Labial hypertrophy is the enlargement of the labia minora or majora. The labia are folds of skin that protect the clitoris and vaginal opening. Enlargement can occur on one or both sides of the labia, and it is a common condition in young women. This condition can either be congenital or developed over time, and approximately one third of women experience labial hypertrophy. The condition has not been known to cause severe issues but can lead to discomfort and low self-esteem. The most common type of labial hypertrophy is the enlargement of the labia minora. Labial hypertrophy is a natural and harmless irregularity barring any condition that is associated which could lead to discomfort, inflammation or pain.
Labial adhesions occur when both sides of the labia minora are abnormally fused together. Occasionally it will affect the entire length of the labia, or just minor sections, this may interfere with bladder and vaginal emptying. This irregularity affects approximately 2% of young girls, and is usually corrected, either naturally or through treatment, between six years of age and the beginning of puberty.
Most girls do not experience symptoms for labial hypertrophy, or their discomfort is not great. Some girls however, may experience irritation, discomfort or pain in the crotch area or vulva, accompanied by a bulge, when wearing underwear or bathing suits, or tightly fitting clothes, such as tights or skinny pants. This discomfort may extend to the entire crotch causing an increase in pain. Labial hypertrophy may also cause discomfort when engaging in certain physical activities gymnastics, cycling, horseback riding, running, or other activities that can cause rubbing of the genital area. Discomfort may also be experienced when engaging in vaginal intercourse.
If the labial hypertrophy is extreme enough, young women may have visible labia minora that protrude out of the labia majora, which is especially noticeable when upright. It can also cause an increased risk of a chronic yeast infection which may cause increased irritation around the vaginal area.
Although labial adhesions are often painless and show no symptoms, in some cases it can cause discomfort, irritation and pain in the genital area. The symptoms of labial adhesions often include:
- The fusion of the inner labia minora
- Vulval soreness can occur, in some cases it can be chronic, or just after urination
- The trickling of urine may occur after bladder emptying due to the interference if the labia.
- In severe cases of labial adhesions, there may be an inability to pass urine.
- Frequent urinary tract infections.
For most instances of labia hypertrophy, it is unclear what the cause is, however there are circumstances in which the condition is congenital and is present at birth, and some where the condition is caused by manipulation or severe trauma. Although the exact cause if the condition is not known, testing has confirmed that labial hypertrophy is not caused by either masturbation or sexually transmitted infections.
Other causes can include:
- Age: the labium will continue to grow as the woman does, and as time continues the loss of tissue and fat in that area leads to sagging of the labia.
- Childbirth: this can cause stretching, in most cases the labia return to normal, but others the labia can remain enlarged.
- Excessive weight change: an extensive gain in weight can cause enlargement of the labium, and followed by an extreme loss of weight this can lead to labial hypertrophy.
- Labial piercings: Although this is an uncommon cause, the length of the labium can be affected by the weight of labial piercings, as it stretches out the inner folds of the vulva.
Even though it is not very clear as to the major cause, labial adhesions are thought to be caused by irritation to the labia majora accompanied by low levels of estrogen. This can occur as early as 6 to 8 weeks after birth.
Long labia can cause discomfort due to rubbing against underwear or the friction caused by the wearing of pants or the engagement in physical exercise. This could lead to tears in the labial tissue causing infection, inflammation, and pain. Labial Hypertrophy can also cause embarrassment due to the “norm” placed on women’s looks by society, especially in adolescent girls struggling already with the changes of puberty. This condition may also cause discomfort, or pain during vaginal intercourse due to friction increased by labial size.
In most cases, women with labial hypertrophy do not need to have surgery, but may choose to undergo the procedure for cosmetic purposes. The labia can vary in size and shape for all women, however if this variation causes pain or discomfort, surgery for vaginal rejuvenation may be recommended. Labioplasty is a procedure usually performed by a gynecological surgeon in which, one or both of the labia are reshaped to become smaller in size.
If you are curious about this procedure and whether or not it will benefit you, seek advice from your health care provider as this is a very emotional decision to make.
For the treatment of labial adhesions, in most cases they are removed naturally during the onset of puberty, however there are cases in which the adhesions are too severe to be torn naturally. Treatment, including whether or not it is necessary, is recommended depending on the severity of the condition.
- Small or mild adhesions: may be removed naturally when puberty is reached or earlier in cases. These most commonly do not cover the vaginal opening and therefore do not affect normal processes. Treatment may only be recommended if damage occurs, which is rare, or if the condition gets worse.
- Moderate adhesions: for cases that these cannot be removed naturally, a mild ointment that smooths and softens the skin is used in conjunction with gentle separation twice daily for multiple weeks until separation is complete and the labia are unable to fuse back together.
- Significant or severe adhesions: these adhesions that cover the entirety of the vaginal and/or urinary opening cause many issues and need to be treated quickly and effectively. These can be treated with oestrogen-containing cream applied twice a day, for several weeks, or until the labia is separated. This treatment requires a prescription from your health care provider.