I’ll bet you’ve never uttered those words out loud at a party. As a gynecologist though, it is a question that I hear frequently.
Doc, do they look normal down there?Of all of the body parts that people can be self-conscious about, the vaginal labia are definitely one. Patients ask me if they are even on both sides, if they are too bumpy, too wide, and especially if they are too long. Well, I want to give you some references to compare. I also want you to know when there may be a problem from an infection standpoint, and when labia could benefit from surgical revision or labioplasty. Let’s begin with anatomy.
Vaginal/Vulvar Anatomy ExplainedThe outer thicker lips are pictured above as the “labium majus,” also known as the labia majora. The inner, thinner lips that are closer to the opening of the vagina are the “labium minus”, also known as the labia minora. The ones that women often ask me about are the labia minora, or the thin inner lips. Sometimes the concern is their appearance, and sometimes the concern is how they feel, either to touch or while sitting.
Let’s compare labia lengthI first saw this article from the Huffington Post in 2014. I was so happy to see women’s differences on display, that I think I tweeted this picture. Needless to say, it got NO love. And not that I am racking up the twitter impressions now, but at least I know my audience when it comes to displaying a large wall of vulva. As you can see, the differences in just this sample of the hundreds of vulva (which is the best way to characterize the external genital region) are clear.
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What are signs of labial problems?
Size/Length ProblemsNow that we all know that appearances can differ substantially, there are times when the labia can be “too long.” One key sign that your labia may benefit from evaluation is if you have pain or discomfort. Some women have difficulty wearing form-fitting jeans. Some can’t ride bikes or take spin classes. Others have challenges with tucking into swimsuits. We call this labial hypertrophy.
Why does labial hypertrophy happen?The length of the labia can grow with age. There isn’t always rhyme or reason as to why the labia grow and to what degree they grow. It’s not like certain activities or types of foods will make your labia longer. This lipstick shade is everything. Anyway, if your labia are bothering you, I think you should, you guessed it, see your gynecologist. I don’t have a natural remedy for decreasing labia size. That would be like making your actual lips on your face smaller with something topical. Skin and tissues don’t just shrink.
When is surgery an option?Surgical options may be available if they are bothering you. Labioplasty is a procedure that is done under light anesthesia. The labia are trimmed and stitches are placed to close the skin where the length was removed. It is one of the few plastic surgery-like procedures that I do as a gynecologist. My take-home in this post, though, is that I think the procedure is best performed on women who are physically bothered by how their labia feel or fit into clothing. I don’t think that a person should have to conform solely to an aesthetic norm. As we learned from The Great Wall Of Vagina, lots of vulvar appearances are normal.
Suspected InfectionIf you touch the labia and you feel a new bump that doesn’t hurt but is hard, you should look and see if it is an ingown hair vs a blocked oil gland vs a genital wart. Warts can sometimes come in clusters or as single lesions. Usually, the tell-tale sign that you may be dealing with a wart is that it doesn’t hurt, it doesn’t go away and it is hard. If you have a lesion on the labia that does hurt but resolves itself, you may be dealing with a boil, ingrown hair or possibly a herpes outbreak. If you know it isn’t an ingrown hair but it is painful and resolves within some days, I wrote a whole post about Lumps and Bumps and what you can do about them. Click here to check it out.
The Take HomeYour labia are your labia. If they bother you, come to get checked out. If they don’t bother you, leave them alone. They can look however they want. Your vulva-print is just like your fingerprint: Unique. Own them. I don’t think I’ll have mine cast for sculpture any time soon, though. Bucket list?
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Dr. Wendy Goodall McDonald is a board certified OBGYN. She began practicing medicine in 2007 and now uses her extensive knowledge and growing following to increase health awareness in a fun and viral way. She is the founder of The Gyneco-blogic and an author of numerous books for adult and childhood health education and social growth. For more, check me, I mean her out at dreverywoman.com