How do you know if your vulva is normal?  This is a question that many women have but don’t want to ask.  We worry about this part of the body and how we measure up to other women.  Everyday someone apologizes to me for not shaving, not showering in the past 2 hours, having a perceived abnormal odor, or even for just needing an exam.  All of this is pretty typical behavior and shows how anxious we are about our genitalia.  It is normal to wonder about odor, symmetry, length, width, and hair distribution. Indeed, this is part of the anatomy that we just are not comfortable with.

Normal vulvar anatomy 101

Labia Majora

The labia majora are the big lips that are on the outside, one on the right and one on the left. The average labia majora are usually about 8 cm long and 2.5 cm wide.  This is roughly the size of my pointer finger.  But the size is highly variable and usually changes based on your weight.  These lips have sweat glands and hair.  They can be a different color than the rest of the skin and have fat tissue.

Labia Minora

The labia minora are the small lips that are more to the middle, one on the right and one on the left.The labia minora tend to be thinner.  The average size is 4 cm long and 1.5 cm wide, just a little smaller than my pinky.  These lips have little fat and no sweat or hair glands. But this part of the anatomy really comes in all shapes and sizes. Your age, the level of estrogen in your body, genetics, and number of pregnancies/deliveries can all change the appearance of the labia minora.   

Jamie McCartney , an artist who did a project called “The Great Wall of Vagina” said, “There are as many appearances of the vulva as there are of the face.”  And that is largely because of the many normal shapes and sizes of the labia minora.  These lips often stick out past the rest of the anatomy.  Sometimes, they are tucked away. Studies have shown that perfect symmetry is rare and one side is almost always bigger than the other.

Introitus

The labia frame the introitus, which is the opening to the vagina.  The introitus can get larger with deliveries and time.  It tends to be smaller if your levator or kegel muscles are strong.  An average size in 2-4 cm.  There is no magic “right size” to the vaginal opening.  And while it is common to think smaller is better, sometimes smaller just results in pain with sex.  The clitoris is at the top (12 o’clock).  It is around 4.5mm wide and 7mm long, roughly the size of a magic jelly bean.

What is considered an abnormal vulva?

The anatomy is really only considered to be abnormal if it actively creates problems for you.  “Abnormal” is not diagnosed based on size and shape.  There have only been 3 times in my career when I have asked someone if their labia bothered them based on their appearance.  And only 1 woman felt that they were a problem.  The labia minora can be uncomfortable or painful if they are long enough to rub on clothing like skinny jeans.  Some sports, like bike or horseback riding, may irritate them.  The labia can be torn during a delivery or an accident, resulting in a sensitive area or big changes in the appearance of one side.  They can pull and be uncomfortable during sex.  But if they aren’t causing physical symptoms, the rule of thumb is to leave your sensitive labia alone. 

If you are more of a visual person and need to see the huge range of normal vulvar anatomy, check out the Great Wall of Vagina.  This project, which amazes me on so many levels, took 400 volunteers, aged 18 to 76, and created plaster casts of their vulvas.  Ten panels were then made out of the casts.  The goal was to normalize the vulva.  And as they say, a picture is worth a thousand words. 

One last thought on the normal vulva….

Don’t worry about using the correct terminology when you see your provider.  Some women know their anatomy but lots don’t.  I am really good at translating what you are saying into medical speak.  Don’t let the terminology be a barrier for you- I can teach you the right words.  We’ll figure it out together.

1. Schick VR et al. Evulvalution:The Portrayal of Women’s External Genitalia and Physique across Time and the Current Barbie Doll ideals.J Sex Research 48;1:74-81.
2. Elective Female Genital Cosmetic Surgery Committee Opinion No.795, Obstet Gynecol 2020; 135(1):e36-42.
3. Widschwendter A et al Perception of Labial Size and Objective Measurements- Is there a correlation? A cross-sectional study in a cohort not seeking labioplasty.J Sex Med 2020;17:461-9.