Protruding labia minora: abnormal or just uncool?

Abstract

There is a wide variety in the appearance of normal female external genitalia. Nevertheless a specific prototype is promoted by the media, leading to a false sense that all other appearances are abnormal. As adolescents become sexually aware at an earlier age, most of them are worried about the appearance of their genitalia, especially when labia minora protrude beyond labia majora.

This is a prospective audit of adolescents presenting for assessment of their perceived abnormal genitalia. Sixteen girls aged 10.2 to 17.8 years presented between June 2009 and December 2010 to a specialist adolescent gynecology service. Their mean labial width was 36 mm (range: 20–55 mm). In six girls, the reason for attending the service was inequality of the size of labia ranging between 6 mm and 35 mm (mean of 20 mm). Among the remaining 10 girls, the concern had arisen through comparison with a prepubescent sibling (one case), change of genitalia during puberty (four cases), looking at internet pictures (four cases), and looking at an anatomy book (one case).

Risks of Female Genital Cosmetic Surgery (FGCS) have not been adequately documented, especially with regards to sexual function and long-term patient satisfaction. External genitalia are likely to change during puberty and therefore, any genital operation in the absence of clear pathology should be deferred until adulthood. Even then, women should have clear expectations of what will be achieved with the operation in terms of appearance and function.

Keywords::

• Labia minora
• labioplasty
• adolescent gynecology
• body image
• sexual education

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Current knowledge on this subject

• Female Genital Cosmetic Surgery (FGCS) is becoming more popular.

• It is an unregulated area of medicine.

• There is limited evidence with regards to long-term risks and satisfaction.

What this study adds

• Adolescent girls may not be aware of the wide variation of female external genitalia.

• Information on normal appearance is skewed by information provided by members of the family and possibly the internet.