Few books are devoted exclusively to the vulva. The assumption that vulva skin is like the skin of external body surfaces is wrong. Vulvar tissue has many unique physiological properties and characteristics that differentiate it from the skin and tissue of other body sites. Researchers studying the vulva and clinicians treating patients with vulvar conditions know that there is a paucity of information about the vulva in the medical literature. Consequently, the unique physiology of the vulva, its normal and diseased states, pertinent cultural and hygiene practices that affect vulvar health, and the direction of current investigative research are not widely recognized. This insufficient body of information is responsible for the existing deficiencies in knowledge of the vulva, education and training of physicians about vulvar conditions, and appropriate diagnosis and treatment of vulvar pathology.

We attempt to redress these deficiencies with this new volume, The Vulva, a compilation of up-to-date clinical and research information collected in one comprehensive work. The Vulva was written primarily for medical and scientific audiences to underscore unique aspects of vulvar physiology, to highlight possible ethnic differences, to review vulvar diseases, to alert researchers and clinicians to cultural and hygiene practices that affect vulvar health, and to share the latest techniques in investigative research on vulvar tissue. The Vulva includes chapters on vulvar anatomy, physiology, microbiology, age-related changes, ethnicity, diseases, global cultural and hygiene practices, personal products used on the vulva, and toxicological and bioengineering research methods applied to vulvar research.

The information included in this book presents the current knowledge and understanding of vulvology. Although this work attempts to be a comprehensive and up-to-date resource, we acknowledge that research on the vulva lags behind other fields. Researchers and clinicians who have contributed to this volume hope to promote a better understanding of the unique physiology of the vulva and to encourage needed research.

This book is intended to increase awareness of the unique health concerns of the vulva and to be a valuable resource on the vulva region for the medical and scientific communities.


Many appreciations and thanks are gratefully owed to the many people who contributed knowingly and indirectly to this book.

The following readers generously offered their time and expertise to peer-review relevant chapters: Drs. Kenneth W. Miller, Bruce E. Jones, Mr. John Blevins, Ms. Lisa Lennon, Drs. Tom Osborn, Brian Gray, Ray Warren, Mr. Ron Visscher and Mr. Kevin Johnson. In addition, Ms. Jan Tremaine, Drs. D. A. Hutchins, and T. L. Nusair have assisted with the review of this book. Their collective recommendations have vastly improved the texts assembled here. Many thanks go to the efforts and help of all the contributors of this book.

This book represents the fruits of a jointly conceived and executed venture and has benefited from partners. Many thanks and appreciations go to Drs. Sharon Mitchell and Bruce E. Jones who encouraged and supported the idea for this book from the start. My thanks go to Ms. Lisa Lennon for her help and support of this book. No praise is excessive for her efforts for which she has my heartfelt gratitude. My deepest and most sincere debt is owed to an exceptional person who shepherded the book from start to finish, Dr. Kenneth W. Miller without whose belief, support, help, encouragement, guidance and understanding, this book would not have seen the light of day.

Above all, my everlasting gratitude, thanks and love go to my family, husband and children who supported, helped and encouraged me all the way with their incredible patience. Your continuous care, unconditional love and sacrifice made all this possible, and easier to achieve.

Miranda A. Farage Howard I. Maibach

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