Labial hypertrophy

The labia minora vary in length, shape and colour, and the differences can be considerable. We speak of hypertrophy when the size starts to interfere with everyday activities, not when it differs from an idea of how they should look.

The structure of the vulva

The labia majora cover the area from the outside. The labia minora lie beneath them and protect the vestibule of the vagina and the opening of the urethra. These are sometimes called the inner lips.

Their size is different in every woman and changes over the course of life. Asymmetry, meaning a difference between the left and right side, is very common, as with other paired body parts. On its own, it is not a defect.

Where hypertrophy comes from

Most often it is an individual trait, visible from puberty onwards. Hormonal changes, childbirth and the passage of time play a role, and sometimes injuries or previous treatments in this area.

No one is at fault here, and there is no way to prevent it. This is one of the reasons why it is worth talking about hypertrophy without feeling that something has been neglected.

When hypertrophy becomes a problem

The criterion is functional. What matters is whether the labia cause discomfort, not how they look in a photo.

The most commonly reported issues are chafing and irritation when walking, running and cycling, discomfort in fitted clothing, difficulty with hygiene, recurrent infections, pain during intercourse and twisting of the labia, which can be troublesome during the day.

As long as none of this occurs, hypertrophy does not require treatment. Appearance alone is not a medical indication, although it can be a reason why a woman comes for a consultation, and that is fine too.

There is no single correct appearance

We do not give measurements that are meant to be the norm, because no such norm exists. Images circulating online show a narrow slice of variation, often further retouched, and are a poor point of reference.

The decision about the treatment belongs to the patient and is made after a conversation with the doctor, following an examination and discussion of what specifically causes discomfort.

What can be done

The correction is performed surgically. The treatment is called labiaplasty and involves reducing, shortening or evening out the labia minora. It is carried out by a gynaecologist, under local anaesthetic, and the return to full activity takes a few days, depending on the extent.

We describe the course, preparation and healing separately, on the labiaplasty page. The qualification is preceded by an examination, and the doctor may advise against the treatment.

When to see a doctor first

Pain, itching, burning, a change in skin colour, a palpable lump, bleeding outside menstruation and recurrent infections require a gynaecological assessment regardless of the size of the labia. The cause can be something other than hypertrophy, and the diagnosis changes the course of action.