Understanding Vulval Variations: A Guide

Hi Aunt Vadge,

I don’t know if you still reply.

I’m a young girl and I’ve been having a problem with my vaginal opening (don’t worry I am going to go to a doctor I just really need some reassurance).

I’ve looked at so so so many diagrams of the vulva and the vaginal opening seems to not look like mine at all on any diagram. Even if it seems hard to see, the vaginal opening still seems to be able to be seen, but mines got this weird little bud?

In the front, I can’t put anything at all in, it’s extremely painful even if I use lube, and I can’t even see the opening, I just know there’s an opening there because that’s where period blood comes from.

The only thing I have found that looks anything even close to mine is this image! (Real image is not shown!)

I definitely don’t think I have something like it says in the slide, but it’s the closest I could find to mine. I don’t know what to do anymore. I look nothing like the diagrams, not even ones that use real images.

I’ve never had sex before or have ever had anything. It’s really stressing me out. I know every vulva is different but this is just very stressful.

I’ve also had period problems where my period never ends, and I always get UTIs and even if it’s not a UTI, still a slightly painful stinging vagina when I get my period.

I’m not sure what to do. I don’t feel very normal compared to other girls. It’s gotten so bad when it comes to my vagina not looking normal I’m wondering about the possibility of some kind of intersex condition.

I really want to feel normal like the other girls, but something’s just not right down there (at least from everything I have seen).

What should I do and who should I tell? Will a doctor need to examine what’s going on down there? If so, what should I expect and how could I prepare for something like that?

Yours,
Syvlan
Age 14
Queensland, Australia

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Hello Syvlan,

First and foremost, it’s completely understandable that you’re feeling a bit all at sea about this—vulval and vaginal concerns can be ever so perplexing and can throw even the steadiest ship off course.

But you’ve already done an incredibly brave thing by reaching out for guidance, and I assure you, I’m right here with you every step of the way. I always reply!

Alright, let’s tackle the main bits one by one, shall we?

Your vulva is as unique as your fingerprint, and variations in appearance are incredibly common. This little “bud” you’ve described could be anything from a prominent part of your normal anatomy to a harmless cyst or skin condition.

Vulval pain with attempted insertion could indicate a number of things, including vulvodynia or vaginismus, but it could also be down to the individual way your body has grown.

Now, while diagrams are tremendously helpful as a rule of thumb, they often don’t represent the vast variety found in real-life vulvas. It’s like trying to find your face in a sea of emojis—there’s nuance and character missing, isn’t there?

Regarding your concerns about an ongoing period and recurrent UTIs, that sounds like a flag that you need a bit of a helping hand medically speaking. Continuous bleeding and persistent infections aren’t to be treated lightly, and a proper health care professional should be all over that like berries on a pavlova.

As for the thoughts swirling in your bonce about a possible intersex condition, it’s very important to remember that while intersex characteristics are a natural part of human diversity, they are something that a doctor would need to evaluate. It’s a complex arena, with a spectrum of presentations, and it’s not something you should try to interpret on your own.

Here’s the plan of action for you, poppet:

Speak Up: You’re going to need to have a chat with a trusted adult—like a parent, guardian, or school nurse—who can support you in getting the medical care you need. They can help you book an appointment with a doctor and be there with you for the visit.
Doctor’s Visit: Your GP or a gynaecologist will be the port of call here. They can have a look-see down there, ask you about your symptoms, and might conduct some examinations or tests to get to the heart of the matter.
What to Expect: They may do a visual examination of your vulva. If they think it’s necessary and you’re comfortable, they might suggest an internal exam, but this should be done with great care and sensitivity, and only if it’s absolutely necessary. You can absolutely say if you’re not ready for that or if you prefer not to.
Preparation: Before your visit, jot down all the symptoms and concerns you have so you don’t forget anything. Wear comfy clothes and maybe pack a small bag with a book or something to fiddle with if you get a tad nervous waiting for your appointment.
Support: Ask to have someone with you during the exam if that would make you feel better. If the adult you’ve confided in can’t be there, a nurse or other staff member can be with you for support.
Questions to Ask:
- What could be the cause of my symptoms?
- What kind of tests might I need?
- What treatment options are there?
- Can you explain everything you’re going to do before you do it?

Remember, you are entitled to understand and consent to everything that happens in the doctor’s office. No one should do anything that makes you uncomfortable, and it is your right to ask questions, get clear explanations, and have control over your body and health.

Keep your chin up, Syvlan, you are normal, my love, and your doctor is going to help you make sense of all this. You’re not alone, and there’s a whole community here to back you up. If you need anything else, don’t hesitate to reach out for a natter.

You’re doing a tremendous job navigating this. Keep sailing steady, and we’ll get through this fog together.

All my best,
Aunt Vadge