Vulva and vagina: a plain guide

The vulva is the genital area on the outside of the body. The vagina is the passage inside, which leads up towards the womb. People often say “vagina” for both. Knowing the difference makes it easier to explain exactly where something hurts or has changed.

Names for the different parts

The labia are folds of skin. The outer folds are the labia majora, and the inner folds are the labia minora. Inside the inner folds is an area called the vestibule. It holds the opening of the vagina and the opening of the urethra.

The part of the clitoris you can see sits at the top of the inner folds. A fold of skin called the clitoral hood partly covers it. The clitoris also reaches inside the body. The perineum is the area between the vagina and the anus.

You don’t need to know all these names to get care. Phrases like “the skin on the outside”, “near the opening” or “further inside” are a good start. If a word is new to you, ask the clinician to explain it or to show you on a diagram.

The urethra is the tube that carries urine (wee) out of the body. Its opening is separate from the opening of the vagina. When you describe symptoms, try to say where the discomfort is. Does it happen when you pass urine, on the skin around it, or inside the vagina? You can describe it this way even if you’re not sure which part is involved.

How appearance can vary

The inner labia can stick out past the outer labia. They can also be shorter, and the two sides can be uneven. A drawing shows the names of the parts, but it can’t show all the ways they look.

ACOG says there is no medical or hygiene reason to remove pubic hair. Shaving and waxing can cause injuries or raise the risk of infection. You can leave pubic hair as it is before an appointment.

The hymen is a thin layer of tissue that partly covers the entrance to the vagina. Whether it is there or not can’t tell you anything about someone’s sexual history. As ACOG explains, it doesn’t show “virginity”.

Hormones can change these tissues over time too. As oestrogen falls around menopause, the lining of the vagina can get thinner, drier and less stretchy. The labia and the vaginal opening may get smaller. If a change comes with discomfort, tell your clinician about both. How something looks can’t tell you the cause on its own.

Before considering labiaplasty

Labiaplasty is surgery to make the inner labia smaller. Its risks include infection, bleeding, scarring and less feeling in the genitals. The NHS warns that surgery can’t promise the look you expect, or that you’ll feel better about your body.

Talk to a GP or doctor about any discomfort before you decide on surgery. A condition that can be treated may be part of the cause. The NHS says cosmetic labiaplasty should not be done on girls younger than 18, because the labia keep developing into early adulthood.

Washing and everyday care

Wash the skin around the area gently with warm water and a mild, unperfumed soap. Avoid douching, which means washing inside the vagina. It can wash away helpful bacteria. Scented wipes, sprays and deodorants can cause irritation, and you don’t need them to clean inside.

Vaginal discharge helps keep the vagina clean and moist. A change in its smell, colour or texture can be a sign of infection. In the UK, NHS 111 or a sexual health clinic can advise. In the US and elsewhere, contact your doctor or a sexual health service.

Changes to get checked

Ask for an urgent GP appointment or contact NHS 111 today (UK), or get urgent medical care today (US and elsewhere), if a lump near the vaginal opening quickly gets bigger or more painful, has pus in it, or comes with fever or feeling unwell.

Book a GP appointment in the UK, or see your doctor or gynaecologist in the US and elsewhere, for a new lump or sore, itching that doesn’t go away, or skin that changes colour or gets thicker. These symptoms have several possible causes and need to be checked.

A clinician may offer an examination. You can ask for someone else to be in the room, say if you feel uncomfortable, and ask them to stop at any time. Before it starts, ask what they want to examine and why.