ALTHOUGH we all have genitals, they are mostly hidden away.
But it’s important to get to know your sex organs because they influence your life – sometimes negatively.
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They not only allow us to have sex, but a woman’s genitals have a key role in pregnancy, childbirth, hormone production and menstruation.
Meanwhile, men’s genitals also produce hormones and allow men to have children.
So, it’s worth making sure they’re healthy.
Dr Susanna Unsworth, women’s health expert for INTIMINA explains that genitals come in all shapes and sizes, with a big range of ‘normal’.
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“However, there are changes that can arise that may indicate underlying problems, so it is important to examine yourself, to learn what is normal for you, so that you can then identify any new changes,” she says.
Speaking of the female genitals, Dr Unsworth says: “The vagina is the internal part of the genitalia, as opposed to the vulva, which is the external part.
“Most of the time it is abnormalities in the vulva that you will be able to spot.
“I often encourage women to get to know what their vulva looks, and feels like. Using a mirror can help.
“Once you have become familiar with things, setting yourself a reminder to examine yourself around once a month is sensible.”
As for male genitals, regular checks for lumps, bumps and changes is also wise.
Not sure what’s normal and what’s not? Here’s when to worry and seek help…
All about size
Penis size, clitoris size, labia size…many of us are worried about size.
“The good news about the clitoris, is that its size doesn’t matter in the slightest: there is no limit to the level of pleasure a woman can have with her clitoris regardless of how big or small it is,” says Marie Morice, clinical sexologist and founder of Lilith your Life.
“And the same goes for male genitals; the average size of an erect penis is the length of a small iPhone (13cm or 5.2in, not the larger 15.4cm or 6in).”
As for your labia ladies, don’t worry if there’s some difference in sizing down there.
According to Marie, the inner lips, also known as the labia minora, “are extremely sexually reactive with erectile tissue that can triple in size and deepen in colour when a woman is aroused”.
In fact, the labia minora can be between 0.25in and 2in wide and between 0.75in and 4in long.
“Labiaplasty – surgery in which the size of the inner lips is reduced – is becoming increasingly common,” explains Marie.
“The sex expert community attributes it to a direct result of unrealistic porn images of women’s inner lips; women in porn are often chosen for having especially small and symmetrical inner lips.”
However, she adds that the labia minora are usually asymmetrical, with one of the lips sometimes being double the size of the other.
For men, if you find that one testicle is bigger than the other, don’t panic.
According to the NHS, it’s common for one testicle to hang lower than the other and also common for one to be slightly bigger or smaller.
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Painful peeing and discharge
It shouldn’t hurt when you pee, but if you feel a burning sensation while peeing, it might be due to a urinary tract infection (UTI), kidney stones or inflammation of the prostate in men, according to Asda Online Doctor, Dr Kathryn Basford.
“It can also be a sign of a sexually transmitted infection (STI),” she says.
“As well as painful urination, STIs like gonorrhoea and chlamydia can cause discharge with an unusual smell or colour.
“For example, gonorrhoea causes yellow or green discharge while chlamydia causes white, watery or cloudy discharge.”
Although a slight odour is normal, if your discharge has a consistently strong scent, it’s best to get checked.
Normal discharge tends to be clear or a little milky, so if you are concerned, visit your GP for an STI test or find at-home STI tests online.
These are a discreet, easy way to help test for an infection.
Sadly, cancers of the vulva are often diagnosed late, as women fail to report these changes
Dr Susanna Unsworth
Dr Unsworth adds that thrush can also cause a white cottage-cheese discharge that can feel itchy.
“Whilst I am happy for women to self-treat this condition, if it does not respond to one course of treatment, or has any other symptom, I would recommend getting it checked out as there is a very good chance it is not thrush,” she adds.
Dr Unsworth warns that it’s vital to keep tabs on any changes.
“Sadly, cancers of the vulva are often diagnosed late, as women fail to report these changes,” she adds.
“I am always amazed how often any vulval symptom is put down to thrush, often treated repeatedly with over-the-counter treatments that don’t help.”
Symptoms of vulva cancer
Symptoms of vulval cancer can include:
- A persistent itch in the vulva
- Pain, soreness or tenderness in the vulva
- Raised and thickened patches of skin that can be red, white or dark
- A lump or wart-like growth on the vulva
- Bleeding from the vulva or blood-stained vaginal discharge between periods
- An open sore in the vulva
- A burning pain when peeing
- A mole on the vulva that changes shape or colour
See a GP if you notice any changes in the usual appearance of your vulva.
While it’s highly unlikely to be the result of cancer, these changes should be investigated.
Most of those affected by vulval cancer are older women over the age of 65.
Source: NHS
Watch out for lumps
It’s important to check for any new lumps. This is partly by looking, but also feeling, to see if any areas feel different.
For men, ‘normal’ testicles should be lump-free, so if you do feel a lump, get it checked. Although it’s uncommon, a lump could be a sign of testicular cancer.
“The most common lumps to be found are likely to be cysts,” says Dr Unsworth.
Cysts can occur on the penis as well as on female genitals.
“Cysts are sacs of tissue that contain fluid,” the doctor explains.
“Generally, these are unlikely to be of concern, although if they become large or infected, they can cause problems.
“If you find a lump that you think is a cyst, I would advise leaving it alone.
“You can try with a warm bath, or compress to see if it helps, but do not be tempted to burst them as it will likely lead to infection.
“If it has not resolved within a week, I would make an appointment with your GP (sooner if it becomes red, hot or painful).”
How to check yourself
Men should monitor any changes to their testicles, and get anything unusual checked by a GP. This means regular self-examinations!
Doctors often recommend doing this during or right after a warm bath or shower, when the scrotal skin is relaxed.
Hold the scrotum in the palm of your hand and use your fingers and thumb to examine each testicle.
You should check for any lumps and swellings, anything unusual, and any differences between the testicles.
Most men’s testicles are about the same size, but it’s common for one to be slightly bigger than the other, and one to hang a bit lower.
Testicles should feel smooth, without any lumps or bumps, and firm but not hard.
You may feel a soft tube at the back of each testicle, which is called the epididymis. This is usually harmless.
Source: NHS and Macmillan Cancer Support
Genital warts, caused by the human papilloma virus that’s transmitted during sex, can cause lumps too.
“Genital warts often look like small lumps with a bumpy surface that resembles cauliflower,” reveals Dr Unsworth.
“They can be difficult to treat, often removed by freezing or with a liquid-therapy treatment.
“If you do have warts, it can mean you are more likely to have other STIs that may not be causing any symptoms, so it is important to get checked out and treated.”
Genital herpes, another STI, can also cause lumps.
Dr Unsworth adds: “There is no cure for this infection and you can get recurrent flare ups from a previous infection, sometimes from years before.
“There are antiviral treatments that can ease the flare-ups but they do not get rid of the infection.”
What’s that rash?
If you notice skin changes or rashes, a change in colour, dryness or change in surface texture, then this can indicate problems.
For both men and women, inspection is always the first thing to do.
If you shave or wax your pubic hair, then you might be left with a rash.
Dr Unsworth adds: “Shaving or waxing can make you more susceptible to developing sebaceous cysts – these are cysts that form in hair follicles, often if the hair becomes trapped and ingrowing.
“These cysts can be prone to infection.
“They are usually best left alone, although a warm bath/warm compresses can sometimes help.
“Try to avoid breaking them open as this is more likely to introduce infection.
“If they do become infected, they may need antibiotics to treat them.
“Rarely, they may need to be surgically incised and drained.”
A doctor answers four questions you’re too embarrassed to ask
1. What is the difference between a vagina and a vulva?
“Lots of people don’t know the answer to this one, and it’s really important to know what you’ve got,” says Dr Philippa Kaye, a GP and author.
“Everything on the outside, the hairy, fatty lips, the inner lips, the clitoris, everything that’s on the outside, is the vulva.
“And the vagina is the muscular tube on the inside, and it’s got a clue in the name, it’s got the letters ‘I’ and ‘N’ in it, vagina, and it’s inside, everything on the outside is the vulva.
“It’s really important that you know your normal – what your normal vulva looks like – and if anything changes, or you have any concerns, you see your doctor.”
2. Is it normal for the inner lips to stick out?
“Actually yes. You are unique, and so is your vulva. Everybody looks different,” explains Dr Philippa.
“You might notice on the fatty outer lips where there may be hair, that the inner lips protrude outside of that.
“You might notice that one side is longer than the other, all of which is normal. You and your vulva are unique.”
3. Is it normal for a vagina to smell?
“Yes! All vaginas and vulvas have a mild odour,” says Dr Philippa.
“Now if that changes in any way, for example, if it’s associated with a lot of discharge or becomes offensive in smell, then it’s time to see the doctor.
“But it’s normal for there to be a mild odour that may change throughout the month and it does not mean that you’re dirty. It’s completely normal.”
4. What is normal for vaginal discharge?
“It is normal to have some vaginal discharge and that might vary from person to person, but even within the same person, it might vary throughout your menstrual cycle,” says Dr Philippa.
“For example, as you’re coming up to ovulation, you might notice the discharge becomes thinner and more watery, and as you come up to your period, it might become more sticky and thick.
“If you notice any changes to what your normal is, for example, if it becomes offensive in smell, if you have much more than normal, changes colour or it’s blood stained, then please see your doctor.
“If you’re at all worried about your sexual health, speak to your GP – don’t be embarrassed, they’re there to help and will not be phased.
“You can always request a female doctor or nurse, and take someone with you if you feel uncomfortable.”
She adds: “Eczema of the vulva or in the groin is also common.
“This can look dry and flaky, and is often itchy.
“Sometimes this can become infected with bacteria or fungus and can be red and sore.
“Moisturising with emollients helps, but it may need steroid cream treatment, or antibacterial/antifungal treatment too.
“So, if it does not settle quickly you should review with your doctor.”
If you notice white patches around your vulva or anus, then Dr Unsworth says that it could be down to lichen sclerosus, another skin condition.
“This can often cause itching and white patches to appear, and the tissue can be more delicate and prone to splitting,” the doctor adds.
“This is usually treated with steroid creams and emollients – however, this condition can develop into vulval cancer (in females) so it is important to be checked out.”
Check for swelling
Although swelling isn’t ‘normal’, swelling in one or both testicles is common, according to Dr Basford, who adds that this can be caused by an injury, the build-up of fluid or swollen veins.
“While it isn’t always a sign of a serious condition, swelling and pain in the testicles should always be checked by your doctor urgently,” the expert says.
You may also notice swelling on the head of the penis.
This can be painful and there may be a foul-smelling discharge from under the foreskin.
“It is usually caused by poor hygiene in uncircumcised men, causing bacteria to build up, or an infection,” explains Dr Basford.
“It is important to speak to your GP to identify the cause of your symptoms and receive the correct treatment.”
A change in shape
Although you might assume that a man’s penis should be dead straight, Dr Basford says that when erect, a slight curve to the penis is common and nothing to worry about.
“But if the bend is significant or painful, it may be a sign of scar tissue forming inside the penis, known as Peyronie’s disease,” she adds.
“The condition can improve or go away on its own but if it is causing problems with sex, speak to your GP.”
Foreskin problems
Men: There shouldn’t be pain around your foreskin, and you shouldn’t feel pain when moving your foreskin either.
However, Dr Basford says that difficulty pulling back the foreskin could be due to phimosis, a condition of the penis.
“This can be treated by using steroid creams to loosen the foreskin or getting circumcised,” the doctor adds.
“A more serious condition is paraphimosis, where the foreskin can’t be pulled back over the tip of the penis, causing bruising, swelling and issues with peeing.
“If you experience this, see a healthcare professional immediately for treatment.”
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