Whether we like it or not, our bodies are prone to change, influenced by everything from hormones to age to lifestyle shifts. The same can be said for genitalia, including the labia, which are the inner and outer folds of the vulva, consisting of four “lips” — the labia minora (inner) and the labia majora (outer) — on either side of the opening of the vagina.
It’s possible you may not notice that your labia are changing — especially if you haven’t taken a close examination in a mirror lately (or ever). But while there are good reasons to examine your labia, it’s important not to compare yourself to other people.
“Just like with breasts, there is a wide variation in the shape and size of labia,” Dr. Lyndsey Harper, founder of sexual wellness app Rosy, tells Yahoo Life. “They can be short, long, uneven and everything in-between. There is no perfect size and shape of labia.”
Still, you may notice that your labia look a little different than usual. While labia don’t change significantly as we age — the way, say, breasts or other parts of our body might — there are certain factors that can influence their appearance.
How hormones impact labia
Pregnancy and childbirth are one thing that affects the appearance of the labia and the vulva as a whole, says Harper. According to VeryWell Health, changes to the size and shape of one’s vulva following childbirth tend to be temporary, with the vulva going back to its previous state as the body heals. One thing that may be permanent, however, is hyperpigmentation or discoloration of the skin, which is caused by pregnancy hormones.
Dr. Andrea Braden, an ob-gyn and co-founder of Lybbie, says that the hormone estrogen plays an important role in how the labia look, as changing levels of estrogen can affect skin elasticity.
“I worked in a transgender clinic, and I had a patient who was transitioning from female to male. He started on testosterone therapy, which decreased the estrogen, and I believe he had his ovaries removed as well,” Braden explains. “He was not going to have bottom surgery, but he said ‘Oh my God, it looks like a grandma down there’ [referring to the wrinkly appearance]. I think, for most people, it’s very gradual, so they don’t notice over time, but in that situation, I noticed a change very quickly.”
While Braden’s patient was purposefully lowering his estrogen levels, there are other factors that may affect one’s estrogen levels. According to the Cleveland Clinic, eating disorders, certain genetic conditions like those affecting your pituitary gland, hypothalamic amenorrhea and certain autoimmune disorders can also cause low estrogen levels.
Most commonly, estrogen decreases gradually as one goes through menopause.
Braden notes that estrogen plays a large role in vulvar changes in general, and that it’s often used as a treatment for when people are going through menopause, as it “increases the thickness of the vaginal skin, which helps reset pH, and it helps with urinary tract infections and with vaginal dryness.”
“It can help get things back in working order, when the decreased estrogen can make things a lot more sensitive, such as with thinner skin that’s easier to tear, causing pain with sex,” she explains. “If you are in a low estrogen state, you can certainly see different changes in the labia.”
But it’s not just about decreases in estrogen. Age also plays a factor, as it does with the rest of our body.
“If you look at the spectrum of young people to old people … the skin gets a little thinner,” Braden says. “There is less fat content, so it may look a little more wrinkly in your labia majora, which is where you will see the most change.”
Just like you would with the hair on your head, you may also notice hair getting a “little lighter,” as well as “gray hairs” and thinning hair.
“As time goes by, and gravity has an effect on our body, no part of the body escapes that,” she notes. “You’re going to see changes in the vulva, just as you would anywhere else in the body, as time goes on.”
When to see a doctor
While labia change is usually not something to be concerned about, Braden says there are certain conditions you should be aware of, such as lichen sclerosus, which can cause intense vulvar and vaginal itching.
“It’s an itch-scratch cycle, and it can scar the skin,” says Braden. “The labia start to fuse together, and you see thinning and cracking, and it doesn’t go back to normal. You need to catch it early on in order to stop that cycle. A lot of times it takes many months of high-dose steroids to stop that problem.”