Where is the normal limit?
The labia minora vary in length, width, density and pigmentation between women, and one side is almost always slightly larger than the other. There is no medical standard that determines the correct size, so the decision is made not by the ruler, but by the presence of complaints. Conventionally, they speak of hypertrophy when the lips noticeably protrude beyond the lips and create inconvenience. It is important to understand: the appearance formed in adolescence is not a defect and does not affect health, hormones and the ability to have children.
- Sizes and shape are individual
- Slight asymmetry occurs in almost everyone
- Pigmentation changes with age and this is normal
- Diagnosis is based on complaints, not centimeters
- Does not affect fertility or cycle
Reasons
In most cases, we are talking about a congenital feature that becomes noticeable during puberty under the influence of sex hormones. Less commonly, an increase develops later: after childbirth, with significant fluctuations in weight, due to chronic irritation and inflammation, prolonged mechanical exposure, and also after certain hormonal conditions. Separately, cases are considered when a change in shape is accompanied by other signs of excess androgens - then an examination by a gynecologist and endocrinologist is needed.
- Congenital anatomical feature
- Hormonal changes during puberty
- Childbirth and tissue stretching
- Sudden weight loss or gain
- Chronic irritation and inflammation
- Age-related tissue changes
What are the inconveniences?
The complaints are usually everyday, but significantly reduce the quality of life. The protruding tissue rubs when walking, running, cycling and working out at the gym, causing redness, chafing and soreness. Wearing tight-fitting clothes and a swimsuit causes discomfort and a feeling of awkwardness. Hygiene becomes more difficult, irritation and diaper rash are more common. Some women report pain or discomfort during sexual intercourse, as well as psychological discomfort that affects relationships and self-esteem.
- Chafing when walking and playing sports
- Irritation and diaper rash
- Discomfort in tight-fitting clothing
- Difficulties with hygiene
- Unpleasant sensations during sexual intercourse
- Psychological discomfort
Diagnostics and preparation
Special studies are not needed to make a diagnosis: the gynecologist examines the external genitalia, assesses symmetry, the condition of the skin and mucous membranes, and excludes diseases that can cause similar changes - lichen sclerosus, cysts, condylomas, swelling due to inflammation. Be sure to discuss what exactly worries the woman and what results she expects. If a decision is made about surgery, a smear for flora and a standard preoperative examination are prescribed, and the time of intervention outside of menstruation is selected.
- Examination by a gynecologist
- Exclusion of skin diseases of the vulva
- Flora smear
- Standard preoperative examination
- Discussion of expectations and possible results
Treatment and recovery
If there are no complaints, no treatment is required - loose cotton underwear and careful hygiene are enough. If there are real inconveniences, labiaplasty is performed: excess tissue is excised, forming a natural edge, often under local anesthesia. Various techniques are used, including laser ones, the choice depends on the anatomy. The sutures are usually dissolvable. In the first days, swelling and moderate pain are possible; sexual activity, sports, swimming pool and tight underwear are excluded for 3-4 weeks. Sensitivity is preserved with proper technique. The operation is not performed on adolescents until tissue formation is complete.
- Observation and selection of linen in the absence of complaints
- Labiaplasty for medical and aesthetic reasons
- Local anesthesia, outpatient setting
- Absorbable sutures
- Limiting exercise and sexual activity for 3–4 weeks
- Hygiene and treatment as prescribed by a doctor
- Refusal of intervention during adolescence