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Labia minora hypertrophy

Authors
Marc R Laufer, MD
Jhansi Reddy, MD
Section Editor
Howard T Sharp, MD
Deputy Editor
Sandy J Falk, MD, FACOG

INTRODUCTION

Girls and women sometimes seek medical and surgical attention due to concerns about the appearance of their external genitalia. One area of concern is the size of the labia minora, although a variation is size is consistent with normal anatomy. Clinical labia minora hypertrophy remains a poorly defined diagnosis. Interest in surgical correction of vulvar appearance may be associated with trends in pubic hair removal, exposure to idealized images of genital anatomy through digital applications or websites, and awareness of cosmetic vulvovaginal surgery [1].

The clinical manifestations, diagnosis, and treatment of hypertrophy of the labia minora will be reviewed here. Congenital anomalies of the reproductive tract and vulvovaginal discomfort syndromes are discussed separately. (See "Diagnosis and management of congenital anomalies of the vagina" and "Congenital cervical anomalies and benign cervical lesions" and "Clinical manifestations and diagnosis of congenital anomalies of the uterus" and "Clinical manifestations and diagnosis of generalized vulvodynia" and "Clinical manifestations and diagnosis of localized vulvar pain syndrome (formerly vulvodynia, vestibulodynia, vulvar vestibulitis, or focal vulvitis)".)

CLINICAL FEATURES

Labia minora hypertrophy is a largely subjective condition. This issue is usually brought to medical attention due to vulvar discomfort, functional symptoms (interference with activities), or concern about vulvar appearance. Discussion with the patient about symptoms and a physical examination help to guide management.

Medical history

Symptoms — Hypertrophy of one or both labia minora can result in irritation, chronic infection, poor hygiene, or pain. In addition, the patient may complain that the labia interfere with activities including walking or sitting, sexual activity, and/or sports (eg, running, cycling, horseback riding, or swimming). A woman may describe discomfort with the fact that there is a "bulge" in her underwear. She may report that she needs to "fold up" her labia and push them into the vagina to reduce the bulge.

Concerns about the appearance of the labia minora can result in considerable emotional distress [2-7]. Given the physical and emotional changes that accompany puberty, adolescent girls are a particularly vulnerable group. For example, girls may become very self-conscious about the size of the labia if they need to change their clothes in the presence of their peers [2-8]. It is also important to make sure that it is the girl who is distressed, not anyone else (eg, parents, peers, sexual partner).

             

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Literature review current through: Aug 2016. | This topic last updated: Jul 11, 2016.
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