Vulvar and Vaginal Disorders
Itching sensations, burning during urination, painful intercourse and discharge are only a few ways that vulvar and vaginal disorders cause significant discomfort – physically and emotionally – for women.
To receive an accurate diagnosis and effective treatment for your vulvar or vaginal disorder, it’s important to seek the help of a healthcare provider who specializes in women’s health issues. At The University of Kansas Health System, our nationally recognized OB-GYN specialists offer advanced care and treatment for these complex, intimate concerns.
What are vulvar and vaginal disorders?
Vulvar and vaginal disorders can refer to a wide spectrum of health conditions and infections that affect a woman’s external genitalia (vulva) and vagina. These can range from mild yeast infections to more significant concerns like gynecologic cancer.
Although they are common, vulvar and vaginal disorders are also frequently misdiagnosed. An OB-GYN with expertise in vulvovaginal health is essential for determining a proper diagnosis along with prompt treatment.
We offer a variety of appointment types, including second opinions. Getting a second opinion can give you confidence in your diagnosis and treatment plan. Call 913-588-1227 and ask for the OB-GYN scheduling team and the vulvovaginal disease experts.
Types of vulvovaginal disorders
There are many different kinds of vulvovaginal disorders. Some of the most common are:
- Bacterial vaginosis occurs when your bacteria levels are out of balance.
- Symptoms include white, gray or green discharge, a fishy odor, itching and burning during urination. It’s also possible to have BV and not experience any symptoms.
- Avoid using scented products or douching to reduce the risk of BV.
- Treatment often includes an antibiotic medication – which can be a pill, gel, cream or suppository.
- Pain during intercourse can feel like burning or aching. It can also continue after intercourse.
- You may be at more risk for experiencing dyspareunia if you’re experiencing menopause, have a vulvar, vaginal or bladder infection, or have neurologic changes.
- Treatment can include physical therapy as well as oral and topical medications.
- Learn more about dyspareunia.
- Genital warts are a sexually transmitted infection. They are caused by human papillomavirus (HPV) and spread through sexual contact.
- Genital warts can look like small, smooth bumps or they can be textured lesions. Sometimes they are too small to be seen.
- You may experience itching or discomfort from warts. There can also be bleeding with intercourse.
- Treatment can include removing the warts or topical medication.
- Lichen planus is one of several vulvar and vaginal diseases that occurs when the immune system is overactive and attacks mucous membranes.
- Skin affected by lichen planus can either be white or have shallow sores. The genital areas that are white are usually itchy, whereas those areas with superficial ulcerations are usually sore and painful.
- Untreated or severe lichen planus sometimes produces scarring. When the vagina is involved, the vaginal walls can scar together so that intercourse is no longer possible.
- Treatment may include topical medication, suppositories or pills.
- Lichen sclerosus is a skin disease that occurs most often on the vulva. This autoimmune condition occurs when the immune system becomes overactive and attacks the skin.
- Skin affected by lichen sclerosus is usually white, and sometimes there is a fine, crinkled texture.
- It causes itching. As the disease progresses it leads to easy bruising, tearing and pain. If untreated, lichen sclerosus often causes scarring, and the opening of the vagina can narrow.
- Most people need 4-8 weeks of daily ultrapotent topical steroid treatment. This usually restores the texture and color, although it does not always reverse scarring.
- Lichen simplex chronicus (LSC) is also called atopic dermatitis, eczema, neurodermatitis and dermatitis. It is an itchy skin rash that occurs in people who have sensitive skin. It is often caused by irritations of daily living such as contact with certain soaps, perspiration, stress or rubbing from clothes. It can also be provoked by prolonged contact with body fluids like urine, blood or vaginal discharge.
- Because people with LSC have skin that is easily irritated, there is no cure for LSC. However, steroid medication and very careful skin care to minimize irritation usually can control the problem.
- Burning that occurs with touch or pressure only at the opening of the vagina, called the “vestibule”, is called vestibulodynia. It is a form of vulvodynia.
- It is diagnosed when you’ve experienced pain for at least 6 months and any other conditions – like a yeast infection – have been treated but the pain persists.
- Vestibulodynia most likely is caused by a combination of a nerve abnormality (neuritis, neuralgia), pelvic floor muscle weakness and irritability, irritation from previous treatments, overwashing and anxiety/depression.
- Vestibulodynia does not affect fertility or the ability to carry pregnancy to term and have a normal delivery. Vestibulodynia is not an early sign of any disease that affects overall health.
- Treatment includes avoiding any products that may irritate the skin. There are topical medications that can be used for numbing any time you feel burning or 15-20 minutes before sexual activity to help you avoid some of the pain.
- Medication for neuropathic pain is often beneficial. These include medications that were originally developed for depression but have been found to have specific benefits for neuropathic pain.
- Topical medications and experimental treatments – like Botox, acupuncture and hypnosis – may be used depending on your specific symptoms, age and response to other treatments.
- A surgical option for vestibulodynia is to remove the painful vestibule. However, success of this surgery (vestibulectomy) is dependent upon the location of the pain being strictly and always limited to the opening of the vagina.
- Pelvic floor therapy can also be beneficial.
- This is when abnormal cells develop in the top layer of skin covering the vulva. It is not cancer but is considered precancerous.
- The symptoms of VIN are itching, burning, tingling or soreness in the vulvar area. There may be red or white areas on the skin or raised skin bumps that can be darker. Pain during intercourse can also be a symptom.
- Some people with VIN do not have any symptoms. Your gynecologist will do a careful skin exam, and may recommend further testing if your skin appears abnormal.
- VIN can be caused by a previous infection, like HPV, immunosuppression or chronic irritation.
- Diagnosis usually includes a colposcopy or looking at the skin with a microscope. Sometimes a biopsy is also needed.
- Treatments may include steroid creams, surgery, laser therapy and topical chemotherapy.
- Vulvar dermatitis is a common chronic skin condition of the vulva. It typically presents with dry, very itchy skin on the vulva, the outside genitalia.
- Estrogen levels can affect your likelihood to have vulvar dermatitis. It can also flare up in response to products that irritate the vulva, like scented soap, detergent, medications and period products.
- It is treated with topical corticosteroids and barrier emollients. Lifestyle changes, like following good skin care recommendations, can help prevent it from returning.
- Vulvodynia is defined as sensations of burning, rawness, stinging, stabbing, tearing, aching, or irritation that have been present for at least 6 months, and are not caused by any specific disease – no infection, skin disease or specific neurologic disorder.
- Vulvodynia can be caused by hormonal factors, inflammation, weakened pelvic muscles and nerve injury, among other things. It’s commonly experienced by people who menstruate.
- It can be treated with numbing medications, nerve blocks, oral medications – including antidepressants – pelvic floor physical therapy and even surgery.
- This is a type of fungal infection that occurs when you have a candida overgrowth. It is also a type of vaginitis and may be called vulvovaginal candidiasis or vaginal candidiasis.
- The symptoms of a yeast infection include burning, itching and redness on your vulva. You may also notice changes in the texture of your vaginal discharge.
- Yeast infections are very common. Your risk of getting one increases with using antibiotics, taking birth control pills, being pregnant, having a weakened immune system or having diabetes.
- Treatment often includes antifungal medications that are taken by mouth or applied to your skin. Talk to your doctor about over-the-counter medications that may be used.
Vulvovaginal disorders symptoms and risks
The symptoms experienced with various vulvovaginal disorders will vary depending on the exact condition. Some signs that could indicate the presence of an infection or other concern can include:
- Irregular bleeding
- Itching or burning, either internally or externally
- Pain with intercourse
- Skin irregularities, such as white patches or bumps
- Vaginal discharge
- Vaginal or vulvar pain
Risk factors also vary depending on the condition diagnosed. Possible risk factors include changes in hormone levels and immune system function. Some conditions can occur due to another underlying health concern. For example, yeast infections are more likely to occur in those with diabetes, and they can also be triggered by taking antibiotics.
Vulvovaginal disorders diagnosis and screening
Because many vulvar and vaginal disorders can present with similar symptoms, a medical history and description of symptoms alone is not sufficient for doctors to make an accurate diagnosis. Instead, your doctor may perform 1 or more additional tests to determine the cause of your symptoms. Those tests could include:
- Amine odor test
- Biopsy, if needed
- Physical evaluation, including a pelvic exam
- Saline wet mount
- Vaginal cultures
- Vaginal pH level test
Find a doctor
Doctors at The University of Kansas Health System are care providers and researchers at the forefront of new medical discoveries. From primary care to complex conditions, we offer hundreds of specialists.
The University of Kansas Health System care providers and researchers are at the forefront of new medical discoveries. We offer hundreds of specialists, including our team of board-certified OB-GYN doctors specializing in vulvar and vaginal conditions.
Vulvovaginal disorders treatment
There are several possible treatments your doctor may recommend, depending on your symptoms and the type of vulvovaginal disorder diagnosed.
- Physical or sexual therapy
- Vaginal dilators
- Pelvic floor exercises
- Prescription inserts
- Low-dose vaginal estrogen
- Muscle relaxer suppositories
- Steroid suppositories
- Prescription oral medication
- Selective estrogen receptor modulators
- Prescription topical creams or ointments
- Local anesthetics
- Low-dose estrogen
Why choose us for vulvar and vaginal care
The University of Kansas Health System has the only specialized vulvar and vaginal disease care team in Kansas and the Kansas City region. In addition to board certification, our specialists are active in the International Society for the Study of Vulvovaginal Disease, the leading organization for medical professionals who treat these conditions.
In-person visits with the vulvar and vaginal specialists are at the College Square Medical Pavilion in Overland Park, Kansas – offering easy, free parking.
Get the care you need at the best hospital in Kansas, as ranked by U.S. News and World Report. Additionally, you’ll benefit from the research and clinical trials conducted at the University of Kansas Medical Center. Our affiliation with an academic medical center means we are at the leading edge of treatments and care.
Frequently asked questions
No, a referral is not required. However, patients have usually sought treatment through their primary care physician or OB-GYN first and not gotten sufficient relief of their symptoms.
Whether you are referred or not, please bring your outside medical records with you to the appointment.
If you have tried other treatments without success, a consultation would be a good place to start. Also, you may be referred by another gynecologist to get care from us.
Most of the time surgery is not necessary. However, your doctor will review your history, examine your condition and discuss treatment options if surgery may be required.