Like facial features and skin color, the physical appearance of the vagina varies from one person to the next. Contrary to popular belief, there’s no “standard” or “normal” aesthetics. However, some women have distinct differences they might want to address.

Labial hypertrophy is a common condition that refers to the size of the labia or vaginal lips. It’s a term that describes noticeable vaginal asymmetry. While the labia aren’t perfectly symmetrical in most women, hypertrophy is when one or both lips are more prominent than usual. This form of hypertrophy is usually not a serious issue. 

The Labia

The labia are fleshy folds of skin surrounding the vaginal opening. They are commonly referred to as the vaginal lips. The labia protect the vagina and urethra using the labia majora (outer labia) and labia minora (inner labia) layers. While it’s fairly common for the labia to change shape and size over the years, there are some situations where dramatic changes in the size and appearance of the labia can cause everything from self-consciousness to increased risk for infection. Understanding the risks associated with changes to the labia is important for maintaining sexual health and wellness!

Labia Minora Hypertrophy

Considered the inner labia, the labia minora are the folds closest to the vagina. They extend from the clitoris to the vaginal opening. This design helps to protect the openings of the vagina and urethra from harmful bacteria by enveloping them in flesh. It’s common for women to feel dissatisfied with the appearance of the labia after noticing enlargement, stretching, or shape changes. These changes are attributed to a condition called labial hypertrophy. In many cases, hypertrophy causes asymmetry because only one side of the labia increases in size. The cause of labial hypertrophy isn’t always clear. While enlargement and asymmetry of the labia are usually considered harmless, these changes can cause pain and discomfort in some cases. Hypertrophy can also increase susceptibility to chronic infections. For this reason, correcting labia hypertrophy can be beneficial for both increasing confidence and preventing health risks.

Labia Majora Hypertrophy

Labia majora refers to the labia folds located on the outside of the vulva. While visible, they are often obscured by pubic hair. Like the labia minora, the majora help to enclose and protect the sexual organs to prevent the entrance of harmful bacteria that could cause infections. However, they also contain important sebaceous and sweat glands that are crucial for producing lubricating secretions.

A condition called hypertrophy creates enlargement of the outer labia. In many cases, women experience enlarged, puffy labia that display noticeable asymmetry. While this condition is generally considered harmless, it can dramatically increase risks for chronic yeast infections for some women. Enlarged labia majora can also create physical discomfort while cycling, horseback riding, and performing other physical activities. It’s also fairly common for hypertrophy to cause a bulge that is visible while wearing underwear, swimsuits, dresses, and fitted pants. This “bulging” effect can result in intense friction that causes rashes and blisters. While not everyone with enlarged labia will experience pain, the truth is that simply being unhappy with the appearance of the most visible and pronounced feature of the sexual organs is often reason enough for women to decide to have hypertrophy corrected.

Symptoms of Labial Hypertrophy

Vaginal aesthetics are a nuanced topic, and symptoms can vary from one woman to the next. That said, most hypertrophy issues are apparent with a brief visual inspection. As a result, it’s often a source of self-consciousness for many women.

Hypertrophy is possible on both the labia minor and the labia majora. However, it’s most likely to change the appearance of the labia minora or inner lips. The tissue becomes noticeably enlarged or thickened. In some cases, the tissue can protrude and create a visible bulge through clothing.

Beyond the cosmetic side of things, hypertrophy can cause severe irritation or discomfort. Tenderness is worse with an enlarged labia minora, as the inner lips are more sensitive than the protective outer lips.

The excess tissue can rub on clothing, leading to sensitivity due to prolonged friction. Meanwhile, the enlarged lips can cause uncomfortable pressure on the genitals during physical exercise or sexual activity.

With extra skin and folds to contend with, some women even suffer from hygiene problems. Hypertrophy often leads to frequent bacterial and yeast infections.

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Causes of Labial Hypertrophy

There are many potential causes for hypertrophied labia. The reason why these physical changes occur is unknown. Like the transformation of breast size and shape, it’s the body’s way of evolving with age and shifts in hormone production.

Many women experience hypertrophy as they get older. The tissue may elongate as estrogen production dips as they approach menopause. The same goes for those going through puberty. Several biological changes occur with hormonal fluctuations, and the growth of the vaginal tissue is one of them.

Pregnancy can cause hypertrophy, too. More blood flow to the vagina sometimes results in enlargement and overall heaviness.

If it’s not a product of biological changes from within, hypertrophy could be down to genetics. It’s not uncommon for women to have enlarged tissue from birth. In those cases, hypertrophy is usually evident long before puberty.

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Labial Hypertrophy Treatment

It’s important to remember that labial aesthetics are entirely subjective. There are no “standards” to compare to or special tests to perform. No official measurements to diagnose a hypertrophied labia exists. Every woman’s vagina is different, and some degree of asymmetry is standard.

Excess tissue is typically not harmful to your overall health or well-being.

That said, there are several options for those who want treatment for discomfort or cosmetic reasons. Doctors will diagnose hypertrophy with nothing more than a physical examination. Again, matters of aesthetics are up to personal preference. While hypertrophy might not be a medical issue, whether or not it’s something worth addressing is between you and your doctor.

The most common way to treat hypertrophy is with labiaplasty. During a labiaplasty, surgeons work to remove excess tissue and achieve the desired look.

There are a couple of different types of labiaplasty procedures. The first is the trim technique. Surgeons utilize a linear cut to reduce the size of the labia while also removing any hyperpigmentation along its edge. The final result is petite tissue with a more youthful shape and color.

The second option is the wedge technique. To remove tissue, surgeons make a triangular keyhole-shaped cut in the center of the labia. The unique incision leaves two cut edges that tighten and shrink the tissue when sutured together. The wedge technique offers a smooth transition to the clitoral hood without altering the natural contours of the labia.

Both labiaplasty procedures can address hypertrophy. The proper course of action depends entirely on the characteristics of the tissue and your needs.

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As a urogynecologist with more than two decades of experience helping women in Los Angeles and the surrounding areas, Dr. Michael Tahery is very familiar with labial hypertrophy and the available treatments. To learn more and go over your options, give Dr. Tahery’s office a call and schedule a consultation.