Vulvar Itch, Lump or Sore That Won't Go Away: When to Get It Checked

Vulvar itching is common after menopause. Thinning tissue, skin conditions, irritation from products and yeast are frequent causes. Our guide to why the vulva itches covers those. Many women keep trying creams for months without being examined. That’s worth changing, because the main warning signs of vulvar cancer overlap with everyday itching.

Signs to get checked

The National Cancer Institute (NCI)¹ lists these signs:¹

• Itching that doesn’t go away
• A lump or growth that looks like a wart or an open sore
• Bleeding that isn’t from a period
• Pain in the vulvar area

Vulvar cancer often causes no early symptoms, and these signs can come from other conditions.¹ The only way to know is an exam.

Who is at higher risk

Risk factors include:²

• older age
• high-risk HPV infection, which causes about half of vulvar cancers³
• vulvar intraepithelial neoplasia (VIN), a precancerous change
• a history of genital warts or abnormal Pap tests

Vulvar cancer usually develops slowly over years, most often on the vaginal lips or the sides of the vaginal opening.³ That slow pace means checking a persistent change can catch it early.

Your checklist

1. Look. Use a hand mirror once a month to get to know how your vulva normally looks. Our guide to skin self-exams has tips.
2. Note changes: color, white or thickened patches, lumps, sores or bleeding.
3. Give treatment a fair trial, then go back if it isn’t working. Don’t keep refilling creams without an exam.
4. Ask for a close look at the vulva, not just a Pap test.
5. Ask whether a biopsy is needed for any spot that doesn’t heal.

Precancerous changes and early cancer are usually treated with surgery to remove the area.⁴ Our guides to vulvar biopsy aftercare, VIN results, vulvoscopy and lichen sclerosus explain related tests and conditions.

Try: “I’ve had itching on one side of my vulva for three months, and two creams haven’t helped. Could you examine the area closely and tell me whether a biopsy makes sense?”

Down There, Decoded includes a Down-There Log and a See script for appointments. Use them to note what you see, how long it’s lasted and what you’ve tried. Explore the intimate-health playbook.