Female Genital Self-Exam

A genital self-exam can be a great way for you to explore and better understand your body in a safe and private setting such as your home. These exams involve using a mirror and bright lighting to help you get an up close, clear look at your vulva (external female genitalia) and all of its parts. Each vulva varies in size, shape, color, and smell—there is no standard of what your vulva should look like.4 However, knowing when there is a change to your vulva that is unusual for your own body is important. Your vulva undergoes normal physical changes throughout the menstrual cycle, and if you are better able to understand these natural changes, it may be easier for you to observe unusual changes in color, texture, bumps, or smells. Regular self-exams are crucial because they increase the likelihood of discovering these physical changes and abnormalities, allowing you to discuss any changes with a physician as soon as possible. Remember, the earlier a problem is detected and treated, the more likely it can be successfully controlled or cured.1 However, self-exams should not replace annual pelvic exams performed by your gynecologist.5 These annual exams include Pap smears and other diagnostic tests designed to detect microscopic changes that cannot be found through self-examination.2

Steps for a Self-Exam

The best time for a genital self-exam is between menstrual periods5, which allows you to see your vulva at a neutral state. Vaginal creams and douches should not be used within 24 hours before a self-examination since they can alter the normal texture or smell of your genitals. A self-exam should be aided with a mirror and good lighting so that your vulva is fully visible. Therefore, these exams are best performed with a handheld mirror and small flashlight. Here are some steps to help guide you through your exam:

  1. Wash your hands and remove clothing below the waist.

  2. Sit down with your back supported by a wall or pillows. Bend your knees so that your feet are near your buttocks. Then, spread your knees apart. This will help aid in giving you a better and more clear view of your vulva.

  3. You may feel some discomfort during your self-exam, so it is important to keep your pelvic muscles relaxed. This is good practice for when you go into an annual gynecological exam with your doctor, since they will usually use a speculum to get a complete look inside your vagina and these devices can sometimes cause slight pain or discomfort. To minimize these negative effects, just remember to relax your muscles.

  4. Hold the mirror in front of your genitals, and take some time to familiarize yourself with the appearance of your vulva. Refer to the diagram on the right to identify the different structures of the vulva. See how these structures look when you are in different positions, including sitting, lying down, and standing.

    The vulva consists of the fatty mons pubis, the outer and inner labia, which are the fleshy lips of the vulva, and the clitoris, which is the main area stimulated during sexual activity. Urination occurs through the urethral opening while vaginal penetration occurs through the vaginal opening.2 The intactness of your hymen, a thin membrane covering the opening of the vagina, can also affect the discomfort you may feel when inserting objects into your vagina. If you are comfortable, this may also be a good opportunity to touch different parts of your vulva to get a better idea of what feels good and stimulates you sexually. This could be helpful to know during masturbation, or something to tell your partner while you are intimate, and will also help you with the next step. 

  5. Look at the different coloration and size of each part of the vulva; note that these physical features temporarily change with sexual arousal. For example, the clitoris and labia minora become enlarged and deepen in color because of the increase of blood flow to the genitals. The clitoral hood may also retract to expose more of the clitoris. The changes should subside within a few hours following sexual activity. Inform your healthcare provider if any significant changes in genital appearance occur.

  1. Spread the vaginal lips with one hand, and use the light and mirror with the other to look into the vagina. It may be easier to prop up the mirror and reflect the light off of it. The vagina has reddish pink walls with small folds throughout.

  1. Once you feel comfortable and ready, place a finger inside your vagina (at a 45 degree angle) and feel the inside walls. You might feel tightness or a lot of moisture.4 The inside of the vagina has a ridge-like surface similar to the feel of the roof of your mouth. Inform your doctor if there are sores or growths along the vaginal wall. To feel the cervix, try squatting while gently pushing your finger deep into your vagina. The cervix feels similar to the tip of your nose. Depending on the time of your menstrual cycle, the cervix may be easier or harder to find, because its position shifts throughout the cycle.4 You might also notice a bumpy area about one to three inches into your vagina on the wall closest to the front of your body. This is known as the G-spot, or Grafenberg Spot, which is an erogenous area that can be a source of sexual pleasure when stimulated. However, the existence of the G-spot has been debated by sexologists, since not all females have been able to locate their G-spot. Feeling comfortable inserting your finger into your vagina can help you decide if barrier methods like the contraceptive sponge or diaphragm (both of which are inserted into the vagina) are right for you.3

  2. Next, examine your vaginal discharge. Healthy discharge is usually clear to cloudy white and undergoes small changes during different stages of the menstrual cycle. Your discharge may or may not also have an odor which are both normal, however, it should not be a foul-smelling odor. Discharge should also not be green, gray, or dark yellow in color, or have a foamy consistency. If any of these abnormal discharge apply to your discharge, you should contact your healthcare provider.

  3. If you feel any abnormal lumps or notice any other changes in your genitals that were not there previously, be sure to contact a healthcare professional immediately to schedule a physical exam.

Although these exams are intended to benefit your health by allowing you to notice changes such as bumps, lumps, spots, or other changes in color, texture, or smell that could be caused by STIs or other diseases, this is a good opportunity to also explore your genitals, become comfortable with your body, and know what feels good.  Remember that every vulva is different and it is important to understand your own without comparing it to others. Even though genital self-exams are an important part of understanding your body and noticing abnormal changes, they should also never replace regular pelvic exams from a healthcare provider or STI testing.

 

References

  1. “Genital Self-Examination.” WebMD. N.p., 16 Nov. 2012. Web. 21 Aug. 2014.
  2. “Vaginal Self-Examination (VSE).” WebMD. N.p., 28 Jan. 2012. Web. 21 Aug. 2014.
  3. Wiseman, Kat. “How To: Female Genital Self-Examination - OfficialJane.” OfficialJane. N.p., 4 Aug. 2014. Web. 21 Aug. 2014.
  4. Bobel, Chris, et al. “Self-Exam: Vulva and Vagina.” Our Bodies Ourselves, 28 Mar. 2014, www.ourbodiesourselves.org/book-excerpts/health-article/self-exam-vulva-....
  5. Amos, Bill, et al. “Vaginal Self-Examination (VSE).” Michigan Medicine, University of Michigan, 14 May 2018, www.uofmhealth.org/health-library/hw235326#hw235329.

Last Updated 6 May 2019.