Dr. Jeff Andrews
Health Information from Dr. Jeff Andrews

Normal Vulva

What is the vulva?

The vulva is the female external genital organ. It is the area bounded by a fatty pad covered by hair (the mons), the groins and the back passage (anus). The vulva has outer lips (labia majora), inner lips (labia minora), the entrance to the vagina (vestibule) and ends at the hymen of the vaginal opening.

People use many different names to describe this part of the body. Because women's genitals, somewhat unlike men's, are hidden, they can seem mysterious and confusing. It is a good idea to get to know your own body including your vulva to help to dispell this mystery. It is also important to learn correct names for our genitalia so that we can communicate with each other and with our health care provider about our experiences, be they experiences of pleasure or pain.

How do we know what is normal?

Don't be shy! Many women get to know their bodies by taking a good look at their vulvas. This can be done by standing or squatting over a mirror and looking at the vulva. Examining the vulva allows a woman to recognize these common parts:

Mons pubis

This is a hair-covered cushion of fat lying over the pubic bone. The amount of hair can vary from person to person and the hair tends to get thinner as we get older.

Labia

The word labia means "lips" in Latin (and a single ‘lip’ is a ‘labium’). The outer labia are two folds of skin and fatty tissue that are covered with pubic hair after puberty and more or less hide the rest of the vulva. They can be large or small, short or long, and even (like breasts) two different sizes. This is all normal and part of what makes each of us unique. They are sexually sensitive and can swell a little when a woman gets sexually aroused. The vulva is responsive to the female hormone estrogen so it changes in appearance from infancy through puberty to old age; estrogen makes the labia look fatter.

The inner labia are also sensitive and swell up when aroused. These are the folds of skin that go from the clitoral hood to below the vagina. The inner labia can vary in color from pink to brownish black depending on the color of a woman's skin. Like nipples, the inner labia can change color as women mature or during pregnancy. Often, they stick out from between the outer labia, and they can be wrinkled or smooth. They are thinner because they don't have any fat in them. The labia may have

small sebaceous (oil) glands that look like yellow dots or perhaps there may be papillae, which are tiny regular fleshy pink projections on the inner surface. These are variations of normal and are harmless.

Clitoris

The clitoris is located beneath the point where the inner labia meet. The head, or glans, of the clitoris may appear to be smaller than a pea or bigger than a fingertip. The size varies from person to person, and it can have different levels of sensitivity. The clitoris becomes erect during sexual stimulation.

Vestibule

This is the inner area of the inner lips around the opening to the vagina. It is normally a moist area and a number of glands open into this area to produce secretions that can increase when we are aroused. The urethra (connecting the bladder to the outside) also opens into this area just above the opening of the vagina. The hymen in childhood is a thin membrane partially covering the opening to the vagina. In adults, hymen remnants form a ring around the vaginal opening. The sides of the vestibule are often visible as ‘Hart’s Line’ on the inside of the inner lips. The line of change from vulvar skin to the smoother mucosa of the inner vulva is called Hart’s Line – similar to the border of the skin of our lips around our mouth.

                                  



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© 2013 by VibrantVista LLC. All rights reserved.
Written and posted by Jeff Andrews MD FRCSC for Vibrant Vista LLC.

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