If you have a problem with your labia, you may — like many women — feel too embarrassed to visit a doctor. Many women aren’t used to talking about their 'private parts' when something goes wrong, so here’s what to do if you think you have a labia problem.

What are the labia?

The labia are the ‘lips’ on the outside of the genitals (vulva). They protect the clitoris, vagina and urethra and become engorged during sexual activity.

There are 2 pairs of labia — the lips on the outside of the vagina, known as the labia majora, and the folds of skin on the inside that lead to the vagina, called the labia minora.

The size, shape and colour of the labia are different in every woman. One lip can be a different shape or size from the other. There’s no need to worry about the shape and size of your labia — you can see how much normal labia vary by visiting the Labia Library.

What health conditions affect the labia?

The labia are a very sensitive part of the body and can develop lumps, rashes, cysts and ingrown hairs.

The most common causes of problems with the labia are skin conditions such as dermatitis (eczema) and psoriasis. Some other conditions are listed below.

Labial hypertrophy

Labial hypertrophy is when one or both of the labia are larger than usual. The labia might be enlarged, one lip might be larger than the other, or the labia minora might extend down past the labia majora.

Labial hypertrophy is harmless. It does not affect a woman’s sex life and it is not a medical condition. But it can be uncomfortable or embarrassing, and it might make it difficult to keep the labia clean. Your doctor can advise you about simple solutions like wearing loose-fitting underwear or using an ointment to reduce any irritation.

Labiaplasty is an option for women who are badly affected by labial hypertrophy. This type of surgery usually involves reducing and reshaping the labia, but it’s not recommended for young women until they finish going through puberty.

Fused labia

Fused labia is the term used when the labia majora are joined together. It is quite common in children and normally develops at around the age of 1 or 2. The labia almost always separate by the time the child finishes puberty.

The best thing to do is leave the labia alone. If the fusion is causing your child problems (for example, with going to the toilet) talk to your doctor about whether creams or massage can help. Surgery is a last resort because there's a high risk that the labia will fuse again.

Swelling of the labia

If your labia are swollen, it could be the sign of a yeast infection, or an imbalance of bacteria in the vagina (called bacterial vaginosis), an allergy or an infection. It could also just be due to friction from having sex.

If it’s getting worse and you also have pain, itching, there is a strong smell, an unusual discharge from your vagina or a lump or bump on the labia, talk to your doctor. Any treatment will depend on what’s causing the swelling.

Bartholin's cysts

The Bartholin's glands are on each side of the vagina. If they get blocked, a cyst (a tender or painful lump) can form. The cyst can become infected, with a build-up of pus that will need to be treated with antibiotics. Sometimes Bartholin’s cysts can develop into an abscess.

Abscesses

An abscess is an infection caused by bacteria underneath the skin. They can develop on your labia just outside the vagina in the Bartholin’s glands. They can also be caused by an ingrown hair, waxing or shaving, a piercing, or by an infection in the skin’s glands or a sexually transmitted infection.

Abscesses cause soreness, redness and swelling. Your doctor may recommend antibiotics, a procedure to remove the pus, and sitting in a sitz bath (shallow bath), using a teaspoon of salt per litre of warm water, to ease the pain.

Psoriasis

Many women and girls who have psoriasis elsewhere on their body also develop it on the labia. Psoriasis is a red, itchy rash, usually found on the hairy skin, and it can extend to the anus. It can be treated with a cream or ointment, but it often comes back.

Genital warts and genital herpes

Genital warts are bumps that can appear on the labia and other parts of the genitals. They are caused by the human papillomavirus (HPV). The warts often go away by themselves but if they are painful or itchy, talk to your doctor about treatments, including special wart paint, freezing or laser treatment. These treatments will only get rid of the warts, not the HPV virus.

Genital herpes is a sexually transmitted infection caused by the herpes simplex virus (HSV). It can cause blisters or sores on the labia that keep coming back throughout life. If you think you have genital herpes, it’s important to see a doctor as soon as possible so you can start treatment. Make sure you use condoms and dental dams during sex because you can pass the virus on to your partner.

Lichen sclerosus or planus

Skin conditions that can affect the labia include lichen sclerosus or lichen planus. These can lead to severe itching, burning or stinging, and painful sex. They are thought to be caused by autoimmune disorders and are most common in women after menopause.

If they’re not treated, these conditions can cause scarring. Your doctor can talk to you about treatments including steroids and pain relief medicines.

Looking after your labia

It’s a good idea to get to know your labia so you can see if there are any changes that might be signs of a problem.

Take showers rather than baths, use hypoallergenic toilet paper and laundry detergent, and avoid soap. Gently pat the area dry, without rubbing, and use lubrication during sex if necessary.

Wearing loose fitting clothes and cotton underwear can help, as can using tampons rather than sanitary pads.

If you have a labia condition, a cool gel pack can help with discomfort.

When should I see my doctor?

It’s a good idea to see your doctor if you have symptoms that won’t go away, such as burning and itching or pain. If you’re embarrassed, using healthdirect’s Question Builder can help you get ready for a conversation with your doctor. And remember: you can always ask to see a female doctor if you would prefer.