Vaginal and Vulva health

Breaking the silence on vulvar health and vulvar cancer

Despite being a visible and vital part of the female body the Vulva remains surrounded by stigma and silence. Many women have never been taught the word, let alone how to recognise changes, symptoms or warning signs that something may be wrong.

I know this firsthand. More than 30 years ago I was diagnosed with Vulva cancer. At that time there was little public education, limited awareness among women, and almost no open conversation. Today, while medicine has advanced, the silence too often remains, and that silence can delay diagnosis, treatment and healing.

Vulva cancer is described as “rare” but in reality, it’s rarely talked about. Persisting itching, lichen sclerosus, skin changes, lumps, ulcers or burning are frequently dismissed, normalised or quietly endured. Some women are told it’s “just aging”, “just hormones”, or “just a skin condition”. Others feel embarrassed to raise concerns at all.

As the founder of International Gynaecological Awareness Day (IGAD), this day exists for one powerful reason, to shine a light on the gynaecological health issues that remain hidden, misunderstood or ignored. Vulva health is one of them.

IGAD matters and reminds us that;

• Knowing your body is not shameful
• Talking about gynaecological health is not taboo
• Early detection saves lives
• Women deserve accurate language, respectful care, and to be believed.

Vulva health is not only about cancer, but also about dignity, sexuality, pelvic health, mental wellbeing, and the right to understand and advocate for our own bodies.

Platforms like Women’s Health Pathway play a critical role in changing outcomes bringing together evidence-based resources and real stories and creating space where care is not just clinical but deeply human.

My message to women is simple:

• Know your vulva
• Look feel and notice changes
• Trust your instincts
• Ask for referrals if symptoms persist
• And never feel embarrassed advocating for your body

When we name the Vulva we legitimise it. When we talk openly, we break the stigma. When we share our lived experience with others symptoms can be recognised earlier, enabling them to seek help sooner. Education saves lives. Conversations save lives.

Let’s keep this important conversation going, for ourselves, for each other and for the women who came before us and whose voices were never heard.

Kath Mazzella OAM

Vulva cancer survivor & women’s health advocate, IGAD founder igad.kathmazzella.com

Caused by imbalance in vaginal bacteria.

Symptoms

• Fishy odour and watery discharge.

Blockage or infection of the Bartholin’s glands near the vaginal opening, leading to swelling, pain, or pus collection.

Skin conditions that can affect the vulva, causing redness, itching, scaling, or irritation.

Small growths around the vulva or vagina caused by human papillomavirus.

(GSM) is the modern medical term that combines what used to be called vulvovaginal atrophy and atrophic vaginitis. It describes the collection of symptoms that occur when estrogen levels drop after menopause, leading to changes in the vagina, vulva, bladder, and urinary tract.

An inflammatory condition that can affect the vulva and vagina, causing erosions, sores, or white streaks.

Symptoms

• Itching and burning – persistent discomfort in the vulva or vagina
• Painful sores or erosions – red, raw, or ulcerated areas that may bleed easily
• White streaks or lacy lesions – often seen on the vulva or at the vaginal opening
• Reddish-brown patches – discoloration on the inner vulva
• Painful sex (dyspareunia) – due to erosions, scarring, or narrowing of the vaginal opening
• Discharge – sometimes yellowish, oozing, or mixed with skin cells
• Scarring and adhesions – labia minora may flatten, clitoris can become buried, vaginal sides may fuse
• Bleeding after sex or exams – fragile tissue that tears easily
• Urinary stinging – pain or burning when passing urine if lesions are near the urethra.

A chronic skin disorder that causes white, thin, crinkled patches around the vulva and anus.

Symptoms

• Itching – persistent and often severe, especially around the vulva or anus
• Skin changes – white, pale, or blotchy patches; skin may look thin, wrinkled, or crinkly
• Fragile skin – prone to tearing, bruising, or bleeding even with minor friction
• Pain or burning – soreness, stinging, or discomfort in affected areas
• Scarring and structural changes – labia minora may flatten, clitoris can become buried under its hood, and the vaginal opening may shrink
• Painful sex (dyspareunia) – due to scarring, narrowing, or fragile tissue
• Skin splitting or ulcers – from scratching or friction, sometimes leading to secondary infections
• Urinary or anal symptoms – narrowing of the urethra (causing difficulty passing urine) or anal pain/bleeding.

Chlamydia, gonorrhoea, trichomonas, herpes, and HPV can all affect vaginal health.

• Primary vaginal cancer, which starts in the vagina
• Secondary vaginal cancer, which spreads to the vagina from other parts of the body (usually the cervix).

Thrush is a condition that occurs when the yeast Candida albicans grow excessively. This yeast is normally present in the bowel and in small amounts within the vagina, where it usually causes no problems.

Symptoms

• Itching or burning around the vulva and vagina
• Thick, white discharge often clumpy, and odorless.
• Pain or discomfort during sex (dyspareunia)
• Stinging or burning when urinating
• Redness, swelling, or soreness of the vulva and vaginal tissues.
• Splits or cracks in vulval skin

General inflammation of the vagina, often linked to infections, irritants, or hormonal changes.

Vaginismus happens when the muscles around the vagina tighten on their own, making it difficult or painful to insert anything.

Symptoms:

• Painful sex (dyspareunia) or inability to have penetrative sex
• Burning or stinging sensation when inserting a tampon or during exams
• Fear or anxiety around penetration
• Involuntary muscle spasms that can’t be consciously stopped.

Symptoms can be subtle at first and are often mistaken for common skin conditions. It’s important to pay attention to changes that persist or feel unusual for you. These may include:

• Persistent itching, burning, or soreness
• A lump, bump, or thickened patch of skin
• Changes in colour or texture of the vulvar skin
• A sore, ulcer, or area that doesn’t heal
• Pain during sex or when urinating
• Bleeding or discharge not related to your menstrual cycle

These symptoms don’t automatically mean cancer, but they do deserve attention. If something feels different, uncomfortable, or persistent, seeking medical advice is advised.

Vulvar varicosities are enlarged veins that appear on the vulva, most commonly during pregnancy. They can look swollen or bulging and may cause aching, pressure, or discomfort especially after standing for long periods.

Common symptoms

• A feeling of heaviness or fullness in the vulva
• Visible swollen or twisted veins
• Aching or throbbing discomfort
• Symptoms that worsen after standing, lifting, or at the end of the day

Most vulvar varicosities are temporary and resolve after childbirth. However, if symptoms are severe, interfere with daily life, or you’re unsure what you’re experiencing, a healthcare provider can offer reassurance and guidance.

Chronic vulval pain, burning, or discomfort without a clear cause. It can be persistent or provoked by touch.

Symptoms

• Pain in the vulva, lasting at least 3 months without a clear cause
• Burning or stinging sensations, rawness or irritation
• Sharp, sudden intense pain that may flare with pressure or penetration
• Soreness and aching, ongoing discomfort that can make sitting or wearing tight clothing difficult
• Swelling or throbbing feelings
• Pain during sex (dyspareunia) especially with penetration
• Difficulty using tampons or undergoing pelvic exams.