Vulva Vitality and Care

Without shame-free sex education as the baseline, it’s hardly a surprise that vulva care and health in general remain on the fringes of women’s health. The Western medical model has catch-all phrases like “vulvodynia” or “vulvovaginitis” but lacks clarity in offering real solutions or even getting to the root of any genital health issues.  

Most women don’t consider their own vulva vitality or relationship to their own genitals until there is a problem or until they intend to give birth. We can change that by learning about vulva vitality and care. 

The Basics 

Let’s start with some basic orientation and un-shaming! 

• Vulvas are configured in a variety of shapes, sizes, textures, colors and hair patterns. There is not one standard “normal.” There is just what is normal and vital for you
• The vulva includes many parts: mons pubis, inner and outer labia, urethral opening, vestibule, clitoral hood, glans clitoris, vaginal opening (introitus), perineum, anus. 
• Standard (in America) sex education leaves out any discussion of erectile tissue and anatomy associated with pleasure. You can check out Sheri Winston’s book Women’s Anatomy of Arousal: Secret Maps to Buried Pleasure for more on that. 
• Vagina and vulva are not interchangeable terms! The vaginal opening is visible and part of the vulva. The vaginal canal is moving towards more internal genital and reproductive anatomy.
• Knowing what’s normal and healthy for you will require that you look! Don’t wait until you have x, y, or z symptoms. 
• Your vulva appearance and sensation will change throughout your menstrual cycle (when not on hormonal contraceptives!) and also throughout the pregnancy continuum. Observing takes away any mystery and starts a deeper un-shaming process!
• How you feel about your genitals matters for your vitality, sexuality and deep sense of ROOT safety!

Root Level Assessment

It’s likely that no one has ever asked you how your vulva is feeling or how you feel about your genitals! We live in such a sex negative culture that everyone has been impacted by deep, subconscious genital shame. It’s really so much so that it’s basically removed from healthcare discussions unless there is a clear issue (pathology)!

However, vulva vitality is a reflection of hormonal resilience, microbiome terrain, emotional processing, biomechanics and sexual identity integration. That’s a lot of power and potential for healing. 

Here’s what to look for if you want to assess your own vulva vitality: 

• Various even skin tones
• Supple quality to tissues
• Skin moisture
• Remember, vulva appearance changes with cycle, pregnancy and arousal. This is all normal!
• No dryness, itching or irritation.
• No excessive redness. Skin tones will vary based on the different tissue types but redness with irritation is not ideal.
• No bumps, lumps or open sores.
• No pain, burning or numbness.

If you have anything that concerns you, be sure to get support! It’s normal to have emotions or questions arise if you haven’t spent a lot of time looking at your own genitals. Give yourself time to approach this if it feels overwhelming or destabilizing in any way.  

Vulva Ecology + Care

Your vaginal (and therefore vulva) microbiome is everything! It affects fertility, reproductive immune system, inflammation, lubrication and infection resistance. Any chronic yeast infections, bacterial vaginosis or UTIs have at least one root in the vaginal microbiome. And the vaginal microbiome resilience and health is rooted in the gut microbiome.

So what can you do to support healthy vulva ecology and care for this root part of you?

• Prioritize tending to your gut health by eating non-industrialized animal products, healthy fats and minimizing alcohol and other foods that are triggers for you!
• Basic hygiene. Wash your hands before sex (partners too), period care and self pleasure. Use soap for your hands and toys, not your vulva! 
• Stay away from chemical filled products when choosing period care, sex toys, lubricant and healthcare! 
• If you have any symptoms, avoid turning to mainstream, over the counter products to “fix” your issue. I’m looking at you monistat and vagisil! These can worsen the situation over time. 
• Only use antibiotics when absolutely necessary! Sometimes it is the best option but only sometimes.
• Consider vaginal steaming. It’s like a medicinal facial for your vulva, rooted in many ancestral traditions. Read more about it here.
• To address any issues, seek out holistic approaches, like vaginal probiotics or herbal washes.
• Get embodied support for sexual healing! 

Vulva vitality matters for sexual health, pleasure, reproductive health and also a root level feeling of safety, belonging and security. There are lots of ways to support this integral part of your body.

Chinese Medicine Perspective

Chinese Medicine can teach us a few things about vulva anatomy and health that western medicine cannot.

The vulva is utmost YIN in relationship to other body parts. It’s somewhat hidden. It’s damp, soft and layered. Yet it also possesses an element of YANG in relationship to the internal genital anatomy and in its changeable nature (engorging with blood, flowering open for a baby to emerge). The vulva is dynamic, resilient and multi-passionate!

The Liver meridian “encircles the genitals” and any stagnation or issues within that organ system can manifest symptoms on, you guessed it, the genitals! Your vulva vitality may be directly affected by physical or emotional stress through this pathway because the Liver is your primary stress modulator! Issues could result in herpes outbreaks or other skin outbreaks, itching, redness, irritation, infections and pain.

The Ren meridian (aka Conception vessel or Sea of Yin) emerges at the perineum and originates in the womb. The first point on the channel is in the perineal body and it’s called “Meeting of Yin.” Because of the location and nature of this meridian, it’s important for vulva vitality and sexual health. Issues with Ren and YIN could result in dryness, pain, tissue fragility, numbness or lack of pleasure. This is also an area that can contain scar tissue due to a birth injury. 

It can be orienting and grounding to relate to vulva health in a way that isn’t rooted in western biomedicine. It’s another way of perceiving your genital health experience that can feel less sterile or medicalized but is still useful and orienting. 

Vulva Vitality + Pregnancy

Pregnancy, birth and postpartum affect all areas of vulva health - hormones, vaginal microbiome, emotions, biomechanics and sexual identity integration. 

There’s a lot more to vulva changes than simply fearing birth (especially tearing) or making jokes about “down there” after your baby is born! Pregnancy increases estrogen and progesterone drastically in the body. Also, blood volume doubles during a healthy pregnancy. More blood flow plus increased hormones often leads to vulva tissue changes in shape, size, color, sensitivity and lubrication.

Hormones of pregnancy directly shift the vaginal microbiome to be less diverse but more resilient against infection, when in a healthy state. This is protective against preterm labor!

The additional pressure and blood flow in the pelvic bowl changes biomechanics and can further affect vulva sensation. Biomechanics are often a factor in vulvar varicosities (swollen, congested veins) that develop during pregnancy. Usually these resolve after pregnancy but if it’s painful, acupuncture and other modalities can help!

Birth is an embodied womb, pelvic and genital initiation. It can be into power, pleasure and deeply rooted, biologically driven love. It can change your relationship to your vulva immediately or through processing and integrating your birth story if things didn’t go as you desired.

With tending and care, vulvas are miraculous in their capacity to heal after opening for vaginal birth, sometimes in reconfigured shapes, textures and layers but still resilient and pleasure capable. If you need help healing in this way, book a session with me here or consider joining the next round of Mother Alchemy. 

Vulva healing is an essential part of postpartum care. You can read more about that here.

Vulva health generally doesn’t get the attention that’s needed because we live in a culture of sexual and genital shame. My hope in providing this information is that you can reclaim this part of your body and feel that you have some agency around your experience of vulva vitality.  

This content was originally posted on Instagram but edited for this post.