What is normal vulval & vaginal anatomy?
The vulva area is one of the most variable parts of the body, with more normal variations than noses! The range of “normal appearances” is so wide that even your family doctor may not be sure about whether you are normal “down there”. So there have always been some women who worry about how their vulvas look. To make matters worse, the internet has allowed the fashionistas who make us feel abnormal about our weight and breast size, to also make us feel abnormal about our vulvas. Is nothing sacred?
If everything is working well down there, then it must be normal! So try not to worry about your vulval size or shape: if it works for you, who cares what anyone else thinks?
On a more serious note, a lot of women have never looked at their own vulva until something doesn’t feel right. Then they look, and are shocked! The fact is, what they are seeing could be perfectly normal.
Vulvas change throughout the menstrual cycle, and can become a little swollen and a bit lumpier just before a period. Normal skin cysts also can get bigger and feel a little sore at this time. All this is perfectly normal.
Things down there change as a woman gets older. Sexual intercourse can make the inner lips of your vagina stretch, so don’t worry if they seem to be getting a little bigger over the years. Putting on lots of weight will make your vulval lips fat as well. Unfortunately,cuddly women who do lose lots of weight may well find that their vulval lips get a lot droopier, in the same way as the skin on the upper arms.
Having a baby by vaginal birth changes everything. Your vagina will never completely shrink back to its pre-baby size. This means that the vaginal walls will be looser, and it may look as if there is a small prolapse ( bulge in the vaginal wall, usually from the bladder or bowel pushing against it). The golden rule is however, that if everything is working all right down there and there is no lump coming down, then the looseness you might see is normal, and nothing to worry about. The inner lips of your vulva often look very different, because of the stretching during childbirth. The hymen (the frilly ring of skin at the entrance to your vagina) gets broken into small pieces during birth, and tends to look like red lumps just inside your vagina. All this is normal as well.
Surprise, surprise, there are lots of normal variations in this too. (No wonder so many women are convinced they are not normal!) Dark-skinned women tend to have darker-coloured vulval skin and this may be patchy, with lighter and darker areas. Light-skinned women also often have partly dark and light vulval skin, although it tends to more light and less dark. Many women have moles on their vulva. Normal moles are flat, and tend to get bigger and/or more numerous with age. The vast majority of these are completely harmless, but if you are concerned, a specialist can check them for you.
Some women have completely white patches down there. This is usually caused by an auto-immune condition called vitiligo but sometimes white birthmarks can also occur on the vulva.