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Vaginas come in all shapes and sizes, a study of hundreds of women has revealed. The findings should reassure women who are worried about whether they are 鈥渘ormal鈥�.

Recent years have seen a surge in cosmetic surgeries in external female genitalia. Collectively called the vulva, these are often colloquially known as the vagina. In the UK, for example, the number of women undergoing labia reductions has increased fivefold in the last 10 years.

This has partly been driven by body image pressures and partly by lack of information about genital diversity, says at the University of Melbourne in Australia. Even medical textbooks tend to depict only one type of vulva: small, neat and symmetrical, she says. 鈥淭hey鈥檙e often highly stylised drawings that don鈥檛 accurately represent real life.鈥�

To better understand the typical dimensions of vulvas, Anne Kreklau at Lucerne Cantonal Hospital in Switzerland and her colleagues performed measurements on over 650 healthy Caucasian women aged 15 to 84. They measured the size of each participant鈥檚 inner and outer labia, clitoris, vaginal opening and perineum.

The results revealed a large amount of variation (see table below). For example, the length of the inner labia was 43 millimetres on average, but ranged from 5 to 100 millimetres. And while the clitoris was 5 millimetres wide on average, it ranged from 1 to 22 millimetres (see box).

Changes over time

These dimensions were found to vary with age, BMI and childbirth history. The inner labia and perineum tended to be shorter in older women, for instance, while the outer labia tended to be longer in women with higher BMIs. Women who had given birth vaginally had larger vaginal openings than non-childbearing women and those who had had caesareans.

The findings should help raise awareness about female genital diversity, says Kreklau. Until now, our knowledge of vulva anatomy has been limited 鈥� mostly coming from small or century-old studies 鈥� including a looking at the relationship between vulval dimensions and female 鈥渇rigidity鈥�.

The updated information will also be a useful resource for doctors, who often feel ill-equipped to judge the appearance of the vulva, says Barnard. A recent survey of Australian GPs found that a quarter .

Most of the time, reassuring women that there鈥檚 nothing wrong with them is enough to dissuade them from going under the knife. For example, over 90 per cent of girls who visit the Royal Children鈥檚 Hospital in Melbourne with concerns about their labia appearance after being told they are normal.

Another useful resource for women who are concerned about their vulva鈥檚 appearance is the , says Barnard. The website features photos of a range of different vulvas to highlight their diversity.

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