When a girl gets a boil on her vulva, it can be a painful experience. It’s important for her to see a doctor so she can get proper treatment and learn how to avoid this problem in the future.
A doctor will do an exam and ask about symptoms. They may also test the pus to see if it’s caused by an infection.
Vaginal discharge
Normal vaginal discharge is made up of fluid and cells and helps keep the vulva clean, fights infections, and provides lubrication. Girls may have lots of it or not much at all, and its color, texture, smell and amount can change throughout the menstrual cycle and over the years. Changes in the amount or shade of a girl’s vaginal discharge should be evaluated by a healthcare professional.
When a girl sees her doctor about vaginal discharge, she will be asked questions about when it started and what it feels like, whether it is achy or itchy, and when she notices a change in the amount of it. The doctor will also perform a physical exam, including a pelvic one. He or she will swab the inside of the vagina and the cervix to get a sample to test in the laboratory for conditions such as bacterial vaginosis (BV), yeast infection (thrush) or trichomoniasis (a sexually transmitted disease, or STD).
The bacteriology tests look for bacteria that cause BV, thrush or trichomonasis, which are often associated with an itchy vulva and irritation. If the results are negative, the healthcare professional will prescribe an antifungal medicine to be taken as a pill or cream. If the bacterial test is positive, a healthcare professional will prescribe antibiotics to be taken as a shot or pills.
The ob/gyn may also want to take a sample of the cervix, which is called a scraping, to check for cervical cancer or human papillomavirus (HPV). The healthcare professional will ask about any symptoms the girl has been having as well as what the usual amount of her vaginal discharge is and how it has changed recently. The ob/gyn may want to order additional lab tests if the diagnosis is unclear, such as a urine test or blood culture. If the ob/gyn thinks there is an infection, he or she will prescribe antibiotics. Some infections will require further diagnostic procedures such as a transvaginal ultrasound or a biopsy of the cervix. This will likely require a trip to the hospital.
Vaginal odor
It’s totally normal for your vulva to smell a little bit, and the scent can vary based on things like your menstrual cycle, hormone levels, personal vaginal bacteria, hygiene practices, and sexual activity. But if your vulva suddenly starts smelling fishy, it could be a sign of an infection or imbalance in your natural flora. The most common causes of this are bacterial vaginosis, yeast infections, or sexually transmitted diseases. The good news is, most of these can be treated with some simple lifestyle changes and home remedies.
A mild, tangy or sour aroma is usually caused by the lactobacilli bacteria that dominate healthy vaginas. These bacteria help keep your vulva acidic, which protects against the growth of harmful bacteria. A slightly fishy or sour odor, especially when it is accompanied by thin vaginal discharge that looks like pee and has a stinging feeling when you urinate, is often a sign of bacterial vaginosis or thrush. It’s also possible that you have a urinary tract infection (UTI), which can cause a strong urine odor, especially if you are drinking lots of fluids to rehydrate.
The poop you excrete can also give off an aroma, and some women notice a stronger scent during or immediately after sexual intercourse. This is often caused by the interaction between semen and vaginal fluid, but can also be a result of certain types of lubricants or condoms, says Dr. Jennifer Wider, a nationally known women’s health expert. Try using a different lubricant or switching to an unscented version if this happens.
If you’re noticing a fishy or putrid odor that is accompanied by a burning sensation in your vulva, it’s likely caused by a tampon or tampon pieces stuck inside of your vagina, says ob-gyn Alyssa Dweck. This is called “tampon stink” and can be easily remedied by calling your gynecologist for help.
A strong or foul smell can also be a sign of pelvic inflammatory disease, which can affect the entire area around your vulva and lower abdomen. This condition may look like cystitis or a UTI and can be painful if left untreated.
Vaginal pain
Pain in or around the vulva can be caused by many things. It may be a sign of an infection from yeast or bacteria, an injury to the area, or health conditions such as menopause or fibrocystic breasts. It can also be caused by sexually transmitted diseases (STDs), which include gonorrhoea, chlamydia and herpes. Infections from STIs, especially if untreated, can cause permanent damage to the pelvic floor and lead to infertility.
Girls who have a sore vulva should see their doctor or nurse. They will ask about their medical and sexual history and give a pelvic exam. They might take a sample of the fluid in the vagina (called vulvar secretions) to test for an infection. Some at-home tests are available that can detect infections, but they cannot detect all causes of vulva pain.
The doctor will ask the girl how the pain feels and where it is. If the pain is constant, it’s called generalized vulvodynia. It can flare up when the vulva is touched, and it can be triggered by certain activities, like inserting a tampon or having sex. It might also be a sign of a condition such as endometriosis.
Yeast infections often have a burning or itchy sensation and can also cause vaginal pain. Girls who experience these symptoms should see their doctor, as they need treatment to prevent an infection from spreading.
Bartholin’s glands are on either side of the entrance to the vulva and help lubricate it. When one of these glands becomes blocked, it can lead to a cyst that looks like a boil and hurts. Girls who experience a cyst should see their doctor, as they might need antibiotics to treat the infection.
A recurrent boil can be a sign of an STI such as herpes, but it can also be caused by stress and hormonal changes. Girls who have a boil should not try to squeeze or pop it themselves, as this can lead to a more serious infection. Instead, they should apply a warm washcloth to the area three or four times a day to encourage drainage. They can also have a doctor collect a sample of the drainage for testing.
Menstrual problems
A girl’s menstrual cycle is how her body prepares for pregnancy each month. She may experience pain, spotting and heavy bleeding. It’s important to track her menstrual cycle and discuss any problems with her health care provider.
Menstrual disorders can range from having no periods at all to extremely heavy and long periods. Girls who have abnormal periods should see their gynecologist. They will ask for a complete medical history, including any family members with women’s health issues. The doctor will also do a pelvic exam and Pap smear to check for signs of uterine abnormalities.
Heavy menstrual bleeding is called dysmenorrhea and is a sign of uterine problems, such as fibroids and endometriosis. It may be accompanied by cramps and abdominal pain. A lumpy, pink discharge with a foul odor is another sign of a problem. A clot more than a quarter of an inch in diameter is also a sign of a serious condition.
Irregular periods are common in adolescence, but if they happen more than 35 days apart and have other symptoms, a health care provider should be consulted. The gynecologist will do an exam and a Pap smear, and may order an ultrasound or magnetic resonance imaging (MRI) to check for any abnormalities.
Normal vaginal discharge is white, off-white or pale yellow and usually has a mild odor. It is healthy and helps clean the vulva, but if it has an offensive odor, is thick or a dark color, it’s a sign of infection and should be evaluated by a health care provider.
Girls should always use a pad or tampon during their period and change it every four to six hours. It is important to avoid scented pads or tampons because they may irritate the vulva. Girls should wash with warm water, but not soap, because it may damage the vulva’s natural bacteria. A health care provider may recommend a special cleanser that will help remove bacteria and clean the vulva without irritating it. A gynecologist may also recommend over-the-counter pain relievers, such as ibuprofen or naproxen, to control the pain and bleeding.