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Recently, I went with a friend to see her gynecologist. For this visit, she wanted company, and another set of eyes. During her last visit, her doctor noticed that the skin of her clitoral hood and part of her labia had turned white. She'd gone in because she was experiencing pain, and it turned out that the pain was due to a skin tag. Skin tags are tiny skin protrusions, and may have a small narrow stalk connecting the skin bump to the surface of the skin. They are usually painless and do not grow or change, except for occasional irritation from rubbing by clothing or other friction. Their origin is unknown.*

Last visit she'd had the skin tag removed (yee-ouch!). This visit she'd be getting back the skin tag biopsy results and address the whiteness. The biopsy results were negative (what a relief!) and lichen sclerosus was diagnosed as the cause of the whitening of her skin.

At one point, her doctor expressed surprise as to how this could have been missed at previous visits. We wondered about that, too. It's not as if this whitening just shows up overnight, and in the case of my friend, the hood of her clitoris had begun fusing to her clitoris and the hood could no longer be pulled back. She is currently trying out a treatment of applying a steroid cream, which should check the spread of the disease.

This got me wondering how much time gynecologists are spending examining our vulvas – and what would be a good self-exam for us to do. Prior to starting on vagina vérité, I didn't give much thought to the health and wellbeing of my vagina and vulva. Most women I talk with also know little about their genital anatomy, and unless we experience pain or itching, assume that everything is fine, have regular exams by a gynecologist, and don't give it a thought. I'm finding that there are many more women than I'd have expected who live with chronic pain (vulvodynia) or diseases like lichen sclerosus, and now see that self-exam should be a matter of routine, and that simply relying on what our gynecologists tell us when we are in front of them is not enough to ensure vagina-vulva health and wellbeing. (My exams last about 10 minutes max and seems to focus on whether my reproductive organs appear to be in good shape, plus a pap smear. I'm told everything looks fine, but I see now that I really don't know what that means). We need to be active participants.

*Skin tag definition excerpted from Medline Plus, a service of the National Library of Medicine and the National Institute of Health.

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