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Normal Variations

When performing an assessment of the female genital tract, it is essential not just to understand the appearance of the normal anatomy, but also the normal variations of this anatomy that may occur. When these normal variations are identified, they may sometimes require treatment to improve quality of life, and this eChapter identifies and describes the most common normal variations of the female genital tract, provides criteria for diagnosis and outlines the preferred treatment of these variations.

In the first section of the eChapter, the author describes four normal variations of the vulva. The first, Fordyce spots require no treatment but may generate confusion during the diagnostic phase for the inexperienced clinician. The second, the large labia majora rarely requires treatment, but women in which it is manifest may request surgical reduction for cosmetic reasons, or because the anatomy causes discomfort whilst walking. Vestibular papillomas once again are a normal variation to the anatomy, but the ability to distinguish them is crucial as they can be mistaken for genital warts and treated inappropriately. Finally, labial adhesions in infancy are discussed.

The next section focuses on normal variations of the vagina and describes two common findings. The first is normal physiological discharge, and although treatment is not normally required, the importance of excluding more sinister causes is emphasised by the author. The second is a comprehensive examination of estrogen deficiency, and photographs are used to show it’s atrophic effects on the vagina. Management options such as estogen replacement are discussed, and the author emphasises the importance of considering the inclusion of psychosexual counselling as an important contribution to the treatment program.

This eChapter forms part of the Ausmed publication The Vulva and Vaginal Manual, edited by Graeme Dennerstein, James Scurry, John Brenan, David Allen and Maria-Grazia Marin. A richly illustrated and comprehensive guide to the identification and treatment of over 275 vulvovaginal diseases The Vulva and Vaginal Manual is an invaluable resource especially suitable for:

  • Gynecologists
  • Dermatologists
  • General Practitioners
  • Obstetricians
  • Midwives
  • General nurses
  • Practice nurses
  • Nurse Practitioners

There are also 14 additional eChapters from The Vulva and Vaginal Manual available for members to download from the Ausmed website. Subscription also entitles members to access the full range of resources that compliment and build upon the material described within The Vulva and Vaginal Manual, including a richly populated catalogue of Audio Lectures, Fast Facts and Video Learning Activities on the topics of gynecology, obstetrics, oncology, women’s health and a wide range of other healthcare topics. Both members and non-subscribers alike may also purchase a hard copy of this book of from the Ausmed Education Online Bookstore, along with hard copies of the complimentary publication Gynecological Cancer Care: A Guide to Practice.

Contents include

  • Fordyce spots, oversized labia minora and vestibular papillomatosis
  • Labial adhesions in infancy
  • The effect of estrogen deficiency on the vaginal epithelium
  • Vaginal discharges
  • Clinical features, diagnosis and treatment of normal variations of the vulva and vagina
  • Illustrative photographs of all normal variations discussed in the eChapter.
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Author / Editor Biographies

John Brenan is a dermatologist practicing in Melbourne. He is a past President of the Australian College of Dermatology, consultant dermatologist to the Mercy Hospital for Women and the original dermatologist for the Dermogynaecology Clinic.
David Allen is a certified gynaecological oncologist practicing at the Mercy Hospital for Women and the Peter MacCallum Cancer Centre, East Melbourne. He is an Associate Professor in the Department of Surgery at the University of Melbourne.
James Scurry is one of Australia's leading gynaecological pathologists. He is a pathologist in Newcastle, New South Wales.
Dr Dennerstein is an Obstetrician and Gynaecologist with medical expertise in the health of the vulva and vagina. He is the former Head of the Dermo-gynaecology Clinic at The Mercy Hospital for Women and co-author of the book entitled: The Vulva and Vagina Manual. He has lectured extensively on this topic, both internationally and nationally. Graeme has extensive experience in family planning and reproductive health. In 1971 he established the Family Planning and Infertility Clinic at the Western General Hospital in Melbourne, serving as its director until 1986. From 1980 to 1989 he was the ...
Grazia Marin is a psychologist in private practice in Melbourne and past committee member and Education Officer of the Victorian Psychosexual Society. She is also a member of the International Society for the Study of Vulvovaginal Diseases and is serving on its Patient Education and Sexual Difficulties committees.

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