Understanding Vulvar Health in Nigeria: Self-Examination Practices, Knowledge, Attitude and Disease Prevalence

Background: Vulvar diseases remain underreported and possibly under-recognised in Nigeria due to limited awareness, primarily, poor health-seeking behaviour, and absence of structured screening programmes. Vulvar self-examination (VSE) has been proposed as a low-cost method for early detection of vulvar pathology. Objective: To assess the knowledge, attitudes and practices surrounding vulvar self-examination and determine vulvar disease prevalence in a community-based Nigerian cohort. Methods: This cross-sectional observational study was conducted in September 2025 across three centres (two urban and one rural). Women attending a community cervical screening programme were recruited through convenience sampling. Participants completed a survey assessing knowledge, attitudes and practices related to VSE. Clinicians performed vulvar examinations, and detailed findings were recorded. Descriptive and inferential statistics were used. Results: A total of 183 women participated, with only 2.2% of women demonstrating some knowledge of structured VSE. Over 95% admitted they had benefited from the VSE education. The prevalence of vulvar disease was 15.8%, with all conditions being benign. Increasing age, urban residence and longer duration of menopause were significantly associated with higher odds of vulvar disease, though not statistically significant. Conclusion: Knowledge and practice of vulvar structured self-examination are poor among Nigerian women and represent a significant unmet need. Structured education on VSE may facilitate earlier detection of vulvar disease and improve outcomes.