth

Don’t put off having a smear test

Many women are put off by the idea of having a smear test as they deem it to be an invasive procedure, however it’s a vital one that could save your life. Women are invited to have a smear test every three years from the age of 25, and in reality it is a quick and simple procedure that is over in a matter of minutes.

Worryingly, a survey by Jo’s Trust (2018) has found that young women are embarrassed to attend smear tests because of,the appearance of their vulva (34%) and concerns over smelling ‘normally’ (38%). In a new survey of 25-35 year old women, a third (31%) admitted they wouldn’t go if they hadn’t waxed or shaved their bikini area.

Even if you are STD free, aren’t sexually active or have gone through the menopause, it is vital that you attend your smear tests if you have a cervix.

I’m experiencing pain during sex…

If you experience pain during sex, don’t simply put up with it, as there could be several causes of vaginal pain. If you have difficulty inserting tampons or having sex, you might be worried that your vagina is simply too small. However, when a woman gets nervous, her vagina tenses up. Vaginal tightening could also be caused by a condition called Vaginismus, which causes the vagina to tighten involuntarily. It is a fairly common condition with high success rates after treatment.

Using a sex toy could help you to relax your vaginal muscles, and help you to overcome tightening issues. The PicoBong Zizo is a great vibrator to help build up your confidence as it can be used both externally and internally, and you may learn to love sex again!

If you are really concerned about vaginal penetration, the Rocks-Off Slinky Pinky is our smallest slim vibrator and ideal to use in conjunction with dilators or to begin enjoying sexual pleasure.

By reaching orgasm through clitoral stimulation, you may find it easier to unwind and shed your inhibitions. Remember, there’s no rush! Over time, you may find it easier to fully insert the Zizo and experience G-Spot orgasms. Make sure to use a lubricant, too, as this will make it easier to fully insert a sex toy or your partner’s penis!

Should I be douching or steaming?

“Douching” refers to washing out the vagina. Many women do this to feel fresher during their period or after sex, but actually it’s an unnecessary process. The vagina is often referred to being a “well oiled engine”, as it is a self-lubricating organ. The vagina also has a very delicate pH balance, so introducing chemicals found in douching products can actually do more harm than good.

Steaming your vagina seems to have become a celebrity trend but will not benefit your vagina health and can damage it. Hot steam can burn the delicate skin of the genitals, it can upset the balance of vaginal flora and it will not have an impact upon your hormones.

Using scented products, cheap sex toys and sexual lubricants on your vulva and vagina can cause irritation and allergies. So avoid scented body wash and perfumed sanitary product, always check what your sex toy is made from and if you can cleanly it properly and what your lubricant contains.

Avoid using household products as sex toys and lubricants to protect your vagina health.

By upsetting the vagina’s pH balance, also known as the “vaginal flora”, Bacterial Vaginosis, a common vaginal infection, can develop. This is because the new environment caused by douching or steaming is a more favourable for the bacteria to grow in. BV is often described as having a fishy odour, so is quite easy to identify. BV is easily treated with antibiotics.

It’s advisable to use a pH balanced lubricant to avoid changing the delicate pH of the vagina. Also avoid products which contain glycerin as this causes thrush.

There is also a risk of developing Pelvic inflammatory disease (PID), an infection that affects the uterus, fallopian tubes, and in some cases, the ovaries. Typically the cervix would prevent bacteria that enters the vagina from reaching internal reproductive organs, and therefore douching or steaming the vagina can expose the cervix itself to infection and unable to perform its vital role.

It’s not unusual for the vagina to have an odour. When a woman is aroused, she produces natural pheromones. After sex, the vagina may smell differently for a number of reasons. If condoms or lubricants have been used, this may have an affect on the vagina’s odour. Direct contact from semen can also cause a different odour, as semen has its own scent and pH balance, which can then change the vaginal flora.

What about discharge?

Clear or white discharge is completely normal. The amount of discharge you secrete will vary depending on where you are in your menstrual cycle. Healthy discharge doesn’t have a strong smell, and while you may experience a damp feeling, your vagina shouldn’t be itchy. If you notice a change in your discharge, there could be a number of reasons for this.

Thrush is a common fungal or yeast infection that causes thick, white discharge that is commonly likened to cottage cheese. It doesn’t have a particularly strong smell, but it does cause itchiness and soreness in the vagina. Almost all women will experience thrush during their lifetime, and while it isn’t an sexual transmitted disease (STI), men can contract it, too. It’s easily treated with antifungal treatment, either in the form of a vaginal pessary and cream or a one dose oral capsule. It is important for your partner to use a topical cream to treat his penis, even if he doesn’t have symptoms.

An STI called Trichomoniasis, which is caused by a small parasite, can turn discharge green, yellow or frothy. Most women find they have a lot of discharge that has an unpleasant, fishy odour. This is Bacterial Vaginosis (BV) and requires antibiotics. Other symptoms can include itchiness, swelling and soreness in and around the vagina, and pain passing urine. It can be treated with antibiotics from your GP or sexual health clinic.

Abnormal discharge that coincides with pain or bleeding could either be caused by the STIs gonorrhoea or chlamydia. If you find you have these symptoms along with blisters or sores around the vagina, it is likely to be herpes. These STIs can all be treated with antibiotics. Again, it is important that your sexual partner is treated too.

Seek medical advice if you notice any abnormal bleeding, including during or after sex.

Pubic hair: yay or ney?

Pubic hair is a very normal symptom of puberty, and while many people like to keep their pubic hair to feel au naturel, if you want to remove or style it it should be your decision that is not influenced by someone else.

However, overgrooming of your pubic hair can lead to vulval irritation, ingrow hairs, and if you accidentally slip while shaving and cut yourself this could lead to an infection.

A recent survey of 3,316 women in the US, published in JAMA Dermatology (July 2016) found that 59% of the women said they removed their pubic hair for “hygiene reasons”. The lead author of the paper, Dr Tami S Rowen, said that “Many women think they are dirty and unclean if they haven’t groomed.”

Of all the women interviewed, 84% said they had done some grooming and 62% said they had removed all their pubic hair at least once. Pubic grooming is more common in young women aged between 18-24, with 20% saying they did it for their partners, many citing that it made them feel sexier.

Embrace your vagina!

NHS statistics have revealed that between 2003 to 2013 that labiaplasty surgery had increased by five times. This surgery, which alters the labia to give a designer vagina can lead to infections and loss of feeling, and isn’t necessary!

Some women are also self-conscious of their vagina’s natural odour as well as its appearance, but healthy vaginas are beautiful in all shapes and sizes!

Learn about your body and what feels normal and when something is abnormal. Don’t let embarrassment stop you seeking medical advice, esepcially if you notice abnormal bleeding, it could save your life. Have a chat with you mum, nanna, aunty, friend, you never know it could save your life ot theirs!

Go Red and support the Eve Appeal to raise money to fund vital, ground breaking research into gyneacological cancers and raise awareness about getting abnormal bleeding check and period education.

Useful Websites

The Eve Appeal : http://eveappeal.org.uk
Womb Cancer Support: http://wombcancersupportuk.weebly.com
Menopause Support: http://www.menopausesupport.co.uk
My Menopause Doctor: http://www.menopausedoctor.co.uk
Royal College of Obstetricians and Gynaecologists ; www.rcog.org.uk
Jo’s Trust: www.jostrust.org.uk
Cervical Screening: cervicalscreen1.wordpress.com
Family Planning Association : www.fpa.org.uk