Labia Clit

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The labia are part of the female genitalia; they are the major externally visible portions of the vulva. In humans, there are two pairs of labia: the labia majora (or the outer labia) are larger and fattier, while the labia minora are folds of skin between the outer labia. The labia surround and protect the clitoris and the openings of the vagina and the urethra.
Labium (plural labia) is a Latin-derived term meaning "lip". Labium and its derivatives (including labial, labrum) are used to describe any lip-like structure, but in the English language, labium often specifically refers to parts of the vulva.
The labia majora, also commonly called outer labia or outer lips, are lip-like structures consisting mostly of skin and adipose (fatty) tissue, which extend on either side of the vulva to form the pudendal cleft through the middle. The labia majora often have a plump appearance, and are thicker towards the anterior.[1] The anterior junction of the labia majora is called the anterior commissure, which is below the mons pubis and above the clitoris. To the posterior, the labia majora join at the posterior commissure, which is above the perineum and below the frenulum of the labia minora. The grooves between the labia majora and labia minora are known as the interlabial sulci or interlabial folds.
The labia minora (obsolete: nymphae), also called inner labia or inner lips, are two soft folds of fat-free, hairless skin between the labia majora. They enclose and protect the vulvar vestibule, urethra and vagina. The upper portion of each labium minora splits to join with both the clitoral glans, and the clitoral hood. The labia minora meet posterially at the frenulum of the labia minora (also known as the fourchette), which is a fold of skin below the vaginal orifice. The fourchette is more prominent in younger women, and often recedes after sexual activity[2] and childbirth.[1] When standing or with the legs together, the labia majora usually entirely or partially cover the moist, sensitive inner surfaces of the vulva, which indirectly protects the vagina and urethra,[1] much like the lips protect the mouth. The outer surface of the labia majora is pigmented skin, and develops pubic hair during puberty. The inner surface of the labia majora is smooth, hairless skin, which resembles a mucous membrane, and is only visible when the labia majora and labia minora are drawn apart.
Both the inner and outer surfaces of the labia majora contain sebaceous glands (oil glands), apocrine sweat glands, and eccrine sweat glands. The labia majora have fewer superficial nerve endings than the rest of the vulva, but the skin is highly vascularized.[2] The internal surface of the labia minora is a thin moist skin, with the appearance of a mucous membrane. They contain many sebaceous glands, and occasionally have eccrine sweat glands. The labia minora have many sensory nerve endings, and have a core of erectile tissue.[1]
The color, size, length and shape of the inner labia can vary extensively from woman to woman.[3] In some women the labia minora are almost non-existent, and in others they can be fleshy and protuberant. They can range in color from a light pink to brownish black,[4] and texturally can vary between smooth and very rugose.[5]
The biological sex of an individual is determined at conception, which is the moment a sperm fertilizes an ovum,[3] creating a zygote.[6] The chromosome type contained in the sperm determines the sex of the zygote. A Y chromosome results in a male, and an X chromosome results in a female. A male zygote will later grow into an embryo and form testes, which produce androgens (primarily male hormones), usually causing male genitals to be formed. Female genitals will usually be formed in the absence of significant androgen exposure.
The genitals begin to develop after approximately 4 to 6 weeks of gestation.[6] Initially, the external genitals develop the same way regardless of the sex of the embryo, and this period of development is called the sexually indifferent stage.[4] The embryo develops three distinct external genital structures: a genital tubercle; two urogenital folds, one on either side of the tubercle; and two labioscrotal swellings, each bounding one of the urogenital folds.[2]
Sexual differentiation starts on the internal sex organs at about 5 weeks of gestation, resulting in the formation of either testes in males, or ovaries in females. If testes are formed, they begin to secrete androgens that affect the external genital development at about week 8 or 9 of gestation.[6] The urogenital folds form the labia minora in females, or penile shaft in males. The labioscrotal swellings become the labia majora in females, or they fuse to become the scrotum in males. Because the male and female parts develop from the same tissues, this makes them homologous (different versions of the same structure). Sexual differentiation is complete at around 12 weeks of gestation.[3][6]
The genital tissues are greatly influenced by natural fluctuations in hormone levels, which lead to changes in labia size, appearance, and elasticity at various life stages. At birth, the labia minora are well-developed, and the labia majora appear plump due to being exposed to maternal hormones in the womb. The labia majora have the same color as the surrounding skin. Labial adhesions can occur between the ages of 3 months and 2 years, and may make the vulva look flat. These adhesions are not usually a cause for concern, and usually disappear without treatment. Treatment options may include estrogen cream, manual separation with local
anesthesia, or surgical separation under sedation.[2]
During early childhood, the labia majora look flat and smooth because of decreasing levels of body fat, and the diminished effects of maternal hormones. The labia minora become less prominent.
During puberty, increased hormone levels often significantly change the appearance of the labia. The labia minora become more elastic, prominent, and wrinkled. The labia majora regain fat, and begin growing pubic hair close to the pudendal cleft. Hair is initially sparse and straight, but gradually becomes darker, denser, and curlier as growth spreads outward and upward toward the thighs and mons pubis. At the end of puberty, pubic hair will be coarse, curly, and fairly thick. The patch of pubic hair covering the genitals will eventually often form a triangle shape.[4]
By adulthood, the outer surface of the labia majora may be darker than the surrounding skin, and may have wrinkles similar to those on a male's scrotum. During the reproductive years, if a woman delivers a child, the fourchette will flatten. Pregnancy may cause the labia minora to darken in color.[3]
Later in life, the labia majora once again gradually lose fat, becoming flatter and more wrinkled, and pubic hair turns grey. Following menopause, falling hormone levels cause further changes to the labia. The labia minora atrophy, making them become less elastic, and pubic hair on the labia majora becomes more sparse.[2]
The labia are one of a woman's erogenous zones. The labia minora are sexually responsive,[7] and sensitivity varies greatly between women. In some women, they are so sensitive that anything other than light touch may be uncomfortable, whereas stimulation may elicit no sexual response in others. The labia may be sexually stimulated as part of masturbation or with a sex partner, such as by fingering or oral sex. Moving the labia minora can also stimulate the extremely sensitive clitoris.
During sexual arousal, the labia majora swell due to increased blood flow to the region,[6] and draw back,[3] opening the vulva slightly. The labia minora become engorged with blood, causing them to expand in diameter by two to three times, and darken or redden in color.[6] Because pregnancy and childbirth increase genital vascularity, the inner and outer labia will engorge faster in women who have had children.[6]
After a period of sexual stimulation, the labia minora will become further engorged with blood approximately 30 seconds to 3 minutes before orgasm,[6] causing them to redden further.[6][8] In women who have had children, the labia majora may also swell significantly during this period, becoming dark red. Continued stimulation can result in an orgasm, and the orgasmic contractions help remove blood trapped in the inner and outer labia, as well as the clitoris and other parts of the vulva, which causes pleasurable orgasmic sensations.
Following orgasm or when a woman is no longer sexually aroused, the labia gradually return to their unaroused state.[6] The labia minora return to their original color within 2 minutes, and engorgement dissipates in about 5 to 10 minutes.[4] The labia majora return to their pre-arousal state in approximately 1 hour.[4]
In many cultures and locations all over the world, the labia, as part of the genitalia, are considered private, or intimate parts, whose exposure (especially in public) is governed by fairly strict socio-cultural mores. In many cases, public exposure is limited, and often prohibited by law.[9][10]
Views on pubic hair differ between people and between cultures. Some women prefer the look or feel of pubic hair, while others may choose to remove some or all of it. Temporary methods of removal include shaving, trimming, waxing, sugaring and depilatory products while permanent hair removal can be accomplished using electrolysis or laser hair removal.[11] In Korea, pubic hair is considered a sign of fertility, leading some women to have pubic hair transplants.[6]
Some women in western societies are self-conscious about the size, color or asymmetry of their labia. Viewing pornography may influence a woman's view of her genitals.[2][3] Models in pornography frequently have small or non-existent labia minora, and images are often airbrushed,[3][11] so pornographic images do not depict the full range of natural variations of the vulva. This can lead viewers of pornography to have unrealistic expectations about how the labia should look. Similar to how some women develop self-esteem issues from comparing their faces and bodies to airbrushed models in magazines, women who compare their vulvas to idealized pornographic images may believe their own labia are abnormal. This can have a negative impact on a woman's life, since genital self-consciousness makes it more difficult to enjoy sexual activity, see a gynecologist, or perform a genital self-examination.[3] Developing an awareness for how much the labia truly differ between individuals may help to overcome this self-consciousness.[11]
In several countries in Africa and Asia, the external female genitals are routinely altered or removed for reasons related to ideas about tradition, purity, hygiene and aesthetics. Known as female genital mutilation, the procedures include clitoridectomy and so-called "pharaonic circumcision," whereby the inner and outer labia are removed and the vulva is sewn shut.[12][13] FGM is mostly outlawed around the world, even in countries where the practice is widespread.[14]
Labiaplasty is a controversial plastic surgery procedure that involves the creation or reshaping of the labia.[15] Labia piercing is a cosmetic piercing, usually with a special needle under sterile conditions, of the inner or outer labia. Jewelry is worn in the resulting opening.
Organs of the female reproductive system.
Median sagittal section of female pelvis.
^ a b c d Moore, Keith L.; Agur, Anne M. R.; Dalley II, Arthur F. (2010). Essential Clinical Anatomy, Fourth Edition. p. 268. ISBN 9781609131128.
^ a b c d e f Farage, Miranda A.; Maibach, Howard I. (2006). The Vulva - Anatomy, Physiology, and Pathology. pp. 1–4, 14, 28–38. ISBN 978-0-8493-3608-9.
^ a b c d e f g h Crooks, Robert; Baur, Karla (2014). Our Sexuality. Cengage Learning. pp. 50–54, 113–116, 163–171. ISBN 978-1-133-94336-5.
^ a b c d e Jones, Richard E.; Lopez, Kristin H. (2006). Human reproductive biology. Elsevier Science. pp. 55, 133–138, 154, 198–201. ISBN 9780080508368.
^ Lloyd, Jillian; et al. (May 2005). "Female genital appearance: 'normality' unfolds" (PDF). British Journal of Obstetrics and Gynaecology. 112 (5): 643–646. CiteSeerX 10.1.1.585.1427. doi:10.1111/j.1471-0528.2004.00517.x. PMID 15842291. S2CID 17818072.
^ a b c d e f g h i j k Carroll, Janell L. (2011). Sexuality Now: Embracing Diversity. Cengage Learning. pp. 86–88, 116–120, 253–256. ISBN 978-0-495-60274-3.
^ Ginger, Van Anh T.; Yang, Claire C. (2011). "Functional Anatomy of the Female Sex Organs" in Cancer and Sexual Health (PDF). Humana Press. pp. 13–23.
^ Lamanna, Mary Ann; Riedmann, Agnes (2011). Marriages, Families, and Relationships: Making Choices in a Diverse Society. Cengage Learning. pp. A7. ISBN 9781133172826.
^ 617.23, Minnesota Statute
^ 18-4116 — INDECENT EXPOSURE - Idaho 18-4116 — INDECENT EXPOSURE - Idaho Code :: Justia
^ a b c Herbenick, Debby; Schick, Vanessa (2011). Read My Lips: A Complete Guide to the Vagina & Vulva. Rowman & Littlefield Publishers. Inc. pp. 148–158, 165, 233–240. ISBN 978-1-4422-0802-5.
^ "Classification of female genital mutilation", Geneva: World Health Organization, 2014.
^ Gruenbaum, Emma (2001). The Female Circumcision Controversy: An Anthropological Perspective, Philadelphia: University of Pennsylvania Press, pp. 2–3.
^ Bonino, Emma (19 December 2012). "Banning Female Genital Mutilation", The New York Times.
^ The Centrefold Project
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The labia minora are the small folds of thin and delicate skin that lie on each side of the actual vaginal introitus. They are about 0.4 to 6.4 cm in length, and about 2 cm wide, on average. It is important to note that the actual range is much wider, with normal variants being anywhere from 1.2 to 10 cm in length and 0.7 to 5 cm in width.
Image Credit: Munimara / Shutterstock
Interestingly, the two labia of the same woman are very often of different lengths. This shows that significant variations in labial size from one side to the other, as well as between different women, is perfectly normal and should never be interpreted as hypertrophy or abnormal in any way.
The clitoris is also between 0.2 to 3.5 cm long, and up to 1 cm wide. Contrary to popular thought, a larger clitoris is associated with greater enjoyment and a higher chance of experiencing sexual climax. It would seem to be counterproductive to reduce the size of this organ to enhance sexual pleasure, or indeed for any purely aesthetic reason!
Labial length and other aspects of labial anatomy have come into the limelight in current decades. This may be traced to many psychosocial rather than medical changes in current thought regarding the female body.
These include the excessive compulsion to have a perfect body, the model for which is often the digitally modified image of the undernourished and cosmetically altered female model. In other words, various grades of severity of body dysmorphic disorder exist in today’s developed society causing more or less abnormal perceptions of what a woman’s body actually ought to look like, in contrast to the easy and natural acceptance of maturation, differences, and related changes in the appearance and function of the female body in somewhat earlier periods.
Another reason may be the early exposure of the developing adolescent mind to pornographic and other ubiquitous images of prepubertal female models including their genital anatomy, which accustoms and trains them to think of and expect the normal vulva to appear the same.
This gives rise to the potent twin dangers of males coming to reject the normal healthy female anatomy in favor of an imaginary ‘perfect’ version, as well as the woman’s own refusal to accept her own body as desirable and normal because of the different images she has grown up with and accepts as ideal.
The casualty in this situation is the woman’s privilege and right to be herself, and the imposed duty of being someone different to fulfil societal expectations passed on to her through illegitimate means and at vulnerable periods.
In a society which has been taught to think that the barely visible labia of a little girl not yet in her teens are the norm for an adult woman past her twenties, it is easy to understand that having supposedly over-large labia may cause the feeling that something is wrong, leading to psychological problems.
It has been established that more than two-thirds of women who ask for labiaplasty have this underlying motivation, rather than purely functional problems which are so uncommon as to be unlikely.
These include abnormal odor, irritation due to tight underwear or while cycling, sitting or walking, and problems with sexual intercourse.
The trend to ‘bare all’ in the sphere of clothing has also led to women with any labia at all beyond a couple of centimeters not being able to wear such revealing items without the labia showing. It is hard to conceive of this being a ground for surgical intervention, however.
It is very clear that what is very often called labial hypertrophy by both doctor and patient is simply a variant of normal, as is supported by the few studies available on female genital dimensions. Again, having asymmetrical labia is simply one common variant of normal.
Pigmentation of the labial edges is similar to that of the lips of the face, and should in no case be considered unsightly.
For all these reasons, it is a dangerous thing to encourage females to view any part of their anatomy as abnormal unless it causes ill-health or is obviously beyond the upper limits of variation seen in healthy females.
Labial hypertrophy has been attempted to be defined in terms of labial length. Felicio’s classification categorizes it into four:
Others define labial hypertrophy as anything over 4 or 5 cm and advocate correction if desired, but acknowledge that most cases are congenital in origin, which implicitly means it is a normal variant.
Acquired labial hypertrophy may be due to several causes which are extremely rare, however. They include:
In most women, the labia do become larger in the reproductive years and acquire their distinctive pigmentation in many. The clitoris is also larger in parous women, but its size is not affected by the woman’s age, height, weight or oral contraceptive use. They start to shrink in the perimenopausal years and afterwards.
Dr. Liji Thomas is an OB-GYN, who graduated from the Government Medical College, University of Calicut, Kerala, in 2001. Liji practiced as a full-time consultant in obstetrics/gynecology in a private hospital for a few years following her graduation. She has counseled hundreds of patients facing issues from pregnancy-related problem
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