Everyone has different facial features, body types, and coloring. There are also differences in female external genitalia, known as the vulva.

The vulva contains two sets of skin folds, or lips. The large outer folds are called the labia majora. The smaller, inner folds are the labia minora.

In most women, the labia aren’t symmetrical. It’s not at all unusual for one side to be larger, thicker, or longer than the other. There’s a wide spectrum of shapes and sizes as well.

The term “labia majora hypertrophy” refers to labia majora that are enlarged. Likewise, the term “labia minora hypertrophy” describes the labia minora that are larger or stick out more than the labia majora.

Either way, labial hypertrophy doesn’t mean that you have a medical issue. Most women will never have a problem due to the size or shape of their labia.

If you have mild labial hypertrophy, you may not notice it. Labia minora, however, are much more sensitive than the protective labia majora. That’s why enlarged labia minora can cause a few difficulties. Labial hypertrophy can cause a noticeable bulge in your clothing, especially when you’re wearing a bathing suit.

Other symptoms of labial minora hypertrophy include:

Hygiene problems

If the area is overly sensitive, you may be inclined to avoid touching it. It can also be trickier to clean between the folds of skin, particularly during your period. This may lead to chronic infections.

Irritation

Long labia can rub on your underwear. Prolonged friction can lead to rough, irritated skin that’s very sensitive.

Pain and discomfort

Enlarged labia can hurt during physical activities, especially those that put pressure on the genital area. A few examples are horseback riding and bike riding.

Pain and discomfort can also occur during sexual foreplay or intercourse.

Just as one of your legs may be slightly longer than the other, your labia probably don’t match exactly. There’s no such thing as a correct size or shape for labia.

Exactly why the labia to grow bigger isn’t always clear. Causes may include the following:

  • Due to genetics, your labia may have been that way since birth.
  • As estrogen and other female hormones increase during puberty, many changes take place, including growth of the labia minora.
  • During pregnancy, increased blood flow to the genital area can increase pressure and lead to a feeling of heaviness.

In some cases, labial hypertrophy may occur due to infection or trauma to the area.

There’s no special test to determine if you have labial hypertrophy. If your labia minora extend beyond your labia majora, your doctor may diagnose it as labial hypertrophy upon physical examination. There isn’t an exact measurement that defines whether the labia are hypertrophied or not, as the diagnosis is generally made based on a physical exam and individual’s symptoms.

When labial hypertrophy isn’t causing a problem, you don’t need treatment. It’s not harmful to your overall health.

If labial hypertrophy interferes with your life and your ability to enjoy physical activities or sexual relations, see your OB-GYN. It’s worth getting a professional opinion.

Your doctor may recommend a surgery called a labioplasty for severe labial hypertrophy. During a labioplasty, a surgeon removes excess tissue. They can reduce the size of the labia and reshape it. This surgery usually requires general anesthesia, although it can sometimes be done with sedation and a local anesthetic.

As with any major surgery, there are a few risks, including:

  • a reaction to the anesthesia
  • infection
  • bleeding
  • scarring

After the surgery, you may have swelling, bruising, and tenderness for a few weeks. During that time, you’ll need to keep the area clean and dry. You should also wear loose clothing and avoid activities that cause friction in the genital area.

The number of labioplasties performed in the United States is growing. In 2013, over 5,000 were performed, a 44 percent increase over the year before. The surgery can provide relief for women who experience pain and discomfort from labial hypertrophy.

Some women choose the surgery for purely cosmetic reasons. When considering labioplasty as a cosmetic procedure, discuss your expectations with your doctor.

In teenagers

Some teenagers may worry about their bodies changing and wonder if those changes are normal. The American College of Obstetricians and Gynecologists recommends that doctors educate and reassure teens about normal variation in anatomy.

Labioplasty can be performed on teenagers, but doctors generally advise waiting until after puberty. This is to ensure the labia are no longer growing. Those wishing to have the surgery should also be assessed for maturity and emotional readiness.

You should be fully healed within a month or two following labioplasty. Your doctor will give you specific instructions about when you can resume normal activities, such as intercourse and vigorous exercise.

The scars usually fade over time, and results are generally positive. In some cases, the surgery can leave permanent scarring or cause chronic vulvar pain or painful intercourse.

Cosmetic results vary. It’s a matter of personal perspective.

Surgery is a big step and not always necessary for labial hypertrophy. Follow these tips to minimize irritation:

  • When bathing or showering, use only mild soap that contains no coloring, scents, or chemicals, and make sure to rinse thoroughly with water.
  • Avoid wearing underwear that rubs your labia or is too tight. Choose loose-fitting, breathable materials, such as cotton.
  • Avoid wearing tight pants, leggings, and hosiery.
  • Wear loose-fitting pants or shorts. Dresses and skirts may be more comfortable on some days.
  • Choose sanitary pads and tampons that are unscented and contain no chemicals or additives.
  • Before exercising, carefully position the labia where they will be most comfortable. This may also be helpful when wearing certain clothing, such as a bathing suit.

Ask your doctor if there are any over-the-counter or prescription-strength topical ointments you can use to soothe irritation. Your doctor may also suggest other ways to manage symptoms of labial hypertrophy.