How to do a vaginal self-exam and why: A guide for every woman

As the name suggests, a vaginal self-exam is the right way a woman can examine her vulva and vagina. The vagina is a delicate organ in a woman’s body and also becomes prone to infection as we age. So, through vaginal self-exam, a woman can better understand her body, the changes that take place during the menstrual cycle, or any underlying medical condition that needs the attention of a healthcare professional. The best time to perform a vaginal self-exam is between your menstruation. However, as long as you are undergoing a routine vaginal exam/pap smear, you can skip doing a vaginal self-exam.

What is vaginal self-exam?

Vaginal self-examination, also known as vulvar self-examination, is a process by which individuals inspect their genital area for any abnormalities or changes. It is an essential aspect of personal health monitoring, allowing individuals to become more familiar with their bodies and detect any potential signs of concern early on.

Vaginal self-examination or female genital self-exam should be done regularly as part of a comprehensive approach to reproductive and gynaecological health. It empowers individuals to take control of their health and detect potential issues early, leading to better outcomes and peace of mind. However, it’s essential to remember that self-examination does not replace regular gynaecological exams and screenings performed by a healthcare professional, gynecologist Dr Chetna Jain tells Health Shots.

What does the inside of a vagina looks?

The inside of the vagina contains several structures and organs that play vital roles in reproduction and sexual pleasure. Here’s an overview of the main components of a vagina:

1. Vaginal canal

The vagina is a muscular tube that extends from the vaginal opening (located between the urethra and anus) to the cervix. Its primary functions include serving as a passageway for menstrual fluid, facilitating sexual intercourse, and providing a birth canal during childbirth.

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2. Cervix

Located at the upper end of the vagina, the cervix is the lower portion of the uterus that protrudes into the vaginal canal. It acts as a barrier between the vagina and the uterus. The cervix contains a small opening called the cervical os, which allows menstrual fluid to pass out of the uterus during menstruation and serves as a pathway for sperm to enter the uterus during ovulation, tells the expert.

3. Uterus (womb)

“The uterus is a hollow, pear-shaped organ where fetal development occurs during pregnancy. It consists of three main parts: the fundus (upper portion), body (middle portion), and cervix (lower portion). The inner lining of the uterus, called the endometrium, thickens and sheds cyclically during the menstrual cycle in response to hormonal changes,” says Namita.

4. Ovaries and fallopian tubes are internal genital organs inaccessible from the vagina.

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How to do a vaginal self-exam?

Here’s a detailed explanation of how to perform a vaginal self-exam:

1. Preparation

Wash your hands thoroughly with soap and water to ensure cleanliness before starting the examination. Find a comfortable, private space where you can relax and concentrate without interruption.

2. Positioning

There are different ways to position yourself for a vaginal self-exam, such as lying down with knees bent and legs apart, squatting, or using a mirror while seated. Choose the position that feels most comfortable and allows for easy access to the genital area.

3. External Examination

“Begin by using a hand mirror to observe the external genital area, including the vulva, labia majora, labia minora, clitoris, and perineum. Look for any redness, swelling, bumps, sores, rashes, or other abnormalities. Pay attention to changes in colour, texture, or size,” says the expert.

4. Internal examination

Gently insert one or two fingers into the vagina, using lubrication if necessary for comfort. Feel the walls of the vagina for any lumps, bumps, or unusual sensations. Note any pain, tenderness, or discomfort during the examination. You can also perform a pelvic floor muscle check by tightening and relaxing the muscles around the vagina.

5. Cervical examination (optional)

Some individuals may choose to perform a more in-depth examination by checking the cervix for any abnormalities. This can be done using a clean, lubricated finger to feel for the cervix’s position, texture, and any unusual discharge.

It is difficult to perform and it is best done by your gynaecologist who can take a cervical smear along. Cervical smear when normal is repeated from age 21 or after first sex and continued till age 64 years.

Also read: Rough sex can lead to vaginal swelling: Here’s what you can do about it

6. Record observations

Keep a journal or note any findings from the examination, including the date, any changes noticed, and any symptoms experienced. This information can help monitor changes over time and discuss concerns with a healthcare provider if needed.

7. Follow-up

If you notice any concerning symptoms or changes during the self-examination, such as unusual discharge, persistent itching or pain, lumps, or sores, it’s important to follow up with a healthcare provider for further evaluation and guidance.

When to call a doctor?

It’s important to seek medical attention promptly if you experience any of the following symptoms or situations related to your vaginal health:

1. Unusual discharge

If you notice changes in vaginal discharge, such as a significant increase, a foul odour, unusual colour (e.g., greenish or greyish), or consistency (e.g., thick, clumpy), it may indicate an infection or other underlying issue. Bleeding outside periods or any time during pregnancy warrants immediate medical attention.

2. Pain or discomfort

Persistent pain, discomfort, or burning sensations in the vaginal area, especially during urination, sexual intercourse, or daily activities, may be signs of an infection, inflammation, or injury.

3. Abnormal bleeding

Any abnormal vaginal bleeding or spotting that occurs outside of your regular menstrual cycle, after menopause, or during sexual intercourse should be evaluated by a healthcare provider.

4. Itching or irritation

Persistent itching, redness, swelling, or irritation in the vaginal area, particularly if accompanied by unusual discharge, may indicate an infection or allergic reaction.

5. Pelvic pain

Chronic or severe pelvic pain, cramping, or pressure, especially if it’s localized to one side or accompanied by fever, nausea, or vomiting, could be a sign of conditions such as pelvic inflammatory disease (PID), endometriosis, or ovarian cysts.

6. Changes in appearance

Any new or unusual growths, lumps, bumps, sores, or lesions in the vaginal area should be evaluated by a healthcare provider, as they may indicate infections, cysts, or other conditions.

7. Difficulty with menstrual cycle

Suppose you experience significant changes in your menstrual cycle, such as irregular periods, unusually heavy or prolonged bleeding, or the absence of menstruation (amenorrhea). In that case, it’s important to consult a doctor to rule out underlying health issues.

8. Sexual health concerns

Any concerns related to sexual health, such as pain during intercourse, difficulty achieving orgasm, or changes in libido, should be discussed with a healthcare provider to determine potential causes and appropriate management.

Remember, it’s always better to err on the side of caution and seek medical advice if you have any concerns about your vaginal health. Your gynaecologist can perform a thorough evaluation, provide a diagnosis, and recommend appropriate treatment options based on your individual needs.