The shape and appearance of the vulva naturally change over the years. The most obvious changes are linked to hormonal changes, occurring at puberty, during the menstrual cycle, in pregnancy and around menopause.
The labia minora are part of the vulva and are covered with delicate keratinized stratified squamous epithelium. This may or may not be pigmented, especially towards the edges.
At birth, the labia may be somewhat swollen due to the passage through the birth canal and the effect of maternal hormones. This wears off within a few days for the normal newborn female labia, which are thin and small.
At puberty, the labia become gradually larger and thicker, but the chief difference is in the keratinization, which changes at cellular level. After puberty, the labia become more easily visible as their prominence increases.
As a woman continues to grow more mature, there is also an increase in labial thickness and length, and also after pregnancy and delivery.
After menopause, the level of female hormones such as estrogen and progesterone decline in the blood because the ovarian function ceases. All over the body, skin tissue begins to atrophy. The skin acts less as a barrier and becomes dry. As a result of decreased skin thickness and hydration, there is an increased risk of chemical and irritant dermatitis.
In addition, tissue shear forces may be more powerful as age advances. The skin over the vulva tends to develop these changes at a later point, but it still occurs eventually. The labia will therefore become smoother than before, seem to be less visible and look indistinct in outline, and their color becomes paler. All of these factors contribute to the increased risk of developing dermatitis in the labial and vulval area in older females.
Symptoms Related to Labial Aging
As the labia become thinner and the skin shrinks in thickness, it also becomes drier, and at the same time tends to retain moisture from outside for a longer time. This can lead to irritation or allergic reactions to common substances such as dyes in underwear. The result is itching and irritation around the labia. The loss of elasticity in vulval skin exacerbates this situation, and may cause dyspareunia as well as a feeling of dryness around the vagina and vulva.
The lack of estrogen is the reason for the skin to become more friable and less elastic in consistency, with cells being readier to shear off with friction or mild trauma.
Reviewed by Yolanda Smith, BPharm