Medically reviewed by Professor Isaac Manyonda, Consultant Obstetrician & Gynaecologist for The Harley Medical Group 

Every part of the human body is unique, and it’s no different when it comes to female genitalia. The external area, known as the ‘vulva’, includes two sets of skin folds, or ‘lips’. The large outer folds are called the ‘labia majora’ and the smaller, inner folds are referred to as the ‘labia minora’. 

Put simply, the labia are fat pads designed to protect a woman's clitoris and vagina from trauma. Often they aren’t symmetrical. Just like any other body part, there’s a broad spectrum of shapes, sizes, and skin tones. And it’s quite common for one to be longer or thicker than the other.

female genitalia anatomy

What is labial hypertrophy?

The term ‘labia hypertrophy’ can refer to two things. Firstly ‘labia majora hypertrophy’ describes when the outside lips are enlarged. Secondly, ‘labia minora hypertrophy’ is used to describe when the inside lips are larger (or stick out more) than the outside ones.

While the term ‘hypertrophy’ sounds scaryit is not an illness, and enlarged labia are usually purely aesthetic. In terms of appearance, more severe cases may create a noticeable bulge that can be seen through clothing, particularly swimwear. Understandably, this can make some women feel self-conscious. 

There are no standard measurements for the size of labia, or tests to identify ‘big’ labia. If you are concerned about the appearance or feel of your labia, book a physical exam with a doctor or gynaecologist.

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Labial hypertrophy symptoms

While most women don’t experience problems because of the size or shape of their labia, large labia can sometimes cause the following issues:

Irritation, discomfort and pain

Long labia can rub on your underwearwith chafing causing rough, irritated, and itchy skin. The labia minora are more sensitive, so large inner labia can be more uncomfortable than if the outer lips are affected. 

Some women with enlarged labia can feel uncomfortable wearing tight clothing and experience pain during physical activities, especially those that put pressure or friction on the area, e.g. horseback riding and cycling. Foreplay and sex can cause discomfort or pain (dyspareunia). And in severe cases, even sitting and walking can be uncomfortable. 

Hygiene issues 

Excess sensitive skin can be difficult to clean and may therefore become a breeding ground for bacteria, particularly during menstruation. As a result, enlarged labia can sometimes cause odour and infectionssuch as thrush or UTIs. 

confident mature woman

What causes big labia?

There is no definitive cause for labial hypertrophy. For most women, it’s simply aestheticlike having different-sized breasts

Some women are born with asymmetrical, looser vaginal lips, or extra skin tissue. And for others, these things can develop during periods of hormone fluctuations. For example, puberty can be a time when labia minora grow larger. During pregnancy, increased blood flow to the genital area can affect the labia by increasing pressure, while childbirth may cause them to become distended. 

Labial hypertrophy also occurs with age, as the skin loses its elasticity. After menopause, the level of female hormones (oestrogen and progesterone) declines because ovarian function ceases. This causes the skin to sagincluding the labia, which can become thinner and looser. 

Labial hypertrophy can occur due to infection or trauma to the area. However, it is not caused by masturbation and is not a sexually transmitted infection.

Treatments

In most cases, labia hypertrophy does not require treatment, it’s simply an aesthetic difference like any other. But for those women who experience discomfort, some very simple changes can eliminate their symptoms. 

Avoiding harsh hygiene products

Irritation can be reduced by using a hypoallergenic soap that is free from harsh chemicals and perfumes, as well as ensuring you only use unscented tampons and sanitary towels. Wearing loose-fitting underwear and clothing may also help prevent unnecessary frictionwith natural materials (such as cotton or linen) improving airflow.  

Cushioning the area

Another simple fix is wearing a protective pad or using a cushioned seat when doing physical activities like cycling. You may want to carefully position the labia where they will be most comfortable before you exercise. This technique may also help when wearing clothing that could make you feel more self-conscious, e.g. a swimming costume or bikini. 

Topical creams and ointments

It’s worth visiting your doctor to discuss any symptoms, as they may be able to offer some solutions (e.g. a topical ointment to relieve irritation). 

Cosmetic surgery

Unfortunately, simple lifestyle changes aren’t enough to help some women experiencing the physical symptoms of enlarged labia. Equally, others may feel that they are suffering from ‘large labia anxiety’ because of how the area looks. If labia hypertrophy is affecting your life by impacting your physical or mental health, you may wish to consider labia reduction with one of our experienced surgeons.

Cosmetic surgery carries risks like all medical procedures. It should therefore be undertaken by consenting, informed adults for the right reasons. Our practitioners will always discuss exactly what will happen during each procedure and answer any questions you may have, so you can make the right choice for your body. 

Labiaplasty

Labia reduction surgery or ‘labioplasty’ is a procedure that alters the size of the labia minora (inner lips) and takes around an hour to complete.

During this time, your cosmetic surgeon makes small incisions to reduce or correct the shape. As the incisions made during labiaplasty are small, they should heal quickly and not be very noticeable.

It’s recommended that you book a week off work for labioplasty surgery and abstain from sex until you are fully healed. This should take around three to four weeks.

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labioplasty

Labiaplasty before and after

 

female gynaecologist

When to see a doctor

When labial hypertrophy isn’t causing a problem, you don’t need treatment as it’s not harmful to your overall health. However, if it’s interfering with your ability to enjoy physical activitiesor the appearance is causing you distressyou may want to book an appointment to see your doctor or gynaecologist. 

It’s important to keep an eye out for any changes in your body, including the labia. While the labia minora can swell during sex, contact your doctor if they do not return to normal size soon after. 

Another problem affecting the labia is Bartholin gland cysts. The Bartholin glands are located close to the opening of the vagina and their job is to provide lubrication.  When they get blocked this can cause a cyst or abscess. As with any lump, it’s important to book an appointment to see your GP if you discover one in the vulva area. 

If you’re concerned about your labia for any reason, or you notice any changes, always speak to a doctor.

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Key takeaways 

  • Labial hypertrophy (enlarged vaginal lips) is common amongst women, its likelihood increasing with age
  • Some women are born with naturally large outer labiaor protruding, large inner labia. However, most find that it’s triggered by factors such as puberty, pregnancy, childbirth, menopause, illness, medications, and ageing.
  • In most cases, it doesn’t cause any problems. However, some women may find that it affects their day to day life and self-confidence 

There are some very simple, effective ways to improve comfort outlined abovebut labia reduction surgery may be considered where there is a major impact on physical or mental wellbeing.

FAQs

Labial hypertrophy is a common occurrence amongst women, particularly as they age. It doesn't usually pose any health risks or discomfort, although some women find that it makes them self-conscious about their appearance. Others report irritation and pain, as well as increased yeast infections and UTIs.

Not for all women, but some find that it’s difficult to effectively clean the skin foldsparticularly during their period. The resulting bacteria may lead to yeast infections such as thrush.  

There isn’t a great deal of research on how labia hypertrophy may impact the chance of developing recurring UTIs. However, a study in the International Urogynecology Journal concludes that “although there are many causes of recurrent urinary tract infections [...] vaginal pH imbalance and labia minora anatomy [...] were among the most important causes”.

It’s possible that the extra skin may be more difficult to keep clean and therefore provide a breeding ground for bacteria that can cause water infections.

While the labia minora may swell due to sexual arousal, they should return to their original size soon after. However, changes that occur with age or a significant event (like puberty, pregnancy, or menopause) are usually permanent. Luckily, most cases of labial hypertrophy don’t cause a problem and if they do, there is a range of treatments available to help.

As with any cosmetic surgery procedure, there are risks associated with undergoing labial reduction surgery including:

  • Pain/discomfort
  • Bruising/swelling
  • Haemetoma/bleeding
  • Infection
  • Delayed healing
  • Allergic reactions
  • Long term sensitivity changes
  • Adverse scar healing
  • Asymmetry
  • Necrosis
  • Potential revision surgery

The decision to go ahead with labiaplasty must be taken with great care, since what has been removed cannot be restored. This is why your surgeon will stipulate a minimum 2 week cooling off period.

The end result of labiaplasty depends to some extent on what was present before surgery: it is often not possible to replicate what a patient may see on the internet.

 

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