THE NORMAL VULVA
THE NORMAL VULVA
What is it?
The vulva is the female external genital organ. It is the area bound by a fatty pad covered by hair (the mons), the groins, and the back passage (anus). It has outer lips (labia majora, covered by hair), the inner lips (labia minora, hair-free), and the vaginal opening. The tissue around the vaginal opening is called the vestibule.
People use many different names to describe this part of the body. Because women’s genitals, unlike men’s, are hidden, they can seem mysterious and confusing. It is a good idea to get to know your vulva to get rid of this mystery. It is also important to learn the correct names for your genitalia, so that you can communicate with your health care provider about your 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 vulva by taking a good look with the help of a mirror. This can be done in a standing or squatting position. Examining the vulva allows a woman to recognize these common parts:
*See PDF for photos
This is a hair-covered cushion of fat lying over the pubic bone. The amount of hair can vary from person to person; the hair also tends to get thinner as you age.
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, and more or less hide the rest of the vulva. They are covered with pubic hair after puberty. They can be large or small, short or long, and even in two different sizes. These are all normal, and are 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; estrogen makes the labia look fatter; as the estrogen level changes from infancy through puberty to old age, the vulva changes in appearance.
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. 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 there may be papillae, which are tiny regular fleshy pink projections on the inner surface. The inner labia can vary in colour from pink to brownish black, depending on the colour of a woman’s skin. They can be wrinkled or smooth. Sometimes they stick out from between the outer labia. Like nipples, the inner labia can change colour as a woman matures or during pregnancy. These are variations of normal and are harmless.
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; its size varies from person to person, and it can have different levels of sensitivity. The clitoris is like the male penis; it becomes erect during sexual stimulation.
This is the inner area of the inner lips, around the opening to the vagina. It is normally a moist area. A number of glands open into this area to produce secretions that increase with arousal. 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 line of change from vulvar skin to the smoother transitional skin of the vulva is called the “Hart´s Line”
International Society for the Study of Vulvovaginal Disease
Patient Information Committee
Illustration copyright 2003 Dawn Danby