There really is no ‘normal’ vagina, scientists conclude in the largest study ever of vulvas – amid an ominous rise in young women getting surgery to tighten their genitalia.
That is the conclusion of the largest study ever conducted on vulvas and their dimensions in a bid to identify what other medical papers mean when they refer to ‘normal’ vulvas.
Swiss researchers measured the inner and outer labia, clitoris, vaginal opening and perineum of 650 white women between the ages of 15 and 84.
There was so much variation in every category that they concluded even offering an ‘average’ would woefully misrepresent most women.
The findings have been hailed as necessary assurance for women amid a steady rise in the rate of labiaplasties – surgical operations on the female genitalia, usually to reduce the size of the labia.
Speaking to DailyMail.com, gynecologist Dr Kenneth Levey, MD of Maiden Lane Medical, who was not involved in the study, said any attempt to identify a ‘normal average’ vagina is ‘concerning’, and warned that the boom in labiaplasties could have grave ramifications for generations to come.
‘The experience of a woman in association with the appearance and feel of her labia is very subjective. There is no way to create an objective standard around it,’ Dr Levey said.
‘That is why insurance companies do not cover cosmetic procedures unless there’s a medical reason for it – it’s completely subjective.
‘I’ve had patients that might look “normal” but they say riding a bike is very, very uncomfortable and after the operation to shorten their labia minora, they felt much better. That is a medical issue.
‘But what about a patient that doesn’t have any of those symptoms? They should be counseled that there is no “normal”, and there is a serious medical downside to all surgeries, from pain to scarring to nerve damage.’
The rate of women getting operations to nip and tuck their vaginas has boomed in recent years.
More than 5,000 women underwent the procedure in 2013, according to the American Society for Aesthetic Plastic Surgery. By 2015, that figure had risen to 9,138 women. In 2016, the figures shot up 39 percent to 12,666.
A labiaplasty is performed on the external part of the vagina, sculpting and removing excess tissue, as well as evening out the labia minora (inner lips). Some doctors remove excess tissue around the clitoris (called prepuce reduction), though most avoid this due to the risk of nerve damage.
It emerged in the 1960s as a follow-up procedure to vaginoplasty, which used to tighten and restructure the interior of the vagina after childbirth or sexual assault. However, labiaplasties were not particularly popular because the use of surgical knives led to scarring.
That changed in 1999, with the introduction of lasers and minimally-invasive techniques that carried far fewer side effects.
By the turn of the century the wave had begun, with labiaplasties marketed by plastic surgeons as something akin to Botox – a makeover for the genitalia.
Despite the fact that gynecologists do not endorse or recommend cosmetic surgery on genitalia, the trend took off.
Now, the fastest-growing client base for labiaplasties in America is millennials.
In fact, a recent pilot study in Australia found a quarter of labiaplasties are performed on females between the ages of five and 25 – a trend that gynecologists and plastic surgeons are seeing in the US and the UK, too.
Research to get to the heart of this trend shows that pornographic images – of ‘minimalist’ vulvas – and the era of photoshopped social media posts are the most likely driving forces.
Many gynecologists warn that this misconception stretches far beyond sexualised content. Even medical textbooks often misrepresent vaginas with cartoonish diagrams of a female anatomy that look nothing like the real thing.
The new study by Lucerne Cantonal Hospital in Switzerland, published earlier this week, found the average length of the inner labia to be 43 millimeters. However, the cohort ranged from five millimeters to 100 millimeters.
The average outer labia length was 80 millimeters, but the results ranged from 12 to 180.
The average clitoris measurement was five millimeters wide, but that was from a range of between one millimeter and 22 millimeters.
For clitoris length, they found the average to be seven millimeters, but the results ranged from 0.5 millimeters to 34.
A study published earlier this year by the University of Calgary showed that women or girls considering labiaplasty for purely aesthetic means tend not to go through with it after being reassured that they are normal.
Experts say this new Swiss study, while lacking in racial diversity, is landmark reference point for gynecologists globally to share with patients that have concerns about their appearance.
‘As the number of procedures increases there are going to be complications,’ Dr Levey warned.
‘The baseline complication rate will go up, even in the best of hands. These patients may not realize the real risks associated with surgery that they do not need, if it’s just cosmetic, and they may not have been counseled that their labia was normal.’