Vulva and vagina: a plain guide

The vulva is the external genital area. The vagina is the passage inside, leading towards the womb. People often use “vagina” for both, but knowing the distinction can make 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. The area inside the inner folds is called the vestibule; it contains the openings of the vagina and urethra.

The visible part of the clitoris sits at the top of the inner folds, partly covered by the clitoral hood. The clitoris also extends inside the body. The perineum is the area between the vagina and anus.

You can seek care without knowing all these names. “The skin on the outside”, “near the opening” or “further inside” are useful starting points. Ask the clinician to explain a word if it is unfamiliar, or to show you what they mean on a diagram.

The urethra is the tube that carries urine out of the body; its opening is separate from the vaginal opening. When describing symptoms, try to say if discomfort happens as you pass urine, on the surrounding skin, or inside the vagina. You can use these descriptions even when you are unsure which structure is involved.

How appearance can vary

The inner labia can extend beyond the outer labia. They can also be shorter, and the sides can be uneven. A drawing labels the parts, but cannot show all the ways they can look.

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

The hymen is a thin membrane that partly covers the vaginal entrance. Its presence or absence cannot tell you someone’s sexual history. As ACOG explains, it does not indicate “virginity”.

Hormones can change the tissues over time too. As oestrogen decreases around menopause, the vaginal lining can become thinner, drier and less elastic, and the labia and vaginal opening may become smaller. If a change comes with discomfort, describe both to your clinician. Appearance alone cannot tell you the cause.

Before considering labiaplasty

Labiaplasty reduces the size of the inner labia. It carries risks including infection, bleeding, scarring and reduced genital sensitivity. The NHS cautions that surgery cannot guarantee the appearance you expect or that you will feel better about your body.

Speak to a GP or doctor about discomfort before deciding on surgery. A treatable condition may be part of the cause. The NHS says cosmetic labiaplasty should not be performed on girls younger than 18 because the labia continue developing into early adulthood.

Washing and everyday care

Wash the surrounding skin gently with warm water and mild, unperfumed soap. Avoid douching, which means washing inside the vagina: this can remove protective bacteria. Scented wipes, sprays and deodorants can irritate, and are not needed to clean the 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 sexual health service.

Changes to get checked

Ask for an urgent GP appointment or contact NHS 111 today (UK), or seek urgent medical care today (US and elsewhere), if a lump near the vaginal opening quickly gets larger or more painful, contains pus, 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, persistent itching, or skin that changes colour or becomes thickened. These symptoms have several possible causes and need assessment.

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