For unclear reasons, one or both labia may not develop normally. This may be evident in childhood or may only be evident through pubertal development as one side develops normally and the other side is noted to be smaller or absent. The labia function as fat pads and specifically function as protection from trauma. The absence of one or both labia have no long term medical implications. For women with labial hypoplasia, sexual function is normal as the clitoris and clitoral hood are normal. If a woman is bothered by the fact that one labia is markedly larger than the other, than the “normal” sized larger labia could be reduced to match the size of the smaller or nonexistent labia.
For unclear reasons, one or both labia may grow to larger sizes. Enlargement of the labia can result in irritation, chronic infections, pain, interference with sexual activity, and/or interference with activity involving vulvar compression such as horseback riding. In addition, some women complain of a “bulge” in their underwear or bathing suit from the enlarged labia and this may be cosmetically displeasing. Women who have labial hypertrophy without symptoms require no surgical intervention and it is my practice to reassure people that this is a normal variance and requires no intervention. If women are symptomatic from the labial hypertrophy than the labia can be surgically reduced to an appropriate size for the individual.