Please help me.

Any chronic discomfort with the labia or vulva can be frustrating and stressful. And it isn't the type of issue that most people mention to just anybody. From your question, it sounds as if you have been dealing with this discomfort for some time. For how long have your labia been bothering you? Have you talked with a health care provider about it? Visiting a medical provider may answer a lot of the questions you have right now.

Women who experience problems with their vulva may feel more stressed-out than if the issue were with, let's say, their elbow. Unfortunately, our culture has many taboos related to sexuality and sexual body parts. Each woman's labia are different. In your case, however, your own unique genitals are causing your physical discomfort. Your labia may also be hurting for reasons other than the length of your vaginal lips.

When you say that your labia are "too long" and hurt, do you mean your inner lips or your outer lips? When you go for a gynecological exam, it's important to tell the provider so that s/he can help identify exactly where the location of the discomfort is. S/he can see irritation, rawness, and/or redness, while perhaps identifying related causes. For example, do you mean your labia get irritated from chronic rubbing while walking or from wearing snug fitting pants, pantyhose, or thong underwear? Or that the lips get stuck in the opening of your vagina during intercourse or penetration? Or that your vaginal lips itch? Your labia could be bothering you because of friction or even an allergic reaction to fabric or a chemical. Perhaps you can see if the following make a difference:

• wearing looser-fitting clothing or even skirts with nothing on underneath
• sleeping without underwear, in only a nightshirt or in the nude
• wearing only white, 100 percent cotton underwear and avoiding wearing undergarments made of nylon, acetate, or other synthetic fibers
• washing your vulva gently with plain warm water
• avoiding feminine hygiene sprays and deodorants, oils, bathing products, and/or talcum powder
• using non-deodorant tampons instead of sanitary pads during your period
• using plain, rather than flavored and/or scented, lubes, condoms, and/or dams
• talking with your health care provider about vaginal moisturizers

For women who have ruled out all other solutions with their health care provider, some feel that a surgical procedure called labiaplasty could be their last resort. Labiaplasty is a surgical procedure that changes the outer labia and usually involves trimming "excess" tissues. Some swelling, bruising, and discomfort may occur for two to three weeks after the procedure. It's also important to avoid intercourse/penetration and genital play for six weeks after the surgery, until the lips are fully healed.

Since labiaplasty is relatively new, no intensive studies have been done on the procedure. The American College of Obstetricians and Gynecologists, the American Medical Women's Association, and the American Association of Sexuality Educators, Counselors, and Therapists (AASECT) do not have official positions on labiaplasty, so no formal or standard protocols have been set. Therefore, policies and procedures vary among health care providers and all of the information out there has not yet been verified by the aforementioned and other respected organizations.

Similar to any medical procedure, labiaplasty has risks. Plastic surgeons who perform this procedure report low rates of complications and side effects, ranging between 3 - 5 percent. These statistics have not been confirmed by any outside organization. Side effects could include:

• blood clots
• infection
• skin loss
• asymmetrical lips
• loss of sensation
• scar overgrowth
• recurrence of labial growth

If, after trying all other ways of relieving your labial discomfort, you decide that labiaplasty is your only option, be aware that some health care providers take advantage of women's insecurities and emphasize appearance as a reason for having the surgery. Through your gynecologist, find a plastic surgeon who is primarily concerned with your well-being, not on supposedly "improving" your vulva. If you are a student at Columbia, you can call Health Services at Columbia at x4-2284 for an appointment and evaluation. Openly talking with a primary care provider or gynecologist will help you figure out the cause of your discomfort and help you find relief.

Alice

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