Data from the past few years show a recent rise in interest for cosmetic surgeries. Specifically, there has been a rise in labiaplasties, which researchers believe shows there may be concern over genital appearance. In fact, previous studies to create measurement scales have revealed that up to 50% of women studied have expressed concern over the appearance for nonaesthetic reasons as well.

Previous research compares genital self-image with sizes of the different parts of the vulva (external female genitalia) in order to create a generalizable tool. The goal of this study is to develop a similar tool for each part of the vulva regarding women living in Spain.

Two-hundred and forty-seven (247) women between 17-73 years old (age of informed consent for health procedures in Spain is 16) were surveyed during their routine pelvic exam and measurements were taken of the labia minora (width, length, thickness), labia majora (width and length), clitoral hood (width and length), as well as records of general appearance (skin color and texture, symmetry, etc.). The women were also asked to complete genital self-image and satisfaction surveys.

Does Size Matter?

Results showed that older women tended to have an increase in labia majora (outer) width, and a decrease in labia minora (inner) length and thickness, which researchers believe is related to menopause and hormonal changes.

Women who showed more concern about their genital appearance tended to be younger (29% under the age of 30), had never given birth (40.3% of this group), had given birth via cesarean delivery (c-section), had more previous sexual partners.

These women tended to be more concerned about the length of their labia minora being longer than others. Interestingly, women who were more concerned about appearance were more likely to have been influenced by porn, the internet, or family, which researchers found consistent with previous studies.

As far as general appearance, there was not much concern over skin color and texture, symmetry, or if the clitoris was visible.

Key Takeaways

• Women may be seeking more labiaplasties than before, potentially because of media influences.
• Younger women, those who have had more sexual partners, and women who have not given birth vaginally were more likely to be concerned about their genital appearance.
  • Having given birth vaginally or being menopausal appeared to decrease concern.
• Overall, more women were concerned about their labia minora (inner labia) being longer than any other measure.
• Researchers stress that this information should not be used to generalize genital appearance.
  • Healthcare providers should be aware of culture norms which may influence patient concerns.

Resources

• Bartolomé, A., Villalaín, C., Alarza, R., García-Castro, Y., Galindo, A., & Tejerizo, Á. (2025). Development of vulva nomograms and assessment of female genital self-image: Does the size of labia minora really matter? The Journal of Sexual Medicine, 22(11), 2011–2020. https://doi.org/10.1093/jsxmed/qdaf243